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Ethics briefingsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Chrispin, E, Brannan, S, English, V, Mussell, R, Sheather, J, Sommerville, A Tags: End of life decisions (geriatric medicine), End of life decisions (palliative care), Suicide (psychiatry), Assisted dying, End of life decisions (ethics), Human rights, Suicide (public health) Ethics briefings Source Type: journals

On the ethics of oestrogen treatment for tall girls: an updateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
New empirical evidence on the long-term effects of oestrogen treatment for tall adolescent girls has shown that the intended psychosocial benefit of the treatment may not have been realised. This paper describes recent trends in the prevalence of the treatment and the results of a large Australian cohort study evaluating girls assessed between 1959 and 1993 for excessive growth. The paper concludes that oestrogen treatment to prevent extreme tallness should belong to the past, not to the future. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Louhiala, P Tags: Epidemiologic studies Brief report Source Type: journals

Who should consent for research in adult intensive care? Preferences of patients and their relatives: a pilot studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Patients are willing to decide on their own participation in a study. If they lose their capacity to decide for themselves, in the great majority of cases, they would agree to delegate the decision to a relative. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Chenaud, C, Merlani, P, Verdon, M, Ricou, B Tags: Patients, Adult intensive care, Informed consent, Legal and forensic medicine Papers Source Type: journals

The acceptability among French lay persons of ending the lives of damaged newbornsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Lay persons’ judgements of the acceptability of the not uncommon practice of ending the life of a damaged neonate have not been studied. Methods: A convenience sample of 1635 lay people in France rated how acceptable it would be for a physician to end a neonate’s life—by withholding care, withdrawing care, or active euthanasia—in 54 scenarios in which the neonate was diagnosed either with perinatal asphyxia or a genetic abnormality. The scenarios were all combinations of four factors: three levels of maturity or immaturity, three levels of severity of the health problem, three levels of...
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Teisseyre, N, dos Reis, I D., Sorum, P C, Mullet, E Tags: End of life decisions (geriatric medicine), End of life decisions (palliative care), Assisted dying, End of life decisions (ethics) Papers Source Type: journals

Harmonisation of ethics committees' practice in 10 European countriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Despite the efforts for harmonisation of the European Clinical Trial Directive, from an ethical point of view, there remains a plurality of ethics committees' systems in Europe. It is important to comprehend the individual national systems to understand the problems they are facing. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Hernandez, R, Cooney, M, Duale, C, Galvez, M, Gaynor, S, Kardos, G, Kubiak, C, Mihaylov, S, Pleiner, J, Ruberto, G, Sanz, N, Skoog, M, Souri, P, Stiller, C O, Strenge-Hesse, A, Vas, A, Winter, D, Carne, X Tags: Research and publication ethics Papers Source Type: journals

Solo doctors and ethical isolationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper uses the case of solo doctors to explore whether working in relative isolation from one’s peers may be detrimental to ethical decision-making. Drawing upon the relevance of communication and interaction for ethical decision-making in the ethical theories of Habermas, Mead and Gadamer, it is argued that doctors benefit from ethical discussion with their peers and that solo practice may make this more difficult. The paper identifies a paucity of empirical research related to solo practice and ethics but draws upon more general medical ethics research and a study that identified ethical isolation among commun...
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Cooper, R J Tags: Papers Source Type: journals

Telecare and self-management: opportunity to change the paradigm?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Telecare, the provision of care through remote interaction enabled by information and communication technology, is quickly developing. Integration with other technological developments is to be expected and will create systems that enable more intense, continuous and unobtrusive monitoring of health, and more personalised feedback and instructions. One of the goals of telecare is enhancing the independence and self-management of patients. In this article three degrees of self-management are described and a distinction is made between compliant and concordant forms of self-management. It is argued that telecare merely promo...
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Schermer, M Tags: Papers Source Type: journals

Fallacies in the arguments for new technology: the case of proton therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a seminal article in the Journal of Medical Ethics, Søren Holm and Tuja Takala analysed two protechnology arguments in bioethics: the hopeful principle and the automatic escalator. They showed how these arguments relate to problematic arguments such as the precautionary principle and the empirical slippery slope argument, and argued that they should be used with great caution. The present article investigates the recent debate on proton beam therapy, where the hopeful principle and the automatic escalator are identified. However, the debate reveals a series of other arguments that deserve similar caution. An anal...
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Hofmann, B Tags: Papers Source Type: journals

