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Journal of Medical Ethics

Stephen David John
No abstract text is available yet for this article.
July 14, 2018: Journal of Medical Ethics
G Owen Schaefer
Mitochondrial replacement therapy (MRT) requires oocytes of women whose mitochondrial DNA will be transmitted to resultant children. These techniques are scientifically, ethically and socially controversial; it is likely that some women who donate their oocytes for general in vitro fertilisation usage would nevertheless oppose their genetic material being used in MRT. The possibility of oocytes being used in MRT is therefore relevant to oocyte donation and should be included in the consent process when applicable...
July 12, 2018: Journal of Medical Ethics
Nasrul Ismail, Nick de Viggiani
BACKGROUND: The principle of equivalence in prison health has been established for nearly four decades. It seeks to ensure that prisoners have access to the same level of healthcare as members of society at large, which is entrenched within the international legal framework and England's national health policies. AIMS: This study examined how key policymakers interpret and implement the principle of equivalence in English prisons. It also identified opportunities and threats associated with the application of the principle...
July 12, 2018: Journal of Medical Ethics
George Gillett
As the prevalence of dementia increases across the Western world, there is a growing interest in advance care planning, by which patients may make decisions on behalf of their future selves. Under which ethical principles is this practice justified? I assess the justification for advance care planning put forward by the philosopher Ronald Dworkin, which he rationalises through an integrity-based conception of autonomy. I suggest his judgement is misguided by arguing in favour of two claims. First, that patients with dementia qualify for some right to contemporary autonomy conceptualised under the 'sense of liberty' it provides...
July 9, 2018: Journal of Medical Ethics
Arthur L Caplan, J Russell Teagarden, Lisa Kearns, Alison S Bateman-House, Edith Mitchell, Thalia Arawi, Ross Upshur, Ilina Singh, Joanna Rozynska, Valerie Cwik, Sharon L Gardner
Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or 'preapproval', access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients' best interests in mind...
July 7, 2018: Journal of Medical Ethics
Quinn Grundy, Katrina Hutchison, Jane Johnson, Brette Blakely, Robyn Clay-Wlliams, Bernadette Richards, Wendy A Rogers
Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be available to health professionals 24 hours a day, 7 days a week, to provide advice...
July 4, 2018: Journal of Medical Ethics
Lainie F Ross, J Richard Thistlethwaite
Both living donor transplantation and human subjects research expose one set of individuals to clinical risks for the clinical benefits of others. In the Belmont Report, the National Commission for the Protection of Human Subjects of Biomedical and Behavior Research (National Commission) articulated three principles to serve as the basis for a research ethics framework: respect for persons, beneficence and justice. In contrast, living donor transplantation lacks a framework. In this manuscript, we adapt the three principles articulated in the Belmont Report to serve as the foundation for an ethics framework for living donor transplantation which we supplement with the principles of vulnerability and responsibility...
July 4, 2018: Journal of Medical Ethics
Michelle Rydon-Grange
Compassionate care is a foundation of the National Health Service (NHS). However, several high-profile inquiries into healthcare failures in the NHS suggest compassion is often absent in our hospitals. Ensuing policies mandate healthcare professionals to 'show more compassion' but, as the psychological evidence-base indicates, this instruction neglects the complexity of this social emotion. This paper applies the psychological research on compassion to modern healthcare settings with the aim of creating a better understanding of the pathways leading to uncompassionate care...
June 29, 2018: Journal of Medical Ethics
Andrea Lavazza, Marcello Massimini
No abstract text is available yet for this article.
June 28, 2018: Journal of Medical Ethics
Shahla Siddiqui, Voo Teck Chuan
This paper will discuss why and how social network sites ought to be used in surrogate decision making (SDM), with focus on a context like Singapore in which substituted judgment is incorporated as part of best interest assessment for SDM, as guided by the Code of Practice for making decisions for those lacking mental capacity under the Mental Capacity Act (2008). Specifically, the paper will argue that the Code of Practice already supports an ethical obligation, as part of a patient-centred care approach, to look for and appraise social network site (SNS) as a source of information for best interest decision making...
June 28, 2018: Journal of Medical Ethics
Keren Ladin, Joanna Emerson, Zeeshan Butt, Elisa J Gordon, Douglas W Hanto, Jennifer Perloff, Norman Daniels, Tara A Lavelle
BACKGROUND: National guidelines require programmes use subjective assessments of social support when determining transplant suitability, despite limited evidence linking it to outcomes. We examined how transplant providers weigh the importance of social support for kidney transplantation compared with other factors, and variation by clinical role and personal beliefs. METHODS: The National survey of the American Society of Transplant Surgeons and the Society of Transplant Social Work in 2016...
