Article Text

Download PDFPDF
Systematic reviews of empirical bioethics
  1. D Strech1,2,
  2. M Synofzik1,3,
  3. G Marckmann1
  1. 1
    Institute for Ethics and History in Medicine, University of Tübingen, Tübingen, Germany
  2. 2
    Department of Bioethics, National Institutes of Health, Bethesda, Maryland, USA
  3. 3
    Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
  1. Dr medDr phil Daniel Strech, Institüt für Ethik und Geschichte der Medizin, Universität Tübingen, Schleichstraße 8, 72076 Tübingen, Germany; daniel.strech{at}


Background: Publications and discussions of survey research in empirical bioethics have steadily increased over the past two decades. However, findings often differ among studies with similar research questions. As a consequence, ethical reasoning that considers only parts of the existing literature and does not apply systematic reviews tends to be biased. To date, we lack a systematic review (SR) methodology that takes into account the specific conceptual and practical challenges of empirical bioethics.

Methods: The steps of systematically reviewing empirical findings in bioethics are presented and critically discussed. In particular, (a) the limitations of traditional SR methodologies in the field of empirical bioethics are critically discussed, and (b) conceptual and practical recommendations for SRs in empirical bioethics that are (c) based on the authors’ review experiences in healthcare ethics are presented.

Results: A 7-step approach for SRs of empirical bioethics is proposed: (1) careful definition of review question; (2) selection of relevant databases; (3) application of ancillary search strategies; (4) development of search algorithms; (5) relevance assessment of the retrieved references; (6) quality assessment of included studies; and (7) data analysis and presentation. Conceptual and practical challenges arise because of various peculiarities in reviewing empirical bioethics literature and can lead to biased results if they are not taken into account.

Conclusions: If suitably adapted to the peculiarities of the field, SRs of empirical bioethics provide transparent information for ethical reasoning and decision-making that is less biased than single studies.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: This work was supported by grant 01GP0608 from the German Federal Ministry of Education and Research and by a grant from the German Academic Exchange Service

  • Competing interests: None declared.

  • The views expressed by the authors do not necessarily reflect policies of the US National Institutes of Health or the US Department of Health and Human Services.

Other content recommended for you