MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinical Ethics' source. Fri, 03 Feb 2012 20:19:46 +0100 http://www.medworm.com/index.php?rid=5483565&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F211%3Frss%3D1 We report key themes arising from a postgraduate workshop organized by the King's Interdisciplinary Discussion Society (KIDS) held in April 2011. KIDS believe that health is a phenomenon that transcends disciplinary boundaries, and therefore issues relating to health care and medical ethics are best addressed with an interdisciplinary approach. The workshop, entitled ‘Everyday Ethics and Primary Healthcare’, included poster presentations and oral presentations from participants from a range of disciplines and occupational backgrounds which highlighted the challenges faced by primary health-care workers. Three common themes emerged: the impersonal and cumbersome work environment that can result from the encroachment of rationalizing tools; the tension between ‘ethical prac... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483565 Mon, 05 Dec 2011 05:00:00 +0100 5483565 http://www.medworm.com/index.php?rid=5483564&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F207%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483564 Mon, 05 Dec 2011 05:00:00 +0100 5483564 http://www.medworm.com/index.php?rid=5483563&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F203%3Frss%3D1 The past few decades have seen patient autonomy ascend to a prime position in health care. Patient consent is seen as a key component to expression of autonomy. Yet, interventions may also be justified without consent because they are deemed to be in the public interest. We observe some subtle shifts in balance in these justifications in health care and illustrate these with a range of examples. We hope thereby to stimulate a more explicit debate so that health-care professionals can manage these competing interests. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483563 Mon, 05 Dec 2011 05:00:00 +0100 5483563 http://www.medworm.com/index.php?rid=5483562&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F200%3Frss%3D1 All major religions accept that organ donation is an individual choice and the same is true when it comes to donating one's whole body to medical science. While religious groups have ‘official’ views, it is common, given the various denominations and subgroups within a religion, to have deviation from the official message. This paper provides some insight into the views of religious leaders from one local community in the UK on the act of body donation. The paper also demonstrates the importance that the Abrahamic religions place on providing opportunities for remembrance and thanksgiving for those who have died and how this is extended through the services of thanksgiving that are held by medical schools for those who have donated their bodies to medical science. (Source: Clin... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483562 Mon, 05 Dec 2011 05:00:00 +0100 5483562 http://www.medworm.com/index.php?rid=5483561&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F195%3Frss%3D1 The value of human bodies for the teaching of anatomy has been recognized since the 16th century. Many medical students are exposed to the process of body donation as human dissection continues to play a fundamental role in many medical courses. The opportunity of dissection not only provides students with an educational approach to learning human structure but also exposes them to the emotions surrounding death and dying and the role of the anatomical donor in their journey. This paper explores the subject of body donation in relation to anatomical examination, the relationship the donor has to the medical student experience and the purpose of thanksgiving services. The paper concludes with a brief description of a study carried out at a UK medical school to seek the views of first- and s... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483561 Mon, 05 Dec 2011 05:00:00 +0100 5483561 http://www.medworm.com/index.php?rid=5483560&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F191%3Frss%3D1 The Nuffield Council on Bioethics' recent report on the ethics of the donation of bodily material for treatment and research (Human Bodies: Donation for Medicine and Research. www.nuffieldbioethics.org/human-bodies) brings to the fore the much-debated question of how far society should go in trying to encourage people to donate their bodily material. Based on conclusions reached by the Working Party with respect to the duties of the stewardship state, the role of altruism and of solidarity, public interest in health-related research, the welfare of the donor and the importance of ‘professional values’ such as trust and respect, the report presents an ‘Intervention Ladder’ that sets out the ethical acceptability of various ways of encouraging people to donate. Policy... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483560 Mon, 05 Dec 2011 05:00:00 +0100 5483560 http://www.medworm.com/index.php?rid=5483559&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F186%3Frss%3D1 This paper discusses confidentiality as a routine issue of concern to British general practitioners participating in a qualitative study as well as in contemporaneous practice literature. While keen to reflect on routine issues, such as confidentiality, participants who professed a lack of expertise in medical ethics also perceived reluctance or inability to access educational resources or ethics support. Such lack of ability might include a perception of non-entitlement to access advice and support, a fear of criticism, or simply that resources fail to be advertised. Participants' insights are set alongside a concurrent debate in the professional literature over whether problems with maintaining confidentiality should be rigorously discussed in a public forum. A preliminary suggestion is ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483559 Mon, 05 Dec 2011 05:00:00 +0100 5483559 http://www.medworm.com/index.php?rid=5483558&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F179%3Frss%3D1 Using video to facilitate data collection has become increasingly common in health research. Using video in research, however, does raise additional ethical concerns. In this paper we utilize family therapy data to provide empirical evidence of how recording equipment is treated. We show that families made a distinction between what was observed through the video by the reflecting team and what was being recorded onto videotape. We show that all parties actively negotiated what should and should not go ‘on the record’, with particular attention to sensitive topics and the responsibility of the therapist. Our findings have important implications for both clinical professionals and researchers using video data. We maintain that informed consent should be an ongoing process and wi... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483558 Mon, 05 Dec 2011 05:00:00 +0100 5483558 http://www.medworm.com/index.php?rid=5483557&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F172%3Frss%3D1 The Grand Chamber of the European Court of Human Rights has recently handed down its judgement in the case of three women contesting the abortion law in the Republic of Ireland, which has one of the most restrictive abortion laws in the world. Although the Court ruled that Ireland had to clarify the current law following the success of one of the three claims, the failure of the other two claims allows Ireland to continue to enforce its law, which has an adverse effect on women's health. This paper, therefore, proposes an amendment to abortion legislation in the Republic of Ireland that would be compatible with safeguarding women's health, highlighting several circumstances in which the continuation of a pregnancy may have a detrimental impact on a woman's physical and/or mental health. (S... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483557 Mon, 05 Dec 2011 05:00:00 +0100 5483557 http://www.medworm.com/index.php?rid=5483556&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F167%3Frss%3D1 This article, and a related one in the next issue, investigates some myths surrounding the application of the right to life at the end of life. The present article focuses upon the myth that the right to life is an absolute right, always requiring the preservation of life. It identifies three distinct situations in which state authorities may be justified in declining to take intervening action in order to save a life. It argues that the right to life encompasses recognition of the impossibility and undesirability of preserving human life in all circumstances and that recognition of this fact will render the right more useful in a health-care context. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483556 Mon, 05 Dec 2011 05:00:00 +0100 5483556 http://www.medworm.com/index.php?rid=5483555&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F162%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483555 Mon, 05 Dec 2011 05:00:00 +0100 5483555 http://www.medworm.com/index.php?rid=5483554&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F159%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483554 Mon, 05 Dec 2011 05:00:00 +0100 5483554 http://www.medworm.com/index.php?rid=5483553&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F154%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483553 Mon, 05 Dec 2011 05:00:00 +0100 5483553 http://www.medworm.com/index.php?rid=5483552&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F4%2F153%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5483552 Mon, 05 Dec 2011 05:00:00 +0100 5483552 http://www.medworm.com/index.php?rid=5204427&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F146%3Frss%3D1 The increasing shortage of donor kidneys available for transplantation combined with an ageing population has resulted in the use of expanded-criteria donor (ECD) kidneys. These kidneys are associated with an increased risk of delayed graft function, acute rejection and reduced graft survival. This paper will cover the use of ECDs and the presentation of risk to patients receiving these organs. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204427 Fri, 09 Sep 2011 04:00:00 +0100 5204427 http://www.medworm.com/index.php?rid=5204426&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F140%3Frss%3D1 Transplantation research on samples and organs from deceased donors in England, Wales and Northern Ireland is under threat. The key problems relate to difficulties encountered in gaining consent for research projects, as distinct from consent to donation for clinical transplantation. They are due partly to the terms of the Human Tissue Act 2004 (the 2004 Act), and partly to its interpretation by the Human Tissue Authority (HTA). They include excessive interaction with donor representatives regarding ‘informed consent’ to research projects, uncertainty as to the scope and duration of a donor's ‘authority’ over an organ, and restrictions caused by the apparent need for licensing of transplantation research under the 2004 Act, combined with lack of certainty, or guidan... