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Journal of Medical Ethics

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https://www.readbyqxmd.com/read/28821579/yours-mine-or-ours-cautions-about-lrt
#1
EDITORIAL
Wendy Elizabeth Bonython, Bruce Baer Arnold
No abstract text is available yet for this article.
August 18, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28821578/nobody-s-dna-but-mine
#2
EDITORIAL
Michele Loi
No abstract text is available yet for this article.
August 18, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28821577/ethical-behaviour-of-physicians-and-psychologists-similarities-and-differences
#3
Michall Ferencz Kaddari, Meni Koslowsky, Michael A Weingarten
OBJECTIVE: To compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas. POPULATION: 88 clinical psychologists and 149 family physicians in Israel. METHOD: Six dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical...
August 18, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28814441/left-of-bang-interventions-in-trauma-ethical-implications-for-military-medical-prophylaxis
#4
Neil Eisenstein, David Naumann, Daniel Burns, Sarah Stapley, Heather Draper
Advances in medical capability should be accompanied by discussion of their ethical implications. In the military medical context there is a growing interest in developing prophylactic interventions that will mitigate the effects of trauma and improve survival. The ethics of this novel capability are currently unexplored. This paper describes the concept of trauma prophylaxis (Left Of Bang Interventions in Trauma) and outlines some of the ethical issues that need to be considered, including within concept development, research and implementation...
August 16, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28801312/bioethics-and-multiculturalism-nuancing-the-discussion
#5
Chris Durante
In his recent analysis of multiculturalism, Tom Beauchamp has argued that those who implement multicultural reasoning in their arguments against common morality theories, such as his own, have failed to understand that multiculturalism is neither a form of moral pluralism nor ethical relativism but is rather a universalistic moral theory in its own right. Beauchamp's position is indeed on the right track in that multiculturalists do not consider themselves ethical relativists. Yet, Beauchamp tends to miss the mark when he argues that multiculturalism is in effect a school of thought that endorses a form of moral universalism that is akin to his own vision of a common morality...
August 11, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28801311/ethical-issues-when-modelling-brain-disorders-in-non-human-primates
#6
Carolyn P Neuhaus
Non-human animal models of human diseases advance our knowledge of the genetic underpinnings of disease and lead to the development of novel therapies for humans. While mice are the most common model organisms, their usefulness is limited. Larger animals may provide more accurate and valuable disease models, but it has, until recently, been challenging to create large animal disease models. Genome editors, such as Clustered Randomised Interspersed Palindromic Repeat (CRISPR), meet some of these challenges and bring routine genome engineering of larger animals and non-human primates (NHPs) well within reach...
August 11, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28798225/ethical-issues-in-alzheimer-s-disease-research-involving-human-subjects
#7
Dena S Davis
As we aggressively pursue research to cure and prevent Alzheimer's disease, we encounter important ethical challenges. None of these challenges, if handled thoughtfully, would pose insurmountable barriers to research. But if they are ignored, they could slow the research process, alienate potential study subjects and do damage to research recruits and others. These challenges are (1) the necessity of very large cohorts of research subjects, recruited for lengthy studies, probably ending only in the subjects' death; (2) the creation of cohorts of 'study ready' volunteers, many of whom will be competent to consent at the beginning of the process, but move into cognitive impairment later; (3) reliance on adaptive trial design, creating challenges for informed consent, equipoise and justice; (4) the use of biomarkers and predictive tests that describe risk rather than certainty, and that can threaten participants' welfare if the information is obtained by insurance companies or long-term care providers; (5) the use of study partners that creates unique risks of harm to the relationship of subject and study partner...
August 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28794241/promoting-the-freedom-of-thought-of-mental-health-service-users-nussbaum-s-capabilities-approach-meets-values-based-practice
#8
Mari Stenlund
This article clarifies how the freedom of thought as a human right can be understood and promoted as a right of mental health service users, especially people with psychotic disorder, by using Martha Nussbaum's capabilities approach and Fulford's and Fulford et al's values-based practice. According to Nussbaum, freedom of thought seems to primarily protect the capability to think, believe and feel. This capability can be promoted in the context of mental health services by values-based practice. The article points out that both Nussbaum's approach and values-based practice recognise that people's values differ...
August 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28794240/empirical-evidence-against-placebo-controls
#9
Sadhvi Batra, Jeremy Howick
The revised Declaration of Helsinki allows placebo-controlled trials to be used even when there is an established therapy, provided there are adequate 'methodological' reasons for doing so. This seems to violate the principle of beneficence: where there is an established therapy, physicians treating patients with a placebo are withholding a known effective therapy. Because of this problem, we hypothesised that clinical researchers may be unwilling to risk violating the principle of beneficence and employ placebo-controlled trials in cases where there is an established therapy...
August 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28794239/cursed-lamp-the-problem-of-spontaneous-abortion
#10
William Simkulet
Many people believe human fetuses have the same moral status as adult human persons, that it is wrong to allow harm to befall things with this moral status, and thus voluntary, induced abortion is seriously morally wrong. Recently, many prochoice theorists have argued that this antiabortion stance is inconsistent; approximately 60% of human fetuses die from spontaneous abortion, far more than die from induced abortion, so if antiabortion theorists really believe that human fetuses have significant moral status, they have strong moral obligations to oppose spontaneous abortion...
