How to apply the MCA capacity criteria more transparently and reliably

By Scott Kim, Nuala Kane, Alex Ruck Keene, Gareth Owen. A lot is at stake in a mental capacity evaluation. An error can lead to a capacitous adult’s decision being ignored or even overruled, or to a vulnerable, incapacitous person being abandoned to their ‘rights.’ Unfortunately, there is no simple formula that generates the right […]

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Ethics guidance for biobanking practice in low-and middle-income-countries during COVID-19

By Shenuka Singh, Rosemary Jean Cadigan and Keymanthri Moodley Biobanking has the potential to make valuable contributions to health research through the collection, storage and sharing of human samples and data for research purposes. During the COVID-19 pandemic, storing samples for future research is a public health imperative. There are, however, several ethical concerns. These […]

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Informed consent and medical device registries

By Daniel B. Kramer, Elizabeth Roe and Efthimios Parasidis. Regulators charged with evaluating new medical devices face several unenviable trade-offs. Extensive pre-market evaluation may delay market entry for useful technology, but a rushed assessment may fail to identify important safety concerns. Rigorous post-market studies may help balance these competing concerns, but must also weigh the […]

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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), […]

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Altered vaccination schedules and informed consent

By Jennifer O’Neill. According to the General Medical Council (GMC) publication Good Medical Practice, medical treatments should be provided “…based on the best available evidence” with a favourable balance between benefit and risk. Legal principles of informed consent and shared decision-making recognise the patient’s right to be informed of the risk-benefit profile of a treatment […]

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Open future or an informed present? Cancer predispositions testing in children

By Sapna Mehta, Dennis John Kuo. Teenagers, and indeed all children to various extents, live in a world that does not recognize their independence fully.  In various situations, they find their rights being exercised by and interests being defined by parents as well as other authorities such as physicians, teachers and the state to a […]

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Vulnerable adults can be autonomous. Assuming that they are not is wrong and harmful.

By Jonathan Lewis. With the establishment of the Mental Capacity Act (“MCA”) 2005 in England and Wales, the days of court interventions into the lives of adults with mental capacity seemed numbered. If you were an adult with capacity, then you were legally recognised as able to give genuine consent to care and medical treatments. […]

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