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Journal of Medical Ethics

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https://www.readbyqxmd.com/read/29784732/duty-to-provide-care-to-ebola-patients-the-perspectives-of-guinean-lay-people-and-healthcare-providers
#1
Lonzozou Kpanake, Tamba Kallas Tonguino, Paul Clay Sorum, Etienne Mullet
AIM: To examine the views of Guinean lay people and healthcare providers (HCPs) regarding the acceptability of HCPs' refusal to provide care to Ebola patients. METHOD: From October to December 2015, lay people (n=252) and HCPs (n=220) in Conakry, Guinea, were presented with 54 sample case scenarios depicting a HCP who refuses to provide care to Ebola patients and were instructed to rate the extent to which this HCP's decision is morally acceptable. The scenarios were composed by systematically varying the levels of four factors: (1) the risk of getting infected, (2) the HCP's working conditions, (3) the HCP's family responsibilities and (4) the HCP's professional status...
May 21, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29776978/ethical-arguments-for-access-to-abortion-services-in-the-republic-of-ireland-recent-developments-in-the-public-discourse
#2
Joan McCarthy, Katherine O'Donnell, Louise Campbell, Dolores Dooley
The Republic of Ireland has some of the most restrictive abortion legislation in the world which grants to the 'unborn' an equal right to life to that of the pregnant woman. This article outlines recent developments in the public discourse on abortion in Ireland and explains the particular cultural and religious context that informs the ethical case for access to abortion services. Our perspective rests on respect for two very familiar moral principles - autonomy and justice - which are at the centre of social and democratic societies around the world...
May 18, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29776977/approaches-to-parental-demand-for-non-established-medical-treatment-reflections-on-the-charlie-gard-case
#3
John J Paris, Brian M Cummings, Michael P Moreland, Jason N Batten
No abstract text is available yet for this article.
May 18, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29773611/charlie-gard-and-the-weight-of-parental-rights-to-seek-experimental-treatment
#4
Giles Birchley
The case of Charlie Gard, an infant with a genetic illness whose parents sought experimental treatment in the USA, brought important debates about the moral status of parents and children to the public eye. After setting out the facts of the case, this article considers some of these debates through the lens of parental rights. Parental rights are most commonly based on the promotion of a child's welfare; however, in Charlie's case, promotion of Charlie's welfare cannot explain every fact of the case. Indeed, some seem most logically to extend from intrinsic parental rights, that is, parental rights that exist independent of welfare promotion...
May 17, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29773610/nhs-constitution-values-for-values-based-recruitment-a-virtue-ethics-perspective
#5
Johanna Elise Groothuizen, Alison Callwood, Ann Gallagher
Values-based recruitment is used in England to select healthcare staff, trainees and students on the basis that their values align with those stated in the Constitution of the UK National Health Service (NHS). However, it is unclear whether the extensive body of existing literature within the field of moral philosophy was taken into account when developing these values. Although most values have a long historical tradition, a tendency to assume that they have just been invented, and to approach them uncritically, exists within the healthcare sector...
May 17, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29764983/is-there-a-nocebo-response-that-results-from-disease-awareness-campaigns-and-advertising-in-australia-and-can-this-effect-be-mitigated
#6
Stuart Benson, David Hunter
Direct-to-consumer advertising is banned in Australia, and instead pharmaceutical companies use disease awareness campaigns as a strategy to raise public awareness of conditions for which the company produces a treatment. This practice has been justified by promoting individual autonomy and public health, but it has attracted criticism regarding medicalisation of normal health and ageing, and exaggeration of the severity of the condition in question, imbalanced reporting of risks and benefits, and damaging the patient-clinician relationship...
