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Journal of Medical Ethics

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https://www.readbyqxmd.com/read/29032368/the-ethical-justification-for-the-use-of-non-human-primates-in-research-the-weatherall-report-revisited
#1
Gardar Arnason
The Weatherall report on the use of non-human primates in research was published in 2006. Its main conclusion was that there is a strong scientific case for the use of non-human primates in some cases, but the report stressed the importance of evaluating each case in the light of the availability of alternatives. In addition to arguing for the scientific necessity of using non-human primates in research, the report also provided an ethical justification. As could be expected, the report was harshly criticised by animal rights groups, but in the academic literature, only two critical replies appeared...
October 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29032367/a-flimsy-case-for-the-use-of-non-human-primates-in-research-a-reply-to-arnason
#2
EDITORIAL
Catia Faria
No abstract text is available yet for this article.
October 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29032366/from-assistive-to-enhancing-technology-should-the-treatment-enhancement-distinction-apply-to-future-assistive-and-augmenting-technologies
#3
Francesca Minerva, Alberto Giubilini
The treatment-enhancement distinction is often used to delineate acceptable and unacceptable medical interventions. It is likely that future assistive and augmenting technologies will also soon develop to a level that they might be considered to provide users, in particular those with disabilities, with abilities that go beyond natural human limits, and become in effect an enhancing technology. In this paper, we describe how this process might take place, and discuss the moral implications of such developments...
October 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29030395/dignitarian-medical-ethics
#4
Linda Barclay
Philosophers and bioethicists are typically sceptical about invocations of dignity in ethical debates. Many believe that dignity is essentially devoid of meaning: either a mere rhetorical gesture used in the absence of good argument or a faddish term for existing values like autonomy and respect. On the other hand, the patient experience of dignity is a substantial area of research in healthcare fields like nursing and palliative care. In this paper, it is argued that philosophers have much to learn from the concrete patient experiences described in healthcare literature...
October 13, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29018178/attitudes-of-paediatric-and-obstetric-specialists-towards-prenatal-surgery-for-lethal-and-non-lethal-conditions
#5
Ryan M Antiel, Farr A Curlin, John D Lantos, Christopher A Collura, Alan W Flake, Mark P Johnson, Natalie E Rintoul, Stephen D Brown, Chris Feudtner
BACKGROUND: While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. METHODS: Survey of 1200 paediatric surgeons, neonatologists and maternal-fetal medicine specialists (MFMs)...
October 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29018177/a-challenge-to-unqualified-medical-confidentiality
#6
Alexander Bozzo
Medical personnel sometimes face a seeming conflict between a duty to respect patient confidentiality and a duty to warn or protect endangered third parties. The conventional answer to dilemmas of this sort is that, in certain circumstances, medical professionals have an obligation to breach confidentiality. Kenneth Kipnis has argued, however, that the conventional wisdom on the nature of medical confidentiality is mistaken. Kipnis argues that the obligation to respect patient confidentiality is unqualified or absolute, since unqualified policies can save more lives in the long run...
October 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29018176/in-defence-of-governance-ethics-review-and-social-research
#7
Mark Sheehan, Michael Dunn, Kate Sahan
There is a growing body of literature that has sought to undermine systems of ethical regulation, and governance more generally, within the social sciences. In this paper, we argue that any general claim for a system of research ethics governance in social research depends on clarifying the nature of the stake that society has in research. We show that certain accounts of this stake-protecting researchers' freedoms; ensuring accountability for resources; safeguarding welfare; and supporting democracy-raise relevant ethical considerations that are reasonably contested...
October 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28993424/competition-cooperation-and-human-flourishing-commentary-on-koch
#8
Hazem Zohny
No abstract text is available yet for this article.
October 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28993423/against-lifetime-qaly-prioritarianism
#9
Anders Herlitz
Lifetime quality-adjusted life-year (QALY) prioritarianism has recently been defended as a reasonable specification of the prioritarian view that benefits to the worse off should be given priority in health-related priority setting. This paper argues against this view with reference to how it relies on implausible assumptions. By referring to lifetime QALY as the basis for judgments about who is worse off lifetime QALY prioritarianism relies on assumptions of strict additivity, atomism and intertemporal separability of sublifetime attributes...
October 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28993422/comments-on-durante-s-account-of-multiculturalism
#10
EDITORIAL
Tom L Beauchamp, Tom L Beauchamp
No abstract text is available yet for this article.
October 9, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28947505/settling-for-second-best-when-should-doctors-agree-to-parental-demands-for-suboptimal-medical-treatment
#11
Tara Nair, Julian Savulescu, Jim Everett, Ryan Tonkens, Dominic Wilkinson
BACKGROUND: Doctors sometimes encounter parents who object to prescribed treatment for their children, and request suboptimal substitutes be administered instead (suboptimal being defined as less effective and/or more expensive). Previous studies have focused on parental refusal of treatment and when this should be permitted, but the ethics of requests for suboptimal treatment has not been explored. METHODS: The paper consists of two parts: an empirical analysis and an ethical analysis...
