Pathogenic variants in the healthy elderly: unique ethical and practical challenges

Journal of Medical Ethics 2017; 43: 714-722.
Author: Paul Lacaze, Joanne Ryan, Robyn Woods, Ingrid Winship, John McNeil
“Genetic research into ageing, longevity and late-onset disease is becoming increasingly common. Yet, there is a paucity of knowledge related to clinical actionability and the return of pathogenic variants to otherwise healthy elderly individuals. Whether or not genetic research in the elderly should be managed differently from standard practices adapted for younger populations has not yet been defined. In this article, we provide an overview of ethical and practical challenges in preparing for a genetic study of over 14?000 healthy Australians aged 70?years or older enrolled in the ASPirin in Reducing Events in the Elderly (ASPREE) Healthy Ageing Biobank.”
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Why health services research needs bioethics

Journal of Medical Ethics 2017; 43: 655-656.
Author: Lucy Frith
“Health services research brings together a wide variety of disciplines and would seem ideally placed to include ethics. However, if you search health services research journals and conference programmes there is very little consideration of ethics as a substantive topic and often scant attention paid to the ethical issues that might be raised by an intervention or policy. Ethics and ethical issues are generally confined to discussions over priority setting, and occasionally health technology assessment, with other areas of health service research seldom engaging in ethical debate.”
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Aetna offers emergency compensation for HIV disclosure victims

The Hill, 2 October 2017
Author: Nathaniel Weixel
“Health insurance giant Aetna is offering cash reimbursements to some of the people who were affected when the company accidentally disclosed the HIV statuses of some of its customers. The “emergency relief” program will offer reimbursement and payments to individuals who say they have incurred financial hardship as a direct result of the privacy breach.”
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Increasing organ donation rates by revealing recipient details to families of potential donors

J Med Ethics, September 2017
Authors: David Shaw, Dale Gardiner
“Many families refuse to consent to donation from their deceased relatives or over-rule the consent given before death by the patient, but giving families more information about the potential recipients of organs could reduce refusal rates. In this paper, we analyse arguments for and against doing so, and conclude that this strategy should be attempted. While it would be impractical and possibly unethical to give details of actual potential recipients, generic, realistic information about the people who could benefit from organs should be provided to families before they make a decision about donation or attempt to over-rule it.”
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Does the doctrine of double effect apply to the prescription of barbiturates? Syme vs the Medical Board of Australia

J Med Ethics, September 2017
Author: Xavier Symons
“The doctrine of double effect (DDE) is a principle of crucial importance in law and medicine. In medicine, the principle is generally accepted to apply in cases where the treatment necessary to relieve pain and physical suffering runs the risk of hastening the patient’s death. More controversially, it has also been used as a justification for withdrawal of treatment from living individuals and physician-assisted suicide. In this paper, I will critique the findings of the controversial Victorian Civil and Administrative Tribunal (VCAT) hearing Syme vs the Medical Board of Australia. In that hearing, Dr Rodney Syme, a urologist and euthanasia advocate, was defending his practice of prescribing barbiturates to terminally ill patients.”
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Organ Donation: Presumed Consent and Focusing on What Matters

JME Blog, 25 September 2017
Author: Rebecca Brown
“It makes intuitive sense that presumed consent systems would increase organ donation rates, and those who fail to support their introduction often come under criticism. Such criticism tends to assume that failure to support presumed consent is due to a failure to properly recognise the importance of organ donation or a sentimental or squeamish attitude towards bodies as well as oversensitivity towards those who are hesitant about organ donation. Yet, even if one is very concerned with increasing organ donation rates, there are grounds for scepticism about the helpfulness of presumed consent systems as a means of achieving this.”
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As Victorian MPs debate assisted dying, it is vital they examine the evidence, not just the rhetoric

The Conversation, 20 September 2017
Authors: Ben White, Andrew McGee, Lindy WIllmott
“A starting point is to distinguish between claims that something should or should not happen (a moral claim about right and wrong), and claims that something is or is not happening (a factual or empirical claim). This distinction matters, because what justifies each type of claim is different.”
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Too many children exposed to unnecessary X-rays, Choosing Wisely experts tell doctors

SMH, 25 September 2017
Author: Kate Aubusson
“Unfortunately what we see is that so many of these children that come in to emergency departments with breathing problems and are having chest X-rays that doesn’t really change the treatment that we offer but it does put them at risk of the radiation that is associated with the X-ray and that is what we are trying to stop,” Dr Dalton said.”
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