May 15, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29728452/ethical-implications-of-medical-crowdfunding-the-case-of-charlie-gard
#7
Gabrielle Dressler, Sarah A Kelly
Patients are increasingly turning to medical crowdfunding as a way to cover their healthcare costs. In the case of Charlie Gard, an infant born with encephalomyopathic mitochondrial DNA depletion syndrome, crowdfunding was used to finance experimental nucleoside therapy. Although this treatment was not provided in the end, we will argue that the success of the Gard family's crowdfunding campaign reveals a number of potential ethical concerns. First, this case shows that crowdfunding can change the way in which communal healthcare resources are allocated...
May 4, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29724811/charlie-gard-in-defence-of-the-law
#8
Eliana Close, Lindy Willmott, Benjamin P White
Much of the commentary in the wake of the Charlie Gard litigation was aimed at apparent shortcomings of the law. These include concerns about the perceived inability of the law to consider resourcing issues, the vagueness of the best interests test and the delays and costs of having disputes about potentially life-sustaining medical treatment resolved by the courts. These concerns are perennial ones that arise in response to difficult cases. Despite their persistence, we argue that many of these criticisms are unfounded...
May 3, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29724810/voices-of-moral-authority-parents-doctors-and-what-will-actually-help
#9
Richard David William Hain
The public often believes that parents have a right to make medical decisions about their child. The idea that, in respect of children, doctors should do what parents tell them to do is problematic on the face of it. The effect of such a claim would be that a doctor who acted deliberately to harm a child would be making a morally correct decision, providing only that it is what the child's parents said they wanted. That is so obviously nonsense that it cannot be what people who claim it actually mean. In this paper, I suggest that the claim actually represents either or both of two misunderstandings...
May 3, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29724809/a-threshold-of-significant-harm-f-or-a-viable-alternative-therapeutic-option
#10
Jo Bridgeman
This article critically examines the legal arguments presented on behalf of Charlie Gard's parents, Connie Yates and Chris Gard, based on a threshold test of significant harm for intervention into the decisions made jointly by holders of parental responsibility. It argues that the legal basis of the argument, from the case of Ashya King, was tenuous. It sought to introduce different categories of cases concerning children's medical treatment when, despite the inevitable factual distinctions between individual cases, the duty of the judge in all cases to determine the best interests of the child is firmly established by the case law...
May 3, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29724808/why-charlie-gard-s-parents-should-have-been-the-decision-makers-about-their-son-s-best-interests
#11
Raanan Gillon
This paper argues that Charlie Gard's parents should have been the decision-makers about their son's best interests and that determination of Charlie's best interests depended on a moral decision about which horn of a profound moral dilemma to choose. Charlie's parents chose one horn of that moral dilemma and the courts, like Charlie Gard's doctors, chose the other horn. Contrary to the first UK court's assertion, supported by all the higher courts that considered it, that its judgement was 'objective', this paper argues that the judgement was not and could not be 'objective' in the sense of objectively correct but was instead a value judgement based on the judge's choice of one horn of the moral dilemma...
May 3, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29720489/ensuring-respect-for-persons-in-compass-a-cluster-randomised-pragmatic-clinical-trial
#12
Joseph E Andrews, J Brian Moore, Richard B Weinberg, Mysha Sissine, Sabina Gesell, Jacquie Halladay, Wayne Rosamond, Cheryl Bushnell, Sara Jones, Paula Means, Nancy M P King, Diana Omoyeni, Pamela W Duncan
Cluster randomised clinical trials present unique challenges in meeting ethical obligations to those who are treated at a randomised site. Obtaining informed consent for research within the context of clinical care is one such challenge. In order to solve this problem it is important that an informed consent process be effective and efficient, and that it does not impede the research or the healthcare. The innovative approach to informed consent employed in the COMPASS study demonstrates the feasibility of upholding ethical standards without imposing undue burden on clinical workflows, staff members or patients who may participate in the research by virtue of their presence in a cluster randomised facility...