Should we enhance animals?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Much bioethical discussion has been devoted to the subject of human enhancement through various technological means such as genetic modification. Although many of the same technologies could be, indeed in many cases already have been, applied to non-human animals, there has been very little consideration of the concept of "animal enhancement", at least not in those specific terms. This paper addresses the notion of animal enhancement and the ethical issues surrounding it. A definition of animal enhancement is proposed that provides a framework within which to consider these issues; and it is argued that if human enhancemen...
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Chan, S Tags: Bioethics Papers Source Type: journals

Autonomy at the end of life: life-prolonging treatment in nursing homes--relatives' role in the decision-making processEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The study reveals failing procedures and thus a great potential for improvement. Both ethical and legal aspects must be addressed when considering patient autonomy. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Dreyer, A, Forde, R, Nortvedt, P Tags: End of life decisions (geriatric medicine), End of life decisions (palliative care), End of life decisions (ethics) Papers Source Type: journals

NICE guidelines, clinical practice and antisocial personality disorder: the ethical implications of ontological uncertaintyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The British National Institute for Health and Clinical Excellence (NICE) has recently (28 January 2009) released new guidelines for the diagnosis, treatment and prevention of the psychiatric category antisocial personality disorder (ASPD). Evident in these recommendations is a broader ambiguity regarding the ontology of ASPD. Although, perhaps, a mundane feature of much of medicine, in this case, ontological uncertainty has significant ethical implications as a product of the profound consequences for an individual categorised with this disorder. This paper argues that in refraining from emphasising uncertainty, NICE risks...
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Pickersgill, M D Tags: Psychology and medicine Papers Source Type: journals

Process and consensus: ethical decision-making in the infertility clinic--a qualitative studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, suggestions as to how ethical decision-making processes can be supported and improved in infertility practice will be made. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Frith, L Tags: Papers Source Type: journals

Agency, duties and the "Ashley treatment"Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In 2006, a paper in the journal Archives of Pediatric and Adolescent Medicine described a novel case of growth attenuation therapy and other treatments carried out on Ashley, a severely cognitively, neurologically and physically disabled 6-year-old girl. Some of the moral arguments that have sprung up in respect of the so-called "Ashley treatment" are considered, and it is suggested that they all miss something—that the proper treatment of Ashley may have as much to do with doctors’ duties to themselves as with their duties to her. It is suggested that the Ashley treatment may have been in violation of doctors&...
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Tan, N, Brassington, I Tags: Disability Controversy Source Type: journals

Re-consenting human subjects: ethical, legal and practical issuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Resnik, D B Tags: Commentary Source Type: journals

Eyewitness in Erewhon Academic HospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: de Beaufort, I, Meulenberg, F Tags: Child health, Hospice, Undergraduate, Philosophy of medicine Eyewitness Source Type: journals

The concise argumentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - October 30, 2009 Category: Medical Ethics Authors: Holm, S. Tags: Oncology, Health policy, Clinical diagnostic tests The concise argument Source Type: journals

On how to interpret the role of the future within the abortion debate [Response]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a previous paper, I had argued that Strong’s counterexamples to Marquis’s argument against abortion—according to which terminating fetuses is wrong because it deprives them of a valuable future—fail either because they have no bearing on Marquis’s argument or because they make unacceptable claims about what constitutes a valuable future. In this paper I respond to Strong’s criticism of my argument according to which I fail to acknowledge that Marquis uses "future like ours" and "valuable future" interchangeably. I show that my argument does not rely on not acknowledging that "future l...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Di Nucci, E Tags: Ethics of abortion, Ethics of reproduction, Sex and sexuality Response Source Type: journals

"Personality disorder" and capacity to make treatment decisions [Brief reports]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Whether treatment decision-making capacity can be meaningfully applied to patients with a diagnosis of "personality disorder" is examined. Patients presenting to a psychiatric emergency clinic with threats of self-harm are considered, two having been assessed and reviewed in detail. It was found that capacity can be meaningfully assessed in such patients, although the process is more complex than in patients with diagnoses of a more conventional kind. The process of assessing capacity in such patients is very time-consuming and may become, in itself, a therapeutic intervention. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Szmukler, G Tags: Emergency medicine, Psychology and medicine Brief reports Source Type: journals

