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Journal of Medical Ethics

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https://www.readbyqxmd.com/read/28432196/the-case-against-libertarian-arguments-for-compulsory-vaccination
#1
Justin Bernstein
In a recent paper in this journal, Jason Brennan correctly notes that libertarians struggle to justify a policy of compulsory vaccination. The most straightforward argument that justifies compulsory vaccination is that such a policy promotes welfare. But libertarians cannot make this argument because they claim that the state is justified only in protecting negative rights, not in promoting welfare. I consider two representative libertarian attempts to justify compulsory vaccination, and I argue that such arguments are unsuccessful...
April 21, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28424230/a-quiet-revolution-in-organ-transplant-ethics
#2
Arthur Caplan, Duncan Purves
A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life...
April 19, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28408724/from-protection-to-entitlement-selecting-research-subjects-for-early-phase-clinical-trials-involving-breakthrough-therapies
#3
Nancy S Jecker, Aaron G Wightman, Abby R Rosenberg, Douglas S Diekema
Our goals are to (1) set forth and defend a multiprinciple system for selecting individuals who meet trial eligibility criteria to participate in early phase clinical trials testing chimeric antigen receptor (CAR T-cell) for acute lymphoblastic leukaemia when demand for participation exceeds spaces available in a trial; (2) show the relevance of these selection criteria to other breakthrough experimental therapies; (3) argue that distinct distributive justice criteria apply to breakthrough experimental therapies, standard research and healthcare and (4) argue that as evidence of benefit increases, the emphasis of justice in research shifts from protecting subjects from harm to ensuring fair access to benefits...
April 13, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28396558/vaccine-testing-for-emerging-infections-the-case-for-individual-randomisation
#4
Nir Eyal, Marc Lipsitch
During the 2014-2015 Ebola outbreak in Guinea, Liberia and Sierra Leone, many opposed the use of individually randomised controlled trials to test candidate Ebola vaccines. For a raging fatal disease, they explained, it is unethical to relegate some study participants to control arms. In Zika and future emerging infections, similar opposition may hinder urgent vaccine research, so it is best to address these questions now. This article lays out the ethical case for individually randomised control in testing vaccines against many emerging infections, including lethal infections in low-income countries, even when at no point in the trial do the controls receive the countermeasures being tested...
April 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28389527/patient-autonomy-and-professional-expertise-in-decisions-near-the-end-of-life-commentary-on-francis-kamm
#5
Robert D Truog
No abstract text is available yet for this article.
April 7, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28385733/institutions-as-an-ethical-locus-of-research-prioritisation
#6
Luke Gelinas, Holly Fernandez Lynch, Barbara Bierer, I Glenn Cohen
No abstract text is available yet for this article.
April 6, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28381583/the-sensitivity-argument-against-child-euthanasia
#7
Geoff Keeling
Is there a moral difference between euthanasia for terminally ill adults and euthanasia for terminally ill children? Luc Bovens considers five arguments to this effect, and argues that each is unsuccessful. In this paper, I argue that Bovens' dismissal of the sensitivity argument is unconvincing.
April 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28356492/the-moral-bioenhancement-of-psychopaths
#8
Elvio Baccarini, Luca Malatesti
We argue that the mandatory moral bioenhancement of psychopaths is justified as a prescription of social morality. Moral bioenhancement is legitimate when it is justified on the basis of the reasons of the recipients. Psychopaths expect and prefer that the agents with whom they interact do not have certain psychopathic traits. Particularly, they have reasons to require the moral bioenhancement of psychopaths with whom they must cooperate. By adopting a public reason and a Kantian argument, we conclude that we can justify to a psychopath being the recipient of mandatory moral bioenhancement because he has a reason to require the application of this prescription to other psychopaths...
March 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28356491/should-gratitude-be-a-requirement-for-access-to-live-organ-donation
#9
Monica Escher, Monique Lamuela-Naulin, Catherine Bollondi, Paola Flores Menendez, Samia A Hurst
Gratitude is both expected and problematic in live organ donation. Are there grounds to require it, and to forbid access to live donor transplantation to a recipient who fails to signal that he feels any form of gratitude? Recipient gratitude is not currently required for organ donation, but it is expected and may be a moral requirement. Despite this, we argue that making it a condition for live organ transplantation would be unjustified. It would constitute a problematic and disproportionate punishment for perceived immoral behaviour on the part of the recipient...
March 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28356490/the-deadly-business-of-an-unregulated-global-stem-cell-industry
#10
Tamra Lysaght, Wendy Lipworth, Tereza Hendl, Ian Kerridge, Tsung-Ling Lee, Megan Munsie, Catherine Waldby, Cameron Stewart
In 2016, the Office of the State Coroner of New South Wales released its report into the death of an Australian woman, Sheila Drysdale, who had died from complications of an autologous stem cell procedure at a Sydney clinic. In this report, we argue that Mrs Drysdale's death was avoidable, and it was the result of a pernicious global problem of an industry exploiting regulatory systems to sell unproven and unjustified interventions with stem cells.
March 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28356489/how-shared-is-shared-decision-making-a-care-ethical-view-on-the-role-of-partner-and-family
#11
Inge van Nistelrooij, Merel Visse, Ankana Spekkink, Jasmijn de Lange
The aim of shared decision-making (SDM) is to provide information to patients in order to enable them to decide autonomously and freely about treatment together with the doctor, without interference, force or coercion by others. Relatives may be considered as hindering or impeding a patient's own decision. Qualitative-empirical research into lived experience of SDM of patients with cancer, however, problematises the patient's autonomy when facing terminal illness and the need to make decisions regarding treatment...
