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Journal of Medical Ethics

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https://www.readbyqxmd.com/read/27903754/trajectories-to-seeking-demedicalised-assistance-in-suicide-a-qualitative-in-depth-interview-study
#1
Martijn Hagens, Bregje D Onwuteaka-Philipsen, H Roeline W Pasman
BACKGROUND: In the Netherlands, people can receive (limited) demedicalised assistance in suicide (DAS)-an option less well known than physician-assisted dying (PAD). AIM: This study explores which trajectories people take to seek DAS, through open-coding and inductive analysis of in-depth interviews with 17 people who receive(d) DAS from counsellors facilitated by foundation De Einder. RESULTS: People sought DAS as a result of current suffering or as a result of anticipating possible prospective suffering...
November 30, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27895084/prescription-preferences-in-antipsychotics-and-attitude-towards-the-pharmaceutical-industry-in-belgium
#2
Stijn Cleymans, Manuel Morrens, Chris Bervoets
OBJECTIVES: The number of antipsychotic prescriptions are increasing rapidly worldwide, a trend which is mainly driven by the steep rise in second-generation antipsychotic (SGA) prescriptions. However, the success of SGA, compared with the older first-generation antipsychotics (FGAs), cannot be explained by evidence. Several studies concluded on equal efficacy of FGA and SGA on positive, negative and cognitive symptoms of schizophrenia. Next to that, the influence of the pharmaceutical industry on prescription behaviour has drawn considerable interest...
November 28, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27888232/parents-perspectives-on-whole-genome-sequencing-for-their-children-qualified-enthusiasm
#3
J A Anderson, M S Meyn, C Shuman, R Zlotnik Shaul, L E Mantella, M J Szego, S Bowdin, N Monfared, R Z Hayeems
OBJECTIVE: To better understand the consequences of returning whole genome sequencing (WGS) results in paediatrics and facilitate its evidence-based clinical implementation, we studied parents' experiences with WGS and their preferences for the return of adult-onset secondary variants (SVs)-medically actionable genomic variants unrelated to their child's current medical condition that predict adult-onset disease. METHODS: We conducted qualitative interviews with parents whose children were undergoing WGS as part of the SickKids Genome Clinic, a research project that studies the impact of clinical WGS on patients, families, and the healthcare system...
November 25, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27879293/living-with-the-animals-animal-or-robotic-companions-for-the-elderly-in-smart-homes
#4
Dirk Preuß, Friederike Legal
Although the use of pet robots in senior living facilities and day-care centres, particularly for individuals suffering from dementia, has been intensively researched, the question of introducing pet robots into domestic settings has been relatively neglected. Ambient assisted living (AAL) offers many interface opportunities for integrating motorised companions. There are diverse medical reasons, as well as arguments from animal ethics, that support the use of pet robots in contrast to living with live animals...
November 22, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27879292/autonomy-age-and-sterilisation-requests
#5
Paddy McQueen
Sterilisation requests made by young, child-free adults are frequently denied by doctors, despite sterilisation being legally available to individuals over the age of 18. A commonly given reason for denied requests is that the patient will later regret their decision. In this paper, I examine whether the possibility of future regret is a good reason for denying a sterilisation request. I argue that it is not and hence that decision-competent adults who have no desire to have children should have their requests approved...
November 22, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27872145/aspects-of-disaster-research-ethics-applicable-to-other-contexts
#6
Bridget Haire
In his article 'The Ebola Clinical Trials: a precedent for research ethics in disasters', Philippe Calain constructs a compelling case as to why and how experiences from the recent Ebola epidemic should be used to develop a framework for disaster research ethics. In particular, Calain proposes a useful model for assessing whether or not an unproven intervention could be suitable for human use in a disaster context, and makes a powerful argument against the separation of patient care from research goals. In this commentary, I argue that the separation of patient care goals from research goals is also unhelpful in the context of other forms of participant disadvantage even when that disadvantage is less severe than an ongoing public health emergency...
November 21, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27856677/withdrawal-of-clinically-assisted-nutrition-and-hydration-decisions-in-patients-with-prolonged-disorders-of-consciousness-best-interests-of-the-patients-and-advance-directives-are-the-keys
#7
https://www.readbyqxmd.com/read/27856676/a-reasonable-objection-commentary-on-further-clarity-on-cooperation-and-morality
#8
Trevor G Stammers
No abstract text is available yet for this article.
November 17, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27852669/second-thoughts-about-second-thoughts
#9
Mark R Wicclair
No abstract text is available yet for this article.
November 15, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27845682/should-violent-offenders-be-forced-to-undergo-neurotechnological-treatment-a-critical-discussion-of-the-freedom-of-thought-objection
#10
Thomas Søbirk Petersen, Kristian Kragh
In this paper we examine one reason for rejecting the view that violent offenders should be forced to undergo neurotechnological treatments (NTs) involving such therapies as psychoactive medication to curb violent behaviour. The reason is based on the concern that forced treatment violates the offender's right to freedom of thought. We argue that this objection can be challenged. First, we present some specifications of what a right to freedom of thought might mean. We focus on the recently published views of Jared Craig, and Jan Cristopher Bublitz and Reinhard Merkel...
