Nonvoluntary Psychiatric Treatment Is Distinct From Involuntary Psychiatric Treatment

JAMA. 2017; 318(11): 999-1000.
Author: Dominic A. Sisti
“Some of the most ethically challenging cases in mental health care involve providing treatment to individuals who refuse that treatment. Sometimes when persons with mental illness become unsafe to themselves or others, they must be taken, despite their outward and often vigorous refusal, to an emergency department or psychiatric hospital to receive treatment, such as stabilizing psychotropic medication. On occasion, to provide medical care over objection, a patient must be physically restrained.”
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The United Kingdom Sets Limits on Experimental Treatments: The Case of Charlie Gard

JAMA. 2017;318(11):1001-1002
Author: Robert D. Truog
“The case of Charlie Gard in London, England, has been the focus of international attention, generating polarized views about the use of experimental treatments. On one side are those who hold that patients should be able to purchase whatever treatments they desire and can afford; on the other are those who maintain that governments must play a regulatory role in protecting patients from harm and that unproven therapies must meet a threshold of scientific validity before they are offered, regardless of the ability of the patient to pay.”
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The ethical basis for performing cardiopulmonary resuscitation only after informed consent in selected patient groups admitted to hospital

Clinical Ethics, 12(3), 111-116
Authors: Philip Berry, Iona Heath
“Cardiopulmonary resuscitation is frequently performed on patients who, in retrospect, had a very low chance of survival. This is because all patients are ‘For cardiopulmonary resuscitation’ on admission to hospital by default, and delays occur before cardiopulmonary resuscitation can be ‘de-prescribed’. This article reviews the nature of potential harms caused by futile cardiopulmonary resuscitation, the reasons why de-prescription may be delayed, recent legal judgements relevant to timely do not attempt cardiopulmonary resuscitation decision making, and the possible detrimental effects of do not attempt cardiopulmonary resuscitation discussions on end of life care.”
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Ethical practice in Telehealth and Telemedicine

JGIM, 2017, 32(10), 1136-1140
Authors: Danielle Chaet, Ron Clearfield, James E. Sabin, Kathryn Skimming, on behalf of the Council on Ethical and Judicial Affairs American Medical Association
“This article summarizes the report of the American Medical Association’s (AMA) Council on Ethical and Judicial Affairs (CEJA) on ethical practice in telehealth and telemedicine. Through its reports and recommendations, CEJA is responsible for maintaining and updating the AMA Code of Medical Ethics (Code).”
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The Nuremberg Code 70 Years Later

JAMA. 2017; 318(9): 795-796.
Authors: Jonathan D. Moreno, Ulf Schmidt, Steve Joffe
“Seventy years ago, on August 20, 1947, the International Medical Tribunal in Nuremberg, Germany, delivered its verdict in the trial of 23 doctors and bureaucrats accused of war crimes and crimes against humanity for their roles in cruel and often lethal concentration camp medical experiments. As part of its judgment, the court articulated a 10-point set of rules for the conduct of human experiments that has come to be known as the Nuremberg Code.”
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The case for an Indigenous Bioethics

Global Bioethics Blog, 25 June 2017
Author: Stuart Rennie
“Indigenous communities in the Americas experience a disproportionate incidence of illness and disease compared to the general population. They also possess sophisticated ethical traditions which diverge and not infrequently conflict with Western-oriented bioethics. This culture gap between patient, provider and ethicist is no small public health concern—it can foster feelings of alienation and distrust which compromise the relationship between those in need of care and those able to offer it. Research ethicists have already made considerable efforts to bring sensitivity for aboriginal cultural mores into their discipline, but bioethicists have been slower out of the gate.”
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Withdrawing clinically assisted nutrition and hydration (CANH) in patients with prolonged disorders of consciousness: is there still a role for the courts?

Journal of Medical Ethics 2017;43:476-480.
Author: English V, Sheather JC
“Currently, in England and Wales, Court of Protection’s Practice Directive 9E (PD9E) requires all cases of proposed withdrawal or withholding of life-sustaining treatment in relation to adults in a permanent vegetative state (PVS) or minimally conscious state be referred to the Court. This paper looks at the origins of PD9E and contrasts the routine requirement to refer cases to court with the complex clinical terrain that comprises those suffering from prolonged disorders of consciousness.”
Find article here (part of a series of articles on this topic)

Suicide and self-harm in prisons hit worst ever levels

The Guardian, 29 June 2017
Author: Rajeev Syal
“Prisons have “struggled to cope” with record rates of suicide and self-harm among inmates following cuts to funding and staff numbers, the public spending watchdog has said. The National Audit Office said it remains unclear how the authorities will meet aims for improving prisoners’ mental health or get value for money because of a lack of relevant data. Auditors said that self-harm incidents increased by 73% between 2012 and 2016 to 40,161, while the 120 self-inflicted deaths in prison in 2016 was the highest figure on record and almost double that for 2012.”
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Euthanasia survey hints at support from doctors, nurses and division

SMH, 24 June 2017
Author: James Robertson
“Most NSW doctors and nurses support a controversial medical euthanasia bill headed for Parliament, according to research that could prompt new debate about the medical fraternity’s willingness to accept changes to assisted suicide laws. A bill, to allow patients to apply for medically assisted euthanasia in specific circumstances when older than 25, will be introduced to the NSW upper house in August for a conscience vote. About 60 per cent of doctors support the Voluntary Assisted Dying Bill and fewer than 30 per cent oppose it.”
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Scotland to introduce soft opt-out system for organ donation

The Guardian, 28 June 2017
Author: Severin Carrell
“Scottish ministers are to introduce a new system of organ donations based on presumed consent in an effort to increase life-saving organ transplants. The change of policy follows the introduction in Wales of a presumed consent system in December 2015, which led to a rise in organ donations and an increase in the number of families agreeing to donations. Last year there were 39 organs transplanted in Wales using its deemed consent system out of 160 organ transplants. Only 6% of people opted out of the system. The Scottish government’s decision to follow suit will increase pressure on ministers in London and possibly in Northern Ireland to introduce similar reforms. ”
Find article here.