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 […]
Category: clinical ethics
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 […]
Does it work what clinical ethicists do – and how do we evaluate it?
By Joschka Haltaufderheide, Stephan Nadolny, Jochen Vollmann, and Jan Schildmann. Clinical ethical case consultations have been widely implemented in clinical practice. It has been hailed as important tool to support clinical decision making. At the same time, it is a matter of debate what ethical case consultations actually do contribute to clinical practice and what […]
Is medico-legal paternalism still rife in UK paediatric best interest decisions?
By Michal Pruski. The UK case of Alta Fixsler is reigniting the debate on paediatric best interest decisions in the case of end of life considerations. The two-year old’s Jewish parents want her to be transferred to Israel to be taken care of by clinicians sharing their religious and moral outlooks. Meanwhile the NHS trust […]
How the laboratory and the pathologist affect access to care
By Cullen M. Lilley and Kamran M. Mirza. As you sit in your hospital room after surgery, a feeling of uncertainty may start to grow. Each tube blood draw is like a tally mark for another day gone by without an answer. Meanwhile, each tube of blood, biopsy material, or the resection from your surgery […]
Values, value and valued
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 […]
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 […]