August 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28794238/paternalism-reasonableness-and-neutrality-a-response-to-commentators
#11
Frances Kamm
No abstract text is available yet for this article.
August 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28794237/prolonged-immigration-detention-complicity-and-boycotts
#12
Melanie Jansen, Alanna Sue Tin, David Isaacs
Australia's punitive policy towards people seeking asylum deliberately causes severe psychological harm and meets recognised definitions of torture. Consequently, there is a tension between doctors' obligation not to be complicit in torture and doctors' obligation to provide best possible care to their patients, including those seeking asylum. In this paper, we explore the nature of complicity and discuss the arguments for and against a proposed call for doctors to boycott working in immigration detention. We conclude that a degree of complicity is unavoidable when working in immigration detention, but that it may be ethically justifiable...
August 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28794236/what-has-philosophy-got-to-do-it-conflicting-views-and-values-in-end-of-life-care
#13
EDITORIAL
Dominic Wilkinson
No abstract text is available yet for this article.
August 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28780528/informed-consent-in-cluster-randomised-trials-new-and-common-ethical-challenges
#14
Sapfo Lignou
Cluster randomised trials are an increasingly important methodological tool in health research but they present challenges to the informed consent requirement. In the relatively limited literature on the ethics of cluster research there is not much clarity about the reasons for which seeking informed consent in cluster randomised trials may be morally challenging. In this paper, I distinguish between the cases where informed consent in cluster trials may be problematic due to the distinct features of 'population-based' interventions, which have not been adequately discussed in the research ethics literature, and the cases where informed consent may be problematic for reasons that investigators also encounter in other research designs...
August 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28780527/assessment-of-orientation-practices-for-ethics-consultation-at-harvard-medical-school-affiliated-hospitals
#15
Danish Zaidi, Jennifer C Kesselheim
BACKGROUND: Few studies have been conducted to assess the quality of orientation practices for ethics advisory committees that conduct ethics consultation. This survey study focused on several Harvard teaching hospitals, exploring orientation quality and committee members' self-evaluation in the American Society of Bioethics and Humanities (ASBH) ethics consultation competencies. METHODS: We conducted a survey study that involved 116 members and 16 chairs of ethics advisory committees, respectively (52% and 62...
August 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28780526/voluntary-sterilisation-and-access-to-ivf-in-qu%C3%A3-bec
#16
Katharine Browne
Bill 20, An Act to Enact the Act to promote access to family medicine and specialized medicine services and to amend various legislative provisions relating to assisted procreation, was introduced to reduce costs associated with Québec's healthcare in general and in vitro fertilisation (IVF) in particular. Passed in November 2015, the new law introduces a number of exclusion criteria for access to and funding for IVF treatment. Remarkably, one exclusion criterion-prior voluntary sterilisation-has prompted little critical commentary...
August 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28780525/medical-students-perceptions-of-professional-misconduct-relationship-with-typology-and-year-of-programme
#17
Juliana Zulkifli, Brad Noel, Deirdre Bennett, Siun O'Flynn, Colm O'Tuathaigh
AIM: To examine the contribution of programme year and demographic factors to medical students' perceptions of evidence-based classification categories of professional misconduct. METHODS: Students at an Irish medical school were administered a cross-sectional survey comprising 31 vignettes of professional misconduct, which mapped onto a 12-category classification system. Students scored each item using a 5-point Likert scale, where 1 represents the least severe form of misconduct and 5 the most severe...
August 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28780524/the-rise-of-reimbursement-based-medicine-the-case-of-bone-metastasis-radiation-treatment
#18
Marcos Santos, Jan Helge Solbakk, Volnei Garrafa
It has been hypothesised that the reimbursement system pertaining to radiotherapy is influencing prescription practices for patients with cancer with bone metastases. In this paper, we present and discuss the results of an empirical study that was undertaken on patient records, referred to radiotherapy for the treatment of bone metastases, in a medium-size city, in southern Brazil, during the period of March 2006 to March 2014. Our findings seem to confirm this hypothesis: after a change in the reimbursement method, radiation prescriptions were adapted accordingly, in order to maximise profits...
August 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28780523/the-uk-mental-capacity-act-and-consent-to-research-participation-asking-the-right-question
#19
Paul Willner
This paper considers the meaning of the term 'intrusive research', as used in the UK Mental Capacity Act 2005 (MCA), in relation to studies in which an informant is asked to provide information about or on behalf of a person who lacks capacity to consent, and who is not otherwise involved in the study. The MCA defines 'intrusive research' as research that would legally require consent if it involved people with capacity. The relevant ethical principles are that consent should be sought from people who would be affected by a piece of research and that this requirement should be implemented proportionately...
August 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28774959/what-is-the-ethics-of-ageing
#20
Christopher Simon Wareham
Applied ethics is home to numerous productive subfields such as procreative ethics, intergenerational ethics and environmental ethics. By contrast, there is far less ethical work on ageing, and there is no boundary work that attempts to set the scope for 'ageing ethics' or the 'ethics of ageing'. Yet ageing is a fundamental aspect of life; arguably even more fundamental and ubiquitous than procreation. To remedy this situation, I examine conceptions of what the ethics of ageing might mean and argue that these conceptions fail to capture the requirements of the desired subfield...
August 3, 2017: Journal of Medical Ethics
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