June 28, 2018: Journal of Medical Ethics
Mark Sheehan, Michael Dunn, Kate Sahan
In this response, we first tackle what we take to be the core disagreement between ourselves and Hammersley, namely the justification for our model of social research ethics governance. We then consider what follows from our defence of governance for ethics review and show how these claims attend to the specific concerns outlined by Hammersley.
June 26, 2018: Journal of Medical Ethics
Phoebe Friesen, Charlotte Blease
While a significant body of bioethical literature considers how the placebo effect might introduce a conflict between autonomy and beneficence, the link between justice and the placebo effect has been neglected. Here, we bring together disparate evidence from the field of placebo studies and research on health inequalities related to race and ethnicity, and argue that, collectively, this evidence may provide the basis for an unacknowledged route by which health disparities are exacerbated. This route is constituted by an uneven distribution of placebo effects, resulting from differences in expressions of physician warmth and empathy, as well as support and patient engagement, across racial and ethnic lines...
June 23, 2018: Journal of Medical Ethics
Rahime Aydın Er, Aysel İncedere, Selda Öztürk
OBJECTIVE: Dignified care protects the patient's rights and provides appropriate ethical care while improving the quality of nursing care. In this context, the opinions of nurses and patients who receive nursing care about dignified care are important. The aim of this study was to explore the opinions and experiences of Turkish patients and nurses about respectful care of human dignity. METHODS: This descriptive cross-sectional study was conducted in Turkey. Participants were inpatients at cardiology, neurology and neurosurgery clinics and nurses working in these clinics...
June 20, 2018: Journal of Medical Ethics
Thomas Ploug
This article reinvigorates a key question in publication ethics: Is there research that it is permissible to conduct but that ought not to be published? The article raises the question in relation to two recent medical studies. It is argued (1) that the publication of these studies may cause significant harm to individuals, (2) that editors of medical journals have a moral responsibility for such harm, (3) that denial of publication is inadequate as an instrument to fulfil this moral responsibility and (4) that internationally acknowledged publication ethics codes should incorporate this aspect of editors' moral responsibility...
June 20, 2018: Journal of Medical Ethics
Ben Saunders
It has traditionally been assumed that organ donation must be altruistic, though the necessity of altruistic motivations has recently been questioned. Few, however, have questioned whether altruism is always a good motive. This paper considers the possibility that excessive altruism, or self-abnegation, may be intrinsically bad. How this may be so is illustrated with reference to Tom Hurka's account of the value of attitudes, which suggests that disproportionate love of one's own good-either excessive or deficient-is intrinsically bad...
June 19, 2018: Journal of Medical Ethics
Lars Ursin, Maria Stuifbergen
Respecting people's consent choices for use of their material and data is a cornerstone of biobank ethics. Participation in biobanks is characteristically based on broad consent that presupposes an ongoing possibility of informing and interacting with participants over time. The death of a participant means the end of any interaction, but usually not the end of participation. Research on causes of death makes biobank material from deceased participants extremely valuable. But as new research questions and methods develop over time, the question arises whether stored biobank material from deceased persons still can be used on the basis of their broad consent...
June 19, 2018: Journal of Medical Ethics
Xavier Symons, Reginald Mary Chua
Several bioethicists have recently discussed the complexity of defining human death, and considered in particular how our definition of death affects our understanding of the ethics of vital organ procurement. In this brief paper, we challenge the mainstream medical definition of human death-namely, that death is equivalent to total brain failure-and argue with Nair-Collins and Miller that integrated biological functions can continue even after total brain failure has occurred. We discuss the implications of Nair-Collins and Miller's argument and suggest that it may be necessary to look for alternative biological markers that reliably indicate the death of a human being...
June 19, 2018: Journal of Medical Ethics
Federica Lucivero, Karin R Jongsma
Mobile health (mHealth) is rapidly being implemented and changing our ways of doing, understanding and organising healthcare. mHealth includes wearable devices as well as apps that track fitness, offer wellness programmes or provide tools to manage chronic conditions. According to industry and policy makers, these systems offer efficient and cost-effective solutions for disease prevention and self-management. While this development raises many ethically relevant questions, so far mHealth has received only little attention in medical ethics...
June 15, 2018: Journal of Medical Ethics
Andreas Eriksen
It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a form of moral compensation. This paper challenges such a 'compensation view' of conflict and argues that it misleadingly makes the role morality into a personal contract between professional and patient. Two competing views are therefore considered. The 'unity view' argues that there are no real conflicts between professional duties...
June 15, 2018: Journal of Medical Ethics
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