By Dominic Wilkinson. Last month, in an emergency hearing, the High court in London heard a case that characterises a familiar problem in medical ethics. A 15 year old adolescent (known as ‘X’) with a long-standing medical condition, sickle cell disease, had a very low blood count and required an urgent blood transfusion. However, X […]
Category: consent
Consent and living organ donation
By Maximilian Kiener. Many people feel very gratified if they can donate an organ to their child or spouse in need. Others, however, are extremely frightened and secretly hope not to be compatible. In interviews, they admit to be ‘scared to death’ and ‘terrified all the way down.’ Yet, many of the most frightened eventually […]
Bad news about prognosis: why is it still so difficult?
By Nicola Grignoli. Today the team of the internal medicine ward asked me as a psychologist to participate in a family meeting: a patient with mental disorder was to be told of a life-threatening illness. We discussed whether the patient had to be present or if the bad news should be disclosed to the partner […]
Does consent make open label placebo research ethical?
By Laura Specker Sullivan Open label placebo studies hypothesize that placebos can be effective even when there is complete transparency about what participants are given. These studies are being run for conditions such as chronic pain, cancer-related fatigue, and irritable bowel syndrome. Open label placebos have garnered significant interest in the popular imagination, perhaps due […]
Do No Harm in cancer screening programmes: can consent save the day?
By Lotte Elton Screening might harm you. That isn’t what the adverts will tell you. But, increasingly, there is a growing awareness that, for some, cancer screening might lead to unnecessary and potentially harmful investigations and treatments. This seems to violate the ethical principle of non-maleficence: the injunction that doctors ‘do no harm’ to their […]
What end of life care do we want to give to persons with end-stage dementia?
By Joseph Dimech, Emmanuel Agius, Julian C Hughes and Paul Bartolo. Dementia is a degenerative neurocognitive disorder that leads to a high level of physical and cognitive disability as the disease progresses to its end-stage. Such patients are also at high risk of suffering from co-morbidities, including aspiration pneumonia secondary to swallowing difficulties. Thus, such […]
Would you enroll in this Covid-19 vaccine trial? — Ethical considerations for protecting the options of subjects in primary epidemic vaccine trials
By Arthur L. Caplan and Jerrold L. Abraham. We responded to the review in JME by Monrad about ethical issues in vaccine trials, in which the discussion was limited to secondary vaccine trials (i.e. testing additional vaccines after one or more vaccines have been approved). We are concerned that the ethics of ongoing primary vaccine […]
Psychiatric patients and the decisional authority in the context of euthanasia. Is the psychiatrist a competent gatekeeper?
By Frank Schweitser In Belgium people with an incurable psychiatric disorder can file a request for euthanasia claiming unbearable psychic suffering. For the request to be accepted, it has to meet stringent legal criteria. Psychiatrists play an important role in the evaluation of these criteria. One of the legal requirements is that the patient possess […]
Ectogenesis, medicalisation and difficulties for the doctor
By Victoria Adkins. In the literature concerning ectogenesis – the process of gestating a foetus outside of the human body (in an artificial womb) – discussions have been concerned with its possible implications for pregnant women. However, in order to consider these implications effectively we must also look at the relationship between pregnant women and […]
Consent in an acute clinical research setting – what should that look like?
Peta Coulson-Smith and Anneke Lucassen. Consent to an intervention serves to recognise a person’s autonomy, be that in clinical care – or in the research that informs that clinical care. Consent is not valid unless it is given voluntarily, on the basis of sufficient information to make the decision, and by someone who has the […]