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Monash Bioethics Review

Dominic Wilkinson, Stavros Petrou, Julian Savulescu
In intensive care, disputes sometimes arise when patients or surrogates strongly desire treatment, yet health professionals regard it as potentially inappropriate. While professional guidelines confirm that physicians are not always obliged to provide requested treatment, determining when treatment would be inappropriate is extremely challenging. One potential reason for refusing to provide a desired and potentially beneficial treatment is because (within the setting of limited resources) this would harm other patients...
January 18, 2018: Monash Bioethics Review
Bob Z Sun
No abstract text is available yet for this article.
December 21, 2017: Monash Bioethics Review
Michael J Selgelid, Justin Oakley
No abstract text is available yet for this article.
November 3, 2017: Monash Bioethics Review
Tatiana Patrone
The paper asks the question whether Kant's ethical theory can be applied to issues in assisted reproductive technology (ART). It argues against three objections to applying Kant's ethics to ART: (i) the non-identity objection, (ii) the gen-ethics objection, and (iii) the care-ethics objection. After showing that neither of the three objections is sufficiently persuasive the paper proposes a reading of Kant's 'formula of humanity,' and especially its negative clause (i.e., the 'merely as means' clause), that can be of some guidance in ART...
September 13, 2017: Monash Bioethics Review
Zohar Lederman, Shmuel Lederman
In 2015, the Israeli Knesset passed the force-feeding act that permits the director of the Israeli prison authority to appeal to the district court with a request to force-feed a prisoner against his expressed will. A recent position paper by top Israeli clinicians and bioethicists, published in Hebrew, advocates for force-feeding by medical professionals and presents several arguments that this would be appropriate. Here, we first posit three interrelated questions: 1. Do prisoners have a right to hunger-strike? 2...
August 15, 2017: Monash Bioethics Review
Zümrüt Alpinar-Şencan, Holger Baumann, Nikola Biller-Andorno
Shortages in the number of donated organs after death and the growing number of end-stage organ failure patients on waiting lists call for looking at alternatives to increase the number of organs that could be used for transplantation purposes. One option that has led to a legal and ethical debate is to have regulated markets in human organs. Opponents of a market in human organs offer different arguments that are mostly founded on contingent factors that can be adjusted. However, some authors have asked the question whether we still have a reason to believe that there is something wrong with offering human organs for sale for transplantation purposes, even if the circumstances under which the practice takes place are improved...
July 11, 2017: Monash Bioethics Review
Hiroyuki Nagai
Informed consent honors the autonomous decisions of patients, and family consent places importance on decisions made by their families. However, there is little understanding of the relationship between these two medical decision-making approaches. Both approaches exist in Japan as part of its truth disclosure policy. What is the status of family consent in the United States, from which Japan introduced informed consent? This paper compares the situation in the United States with that in Japan, where family consent has been combined with informed consent...
April 21, 2017: Monash Bioethics Review
Justin Oakley
No abstract text is available yet for this article.
June 2016: Monash Bioethics Review
Ryan Essex
Australian immigration detention has received persistent criticism since its introduction almost 25 years ago. With the recent introduction of offshore processing, these criticisms have intensified. Riots, violence, self-harm, abuse and devastating mental health outcomes are all now well documented, along with a number of deaths. Clinicians have played a central role working in these environments, faced with the overarching issue of delivering healthcare while facilitating an abusive and harmful system. Since the re-introduction of offshore processing a number of authors have begun to discuss the possibility of a boycott...
June 2016: Monash Bioethics Review
Hojjat Soofi
Sigrid Fry-Revere's The Kidney Sellers: A Journey of Discovery in Iran, an allegedly first-hand examination of the Iranian paid kidney donation model, has been criticized by Koplin in an essay formerly published in the Monash Bioethics Review. Koplin especially challenges Fry-Revere's claim that financially compensating kidney vendors might facilitate altruistic kidney donation. The current situation in Iran, according to Koplin, suggests that the market model has undermined altruistic donation. On this point, this commentary tries to show that healthcare policymakers in Iran no longer see the Iranian paid kidney donation model as a sustainable and ethically justifiable status quo...