March 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28356488/the-opinions-and-experiences-of-irish-obstetric-and-gynaecology-trainee-doctors-in-relation-to-abortion-services-in-ireland
#12
Kara Aitken, Paul Patek, Mark E Murphy
INTRODUCTION: The provision of abortion services in the Republic of Ireland is legally restricted. Recent legislation that has been implemented allows for abortion if there is a real and substantial risk to the woman's life, but in general Irish women must travel abroad for abortion services. The aims of this study were to investigate the clinical experiences of Irish obstetric non-consultant hospital doctors (NCHDs) that work in this environment and to assess their attitudes towards termination of pregnancy (ToP)...
March 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28348164/undue-inducement-a-case-study-in-caprisa-008
#13
Kathryn T Mngadi, Jerome A Singh, Leila E Mansoor, Douglas R Wassenaar
: Participant safety and data integrity, critical in trials of new investigational drugs, are achieved through honest participant report and precision in the conduct of procedures. HIV prevention post-trial access studies in middle-income countries potentially offer participants many benefits including access to proven efficacious but unlicensed technologies, ancillary care that often exceeds local standards-of-care, financial reimbursement for participation and possibly unintended benefits if participants choose to share or sell investigational drugs...
March 27, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28348163/process-factors-facilitating-and-inhibiting-medical-ethics-teaching-in-small-groups
#14
Miriam Ethel Bentwich, Ya'arit Bokek-Cohen
PURPOSE: To examine process factors that either facilitate or inhibit learning medical ethics during case-based learning. METHODS: A qualitative research approach using microanalysis of transcribed videotaped discussions of three consecutive small-group learning (SGL) sessions on medical ethics teaching (MET) for three groups, each with 10 students. RESULTS: This research effort revealed 12 themes of learning strategies, divided into 6 coping and 6 evasive strategies...
March 27, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28348162/why-health-services-research-needs-bioethics
#15
EDITORIAL
Lucy Frith
No abstract text is available yet for this article.
March 27, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28341755/pathogenic-variants-in-the-healthy-elderly-unique-ethical-and-practical-challenges
#16
Paul Lacaze, Joanne Ryan, Robyn Woods, Ingrid Winship, John McNeil
: Genetic research into ageing, longevity and late-onset disease is becoming increasingly common. Yet, there is a paucity of knowledge related to clinical actionability and the return of pathogenic variants to otherwise healthy elderly individuals. Whether or not genetic research in the elderly should be managed differently from standard practices adapted for younger populations has not yet been defined. In this article, we provide an overview of ethical and practical challenges in preparing for a genetic study of over 14 000 healthy Australians aged 70 years or older enrolled in the ASPirin in Reducing Events in the Elderly (ASPREE) Healthy Ageing Biobank...
March 24, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28341756/distress-disease-desire-perspectives-on-the-medicalisation-of-premature-ejaculation
#17
Ylva Söderfeldt, Adam Droppe, Tim Ohnhäuser
The discovery that certain selective serotonin reuptake inhibitors delay ejaculation and the later development and approval of dapoxetine as an on-demand treatment option has led to a dramatic increase in medical interest in premature ejaculation. This paper analyses the diagnostic criteria and the discussion within the medical community about suitable treatments against the backdrop of theories of science, sex and gender. Our conclusion is that the diagnosis itself and the suggested treatments contribute to normative models of sexual conduct and therefore reinforce the norms that cause patients' distress over ejaculating 'too soon'...
March 23, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28331052/cpr-decision-making-why-winspear-needs-to-be-challenged
#18
Rosemarie Anthony-Pillai
This is a personal view about the recent high court decision around cardiopulmonary resuscitation (CPR). This opinion identifies that the judge failed to recognise the statutory role given to clinicians in identifying when a treatment is life sustaining. In failing to recognise the role of the clinician, the ruling in Winspear risks the likelihood of inappropriate CPR attempts.
March 22, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28331051/the-ethics-of-and-the-appropriate-legislation-concerning-killing-people-and-letting-them-die-a-response-to-merkel
#19
Hugh V McLachlan
With regard to ethics and legislation, what is the significant difference between a doctor terminating the life-supporting treatment of a patient in the course of his job and a greedy relative of the patient doing the same thing to inherit his wealth? Merkel offers an interesting and inventive answer to this question in terms of the improper violation of personal boundaries. However, despite Merkel's claim to the contrary, his answer does not directly address the question of the relevant ethical similarities and differences between killing and letting die in general...
March 22, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28325745/aid-in-dying-laws-and-the-physician-s-duty-to-inform
#20
Mara Buchbinder
On 19 July 2016, three medical organisations filed a federal lawsuit against representatives from several Vermont agencies over the Patient Choice and Control at End of Life Act. The law is similar to aid-in-dying (AID) laws in four other US states, but the lawsuit hinges on a distinctive aspect of Vermont's law pertaining to patients' rights to information. The lawsuit raises questions about whether, and under what circumstances, there is an ethical obligation to inform terminally ill patients about AID as an end-of-life option...
March 21, 2017: Journal of Medical Ethics
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