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204426 Fri, 09 Sep 2011 04:00:00 +0100 5204426 http://www.medworm.com/index.php?rid=5204425&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F134%3Frss%3D1 The decline in organs donated after brain death has been countered by an increase in organs donated after circulatory death. Organs donated after circulatory death present an increased risk of complications for their eventual recipients when compared with organs donated after brain death, so the likelihood of successful transplantation is decreased. If organ donation is considered to be in the best interests of the patient, interventions that facilitate successful donation and transplantation might be permissible. This paper seeks to establish whether it is ethically permissible to manage the end-of-life care of a dying patient to maximize the chances of successful transplantation, and if so, whether it is permissible to further maximize these chances by managing the potential donor to ena... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204425 Fri, 09 Sep 2011 04:00:00 +0100 5204425 http://www.medworm.com/index.php?rid=5204424&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F127%3Frss%3D1 Rates of deceased organ donation in the UK fall well short of those reported from other parts of the world, and result in unnecessary deaths and avoidable morbidity. A particular feature of the UK problem is that its total potential for donation is lower than the actual number of donors reported in the highest-donating countries. This implies that while the identification, referral and conversion of recognized potential deceased donors is an important component of any strategic effort to increase donation, more fundamental is an understanding of why some countries have a greater potential for donation, particularly donation after brain death. While it is possible that these differences reflect a difference in the incidence catastrophic brain injury or the outcomes from it, it is also possi... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204424 Fri, 09 Sep 2011 04:00:00 +0100 5204424 http://www.medworm.com/index.php?rid=5204423&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F122%3Frss%3D1 New protocols have been developed for donors after circulatory death involving early assessment of donor status and premortem supporting treatment in appropriate cases where there is evidence that the patient wished to be an organ donor. These donors are now making an increasingly marked impact on overall deceased donor numbers in the UK. Donors after brainstem death, on the other hand, are much less buoyant yet require the same flexibility in approach in order to improve rates of donation and to realize the wishes of potential deceased organ donors to the proper requisite extent. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204423 Fri, 09 Sep 2011 04:00:00 +0100 5204423 http://www.medworm.com/index.php?rid=5204422&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F117%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204422 Fri, 09 Sep 2011 04:00:00 +0100 5204422 http://www.medworm.com/index.php?rid=5204421&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F113%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204421 Fri, 09 Sep 2011 04:00:00 +0100 5204421 http://www.medworm.com/index.php?rid=5204420&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F111%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204420 Fri, 09 Sep 2011 04:00:00 +0100 5204420 http://www.medworm.com/index.php?rid=5204419&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F3%2F109%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=5204419 Fri, 09 Sep 2011 04:00:00 +0100 5204419 http://www.medworm.com/index.php?rid=4983709&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F103%3Frss%3D1 The conference entitled ‘Best Practices in Clinical Ethics Consultation and Decision-Making’, held in London 8–9 July 2010, was the first of its kind dedicated to identifying best practices in clinical ethics consultation and decision-making. Academics, health and social care professionals, clinical ethics committee members, lawyers, service users and carers from the UK, USA, Europe, Canada, Australia and Asia attended lectures, workshops, parallel paper sessions and clinical ethics case discussions across adult, maternity, children's, older persons, mental health and learning disabilities settings. Seventy-eight best-practice points impacting on the quality of clinical ethics consultations and subsequent decisions were identified and grouped into eight themes: who tells ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983709 Wed, 29 Jun 2011 23:00:00 +0100 4983709 http://www.medworm.com/index.php?rid=4983708&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F101%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983708 Wed, 29 Jun 2011 23:00:00 +0100 4983708 http://www.medworm.com/index.php?rid=4983707&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F97%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983707 Wed, 29 Jun 2011 23:00:00 +0100 4983707 http://www.medworm.com/index.php?rid=4983706&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F91%3Frss%3D1 Biomedical research involving human participants is highly regulated and subject to stringent ethical requirements. Clinical research ethics, regulation and policy have tended to focus almost exclusively on the protection of participants' interests against harms that might result from taking part in research. Less consideration, however, has been given to the interests that patients may themselves have in research participation, even in trials that may be beyond the bounds of current clinical research practice. In this paper, we consider the case of a suggested extension to clinical trial protocols to explore the ethics of participation in ‘risky’ research. We argue that patients may have a strong interest in taking part in research, and that even when greater-than-usual risks ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983706 Wed, 29 Jun 2011 23:00:00 +0100 4983706 http://www.medworm.com/index.php?rid=4983705&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F86%3Frss%3D1 We present the case of a six-year-old child with a fatal brainstem tumour, who was left in a ‘locked-in state’ post-decompressive biopsy. A discussion of the ethical dilemma this situation presents, together with the deliberations of the ethics service when consulted about the optimal course of action, follow. The issues raised highlight an important conflict between the parental view of what is in the child's best interests and what may appear, prima facie, to clinical staff, to be in that child's best interests. We discuss how creative ethical thinking may facilitate resolution of seemingly insoluble situations. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983705 Wed, 29 Jun 2011 23:00:00 +0100 4983705 http://www.medworm.com/index.php?rid=4983704&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F78%3Frss%3D1 Acceptance of elderly or marginal health individuals as kidney donors is debated, with practices varying between centres. Transplant recipients, live kidney donors and health-care professionals caring for patients with renal failure were surveyed regarding their views on live donor kidney transplantation (LDKT) of marginal health (diabetes, hypertension, atherosclerosis, obesity, etc.) and elderly donors. Participants were recruited within a tertiary renal and transplant centre and invited to participate in focus groups and structured interviews. They also completed an anonymous questionnaire. Of 464 participants who completed the questionnaire (36% health-care professionals and 64% patients), 49% and 64%, respectively, stated that marginal and elderly donors should be accepted for LDKT. I... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983704 Wed, 29 Jun 2011 23:00:00 +0100 4983704 http://www.medworm.com/index.php?rid=4983703&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F68%3Frss%3D1 The Corporate Manslaughter and Corporate Homicide Act 2007 establishes the statutory offence of corporate manslaughter, replacing the previous common law corporate liability for manslaughter. Health-care providers are potentially liable. This includes, but is not restricted to, National Health Service bodies. This paper considers the hypothetical liability of the various bodies involved in a well-known case of death arising from medical error, had the Act been in force when it occurred. The discussion illustrates the likelihood of difficulty in establishing liability. This difficulty arises not only from the requirements of the Act but also the involvement of several different bodies in the facts and circumstances of the fatal mistake. There are implications for a National Health Service w... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983703 Wed, 29 Jun 2011 23:00:00 +0100 4983703 http://www.medworm.com/index.php?rid=4983702&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F64%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983702 Wed, 29 Jun 2011 23:00:00 +0100 4983702 http://www.medworm.com/index.php?rid=4983701&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F58%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983701 Wed, 29 Jun 2011 23:00:00 +0100 4983701 http://www.medworm.com/index.php?rid=4983700&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F56%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983700 Wed, 29 Jun 2011 23:00:00 +0100 4983700 http://www.medworm.com/index.php?rid=4983699&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F2%2F55%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4983699 Wed, 29 Jun 2011 23:00:00 +0100 4983699 http://www.medworm.com/index.php?rid=4652134&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F52%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652134 Sun, 27 Mar 2011 23:00:00 +0100 4652134 http://www.medworm.com/index.php?rid=4652133&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F45%3Frss%3D1 In this paper, we offer a new account of disability. According to our account, some state of a person's biology or psychology is a disability if that state makes it more likely that a person's life will get worse, in terms of his or her own wellbeing, in a given set of social and environmental circumstances. Unlike the medical model of disability, our welfarist approach does not tie disability to deviation from normal species’ functioning, nor does it understand disability in essentialist terms. Like the social model of disability, the welfarist approach sees disability as a harmful state that results from the interaction between a person's biology and psychology and his or her surrounding environment. However, unlike the social model, it denies that the harm associated with disabili... