By Kayla Wiebe, Simon Kelley, Roxanne Kirsch An arguably positive accident of the COVID-19 pandemic is that it rejuvenated public, political, and academic interest in the ethical dimensions of resource allocation, with specific focus on how extreme resource shortages (like in triage) exacerbates health inequities. Unfortunately, of far greater significance, are the kinds of exacerbations […]
Category: clinical ethics
The Moral Elephant in the Room – Patient Morality in Psychiatry
By Doug McConnell, Matthew Broome, and Julian Savulescu. In our paper, “Making psychiatry moral again”, we aim to develop and justify a practical ethical guide for psychiatric involvement in patient moral growth. Ultimately we land on the view that psychiatrists should help patients express their own moral values by default but move to address the […]
Law and Ethics: ‘Basic Science’
By Robert Wheeler Following the foundation of a Clinical Ethics Committee (CEC) in Southampton in 2002 by Dr Tom Woodcock, we have dealt with a steady trickle of cases posing significant ethical and legal questions concerning management of individual patients. It gradually dawned on us that many less contentious (but nonetheless relevant) enquiries were not […]
Against ethical experts
By Doug Hardman and Phil Hutchinson. The clinical ethics business is booming. Since the field’s emergence in the 1970s, ethicists have established research and teaching centres, taken control of teaching ethics to medical students, and more recently begun to establish a new applied role: the clinical ethics consultant. Academics in philosophy, law and the social […]
Respecting autonomy in altered states: Navigating ethical quandaries in psychedelic therapy
By Hannah McLane, Courtney Hutchison, Daniel Wikler, Timothy Howell, & Emma Knighton. Research into psychedelic-assisted therapy has grown in the past ten years as non-profits, academic institutions, pharmaceutical companies, and even venture capitalists race to develop protocols for using MDMA, psilocybin, ketamine, and other psychedelic substances to treat mental illness. Already, dozens of ketamine clinics […]
Patients reading their medical notes: the end of deceptive placebos?
By Charlotte Blease Martha* – not her real name – is 40 years old. For ten years – throughout her thirties – Martha experienced health changes: “excessive fatigue, tingling in my feet, and muscle tightness in my hands.” These symptoms were serious enough for Martha to visit her GP. Various things were prescribed but no […]
The Sequential Organ Failure Assessment (SOFA) and revised ventilator triage guidance: since we are still implementing outdated and more inequitable frameworks now, will we learn any lessons longer term?
By Harald Schmidt, Dorothy E Roberts, Amaka D Eneanya Ventilator triage guidance can reduce, maintain, or exacerbate existing social, racial and ethnic health inequities, raising non-trivial legal issues. Over the last 18 months, there has been an intense reckoning with the fact that traditional rationing frameworks focused on maximizing overall benefits tend to worsen Covid-19’s disparate impact on disadvantaged communities of color. Yet, as ICUs […]
How we never met – and wrote an article about it: Communication, relationship and ethics in video-based telepsychiatric consultations
By: Eva-Maria Frittgen, Joschka Haltaufderheide During the first waves of the COVID-pandemic, videoconferencing quickly became one of the preferred ways of communicating. This was also the way how we as authors first met (and have met ever since without ever meeting in person) and started to think about the use of video-based consultations in healthcare: […]
Let the patient speak! The need for patient-developed concepts of empowerment
By Brenda Bogaert We talk so much about patient empowerment today that it is hard to imagine that the concept only became part of healthcare policy in the past few decades. How did patient empowerment come to be discussed and conceptualised? And what has been the patient’s involvement in this process? Firstly, it is important […]
Why all self-fulfilling prophecies matter
By Mayli M. Consider Chris, an unconscious coma patient in intensive care. Suppose that, according to tests of Chris’s brain activity, he is predicted to have a ‘poor outcome’, which could be death or a prolonged disorder of consciousness like vegetative or minimally conscious state. This prognosis informs treatment decisions about this patient, specifically the […]