By Rosalind McDougall, Lynn Gillam, Danielle Ko, Isabella Holmes, Clare Delany Prior to the COVID-19 pandemic, clinicians in well-resourced healthcare systems usually had the information and resources they needed to appropriately protect themselves while still providing optimal care for patients. However, achieving both staff protection and high quality patient care has now become difficult in […]
Category: clinical ethics
Mechanical ventilators: the evidence of effectiveness
By Jonathan J. Darrow and Jing Luo As government leaders move to relax physical distancing requirements related to severe acute respiratory coronavirus 2 (SARS-CoV-2), a central assumption is that mechanical ventilators will form part of the safety net needed to sustain life in those afflicted with the disease it causes, Covid-19. Ventilators have been described as […]
Must Clinical Ethics Committees involve patients or families in their meetings?
By Dominic Wilkinson @Neonatalethics and Michael Dunn @ethical_mikey Originally posted on PRACTICAL ETHICS In a high court case reported last week, a judge strongly criticised a London hospital’s clinical ethics committee (CEC). The case related to disputed treatment for a gravely ill nine-year old child. There had been a breakdown in the relationship between the […]
Ongoing puberty suppression should be an available treatment option for non-binary adults, but case-by-case analysis is also needed
By Lauren Notini The use of medications to suppress puberty (puberty suppression or puberty blockers) in young people who identify as transgender (trans) or gender diverse (TGD) has generated ongoing debate in the media and bioethics literature. Puberty blockers are typically recommended as a treatment option for TGD young people who are experiencing gender dysphoria […]
Challenging cognitive biases in the intensive care unit
By Harleen Kaur Johal & Christopher Danbury Unsurprisingly, the intensive care unit (ICU) is an “intense” environment, for staff, patients, and their families. These busy, 24-hour units provide care for the most unwell patients in a hospital. As many of these patients are incapacitated, due to the effects of their illness or sedation, decisions must […]
Utilizing parents to hand-bag ventilate when resources are scarce: Is it ethical?
By Emily E. Barsky and Sadath Sayeed Amidst the COVID-19 pandemic, many nations are coping with what resource limited settings are all too familiar with—ventilator scarcity. In low-income countries, people— and particularly children— frequently die of reversible, acute respiratory failure due to across-the-board resource scarcity. Some such settings have responded to this by allowing parents […]
Toward enhanced consent for psychedelic psychiatry
By William R Smith. and Dominic Sisti. Imagine living with treatment-resistant depression. You’ve already tried several lines of medication, electroconvulsive therapy, and psychotherapy to no avail. You might have even have used augmentation strategies such as transcranial magnetic stimulation. Maybe you have spent years of your life struggling with this disease despite these attempts; maybe […]
It’s a complex world in primary care, and it changes medical ethics!
By Sanjiv Ahluwalia, Rupal Shah & John Spicer. In this post, we want to challenge to the idea that ethical decision making exists independently of context or of the interactions that influence us. We propose that social complexity offers an alternative perspective to our existing normative frameworks; a perspective which validates our subjective experience of […]
Be careful what you wish for: ICU is no panacea
By Angela Ballantyne, Wendy Rogers, Vikki Entwistle, Cindy Towns In current debates about allocation of scarce ICU resources, we suggest there is undue optimism about the ‘good’ of intensive care unit (ICU) access. Most critical COVID-19 patients who receive access to a ventilator will still die. The minority who survive will likely leave with significant […]
Prioritizing justice in ventilator allocation
By L. Syd M Johnson As the Covid-19 pandemic intensified worldwide, grim reports out of Italy’s embattled and overwhelmed hospitals foretold the need to plan for rationing ventilators in the event that the number of patients requiring them exceeded the number available. Hospitals, ethics committees, and government agencies around the US began planning for the […]