June 2016: Monash Bioethics Review
Carlos Mariscal, Angel Petropanagos
The CRISPR system for gene editing can break, repair, and replace targeted sections of DNA. Although CRISPR gene editing has important therapeutic potential, it raises several ethical concerns. Some bioethicists worry CRISPR is a prelude to a dystopian future, while others maintain it should not be feared because it is analogous to past biotechnologies. In the scientific literature, CRISPR is often discussed as a revolutionary technology. In this paper we unpack the framing of CRISPR as a revolutionary technology and contrast it with framing it as a value-threatening biotechnology or business-as-usual...
June 2016: Monash Bioethics Review
Danielle M Wenner
No abstract text is available yet for this article.
June 2016: Monash Bioethics Review
Ian Pieper, Colin J H Thomson
Beneficence is one of the four principles that form the basis of the Australian National Statement. The aim of this paper is to explore the philosophical development of this principle and to clarify the role that beneficence plays in contemporary discussions about human research ethics. By examining the way that guidance documents, particularly the National Statement, treats beneficence we offer guidance to researchers and human research ethics committee members on the practical application of what can be a conceptually difficult principle...
June 2016: Monash Bioethics Review
Michael J Selgelid
No abstract text is available yet for this article.
March 2016: Monash Bioethics Review
Ryan Tonkens
The focus of this paper is on the ethics of the act of wilfully "abandoning" human embryos. I offer a critique of this unique behaviour, which draws on empirical data about who wilfully abandons their surplus embryos and why. I argue that wilful embryo abandonment is in all cases avoidable. Given this, I make three observations which speak to the moral unacceptability of embryo abandonment. The first has to do with the abandoner's unfair treatment of the clinic storing their abandoned embryos, and the second the abandoner's apparent lack of sympathy for the plight of other people like them, who require assistance (e...
March 2016: Monash Bioethics Review
César Palacios-González
Several objections against the morality of researching or employing mitochondrial replacement techniques have been advanced recently. In this paper, I examine three of these objections and show that they are found wanting. First I examine whether mitochondrial replacement techniques, research and clinical practice, should not be carried out because of possible harms to egg donors. Next I assess whether mitochondrial replacement techniques should be banned because they could affect the study of genealogical ancestry...
March 2016: Monash Bioethics Review
Ezio Di Nucci
I argue against various versions of the 'attitude' view of consent and of the 'action' view of consent: I show that neither an attitude nor an action is either necessary or sufficient for consent. I then put forward a different view of consent based on the idea that, given a legitimate epistemic context, absence of dissent is sufficient for consent: what is crucial is having access to dissent. In the latter part of the paper I illustrate my view of consent by applying it to the case of consenting to being an organ donor...
March 2016: Monash Bioethics Review
Spencer Phillips Hey, Charles Weijer
The concept of clinical equipoise restricts the use of placebo controls in clinical trials when there already exists a proven effective treatment. Several critics of clinical equipoise have put forward alleged counter-examples to this restriction-describing instances of ethical placebo-controlled trials that apparently violate clinical equipoise. In this essay, we respond to these examples and show that clinical equipoise is not as restrictive of placebos as these authors assume. We argue that a subtler appreciation for clinical equipoise-in particular the distinction between de facto and de jure interpretations of the concept-allows the concept to explain when and why a placebo control may be necessary to answer a question of clinical importance...
March 2016: Monash Bioethics Review
Carole Ramsey
The world's first legal euthanasia death occurred in the Australian City of Darwin on Sunday 22 September 1996 when Bob Dent ended his life under the Northern Territory's short-lived Rights of the Terminally Ill Act 1995. Dent's death intensified argument about euthanasia in Australia, transforming the debate from a textbook discussion in social ethics into a vigorous and divisive social dispute. The day before he ended his life, Dent dictated a letter, written down by his wife. This description of his experience with terminal illness is graphic-the letter, his last effort to bring the plight of those living with terminal illness to public consciousness...
March 2016: Monash Bioethics Review
Daniel J Hicks
No abstract text is available yet for this article.
March 2016: Monash Bioethics Review
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