September 25, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28947504/medical-and-bioethical-considerations-in-elective-cochlear-implant-array-removal
#12
Maryanna S Owoc, Elliott D Kozin, Aaron Remenschneider, Maria J Duarte, Ariel Edward Hight, Marjorie Clay, Susanna E Meyer, Daniel J Lee, Selena Briggs
OBJECTIVE: Cochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation. DATA SOURCES: We address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community...
September 25, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28912289/using-best-interests-meetings-for-people-in-a-prolonged-disorder-of-consciousness-to-improve-clinical-and-ethical-management
#13
Derick T Wade
Current management of people with prolonged disorders of consciousness is failing patients, families and society. The causes include a general lack of concern, knowledge and expertise; a legal and professional framework which impedes timely and appropriate decision-making and/or enactment of the decision; and the exclusive focus on the patient, with no legitimate means to consider the broader consequences of healthcare decisions. This article argues that a clinical pathway based on the principles of (a) the English Mental Capacity Act 2005 and (b) using time-limited treatment trials could greatly improve patient management and reduce stress on families...
September 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28912288/sometimes-not-always-not-never-a-response-to-pickard-and-pearce
#14
Patrick J Sullivan
This paper provides a response to Hanna Pickard and Stephen Pearce's paper 'Balancing costs and benefits: a clinical perspective does not support a harm minimisation approach for self-injury outside of community settings.' This paper responded to my article 'Should healthcare professionals sometimes allow harm? The case of self-injury.' There is much in the paper that I would agree with, but I feel it is important to respond to a number of the criticisms of my paper in order to clarify my position and to facilitate ongoing debate in relation to this important issue...
September 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28912287/public-reason-and-the-limited-right-to-conscientious-objection-a-response-to-magelssen
#15
Jake Greenblum
In a recent article for this journal, Morten Magelssen argues that the right to conscientious objection in healthcare is grounded in the moral integrity of healthcare professionals, a good for both professionals and society. In this paper, I argue that there is no right to conscientious objection in healthcare, at least as Magelssen conceives of it. Magelssen's conception of the right to conscientious objection is too expansive in nature. Although I will assume that there is a right to conscientious objection, it does not extend to objections that are purely religious in nature...
September 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28899906/does-the-doctrine-of-double-effect-apply-to-the-prescription-of-barbiturates-syme-vs-the-medical-board-of-australia
#16
Xavier Symons
The doctrine of double effect (DDE) is a principle of crucial importance in law and medicine. In medicine, the principle is generally accepted to apply in cases where the treatment necessary to relieve pain and physical suffering runs the risk of hastening the patient's death. More controversially, it has also been used as a justification for withdrawal of treatment from living individuals and physician-assisted suicide. In this paper, I will critique the findings of the controversial Victorian Civil and Administrative Tribunal (VCAT) hearing Syme vs the Medical Board of Australia In that hearing, Dr Rodney Syme, a urologist and euthanasia advocate, was defending his practice of prescribing barbiturates to terminally ill patients...
September 12, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28887359/wearing-humanism-on-your-sleeve
#17
Jason J DuBroff
No abstract text is available yet for this article.
September 8, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28882903/the-structure-of-ethics-review-expert-ethics-committees-and-the-challenge-of-voluntary-research-euthanasia
#18
Julian Savulescu
No abstract text is available yet for this article.
September 7, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28882902/increasing-organ-donation-rates-by-revealing-recipient-details-to-families-of-potential-donors
#19
David Shaw, Dale Gardiner
Many families refuse to consent to donation from their deceased relatives or over-rule the consent given before death by the patient, but giving families more information about the potential recipients of organs could reduce refusal rates. In this paper, we analyse arguments for and against doing so, and conclude that this strategy should be attempted. While it would be impractical and possibly unethical to give details of actual potential recipients, generic, realistic information about the people who could benefit from organs should be provided to families before they make a decision about donation or attempt to over-rule it...
September 7, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28848063/do-the-brain-dead-merely-appear-to-be-alive
#20
Michael Nair-Collins, Franklin G Miller
The established view regarding 'brain death' in medicine and medical ethics is that patients determined to be dead by neurological criteria are dead in terms of a biological conception of death, not a philosophical conception of personhood, a social construction or a legal fiction. Although such individuals show apparent signs of being alive, in reality they are (biologically) dead, though this reality is masked by the intervention of medical technology. In this article, we argue that an appeal to the distinction between appearance and reality fails in defending the view that the 'brain dead' are dead...
August 28, 2017: Journal of Medical Ethics
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