The Nuremberg Code and Informed Consent for Research

JAMA. 2018; 319(1): 85-86
Author: Jon F Merz
“The Viewpoint by Dr Moreno and colleagues understated the precedential value of the International Medical Tribunal’s decision in the trial of Nazi doctors accused of war crimes that established the Nuremberg Code and the code’s influence on common law development of the legal duty of researchers to secure informed consent from their research participants.”
Find letter here.

A libertarian case for mandatory vaccination

Journal of Medical Ethics 2018;44:37-43.
Author: J Brennan
“This paper argues that mandatory, government-enforced vaccination can be justified even within a libertarian political framework. If so, this implies that the case for mandatory vaccination is very strong indeed as it can be justified even within a framework that, at first glance, loads the philosophical dice against that conclusion. I argue that people who refuse vaccinations violate the ‘clean hands principle’, a (in this case, enforceable) moral principle that prohibits people from participating in the collective imposition of unjust harm or risk of harm.”
Find article here.

Navigating individual and collective interests in medical ethics

Journal of Medical Ethics 2018;44:1-2.
Author: J Pugh
“In medical ethics, we are often concerned with questions that pertain predominantly to the treatment of a particular individual. However, in a number of cases it is crucial to broaden the scope of our moral inquiry beyond consideration of the individual alone, since the interests of the individual can come into conflict with the interests of the wider community.”
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The Ebola clinical trials: a precedent for research ethics in disasters

Journal of Medical Ethics 2018;44:3-8.
Author: P Calain
“The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course of a major public health crisis. This unprecedented effort was supported by the recommendations of an ad hoc ethics panel convened in August 2014 by the WHO. By considering why and on what conditions the exceptional circumstances of the Ebola epidemic justified the use of unproven interventions, the panel’s recommendations have challenged conventional thinking about therapeutic development and clinical research ethics.”
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Too Many Older Patients Get Cancer Screenings

NYT, 19 December 2017
Author: Liz Szabo
“A growing chorus of geriatricians, cancer specialists and health system analysts say that for the best quality of life, she’d be better off skipping the screening. Such testing in the nation’s oldest patients is highly unlikely to detect lethal disease. It is also hugely expensive and more likely to harm than help, since any follow-up testing and treatment is often invasive.”
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The surgeon who signed patients’ livers was silly, not criminal. The law is an ass

The Guardian, 16 December 2017
Author: Henry Marsh
“Last Wednesday Simon Bramhall, a consultant surgeon specialising in liver transplantation, pleaded guilty in Birmingham crown court to “assault by beating”. He awaits sentencing. On two occasions during liver transplantation surgery – a highly complex and difficult procedure – he had signed his initials on the surface of his patients’ organs using an argon gas coagulator.”
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Rethinking moral distress: conceptual demands for a troubling phenomenon affecting health care professionals

Med Health Care and Philos, 2017, pp1-10
Author: Daniel W. Tigard
“Recent medical and bioethics literature shows a growing concern for practitioners’ emotional experience and the ethical environment in the workplace. Moral distress, in particular, is often said to result from the difficult decisions made and the troubling situations regularly encountered in health care contexts. It has been identified as a leading cause of professional dissatisfaction and burnout, which, in turn, contribute to inadequate attention and increased pain for patients. Given the natural desire to avoid these negative effects, it seems to most authors that systematic efforts should be made to drastically reduce moral distress, if not altogether eliminate it from the lives of vulnerable practitioners.”
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Health Care Complaints Commission v Harvey [2017] NSWCATOD 175

Decision date: 6 December 2017
“Unsatisfactory professional conduct – improper and unethical conduct. Breach of Conditions Imposed by Nursing and Midwifery Council of NSW. Whether conduct amounted to professional misconduct. Where practitioner does not attend the hearing.”
Find decision here.

Moral Choices for Today’s Physician

JAMA. 2017;318(21):2081-2082.
Author: Donald M Berwick
“The work of a physician as healer cannot stop at the door of an office, the threshold of an operating room, or the front gate of a hospital. The rescue of a society and the restoration of a political ethos that remembers to heal have become the physician’s jobs, too. Professional silence in the face of social injustice is wrong.”
Find article here.

Medical practitioner’s registration cancelled for serious and unethical misconduct

Medical Board of Australia, 29 November 2017
“A tribunal has cancelled medical practitioner Wijeneka Liyanage’s registration for serious and unethical misconduct, which included an inappropriate personal relationship with a patient, unsatisfactory professional performance in relation to two other patients, and for deleting and falsifying medical records with the intention of misleading an investigation into his practice.”
Find further detail here.