May 2, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29703860/thinking-clearly-about-the-first-trial-addressing-ethical-challenges-in-cluster-randomised-trials-of-policy-interventions-involving-health-providers
#13
Austin R Horn, Charles Weijer, Spencer Phillips Hey, Jamie Brehaut, Dean A Fergusson, Cory E Goldstein, Jeremy Grimshaw, Monica Taljaard
The ethics of the Flexibility In duty hour Requirements for Surgical Trainees (FIRST) trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trials (CRTs) of policy interventions involving healthcare professionals. In what follows, we have three objectives. First, we critically review the FIRST trial controversy, finding that commentators have failed to sufficiently identify and address many of the relevant ethical issues...
April 27, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29695408/ethics-of-routine-a-critical-analysis-of-the-concept-of-routinisation-in-prenatal-screening
#14
Adriana Kater-Kuipers, Inez D de Beaufort, Robert-Jan H Galjaard, Eline M Bunnik
In the debate surrounding the introduction of non-invasive prenatal testing (NIPT) in prenatal screening programmes, the concept of routinisation is often used to refer to concerns and potential negative consequences of the test. A literature analysis shows that routinisation has many different meanings, which can be distinguished in three major versions of the concept. Each of these versions comprises several inter-related fears and concerns regarding prenatal screening and particularly regarding NIPT in three areas: (1) informed choice, (2) freedom to choose and (3) consequences for people with a disability...
April 25, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29695407/healthcare-professionals-understanding-of-the-legislation-governing-research-involving-adults-lacking-mental-capacity-in-england-and-wales-a-national-survey
#15
Victoria Shepherd, Richard Griffith, Mark Sheehan, Fiona Wood, Kerenza Hood
OBJECTIVE: To examine health and social care professionals' understanding of the legislation governing research involving adults lacking mental capacity in England and Wales. METHODS: A cross-sectional online survey was conducted using a series of vignettes. Participants were asked to select the legally authorised decision-maker in each scenario and provide supporting reasons. Responses were compared with existing legal frameworks and analysed according to their level of concordance...
April 25, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29680805/examining-the-use-of-natural-in-breastfeeding-promotion-ethical-and-practical-concerns
#16
Jessica Martucci, Anne Barnhill
References to the 'natural' are common in public health messaging about breastfeeding. For example, the WHO writes that 'Breast milk is the natural first food for babies' and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called 'It's only natural', which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of 'natural' language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as 'natural' is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts...
April 21, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29669789/at-odds-with-the-truth
#17
William Simkulet
No abstract text is available yet for this article.
April 18, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29650760/so-not-mothers-responsibility-for-surrogate-orphans
#18
Jennifer A Parks, Timothy F Murphy
The law ordinarily recognises the woman who gives birth as the mother of a child, but in certain jurisdictions, it will recognise the commissioning couple as the legal parents of a child born to a commercial surrogate. Some commissioning parents have, however, effectively abandoned the children they commission, and in such cases, commercial surrogates may find themselves facing unexpected maternal responsibility for children they had fully intended to give up. Any assumption that commercial surrogates ought to assume maternal responsibility for abandoned children runs contrary to the moral suppositions that typically govern contract surrogacy, in particular, assumptions that gestational carriers are not 'mothers' in any morally significant sense...
April 12, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29602896/newborn-health-benefits-or-financial-risk-protection-an-ethical-analysis-of-a-real-life-dilemma-in-a-setting-without-universal-health-coverage
#19
Kristine Hus√ły Onarheim, Ole Frithjof Norheim, Ingrid Miljeteig
INTRODUCTION: High healthcare costs make illness precarious for both patients and their families' economic situation. Despite the recent focus on the interconnection between health and financial risk at the systemic level, the ethical conflict between concerns for potential health benefits and financial risk protection at the household level in a low-income setting is less understood. METHODS: Using a seven-step ethical analysis, we examine a real-life dilemma faced by families and health workers at the micro level in Ethiopia and analyse the acceptability of limiting treatment for an ill newborn to protect against financial risk...
March 30, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29599415/the-ethics-committee-job-is-administrative-a-response-to-commentaries
#20
Andrew John Moore
No abstract text is available yet for this article.
March 29, 2018: Journal of Medical Ethics
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