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652133 Sun, 27 Mar 2011 23:00:00 +0100 4652133 http://www.medworm.com/index.php?rid=4652132&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F39%3Frss%3D1 This paper recounts the events surrounding the case of Ashley X, a severely disabled young girl whose parents opted for oestrogen therapy, a hysterectomy and breast removal – the so-called ‘Ashley treatment’ – in order to reduce her projected adult weight and improve her quality of life. Following a description of the events leading up to the procedure itself, and the worldwide debate which ensued, the main arguments in favour and against the procedures are presented. The paper also critically engages with a recent defence of the treatments presented by one of those closely involved with the case – Dr D Diekema. Finally, the recommendations of a report which criticizes procedures at the hospital in which the treatments took place are described, and it is argue... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652132 Sun, 27 Mar 2011 23:00:00 +0100 4652132 http://www.medworm.com/index.php?rid=4652131&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F32%3Frss%3D1 It is now broadly accepted that disability is a concept infused with both descriptive and evaluative meaning, such that invoking the concept of disability necessarily involves making judgements of moral value as well as describing certain facts about individuals. This paper aims to map the complex terrain that shapes our current understandings of disability by outlining five distinct ‘discourses of disability’. It is shown how the similarities and differences between the discourses hinge on different ways of making sense of the descriptive and evaluative dimensions of the concept, and the relationships between these dimensions. The paper concludes by considering the specific implications that these different ways of elucidating the concept of disability might have for the provi... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652131 Sun, 27 Mar 2011 23:00:00 +0100 4652131 http://www.medworm.com/index.php?rid=4652130&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F27%3Frss%3D1 Elective surgery can be cancelled when resources are overwhelmed by emergency cases. We hypothesized that such cancellations, on psychological grounds, are followed also by inferior clinical results and we conducted a retrospective survey of patients following joint replacement surgery. Sixty patients having suffered from administrative cancellation prior to their operation during an 18-month period and with six months follow-up were identified and compared with another 60 matched patients after having the same type of surgery but without prior cancellation. All patients received questionnaires on complications and on visual analogue scale (VAS) assessment on subjective wellbeing and quality of life (QoL) at follow-up. The study group reported 50 complications versus 33 for controls (P &lt... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652130 Sun, 27 Mar 2011 23:00:00 +0100 4652130 http://www.medworm.com/index.php?rid=4652129&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F20%3Frss%3D1 No law in any jurisdiction that permits physician assisted dying offers individuals a medically assisted death without the need to comply with certain criteria. The Netherlands is no exception. There is evidence to suggest that physicians are averse to providing an assisted death even when the Dutch ‘due care criteria’ have been met and the unbearable pain and suffering requirement is especially difficult to satisfy. Some individuals with an enduring desire to die who do not meet the ‘due care’ criteria under the Dutch legislation turn to other means of achieving a self-appointed death. This paper explores two alternative methods of securing a self-determined death (an assisted death involving lay assistors or a self-hastened death by stopping eating and drinking), ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652129 Sun, 27 Mar 2011 23:00:00 +0100 4652129 http://www.medworm.com/index.php?rid=4652128&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F15%3Frss%3D1 This article focuses on the legal and ethical implications of recruiting into health-care research minors who are not competent to consent. It considers the role played by best interests in obtaining valid parental consent for the participation of children in research, both at common law and under the Regulations that govern clinical trials of medicinal products. In doing so it questions the legality of parental consent to children's involvement in research, and identifies some inconsistencies in parental understandings of best interests in relation to medical research and treatment. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652128 Sun, 27 Mar 2011 23:00:00 +0100 4652128 http://www.medworm.com/index.php?rid=4652127&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F11%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652127 Sun, 27 Mar 2011 23:00:00 +0100 4652127 http://www.medworm.com/index.php?rid=4652126&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F5%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652126 Sun, 27 Mar 2011 23:00:00 +0100 4652126 http://www.medworm.com/index.php?rid=4652125&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F2%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652125 Sun, 27 Mar 2011 23:00:00 +0100 4652125 http://www.medworm.com/index.php?rid=4652124&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F6%2F1%2F1%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4652124 Sun, 27 Mar 2011 23:00:00 +0100 4652124 http://www.medworm.com/index.php?rid=4360373&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F220%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360373 Tue, 18 Jan 2011 00:00:00 +0100 4360373 http://www.medworm.com/index.php?rid=4360372&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F217%3Frss%3D1 Oncologists frequently have to break bad news to patients. Although they are not normally the ones who tell patients that they have cancer, they are the ones who have to tell patients that treatment is not working, and they are almost always the ones who have to tell them that they are going to die and that nothing more can be done to cure them. Perhaps the most difficult cases are those where further treatment is almost certainly futile, but there remains an extremely slim chance of yet more aggressive treatment having a near-miraculous effect. In such situations, it can be difficult for the oncologist to decide how to explain things to the patient, and how much to tell them. It can also be very difficult to achieve the correct balance between respecting the patient's autonomy and not exp... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360372 Tue, 18 Jan 2011 00:00:00 +0100 4360372 http://www.medworm.com/index.php?rid=4360371&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F207%3Frss%3D1 In 2004, prenatal risk assessment (PRA) was implemented as a routine offer in Denmark, in order to give all pregnant women an informed choice about whether to undergo prenatal testing. PRA is a non-invasive intervention performed in the first trimester of pregnancy and measures the risk of a fetus having Down's syndrome or other chromosomal disorders. The risk figure provides the basis for action, i.e. the decision about whether or not to undergo invasive fetal testing via the maternal route (amniocentesis or chorionic villus sampling), which, however, involves the risk of inducing a miscarriage. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, this paper investigates how ideals such as autonomy and non-directi... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360371 Tue, 18 Jan 2011 00:00:00 +0100 4360371 http://www.medworm.com/index.php?rid=4360370&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F201%3Frss%3D1 This article explores the attitudes of consultants in a large UK teaching hospital to the need for formal clinical ethics support. Data obtained through an anonymous online questionnaire illustrate the ways in which consultants deal with clinical ethical dilemmas and their confidence in such decision-making. In the absence of formal ethics support a large proportion of consultants who took part in the survey said that they would consult with colleagues when faced with a clinical ethical dilemma and the majority considered that this satisfactorily resolved the issue. However, 80% of respondents stated that they would find a form of ethics support within the Trust to be useful. Consultants also noted the reasons for, and barriers to, using ethics support. The response rate to the survey was ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360370 Tue, 18 Jan 2011 00:00:00 +0100 4360370 http://www.medworm.com/index.php?rid=4360369&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F195%3Frss%3D1 In an earlier paper I argued that we do not have an objective conception of best interests and that this is a particular problem because the courts describe that they use an ‘...objective approach or test. That test is the best interests of the patient’ when choosing for children. I further argued that there was no obvious way in which we could hope to develop an objective notion of best interests. As well as this, I argued that a best-interest-based approach was a particular problem around the time of death of some children. A response from a legal perspective argued that, while there is not a clear conception of objective best interests, the courts have a well-described approach to finding a child's objective best interests. In this paper, I argue that without clear agreement... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360369 Tue, 18 Jan 2011 00:00:00 +0100 4360369 http://www.medworm.com/index.php?rid=4360368&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F188%3Frss%3D1 In the context of critically ill children, Baines contended that the best interests test was neither objective nor coherent, and thus of little applicability in making end-of-life decisions. In reply, Bridgeman attempted to refute these claims through legal analysis and contended that the doctrine allowed for responsive, fact-specific, context-sensitive and prudential reasoning. This paper is a response to Bridgeman, and argues that an examination of case law reveals the subjective and value-laden nature of the test. Courts must make decisions in contested cases, but there is no reason to hold that a judge can divine the best interests of a critically ill child better than either parents or medical staff. This paper analyses a number of cases where judicial decisions appear at odds with th... