By Raj Mohindra. The idea of trying to reconnect values to the value produced for patients came from direct personal experience on the wards, in the clinic and in the ethics committee. Clinical ethics does not operate in a vacuum. In the past clinicians had the power to decide and were rightly held accountable for […]
Category: clinical ethics
Who should get to choose their surrogates?
By Mark Christopher Navin, Jason Adam Wasserman, Devan Stahl, and Tom Tomlinson, Clinical ethics consultants regularly witness something like the following progression: A patient is determined to lack decision-making capacity (DMC). In the absence of an Advanced Care Planning document that names a surrogate decision maker (e.g. a Durable Power of Attorney for Health Care), […]
Who’s responsible for informing relatives about genetic risk?
By Kalle Grill and Anna Rosén. It is established practice in many countries that healthcare professionals encourage patients to share relevant risk information with genetic relatives. We mostly endorse this practice but question a normative assumption that typically underpins it. Both practitioners and academics in the field are in general agreement that: It is desirable […]
Clinical ethics support: Addressing legal uncertainties
By Joe Brierley, David Archard and Emma Cave. Clinical ethics support has adapted to embrace patient-centred care, to help clarify ethical matters in patient care and to occasionally help resolve disputes without recourse to the courts. The pace of change and, indeed, the sheer number of clinical ethics committees accelerated during the first wave of […]
Is insisting on prospective consent in paediatric critical care research throwing the baby out with the bathwater?
By Rebecca Doyle. Robust, research evidence informs best practice and facilitates medical care that is both current and of the highest quality. In an effort to protect children and families who may be exposed to sources of vulnerability in the paediatric critical care environment, is the Australian National Statement jeopardising advancements to critical care research […]
How to ethically manage the double agency of physicians during a pandemic
By Thibaud Haaser The Covid-19 constitutes a real global crisis, going beyond the sole medical dimension. Medical, socio-economic or educational issues have highlighted the need to identify specific therapeutic or preventive agents as soon as possible. The necessity to build reliable medical knowledge is part of the response to such a crisis. Although the crisis […]
The return of psychedelics to psychiatry. Can the therapeutic effects of psychedelic experiences be justified?
By Riccardo Miceli McMillan. The use of psychedelic-assisted psychotherapy to treat mental illness is a paradigm which is reattracting significant attention both within medico-scientific communities as well as the public more broadly. After a long hiatus from their controversial debut during the 1960’s, psychedelics such as psilocybin (one of the active ingredients inside so-called ‘magic’ […]
Why your doctor may be right to not tell you about your abnormal results
By Patrick Burch. As a GP I spend a significant proportion of time interpreting blood results. When a patient has any test performed, they should understand why it is being done and have consented to it. However, in many cases, perhaps the majority, patients are not fully aware what blood tests are being done and […]
Bad news about prognosis: why is it still so difficult?
By Nicola Grignoli. Today the team of the internal medicine ward asked me as a psychologist to participate in a family meeting: a patient with mental disorder was to be told of a life-threatening illness. We discussed whether the patient had to be present or if the bad news should be disclosed to the partner […]
Would you enroll in this Covid-19 vaccine trial? — Ethical considerations for protecting the options of subjects in primary epidemic vaccine trials
By Arthur L. Caplan and Jerrold L. Abraham. We responded to the review in JME by Monrad about ethical issues in vaccine trials, in which the discussion was limited to secondary vaccine trials (i.e. testing additional vaccines after one or more vaccines have been approved). We are concerned that the ethics of ongoing primary vaccine […]