Locked inpatient units in modern mental health care: values and practice issues [Brief reports]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Locked inpatient units are an increasing phenomenon, introduced in response to unforseen abscondences and suicides of patients. This paper identifies some value issues concerning the practice of locked psychiatric inpatient units. Broad strategies, practicalities and ethical matters that must be considered in inpatient mental health services are also explored. The authors draw on the published research and commentary to derive relevant information to provide to patients and staff regarding the aims and rationales of locked units. Further debate is warranted in relation to best practice. Inpatient staff need to be aware of ...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Cleary, M, Hunt, G E, Walter, G, Robertson, M Tags: Suicide (psychiatry), Suicide (public health) Brief reports Source Type: journals

Obtaining informed consent: observations from community research with refugee and impoverished youth [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper presents challenges facing researchers in applying basic ethical principles while conducting research with youth in a developing country context. A discussion of the cultural and social challenges to adherence to the elements of informed consent: disclosure, comprehension, capacity, voluntariness and consent is presented. The authors argue that the current institutional review board requirements that guide research reflect values and stem from western contexts that may not be fully applicable to non-western contexts. More dialogue is needed among researchers in developing world contexts on challenges of and poss...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Nakkash, R, Makhoul, J, Afifi, R Tags: Informed consent, Legal and forensic medicine Papers Source Type: journals

Mixed motives, mixed outcomes when accused parents won't agree to withdraw care [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One of the basic tenets of paediatric ethics is that competent parents may render healthcare decisions for children who are too young or too incapacitated to make meaningful medical choices for themselves. In the USA, many jurisdictions have expanded this principle to include the right to terminate a child's life support, including nutrition and hydration, when that child enters a persistent vegetative state. However, this approach to the withdrawal of care in the paediatric setting has been put to the test by an increasing number of cases in which one or both parents are themselves accused of causing the child's life-thre...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Appel, J M Tags: Papers Source Type: journals

Clinical obligations and public health programmes: healthcare provider reasoning about managing the incidental results of newborn screening [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Miller, F A, Hayeems, R Z, Bombard, Y, Little, J, Carroll, J C, Wilson, B, Allanson, J, Paynter, M, Bytautas, J P, Christensen, R, Chakraborty, P Tags: Child health, Screening (epidemiology), Screening (public health) Papers Source Type: journals

The robustness of medical professional ethics when times are changing: a comparative study of general practitioner ethics and surgery ethics in The Netherlands [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Society in the 21st century is in many ways different from society in the 1950s, the 1960s or the 1970s. Two of the most important changes relate to the level of education in the population and the balance between work and private life. These days a large percentage of people are highly educated. Partly as a result of economic progress in the 1950s and the 1960s and partly due to the fact that many women entered the labour force, people started searching for ways to combine their career with family obligations and a private life (including hobbies, outings and holidays). Medical professional ethics, more specifically: prof...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Dwarswaard, J, Hilhorst, M, Trappenburg, M Tags: General practice / family medicine, Research and publication ethics Papers Source Type: journals

Death and organ donation: back to the future [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The practice of transplantation of vital organs from "brain-dead" donors is in a state of theoretical disarray. Although the law and prevailing medical ethics treat patients diagnosed as having irreversible total brain failure as dead, scholars have increasingly challenged the established rationale for regarding these patients as dead. To understand the ethical situation that we now face, it is helpful to revisit the writings of the philosopher Hans Jonas, who forcefully challenged the emerging effort to redefine death in the late 1960s. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Miller, F G Tags: Artificial and donated transplantation Papers Source Type: journals

Smart drugs for cognitive enhancement: ethical and pragmatic considerations in the era of cosmetic neurology [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the ethical and pragmatic implications of nootropic use in academia by drawing parallels with issues relevant to the drugs in sport debate. It is often argued that performance-enhancing drugs should be prohibited because they create an uneven playing field. However, this appears dubious given that "unfair" advantages are already ubiquitous and generally tolerated by society. There are concerns that widespread use will indirectly coerce non-users also to employ nootropics in order to remain competitive. However, to restrict the autonomy of all people for fear that it may influence the actions of some is...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Cakic, V Tags: Psychology and medicine Papers Source Type: journals

