Guest Post by Karolina Wartolowska Re: Randomised placebo-controlled trials of surgery: ethical analysis and guidelines [open access] Surgical placebo-controlled randomised controlled trials are, in many ways, like placebo-controlled drug trials. Like in case of drug trials, sometimes, a placebo-controlled design is necessary so that the results are valid and unbiased. Placebo control is usually necessary when a […]
Category: clinical ethics
Natal Nativism
Scene: the boardroom of a large NHS Trust, somewhere in England. “And so that brings us neatly to the last item on the agenda: passport checks for pregnant women who want a checkup. The thing is, you see, that it turns out that we’ve been providing obstetric care to some women who aren’t actually UK citizens. […]
An Accidental Expert
Guest Post by Derick Wade Re: Back to the Beside: Making Clinical Decisions in Patients with Prolongued Unconsciousness In 1994, not long after the Bland judgement, I was telephoned one day by the office of the Official Solicitor. “Was I familiar with the vegetative state, and if so would I be prepared to see two people for […]
No Diagnosis for You, Matey!
Here’s a little amusement for the weekend, from a friend who lives in the States: I received a state of the arts cardio monitor, per a prescription from a cardiologist, to determine if I have an irregular heart beat. All chrome and aluminium and clean and small with various electronic devices to transmit “information” to […]
The Challenge of Futile Treatment
Guest Post by Lindy Willmott and Ben White For decades, researchers from around the world have found evidence that doctors provide futile treatment to adult patients who are dying. Some discussion of this topic has turned on matters of definition (see our recent contribution to this debate), with a broader concept of “perceived inappropriate treatment” […]
Individualised and Personalised QALYs in Exceptional Treatment Decisions
Guest Post by Warwick Heale When NICE decides whether to make a treatment available on the NHS it considers both clinical effectiveness and cost effectiveness. Cost effectiveness is based on population-level QALY data, as is appropriate for a population-level policy. However, this can cause problems for exceptional individual patients. When a doctor wants to offer an […]
There’s Argument, and there’s Disputation.
Very well, then: let’s allow that the quality of argument in bioethics – and clinical ethics in particular – is not of high quality. What should be done about it? That’s a hard question, though it’s predictable and wholly justifiable that it should be asked. And, to be honest, I don’t know offhand. I might […]
Writers Whose Expertise is Deplorably Low
Something popped up on my twitter feed the other day: this document from Oxford’s philosophy department. (I’m not sure quite what it is. Brochure? In-house magazine? Dunno. It doesn’t really matter, though.) In it, there’s a striking passage from Jeff McMahan’s piece on practical ethics: Even though what is variously referred to as ‘practical ethics’ or […]
Healthcare Ethics Consultants’ Place in the World of Health Care ‘Professionals’
Guest Post by Abraham Schwab During a recent meeting at a local hospital, I was asked what role a good Healthcare Ethics Consultant should play. I gave a more ambiguous answer than I would like. I pointed out that Healthcare Ethics Consultants can help patients, providers, and administrators come to a common understanding of the values […]
Patient Views about Consent, Confidentiality & Information-Sharing in Genetic Medicine.
Guest post by Sandi Dheensa, Angela Fenwick and Anneke Lucassen Imagine you’re a clinician in genetic medicine. For a while, you’ve been seeing Joe Bloggs, a patient with a mutation in a gene that’s caused a hereditary form of colon cancer. As is your standard practice, you help Joe identify who in his family is also […]