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360368 Tue, 18 Jan 2011 00:00:00 +0100 4360368 http://www.medworm.com/index.php?rid=4360367&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F184%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360367 Tue, 18 Jan 2011 00:00:00 +0100 4360367 http://www.medworm.com/index.php?rid=4360366&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F180%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360366 Tue, 18 Jan 2011 00:00:00 +0100 4360366 http://www.medworm.com/index.php?rid=4360365&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F175%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360365 Tue, 18 Jan 2011 00:00:00 +0100 4360365 http://www.medworm.com/index.php?rid=4360364&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F172%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360364 Tue, 18 Jan 2011 00:00:00 +0100 4360364 http://www.medworm.com/index.php?rid=4360363&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F4%2F171%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4360363 Tue, 18 Jan 2011 00:00:00 +0100 4360363 http://www.medworm.com/index.php?rid=4030648&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F164%3Frss%3D1 (No summary is available for this citation) (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030648 Mon, 04 Oct 2010 22:20:01 +0100 4030648 http://www.medworm.com/index.php?rid=4030647&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F159%3Frss%3D1 There is a significant body of evidence showing that patients want to know when they are harmed as a result of their medical care. In 2005 the National Patient Safety Agency issued guidance on the process to be followed when communicating errors to patients and their carers. However, there is still a significant gap between the rhetoric of being open and clinical practice. This gap reflects the competing interests arising from the concept of being open and the difficulties involved in the process itself. This paper presents several case studies to explore the complexities of being open and the organizational support required to overcome these. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030647 Mon, 04 Oct 2010 22:20:01 +0100 4030647 http://www.medworm.com/index.php?rid=4030646&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F156%3Frss%3D1 Teaching and learning of medical ethics and law are at the heart of medical education because they are integral to all clinical encounters and public health interventions, and a foundation in medical ethics and law is essential for students to become virtuous doctors. The first model curriculum for medical ethics and law within medical education in the UK, published in 1998, has recently been reviewed and updated. Now called a core content of learning, it emphasizes that teaching and learning of medical ethics and law should be attuned to the students' needs appropriate both to their particular stage of training and to relevant specialty-specific ethical issues; is a shared obligation of all teachers throughout the course; and should be integrated vertically and horizontally throughout the... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030646 Mon, 04 Oct 2010 22:20:01 +0100 4030646 http://www.medworm.com/index.php?rid=4030645&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F148%3Frss%3D1 In conclusion, parents participating or declining a neonatal study involving venepuncture are different, but participating parents were well informed and seemed able to judge that participation was right for them such that in consenting families venepuncture itself is not problematic. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030645 Mon, 04 Oct 2010 22:20:01 +0100 4030645 http://www.medworm.com/index.php?rid=4030644&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F142%3Frss%3D1 In conclusion, this paper adds a pragmatic approach to the debate on informed consent by describing the development of a written information sheet and consent form being used in a current social research study. Particular emphasis is placed on the importance of written information being adapted according to the needs of potential participants. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030644 Mon, 04 Oct 2010 22:20:01 +0100 4030644 http://www.medworm.com/index.php?rid=4030643&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F136%3Frss%3D1 There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics case consultation practices. The tool was developed during meetings of the European Clinical Ethics Network. Based on written reports and participation in the network meetings, the development and the content of the tool and the results of its application in presenting... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030643 Mon, 04 Oct 2010 22:20:01 +0100 4030643 http://www.medworm.com/index.php?rid=4030642&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F130%3Frss%3D1 In this paper I argue that doctors who are found guilty of serious professional misconduct should be required to apologize as a condition of their registration. I argue that such a requirement is to be justified on the basis of the need to protect patients, maintain public confidence in the profession, and declare and uphold proper standards of conduct and behaviour. I also answer an objection that might be made to the position I defend. Finally, I consider whether there should be any exceptions to the demand for an apology from doctors who have been found guilty of serious professional misconduct. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030642 Mon, 04 Oct 2010 22:20:01 +0100 4030642 http://www.medworm.com/index.php?rid=4030641&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F125%3Frss%3D1 The Director of Public Prosecutions has recently released the Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide. These guidelines provide information on the factors that shall be considered when contemplating whether to bring a prosecution in the public interest in cases concerning assisting and encouraging suicide. While intended to clarify the potential liability of those engaged in or considering such practices, the guidelines have also stumbled into controversial and murky areas of law. As such any potential positive outcomes the guidelines may produce must be weighed against the potential confusion they may also cause. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030641 Mon, 04 Oct 2010 22:20:01 +0100 4030641 http://www.medworm.com/index.php?rid=4030640&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F122%3Frss%3D1 (No summary is available for this citation) (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030640 Mon, 04 Oct 2010 22:20:01 +0100 4030640 http://www.medworm.com/index.php?rid=4030639&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F118%3Frss%3D1 (No summary is available for this citation) (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030639 Mon, 04 Oct 2010 22:20:01 +0100 4030639 http://www.medworm.com/index.php?rid=4030638&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F115%3Frss%3D1 (No summary is available for this citation) (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030638 Mon, 04 Oct 2010 22:20:01 +0100 4030638 http://www.medworm.com/index.php?rid=4030637&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F3%2F113%3Frss%3D1 (No summary is available for this citation) (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=4030637 Mon, 04 Oct 2010 22:20:01 +0100 4030637 http://www.medworm.com/index.php?rid=3671020&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F111%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671020 Wed, 16 Jun 2010 23:46:25 +0100 3671020 http://www.medworm.com/index.php?rid=3671019&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F108%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671019 Wed, 16 Jun 2010 23:46:25 +0100 3671019 http://www.medworm.com/index.php?rid=3671018&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F103%3Frss%3D1 Personal narratives in which medical students and clinicians reflect on their education and practice, or recipients of health care reflect on their journey though the system can provide valuable insights which can usefully be shared. In this paper, a medical student describes the effect of a humanities-based student-selected component on her understanding of anatomy and dissection, and a junior doctor in Iraq learns some painful lessons about medicine and society during a night shift in the casualty department. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671018 Wed, 16 Jun 2010 23:46:25 +0100 3671018 http://www.medworm.com/index.php?rid=3671017&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F95%3Frss%3D1 The aim of the present study was to describe and explore the perception of ethical guidelines and their role in ethical competence-building among Swedish physicians and research nurses. Twelve informants were interviewed in depth. The results demonstrated that the informants had a critical attitude towards ethical guidelines and claimed to make little use of them in practical moral judgements. Ethical competence was seen primarily as character-building, related to virtues such as being empathic, honest and loyal to patients. Ethical competence was assumed to be learned through good examples, role models and practical experience, while ethical guidelines were not perceived as valuable in this process. In order to improve the staff's familiarity with and the usability of ethical guidelines, ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671017 Wed, 16 Jun 2010 23:46:25 +0100 3671017 http://www.medworm.com/index.php?rid=3671016&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F86%3Frss%3D1 We present the results of a questionnaire audit exploring the views of patients on how long they waited to undergo invasive procedures for intraocular melanoma. The findings inform a discussion of three plausible reasons for doubting the validity of consent to rapid intervention: the distress of diagnosis may temporarily undermine patients' capacity to choose; the decision may be too complex to make quickly; and rapid availability of treatment may be unduly influential, undermining the voluntariness of the decision. Using the example of enucleation, we argue that, with adequate safeguards, rapid intervention does not undermine the validity of patients' consent. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671016 Wed, 16 Jun 2010 23:46:25 +0100 3671016 http://www.medworm.com/index.php?rid=3671015&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F77%3Frss%3D1 This paper reports from an ongoing multidisciplinary, ethnographic study that is exploring the views, values and practices (the ethical frameworks) drawn on by professional staff in assisted conception units and stem cell laboratories in relation to embryo donation for research purposes, particularly human embryonic stem cell (hESC) research, in the UK. We focus here on the connection between possible incidental findings and the circumstances in which embryos are donated for hESC research, and report some of the uncertainties and dilemmas of our staff participants. We explore the views of our study participants in relation to two themes: (1) rights to information and anticipating how donors might be informed about future research findings and (2) occupational work goals and trust. (Source:... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671015 Wed, 16 Jun 2010 23:46:25 +0100 3671015 http://www.medworm.com/index.php?rid=3671014&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F73%3Frss%3D1 In this paper the current legislative landscape and the challenges researchers face in obtaining informed consent in acute situations are explored. In such situations, some current guidelines can be difficult or impossible to apply. Capacity should be formally assessed before consent is sought to ensure that vulnerable persons are neither inappropriately recruited to a study nor denied the opportunity to participate. However, there is little guidance in current legislation as to how this should be achieved. When the patient is considered to be unable to provide prospective informed consent, other forms are sometimes permissible, although all have specific drawbacks. First, it is argued that a brief instrument, suitable for the acute situation, is needed to determine whether patients have t... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671014 Wed, 16 Jun 2010 23:46:25 +0100 3671014 http://www.medworm.com/index.php?rid=3671013&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F67%3Frss%3D1 This paper explores the significance of a landmark Italian judgement regarding end-of-life advance directives, emphasizing the legal and political context in which the decision was made. The analysis particularly focuses on the political majority's attempt to overturn the outcome of the courts' proceedings – thereby challenging the country's institutional order and jeopardizing constitutional rights. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671013 Wed, 16 Jun 2010 23:46:25 +0100 3671013 http://www.medworm.com/index.php?rid=3671012&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F63%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671012 Wed, 16 Jun 2010 23:46:25 +0100 3671012 http://www.medworm.com/index.php?rid=3671011&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F57%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671011 Wed, 16 Jun 2010 23:46:25 +0100 3671011 http://www.medworm.com/index.php?rid=3671010&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F54%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671010 Wed, 16 Jun 2010 23:46:25 +0100 3671010 http://www.medworm.com/index.php?rid=3671009&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F2%2F51%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3671009 Wed, 16 Jun 2010 23:46:25 +0100 3671009 http://www.medworm.com/index.php?rid=3279528&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F46%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279528 Tue, 16 Feb 2010 22:14:12 +0100 3279528 http://www.medworm.com/index.php?rid=3279527&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F35%3Frss%3D1 The success of assisted reproductive technologies (ARTs) worldwide has led to an accumulation of frozen embryos that are surplus to the reproductive needs of those for whom they were created. In these situations, couples must decide whether to discard them or donate them for scientific research or for use by other infertile couples. While legislation and regulation may limit the decisions that couples make, their decisions are often shaped by their religious beliefs. Unfortunately, health professionals, scientists and policy-makers are often unaware of the way in which faith traditions view ART and decisions concerning the ‘fate’ of surplus embryos. In this paper scholars representing six major religious traditions provide a commentary on a hypothetical case concerning the dona... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279527 Tue, 16 Feb 2010 22:14:12 +0100 3279527 http://www.medworm.com/index.php?rid=3279526&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F28%3Frss%3D1 The objective of the present paper is to explore parents' views on safety and confidentiality, information and consent, the importance of different kinds of research, and their responsibilities regarding children's participation. A questionnaire was distributed to 2500 families in south-east Sweden with children born during the years 1997–1999; 1302 responded. The sample was chosen to include views of families with and without earlier research experience. A clear majority of responding parents stated that parents have a moral responsibility to let their children participate in research that is considered important, safe and moderately time-consuming. Respondents stressed the importance of thorough review and control of research involving children. Respondents also found it important ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279526 Tue, 16 Feb 2010 22:14:12 +0100 3279526 http://www.medworm.com/index.php?rid=3279525&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F22%3Frss%3D1 In conclusion, the positive finding of a commitment to mutuality in cord blood banking among these women is underlined, and its implications for the wider debate on cord blood banking are discussed. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279525 Tue, 16 Feb 2010 22:14:12 +0100 3279525 http://www.medworm.com/index.php?rid=3279524&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F16%3Frss%3D1 Restraint has recently become an important legal and clinical issue in England and Wales with the introduction of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards introduced by the Mental Health Act 2007. The requirements of these two new pieces of legislation are complex, and therefore pose major challenges to the provision of high quality and patient-centred care, support and treatment in a range of health and social care settings. In this paper, the legal and ethical aspects of physical restraint in an acute medical care environment are considered, and practical guidance is provided to individuals adopting methods of restraint to care for general hospital patients. Aspects of the Introduction below are written in the first person to reflect the personal experiences... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279524 Tue, 16 Feb 2010 22:14:12 +0100 3279524 http://www.medworm.com/index.php?rid=3279523&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F13%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279523 Tue, 16 Feb 2010 22:14:12 +0100 3279523 http://www.medworm.com/index.php?rid=3279522&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F7%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279522 Tue, 16 Feb 2010 22:14:12 +0100 3279522 http://www.medworm.com/index.php?rid=3279521&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F3%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279521 Tue, 16 Feb 2010 22:14:12 +0100 3279521 http://www.medworm.com/index.php?rid=3279520&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F5%2F1%2F1%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=3279520 Tue, 16 Feb 2010 22:14:12 +0100 3279520 http://www.medworm.com/index.php?rid=2999168&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F213%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999168 Tue, 17 Nov 2009 01:45:09 +0100 2999168 http://www.medworm.com/index.php?rid=2999167&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F211%3Frss%3D1 A recent article in the March 2009 edition of Clinical Ethics stated that, ‘In the Summa Theologica, Thomas Aquinas discusses how murder may be justified in self defence’, provided that killing is not intended. This statement is open to challenge on historical and semantic grounds, with respect to the writings of the 13th Century Roman Catholic philosopher Thomas Aquinas (1225–1274). A better appreciation of Aquinas' writings on this topic could inform the debate relating to medical end-of-life decisions. The normatively loaded word ‘murder’ is not applicable to Aquinas' conclusion on unintended homicide, nor is it applicable to unintended homicide in current law, which is by definition not murder. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999167 Tue, 17 Nov 2009 01:45:09 +0100 2999167 http://www.medworm.com/index.php?rid=2999166&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F208%3Frss%3D1 We present a remarkable case of family members exercising substituted misjudgement for a 42-year-old man hospitalized with multiorgan failure on life support. Feeling that their loved one would rather die than face severe disability, they elected to withdraw life support. Although this was done, the patient remained alive and recovered enough to clearly indicate his preference for life, even with severe disability. This case suggests that in instances of unusual quality-of-life judgements where the patient's wishes cannot be known with reasonable certainty, families and physicians should be very wary using substituted judgement to refuse life support. Unless there are strong considerations based on the patient's prior statements, actions and values to decline life support, it would seem et... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999166 Tue, 17 Nov 2009 01:45:09 +0100 2999166 http://www.medworm.com/index.php?rid=2999165&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F202%3Frss%3D1 It is now possible for someone with HIV disease to receive a kidney transplant from a living donor, although there is evidence only about the short-term outcomes of such a procedure. A person with HIV disease may not wish to disclose their diagnosis to a potential kidney donor. This paper argues that disclosure of the diagnosis of HIV to the donor is not necessary for informed consent. Concerns about the relationship of trust between the clinical team and the donor hold weight in deciding whether disclosure is essential, though openness about the limited nature of informed consent may facilitate a trusting relationship in the absence of disclosure. In general, the recipient's medical information should be treated as confidential, thereby avoiding any need to distinguish between HIV and oth... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999165 Tue, 17 Nov 2009 01:45:09 +0100 2999165 http://www.medworm.com/index.php?rid=2999164&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F195%3Frss%3D1 In conclusion, what patients react most strongly against is when health-care personnel treat them disrespectfully by not abiding by established social norms. The results indicate that the combination of failure in medical treatment and not receiving an apology often leads patients to complain to the Patients' Advisory Committee. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999164 Tue, 17 Nov 2009 01:45:09 +0100 2999164 http://www.medworm.com/index.php?rid=2999163&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F187%3Frss%3D1 Ethical review of applications to conduct research projects continues to be a focus of scrutiny and controversy. We argue that attention to the actual practices of ethical review has the potential to inform debate. We explore how research ethics committees (RECs) establish their position and authority through the texts they use in their correspondence with applicants. Using a discursive analysis applied to 260 letters, we identify four positions of particular interest: RECs positioned as disinterested and responsible; as representing the interests of potential participants; as facilitating ethically sound, high-quality research; and as engaged in dialogue. These positions are used strategically to deflect criticism or complaint. This analysis has implications for reducing contestation betw... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999163 Tue, 17 Nov 2009 01:45:09 +0100 2999163 http://www.medworm.com/index.php?rid=2999162&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F181%3Frss%3D1 Current General Medical Council (GMC) guidelines state that any doctor who does not wish to carry out a non-therapeutic circumcision (NTC) on a boy must invoke conscientious objection. This paper argues that this is illogical, as it is clear that an ethical doctor will object to conducting a clinically unnecessary operation on a child who cannot consent simply because of the parents’ religious beliefs. Comparison of the GMC guidelines with the more sensible British Medical Association guidance reveals that both are biased in favour of NTC and subvert standard consent procedures. It is further argued that any doctor who does participate in NTC of a minor may be guilty of negligence and in breach of the Human Rights Act. In fact, the GMC guidance implies that doctors must claim conscie... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999162 Tue, 17 Nov 2009 01:45:09 +0100 2999162 http://www.medworm.com/index.php?rid=2999161&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F176%3Frss%3D1 This article explores the tensions between law and ethics in relation to clinical research involving minors and concludes that greater respect should be given to the autonomy of those minors who are competent to decide for themselves. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999161 Tue, 17 Nov 2009 01:45:09 +0100 2999161 http://www.medworm.com/index.php?rid=2999160&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F173%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999160 Tue, 17 Nov 2009 01:45:09 +0100 2999160 http://www.medworm.com/index.php?rid=2999159&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F169%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999159 Tue, 17 Nov 2009 01:45:09 +0100 2999159 http://www.medworm.com/index.php?rid=2999158&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F165%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999158 Tue, 17 Nov 2009 01:45:09 +0100 2999158 http://www.medworm.com/index.php?rid=2999157&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F4%2F163%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2999157 Tue, 17 Nov 2009 01:45:09 +0100 2999157 http://www.medworm.com/index.php?rid=2757168&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F159%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757168 Mon, 31 Aug 2009 23:00:00 +0100 2757168 http://www.medworm.com/index.php?rid=2757167&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F156%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757167 Mon, 31 Aug 2009 23:00:00 +0100 2757167 http://www.medworm.com/index.php?rid=2757166&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F152%3Frss%3D1 The Clinical ethics centre in Paris offers its services equally to doctors and patients/proxies. Its primary goal is to re-equilibrate doctor–patient roles through giving greater voice to patients individually in medical decisions. Patients are present at virtually all levels, initiating consults, providing their point of view and receiving feedback. The implications of patients' involvement are threefold. At an operational level, decision-making is facilitated by repositioning the debate on ethical grounds and introducing a dynamic of decisional partnership, although contact with patients can make it difficult to deny their demands and set the limits of our role. Ethically, it reinforces patients' autonomy and grants them a place of veritable ethics ‘actors’, with the da... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757166 Mon, 31 Aug 2009 23:00:00 +0100 2757166 http://www.medworm.com/index.php?rid=2757165&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F146%3Frss%3D1 Ethics consultation is a novel paradigm in European health-care institutions. In this paper, patient involvement in all clinical ethics activities is scrutinized. It is argued that patients should have access to case consultation services via clearly defined access paths. However, the right of both health-care professionals and patients indicates that patients should not always be notified of a consultation. Ethics education, another well-established function of an ethics committee, should equally be available for patients, lay people and hospital staff. Beyond access and utilization, lay membership on a clinical ethics service is a matter of transparency, equal participation, empowerment and democratization. Lay and patient perspectives will contribute to the quality of ethics services on... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757165 Mon, 31 Aug 2009 23:00:00 +0100 2757165 http://www.medworm.com/index.php?rid=2757164&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F139%3Frss%3D1 This study reports the first specific investigation of patient contact with UK CECs. A questionnaire study was carried out with representatives from UK CECs. Results suggest that patient participation in clinical ethics consultation is low and unlikely to change significantly in the near future. Attitudes towards patients having a role in clinical ethics consultation are mixed, with a variety of reasons put forward both for and against patient participation. These results are discussed in the light of common themes in the literature and the practical and political context of clinical ethics support in the UK. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757164 Mon, 31 Aug 2009 23:00:00 +0100 2757164 http://www.medworm.com/index.php?rid=2757163&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F131%3Frss%3D1 Clinical ethics has developed significantly in Europe over the past 15 years and remains an evolving process. While sharing our experiences in different European settings, we were surprised to discover marked differences in our practice, especially regarding the position and role of patients. In this paper, we describe these differences, such as patient access to and participation or representation in ethics consults. We propose reasons to explain these differences, hypothesizing that they relate to the historic and sociocultural context of implementation of clinical ethics consultation services (Cecs), as well as the initial aims for which each structure was established. Then, we analyse those differences with common ethical arguments arising in patient involvement. We conclude that there... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757163 Mon, 31 Aug 2009 23:00:00 +0100 2757163 http://www.medworm.com/index.php?rid=2757162&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F125%3Frss%3D1 To date, few Norwegian clinical ethics committees (CECs) have included patients or next of kin in case discussions. In 2008, Rikshospitalet's (The National Hospital's) CEC began to routinely invite patients and relatives into case discussions. In this paper, we describe seven cases discussed by this committee in 2008. Six involved life and death decision-making in collaboration with the next of kin, while one related case did not include relatives. In our opinion, representing the patient's perspective was advantageous to the discussion itself, to the conclusion made and to the next of kin's acceptance of the resolution. We believe that if the patient had been represented in the last case, the outcome might have been different. We conclude that successful patient involvement will rely on w... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757162 Mon, 31 Aug 2009 23:00:00 +0100 2757162 http://www.medworm.com/index.php?rid=2757161&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F119%3Frss%3D1 In this paper we argue that while individual private interests such as autonomy and the need for a medical procedure or treatment are important in the provision and delivery of health care and the utilization of biotechnologies, these concepts need to be balanced with other interests such that in certain situations they do not take priority. We use as an example a particular developing biotechnology, xenotransplantation, to suggest that interest in the health of the public is such that this biotechnology should not be permitted to move to the clinical trial stage because of the particular risk of harm it poses to the potential xeno-recipient, their close contacts and the wider population. This is despite the interest of those in need of a transplant in allowing such clinical trials to proc... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757161 Mon, 31 Aug 2009 23:00:00 +0100 2757161 http://www.medworm.com/index.php?rid=2757160&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F116%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757160 Mon, 31 Aug 2009 23:00:00 +0100 2757160 http://www.medworm.com/index.php?rid=2757159&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F111%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757159 Mon, 31 Aug 2009 23:00:00 +0100 2757159 http://www.medworm.com/index.php?rid=2757158&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F3%2F109%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2757158 Mon, 31 Aug 2009 23:00:00 +0100 2757158 http://www.medworm.com/index.php?rid=2432255&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F106%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432255 Fri, 22 May 2009 04:00:00 +0100 2432255 http://www.medworm.com/index.php?rid=2432253&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F102%3Frss%3D1 This article explores these controversies through four case scenarios. These scenarios are loosely based on the authors' prior experiences as paediatric surgeons. In light of current statutory guidance, and the paucity of legal precedent, there are few answers to be offered. However, exploring the issues, enabling them to be thoughtfully considered by health professionals, is in itself valuable. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432253 Fri, 22 May 2009 04:00:00 +0100 2432253 http://www.medworm.com/index.php?rid=2432251&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F98%3Frss%3D1 In conclusion, most patients with LIS are competent and intellectually intact. In The Netherlands the autonomy of the patient is respected by law. In respecting this autonomy, medical choices can be different in comparable patients. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432251 Fri, 22 May 2009 04:00:00 +0100 2432251 http://www.medworm.com/index.php?rid=2432249&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F91%3Frss%3D1 This paper examines the role of clinical ethics committees (CECs) in infertility clinics in the UK, focusing on whether they usefully support infertility clinicians' ethical decision-making. The overall aim of the study reported here was to investigate how infertility clinicians approached and handled ethical problems in their everyday practice and this paper reports on one aspect of these data – what they thought about the use of CECs. This paper gives an overview of what arrangements there are for such committees in infertility clinics; considers why the clinicians used CECs; and examines how these committees provided a useful function in the infertility setting and contributed to making ‘good’ ethical decisions. Finally, the paper examines how the form of ethics suppor... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432249 Fri, 22 May 2009 04:00:00 +0100 2432249 http://www.medworm.com/index.php?rid=2432247&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F85%3Frss%3D1 There is increasing recognition among bioethicists that health-care practitioners' everyday ethical challenges ought to be the focus of ethical analysis. Interviews were conducted with Australian junior doctors to identify some of the kinds of situations that they found ethically challenging, as a basis for this type of grounded philosophical analysis and for further empirical research into junior doctors' ethical issues. Fourteen doctors in their first to fourth year of work from six hospitals in Melbourne participated. Issues discussed included involvement in treatment perceived as inappropriate, seniors discouraging disclosure of errors, coping when requested help was not forthcoming, observing behaviour perceived as unethical, truth-telling and informed consent. The difficulties descri... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432247 Fri, 22 May 2009 04:00:00 +0100 2432247 http://www.medworm.com/index.php?rid=2432245&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F79%3Frss%3D1 While several studies have explored parents' perceptions of their children's participation in research, very few studies have described the children's own perceptions of their participation in research. The aim of this study was to describe children's perceptions of their participation in a comprehensive longitudinal clinical study. Semi-structured qualitative interviews were conducted with 17 children aged seven participating in the Copenhagen Prospective Study on Asthma in Childhood. The interviews were audiotaped, transcribed and analysed using the template analysis method. The children rated their experiences with venepunctures on a Wong-Baker faces scale. The regular visits to the hospital and comprehensive clinical tests did not seem to have affected the children negatively. In parti... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432245 Fri, 22 May 2009 04:00:00 +0100 2432245 http://www.medworm.com/index.php?rid=2432243&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F74%3Frss%3D1 Public policy on alcohol in the UK relies on health promotion campaigns that encourage individuals who misuse alcohol to make healthier choices about their drinking. Individuals with alcohol-dependence syndrome have an impaired capacity to choose health. As a result, individuals with the worst alcohol misuse problems lie largely outside the reach of choice-based policy. However, such policy has been widely criticized and efforts to reform it are underway. This paper argues that the British Medical Association's recent attempt to improve policy on alcohol in the UK by introducing strategies which have been shown to control drinking within populations still gives insufficient attention to alcohol dependence. This is because it fails accurately and consistently to characterize alcohol depende... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432243 Fri, 22 May 2009 04:00:00 +0100 2432243 http://www.medworm.com/index.php?rid=2432241&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F67%3Frss%3D1 The General Medical Council instructs doctors not to allow their personal beliefs to interfere with their practice. But if attitudes can threaten to impact negatively on a doctor's practice then the question arises: should doctors ever be professionally required to change their attitudes? In this paper I suggest that doctors should be required to amend their attitudes if two conditions are met, namely: (1) the doctor has an attitude that if neglected by the doctor will (or is very likely to) compromise his or her fitness to practise; and (2) the only way in which the doctor can prevent that attitude from compromising his or her fitness to practise is by changing the attitude. I also answer three objections that might be raised against the position that I advance. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432241 Fri, 22 May 2009 04:00:00 +0100 2432241 http://www.medworm.com/index.php?rid=2432240&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F64%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432240 Fri, 22 May 2009 04:00:00 +0100 2432240 http://www.medworm.com/index.php?rid=2432239&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F59%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432239 Fri, 22 May 2009 04:00:00 +0100 2432239 http://www.medworm.com/index.php?rid=2432238&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F57%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432238 Fri, 22 May 2009 04:00:00 +0100 2432238 http://www.medworm.com/index.php?rid=2432237&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F2%2F55%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2432237 Fri, 22 May 2009 04:00:00 +0100 2432237 http://www.medworm.com/index.php?rid=2192075&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F50%3Frss%3D1 People often have a strong intuitive sense that we ought to rescue those in serious need, even in cases where we could produce better outcomes by acting in other ways. It has become common in such cases to refer to this as the Rule of Rescue. Within the medical field this rule has predominantly been discussed in relation to decisions about whether to fund particular treatments. While, in this setting, the arguments in favour of the Rule of Rescue have generally been found to be unconvincing, there are some reasons for thinking that it may have more of a role to play at the clinical level. In this article, we examine three lines that such reasoning might take. In each case, we argue that the reasons given do not support the adoption of a Rule of Rescue in clinical practice. (Source: Clinica... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192075 Tue, 17 Feb 2009 05:00:00 +0100 2192075 http://www.medworm.com/index.php?rid=2192074&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F44%3Frss%3D1 This article examines when deceptive withholding of information is ethically acceptable in research. The first half analyses the concept of deception. We argue that there are two types of accounts of deception: normative and non-normative, and argue that non-normative accounts are preferable. The second half of the article argues that the relevant ethical question which ethics committees should focus on is not whether the person from whom the information is withheld will be deceived, but rather on the reasonableness of withholding the information from the person who is deceived. We further argue that the reasonableness of withholding information is dependent on the context. The last section examines how the context of research should shape our judgements about the circumstances in which wi... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192074 Tue, 17 Feb 2009 05:00:00 +0100 2192074 http://www.medworm.com/index.php?rid=2192073&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F38%3Frss%3D1 Sustaining hope in patients is an important element of health care, allowing improvement in patient welfare and quality of life. However in the palliative care context, with patients who are terminally ill, it might seem that in order to maintain hope the palliative care practitioner would sometimes have to deceive the patient about the full nature or prospects of their condition by providing a ‘false hope’. This possibility creates an ethical tension in palliative practice, where the beneficent desire to improve patient welfare through sustaining hope appears to be in conflict with an autonomy-based requirement not to deceive patients about their condition. In order to resolve this ethical tension, we provide an analysis of the concept of hope and argue that there is at least ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192073 Tue, 17 Feb 2009 05:00:00 +0100 2192073 http://www.medworm.com/index.php?rid=2192072&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F36%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192072 Tue, 17 Feb 2009 05:00:00 +0100 2192072 http://www.medworm.com/index.php?rid=2192071&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F31%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192071 Tue, 17 Feb 2009 05:00:00 +0100 2192071 http://www.medworm.com/index.php?rid=2192070&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F26%3Frss%3D1 The relationship between the media and the medical profession is often one of mutual mistrust. However, the media, and especially television, is a powerful tool for telling individual stories and for providing a medium for medico-ethical dilemmas to be portrayed to a wide audience. The extent to which the use of individual narratives can or should influence public opinion about complex medical issues is examined in this paper from the perspective of a former television journalist with a postgraduate degree in medical law and ethics. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192070 Tue, 17 Feb 2009 05:00:00 +0100 2192070 http://www.medworm.com/index.php?rid=2192069&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F19%3Frss%3D1 Two questionnaires directed to Swedish physicians and a sample of the Swedish population investigated attitudes towards physician-assisted suicide (PAS). The aim of the present work was to analyse qualitative data from these questionnaires in order to explore how respondents reason about PAS. Data were analysed in two steps. First, we categorized different kinds of responses and identified pro and con arguments. Second, we identified general conclusions from the responses. The data reflect the differences in attitudes towards PAS among the public and physicians, with the former mainly in favour of PAS and the latter mainly against. There was, however, considerable agreement about what requirements must be met before PAS could be considered ethical. Many arguments against PAS concerned the ... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192069 Tue, 17 Feb 2009 05:00:00 +0100 2192069 http://www.medworm.com/index.php?rid=2192068&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F15%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192068 Tue, 17 Feb 2009 05:00:00 +0100 2192068 http://www.medworm.com/index.php?rid=2192067&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F12%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192067 Tue, 17 Feb 2009 05:00:00 +0100 2192067 http://www.medworm.com/index.php?rid=2192066&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F6%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192066 Tue, 17 Feb 2009 05:00:00 +0100 2192066 http://www.medworm.com/index.php?rid=2192065&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F3%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192065 Tue, 17 Feb 2009 05:00:00 +0100 2192065 http://www.medworm.com/index.php?rid=2192064&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F4%2F1%2F1%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=2192064 Tue, 17 Feb 2009 05:00:00 +0100 2192064 http://www.medworm.com/index.php?rid=1985708&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F205%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985708 Mon, 24 Nov 2008 05:00:00 +0100 1985708 http://www.medworm.com/index.php?rid=1985707&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F199%3Frss%3D1 The Nuffield Council on Bioethics examines ethical issues raised by new developments in biology and medicine. Established by the Nuffield Foundation in 1991, the Council is an independent body, funded jointly by the Foundation, the Medical Research Council and the Wellcome Trust. Independence and quality are the underlining principles of the Council, and the way the Council works has been designed to ensure that its reports are thorough, authoritative and provide a novel, policy-oriented approach to difficult ethical dilemmas. Recent reports have considered the issues raised by public health and critical care decisions in fetal and neonatal medicine. The Council is currently considering the ethical dilemmas surrounding dementia. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985707 Mon, 24 Nov 2008 05:00:00 +0100 1985707 http://www.medworm.com/index.php?rid=1985706&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F194%3Frss%3D1 Beauchamp and Childress (1994) elaborated an approach to bioethical deliberations based on four universalistic principles. This framework of ‘principlism’ has been criticized from within biomedical ethics as insufficient and problematic. However, this article considers a more radical sociological critique by John Evans (2002) that rejects the entire approach of defining ‘principles’ a priori. This sociological critique is based on classical sociologist Max Weber's (1925) distinction between instrumental (‘thin’) and substantive (‘thick’) rationality. As an exploratory assessment of Evans' critique, his conceptualization of ‘thin’ versus ‘thick’ rationalization is applied to a large sample of Anglo-American press covera... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985706 Mon, 24 Nov 2008 05:00:00 +0100 1985706 http://www.medworm.com/index.php?rid=1985705&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F189%3Frss%3D1 Selection in reproductive medicine today relies on normative assessments of what ‘good life’ consists of. This paper explores the terms under which such assessments are made by focusing on three particular concepts of ‘quality’: quality of life, biological quality and population quality. It is suggested that the apparently conflicting hypes, hopes and fears that surround reproductive medicine can co-circulate because of the different forms of normative assessment that these concepts allow. To ensure clarity in bioethical deliberations about selection, it is necessary to highlight how these differing forms of assessment are mobilized and invoked in practices of and debates about reproductive medicine. (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985705 Mon, 24 Nov 2008 05:00:00 +0100 1985705 http://www.medworm.com/index.php?rid=1985704&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F185%3Frss%3D1 This paper argues that bioethics requires analysis, which is not explicitly ethical in character. The first part of the paper argues the general point, that ethical problems can arise not only on occasions when moral values make conflicting recommendations, but also in understanding the facts. I suggest that this is particularly so where the facts are provided by the biomedical sciences, since it is often not clear how to relate their conceptual framework to that in which we frame our value judgements. In the second part, I illustrate the argument by criticizing the moral conclusions drawn by the authors of a recent widely publicized study of paediatric obesity. There is a failure to translate properly these results into the language we use for moral evaluation. The case therefore illustra... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985704 Mon, 24 Nov 2008 05:00:00 +0100 1985704 http://www.medworm.com/index.php?rid=1985703&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F180%3Frss%3D1 The aim of this study is to assess patients' recall of their previous research participation. Recall was established during interviews and compared with entries from clinical notes. Participants were 49 patients who had previously participated in different types of research. Of the 49 patients, 45 (92%) interviewees recalled 69 of 109 (63%) study participations. Level of recall varied according to the type of research, some participants clearly recalled the details of research aims, giving consent and research procedures. Others recalled procedures (e.g. DNA testing) but were unclear about their purpose. There was no significant effect of time on recall. Some types of research participation (e.g. DNA testing) may be recalled as clinical care. We argue that such misunderstandings may have t... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985703 Mon, 24 Nov 2008 05:00:00 +0100 1985703 http://www.medworm.com/index.php?rid=1985702&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F176%3Frss%3D1 Developments in biotechnology present difficult social and ethical challenges that need to be resolved by regulators among others. One crucial problem for regulators of new technologies is to ensure that regulation is both clear and sufficiently flexible to respond to new developments. This is particularly difficult to achieve in contentious fields such as medical biotechnology. In the European Union there is a divergence in the solutions to this problem which has lead to different regulatory frameworks for medical biotechnology. This paper compares and contrasts the British and Dutch regulatory frameworks for the selection of embryos by preimplantation genetic diagnosis as an example of the regulation of medical biotechnology. Some of the outcomes of the regulatory choices and possible re... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985702 Mon, 24 Nov 2008 05:00:00 +0100 1985702 http://www.medworm.com/index.php?rid=1985701&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F171%3Frss%3D1 I will consider how we can assess the interests of critically ill children who will survive only while aggressive medical support is continued. If aggressive medical support is withdrawn, the child will die shortly afterwards. This is important because when the courts are asked to decide treatments, the standard is that decisions should be made in the best interests of the child. My claim is that this is not a coherent way to consider how some children in this situation should be treated. I will consider two separate aspects of this problem. First, I will argue that there is no objective best interests test and no immediate prospect that we will be able to develop one. Secondly, I will argue that best interests are not a coherent way to consider the interests of children who will die short... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985701 Mon, 24 Nov 2008 05:00:00 +0100 1985701 http://www.medworm.com/index.php?rid=1985700&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F168%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985700 Mon, 24 Nov 2008 05:00:00 +0100 1985700 http://www.medworm.com/index.php?rid=1985699&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F164%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985699 Mon, 24 Nov 2008 05:00:00 +0100 1985699 http://www.medworm.com/index.php?rid=1985698&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F160%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985698 Mon, 24 Nov 2008 05:00:00 +0100 1985698 http://www.medworm.com/index.php?rid=1985697&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F4%2F159%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1985697 Mon, 24 Nov 2008 05:00:00 +0100 1985697 http://www.medworm.com/index.php?rid=1735240&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F3%2F155%3Frss%3D1 (Source: Clinical Ethics) Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1735240 Mon, 25 Aug 2008 04:00:00 +0100 1735240 http://www.medworm.com/index.php?rid=1735239&cid=s_37241_74_f&fid=37241&url=http%3A%2F%2Fce.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F3%2F3%2F149%3Frss%3D1 This article sets out the key findings from the seminar series ‘Transplantation and organ deficit in the UK: Pragmatic solutions to ethical controversy’ which ran from November 2006 to March 2008, and was sponsored by the Economic and Social Research Council. A broad range of issues were examined in the seminars, including religious and cultural attitudes affecting organ donation, the role of health-care professionals and what could be learned from the experiences of other countries, particularly in the European context. Core participants in the series came from a range of academic and practitioner backgrounds and had different ethical perspectives on issues affecting organ donation and transplantation. Notwithstanding such diversity, the findings set out in the article reflect... Clinical Ethics journals http://www.medworm.com/rss/comments.php?id=1735239 Mon, 25 Aug 2008 04:00:00 +0100 1735239