All hail the new flesh: some thoughts on scarification, children and adults [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Body art as expressed through non-therapeutic bodily modification is extremely popular, with techniques ranging from the commonplace such as ear piercing to the more esoteric forms such as tongue splitting. Scarification is one such body art practice that is becoming popular as an alternative to tattooing and ear piercing. This paper begins by outlining the regulatory problems that scarification poses. It then goes on to argue that although there is a reasonable case for permitting competent adults to make use of scarification, the practice should not be made available to minors. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Oultram, S Tags: Papers Source Type: journals

Undertreating pain violates ethical principles [Papers]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Disabling pain or symptoms can occur at any age from many different causes. Pain and palliative specialists are able to relieve most pain and symptoms, although repeated adjustments to modalities, medications and doses may be needed. Because pain and palliative specialists comprise only a small percentage of physicians, many patients find it difficult to access them or obtain pain relief. Globally, there are too few such specialists to meet existing needs. Most are affiliated with hospice and palliative units, so their accessibility to patients without terminal conditions is negligible. Doctors outside pain and palliative ...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Macpherson, C Tags: Pain (neurology), Pain (palliative care), Education, medical Papers Source Type: journals

Is it ethical for a general practitioner to claim a conscientious objection when asked to refer for abortion? [Controversies]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abortion is one of the most divisive topics in healthcare. Proponents and opponents hold strong views. Some health workers who oppose abortion assert a right of conscientious objection to it, a position itself that others find unethical. Even if allowance for objection should be made, it is not clear how far it should extend. Can conscientious objection be given as a reason not to refer when a woman requests her doctor to do so? This paper explores the idea of the general practitioner (GP) who declines to make a direct referral for abortion, asking the woman to see another GP instead. The purpose is to defend the claim tha...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Gerrard, J W Tags: General practice / family medicine, Ethics of abortion, Ethics of reproduction, Sex and sexuality Controversies Source Type: journals

Unanswered questions and ethical issues concerning US biodefence research [Controversies]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Unanswered questions and ethical issues associated with US biodefence medical research over the past five decades are discussed. Objective scientific standards are essential for making policy decisions that can stand the test of time. For decades, scholars have reported that the human anthrax vaccine field trials conducted in the 1950s by Brachman and his colleagues were single-blind rather than double-blind. Nevertheless, in March 2005, Dr Philip S Brachman reported in a letter to the US Food and Drug Administration that his study had been double-blind. It is here argued that, rather, the field trial of a human anthrax va...
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Schumm, W R, Nazarinia, R R, Bosch, K R Tags: Clinical trials (epidemiology) Controversies Source Type: journals

Eyewitness in Erewhon Academic Hospital [Eyewitness]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: de Beaufort, I, Meulenberg, F Tags: Research and publication ethics, Philosophy of medicine Eyewitness Source Type: journals

Free riding and organ donation [Editorial]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Glannon, W. Tags: Editorial Source Type: journals

The concise argument [The concise argument]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 30, 2009 Category: Medical Ethics Authors: Chan, S. Tags: Cardiovascular medicine, End of life decisions (geriatric medicine), Child health, End of life decisions (palliative care), Transplantation, Screening (epidemiology), Artificial and donated transplantation, End of life decisions (ethics), Research and pub Source Type: journals

[Response] On how to interpret the role of the future within the abortion debateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a previous paper, I had argued that Strong’s counterexamples to Marquis’s argument against abortion—according to which terminating fetuses is wrong because it deprives them of a valuable future—fail either because they have no bearing on Marquis’s argument or because they make unacceptable claims about what constitutes a valuable future. In this paper I respond to Strong’s criticism of my argument according to which I fail to acknowledge that Marquis uses "future like ours" and "valuable future" interchangeably. I show that my argument does not rely on not acknowledging that "future l...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Di Nucci, E Tags: Ethics of abortion, Ethics of reproduction, Sex and sexuality Response Source Type: journals

[Brief reports] "Personality disorder" and capacity to make treatment decisionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Whether treatment decision-making capacity can be meaningfully applied to patients with a diagnosis of "personality disorder" is examined. Patients presenting to a psychiatric emergency clinic with threats of self-harm are considered, two having been assessed and reviewed in detail. It was found that capacity can be meaningfully assessed in such patients, although the process is more complex than in patients with diagnoses of a more conventional kind. The process of assessing capacity in such patients is very time-consuming and may become, in itself, a therapeutic intervention. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Szmukler, G Tags: Emergency medicine, Psychology and medicine Brief reports Source Type: journals