November 14, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27836930/the-ethics-of-compromise-third-party-public-health-and-environmental-perspectives
#11
Jonathan H Marks
No abstract text is available yet for this article.
November 11, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27799407/against-the-accommodation-of-subjective-healthcare-provider-beliefs-in-medicine-counteracting-supporters-of-conscientious-objector-accommodation-arguments
#12
Ricardo Smalling, Udo Schuklenk
We respond in this paper to various counter arguments advanced against our stance on conscientious objection accommodation. Contra Maclure and Dumont, we show that it is impossible to develop reliable tests for conscientious objectors' claims with regard to the reasonableness of the ideological basis of their convictions, and, indeed, with regard to whether they actually hold they views they claim to hold. We demonstrate furthermore that, within the Canadian legal context, the refusal to accommodate conscientious objectors would not constitute undue hardship for such objectors...
October 31, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27793978/mere-sincerity
#13
Edward Collins Vacek
No abstract text is available yet for this article.
October 28, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27780889/decision-making-on-behalf-of-people-living-with-dementia-how-do-surrogates-decision-makers-decide
#14
Deirdre Fetherstonhaugh, Linda McAuliffe, Michael Bauer, Chris Shanley
BACKGROUND: For people living with dementia, the capacity to make important decisions about themselves diminishes as their condition advances. As a result, important decisions (affecting lifestyle, medical treatment and end of life) become the responsibility of someone else, as the surrogate decision-maker. This study investigated how surrogate decision-makers make important decisions on behalf of a person living with dementia. METHODS: Semi-structured interviews were conducted with 34 family members who had formally or informally taken on the role of surrogate decision-maker...
October 25, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27777269/randomised-placebo-controlled-trials-of-surgery-ethical-analysis-and-guidelines
#15
Julian Savulescu, Karolina Wartolowska, Andy Carr
Use of a placebo control in surgical trials is a divisive issue. We argue that, in principle, placebo controls for surgery are necessary in the same way as for medicine. However, there are important differences between these types of trial, which both increase justification and limit application of surgical studies. We propose that surgical randomised placebo-controlled trials are ethical if certain conditions are fulfilled: (1) the presence of equipoise, defined as a lack of unbiased evidence for efficacy of an intervention; (2) clinically important research question; (3) the risk to patients is minimised and reasonable; (4) there is uncertainty about treatment allocation rather than deception; (5) there is preliminary evidence for efficacy, which justifies a placebo-controlled design; and (6) ideally, the placebo procedure should have some direct benefit to the patient, for example, as a diagnostic tool...
October 24, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27754861/deciphering-assumptions-about-stepped-wedge-designs-the-case-of-ebola-vaccine-research
#16
Adélaïde Doussau, Christine Grady
Ethical concerns about randomising persons to a no-treatment arm in the context of Ebola epidemic led to consideration of alternative designs. The stepped wedge (SW) design, in which participants or clusters are randomised to receive an intervention at different time points, gained popularity. Common arguments in favour of using this design are (1) when an intervention is likely to do more good than harm, (2) all participants should receive the experimental intervention at some time point during the study and (3) the design might be preferable for practical reasons...
October 17, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27738256/health-incentive-research-and-social-justice-does-the-risk-of-long-term-harms-to-systematically-disadvantaged-groups-bear-consideration
#17
Verina Wild, Bridget Pratt
The ethics of health incentive research-a form of public health research-are not well developed, and concerns of justice have been least examined. In this paper, we explore what potential long term harms in relation to justice may occur as a result of such research and whether they should be considered as part of its ethical evaluation. 'Long term harms' are defined as harms that contribute to existing systematic patterns of disadvantage for groups. Their effects are experienced on a long term basis, persisting even once an incentive research project ends...
October 13, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27738255/feasibility-of-conducting-prospective-observational-research-on-critically-ill-dying-patients-in-the-intensive-care-unit
#18
Amanda van Beinum, Laura Hornby, Sonny Dhanani, Roxanne Ward, Jane Chambers-Evans, Kusum Menon
Studying patients during the end of life is important, as it has the potential to lead to improvements in care for the dying. For patients who die after a controlled withdrawal of life-sustaining therapies in the intensive care unit, information about the natural history of death and the process of removing life support has additionally led to advances in practice for deceased organ donation. However, this unique population of severely critically ill and imminently dying patients has been difficult to study, largely due to assumptions made by research teams and ethics boards alike about the logistical difficulties of obtaining consent and completing research procedures before or during the process of withdrawal of life-sustaining therapies...
October 13, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27738254/social-values-and-the-corruption-argument-against-financial-incentives-for-healthy-behaviour
#19
Rebecca C H Brown
Financial incentives may provide a way of reducing the burden of chronic diseases by motivating people to adopt healthy behaviours. While it is still uncertain how effective such incentives could be for promoting health, some argue that, even if effective, there are ethical objections that preclude their use. One such argument is made by Michael Sandel, who suggests that monetary transactions can have a corrupting effect on the norms and values that ordinarily regulate exchange and behaviour in previously non-monetised contexts...
October 13, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27733439/the-untimely-death-of-the-uk-donation-ethics-committee
#20
David Shaw
This brief report describes the contribution of the UK Donation Ethics Committee to organ donation and transplantation in the UK, and explains why the committee has met an early demise.
October 12, 2016: Journal of Medical Ethics
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