By Philip E Baker and Jordan A Parsons. Direct-to-consumer (DTC) genetic testing is becoming increasingly popular. However, with genetic testing comes the possibility of discovering mutations that confer increased risk of genetic diseases not only to the tested individual (the proband), but also their genetic relatives. This raises the challenging ethical question of what should […]
Category: consent
Why do we need to distinguish ‘valid’ and ‘informed’ consent to medical treatment?
By Emma Cave. Common law and ethics require that consent is voluntary, that it is made by a person with capacity and that it is sufficiently informed. But it does not follow that consent that is insufficiently informed will necessarily be considered in law to be invalid. Since Montgomery in 2015, the requirement of informed […]
Refusal redux: Revisiting debate about adolescent refusal of treatment
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 […]
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 […]