[Brief reports] Locked inpatient units in modern mental health care: values and practice issuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Locked inpatient units are an increasing phenomenon, introduced in response to unforseen abscondences and suicides of patients. This paper identifies some value issues concerning the practice of locked psychiatric inpatient units. Broad strategies, practicalities and ethical matters that must be considered in inpatient mental health services are also explored. The authors draw on the published research and commentary to derive relevant information to provide to patients and staff regarding the aims and rationales of locked units. Further debate is warranted in relation to best practice. Inpatient staff need to be aware of ...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Cleary, M, Hunt, G E, Walter, G, Robertson, M Tags: Suicide (psychiatry), Suicide (public health) Brief reports Source Type: journals

[Papers] Obtaining informed consent: observations from community research with refugee and impoverished youthEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This paper presents challenges facing researchers in applying basic ethical principles while conducting research with youth in a developing country context. A discussion of the cultural and social challenges to adherence to the elements of informed consent: disclosure, comprehension, capacity, voluntariness and consent is presented. The authors argue that the current institutional review board requirements that guide research reflect values and stem from western contexts that may not be fully applicable to non-western contexts. More dialogue is needed among researchers in developing world contexts on challenges of and poss...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Nakkash, R, Makhoul, J, Afifi, R Tags: Informed consent, Legal and forensic medicine Papers Source Type: journals

[Papers] Mixed motives, mixed outcomes when accused parents won't agree to withdraw careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One of the basic tenets of paediatric ethics is that competent parents may render healthcare decisions for children who are too young or too incapacitated to make meaningful medical choices for themselves. In the USA, many jurisdictions have expanded this principle to include the right to terminate a child's life support, including nutrition and hydration, when that child enters a persistent vegetative state. However, this approach to the withdrawal of care in the paediatric setting has been put to the test by an increasing number of cases in which one or both parents are themselves accused of causing the child's life-thre...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Appel, J M Tags: Papers Source Type: journals

[Papers] Clinical obligations and public health programmes: healthcare provider reasoning about managing the incidental results of newborn screeningEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Miller, F A, Hayeems, R Z, Bombard, Y, Little, J, Carroll, J C, Wilson, B, Allanson, J, Paynter, M, Bytautas, J P, Christensen, R, Chakraborty, P Tags: Child health, Screening (epidemiology), Screening (public health) Papers Source Type: journals

[Papers] The robustness of medical professional ethics when times are changing: a comparative study of general practitioner ethics and surgery ethics in The NetherlandsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Society in the 21st century is in many ways different from society in the 1950s, the 1960s or the 1970s. Two of the most important changes relate to the level of education in the population and the balance between work and private life. These days a large percentage of people are highly educated. Partly as a result of economic progress in the 1950s and the 1960s and partly due to the fact that many women entered the labour force, people started searching for ways to combine their career with family obligations and a private life (including hobbies, outings and holidays). Medical professional ethics, more specifically: prof...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Dwarswaard, J, Hilhorst, M, Trappenburg, M Tags: General practice / family medicine, Research and publication ethics Papers Source Type: journals

[Papers] Death and organ donation: back to the futureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The practice of transplantation of vital organs from "brain-dead" donors is in a state of theoretical disarray. Although the law and prevailing medical ethics treat patients diagnosed as having irreversible total brain failure as dead, scholars have increasingly challenged the established rationale for regarding these patients as dead. To understand the ethical situation that we now face, it is helpful to revisit the writings of the philosopher Hans Jonas, who forcefully challenged the emerging effort to redefine death in the late 1960s. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Miller, F G Tags: Artificial and donated transplantation Papers Source Type: journals

[Papers] Smart drugs for cognitive enhancement: ethical and pragmatic considerations in the era of cosmetic neurologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the ethical and pragmatic implications of nootropic use in academia by drawing parallels with issues relevant to the drugs in sport debate. It is often argued that performance-enhancing drugs should be prohibited because they create an uneven playing field. However, this appears dubious given that "unfair" advantages are already ubiquitous and generally tolerated by society. There are concerns that widespread use will indirectly coerce non-users also to employ nootropics in order to remain competitive. However, to restrict the autonomy of all people for fear that it may influence the actions of some is...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Cakic, V Tags: Psychology and medicine Papers Source Type: journals

