Background Bioethical principles should be an integral part of all guidelines. Recently, there has been a movement towards ethical principles to be explicit in guidelines. They should be systematically evaluated.

Objectives We have done a systematic review on ethical principles in guidelines and developed an instrument for evaluation of ethical principles in guidelines based on the AGREE II instrument.

Methods The Questionnaire and User’s guide have been developed and tested. The questionnaire covers basic ethical principles, i.e. respect for autonomy, beneficence, non-maleficence and justice, as well as other very important issues such as health professional-patient relationship and inter-professional collaboration. The last question is whether a particular CPG contains examples of ethical dilemmas. New domain on equity was added. A pilot version of case reports for some domains was developed. The instrument will be disseminated, implemented, evaluated and updated if needed.

Results Instrument for evaluation of ethical principles in guidelines.

Discussion: Useful instrument for the evaluation of ethical principles in guidelines has been developing.

Implications for Guideline Developers/Users The instrument can be used during guideline development process as well as during implementation and for evaluation of the quality.