[Papers] All hail the new flesh: some thoughts on scarification, children and adultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Body art as expressed through non-therapeutic bodily modification is extremely popular, with techniques ranging from the commonplace such as ear piercing to the more esoteric forms such as tongue splitting. Scarification is one such body art practice that is becoming popular as an alternative to tattooing and ear piercing. This paper begins by outlining the regulatory problems that scarification poses. It then goes on to argue that although there is a reasonable case for permitting competent adults to make use of scarification, the practice should not be made available to minors. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Oultram, S Tags: Papers Source Type: journals

[Papers] Undertreating pain violates ethical principlesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Disabling pain or symptoms can occur at any age from many different causes. Pain and palliative specialists are able to relieve most pain and symptoms, although repeated adjustments to modalities, medications and doses may be needed. Because pain and palliative specialists comprise only a small percentage of physicians, many patients find it difficult to access them or obtain pain relief. Globally, there are too few such specialists to meet existing needs. Most are affiliated with hospice and palliative units, so their accessibility to patients without terminal conditions is negligible. Doctors outside pain and palliative ...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Macpherson, C Tags: Pain (neurology), Pain (palliative care), Education, medical Papers Source Type: journals

[Controversies] Is it ethical for a general practitioner to claim a conscientious objection when asked to refer for abortion?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abortion is one of the most divisive topics in healthcare. Proponents and opponents hold strong views. Some health workers who oppose abortion assert a right of conscientious objection to it, a position itself that others find unethical. Even if allowance for objection should be made, it is not clear how far it should extend. Can conscientious objection be given as a reason not to refer when a woman requests her doctor to do so? This paper explores the idea of the general practitioner (GP) who declines to make a direct referral for abortion, asking the woman to see another GP instead. The purpose is to defend the claim tha...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Gerrard, J W Tags: General practice / family medicine, Ethics of abortion, Ethics of reproduction, Sex and sexuality Controversies Source Type: journals

[Controversies] Unanswered questions and ethical issues concerning US biodefence researchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Unanswered questions and ethical issues associated with US biodefence medical research over the past five decades are discussed. Objective scientific standards are essential for making policy decisions that can stand the test of time. For decades, scholars have reported that the human anthrax vaccine field trials conducted in the 1950s by Brachman and his colleagues were single-blind rather than double-blind. Nevertheless, in March 2005, Dr Philip S Brachman reported in a letter to the US Food and Drug Administration that his study had been double-blind. It is here argued that, rather, the field trial of a human anthrax va...
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Schumm, W R, Nazarinia, R R, Bosch, K R Tags: Clinical trials (epidemiology) Controversies Source Type: journals

[Eyewitness] Eyewitness in Erewhon Academic HospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: de Beaufort, I, Meulenberg, F Tags: Research and publication ethics, Philosophy of medicine Eyewitness Source Type: journals

[Editorial] Free riding and organ donationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Glannon, W. Tags: Editorial Source Type: journals

[The concise argument] The concise argumentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - September 29, 2009 Category: Medical Ethics Authors: Chan, S. Tags: Cardiovascular medicine, End of life decisions (geriatric medicine), Child health, End of life decisions (palliative care), Transplantation, Screening (epidemiology), Artificial and donated transplantation, End of life decisions (ethics), Research and pub Source Type: journals

[Ethics briefings] Ethics briefingsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - August 27, 2009 Category: Medical Ethics Authors: Brannan, S, English, V, Mussell, R, Sheather, J, Sommerville, A, Chrispin, E Tags: Cardiovascular medicine, Genetic screening / counselling, Artificial and donated transplantation Ethics briefings Source Type: journals

[Brief report] Medical professionalism in the age of online social networkingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The rapid emergence and exploding usage of online social networking forums, which are frequented by millions, present clinicians with new ethical and professional challenges. Particularly among a younger generation of physicians and patients, the use of online social networking forums has become widespread. In this article, we discuss ethical challenges facing the patient–doctor relationship as a result of the growing use of online social networking forums. We draw upon one heavily used and highly trafficked forum, Facebook, to illustrate the elements of these online environments and the ethical challenges peculiar t...
Source: Journal of Medical Ethics - August 27, 2009 Category: Medical Ethics Authors: Guseh, J S, Brendel, R W, Brendel, D H Tags: Brief report Source Type: journals