Medics as force multipliers around Mosul—at the expense of medical ethics?

The BMJ Opinion, 14 June 2017
Author: Jonathan Whittall
“But there is also a vital role for independent civilian health providers, such as MSF, to operate in accordance with the basic principles of impartiality and medical ethics. Independent health facilities allow patients who do not feel safe going to military installations to still access care, whereas the marriage between medicine and the military limits the safe options available to patients. If healthcare is only carried out as a component of the overall military strategy, it undermines the very basis of medical ethics.”
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New Frontiers in End-of-Life Ethics (and Policy): Scope, Advance Directives and Conscientious Objection

Bioethics, 31(6) 2017, 422-423
Author: Udo Schuklenk
“However, it would be premature to conclude that all arguments are settled now, if not in politics and law, and that, certainly in ethics, nothing much original could be added to the existing corpus of critical analysis and argument. In fact jurisdictions considering the decriminalization of medical aid in dying are grappling today with three issues that deserve further analysis.”
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What’s the Point of Professional Ethical Codes?

JME Blog, 13 June 2017
Author: Iain Brassington
“They can’t be meant as a particularly useful tool for solving deep moral dilemmas: they’re much too blunt for that, often presuppose too much, and tend to bend to suit the law. To think that because the relevant professional code enjoins x it follows that x is permissible or right smacks of a simple appeal to authority, and this flies in the face of what it is to be a moral agent in the first place. But what a professional code of ethics may do is to provide a certain kind of Bolamesque legal defence: if your having done ? attracts a claim that it’s negligent or unreasonable or something like that, being able to point out that your professional body endorses ?-ing will help you out. But professional ethics, and what counts as professional discipline, stretches way beyond that.”
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Ethics involved in life support decisions remain matter of debate

The Globe and Mail, 15 June 2017
Author: Wency Leung
“When doctors aren’t able to have end-of-life discussions with patients themselves, they often have to approach the delicate subject with the patient’s caregiver or family members. From a doctor’s perspective, these discussions typically involve presenting the evidence of what is known about the situation, what the likely outcomes may be, given that evidence, and most importantly, understanding the patient – what their values are, their expectations and ideology. To make a choice about whether to proceed with aggressive treatment, families should be informed about what those treatments are, the possible risks and benefits and what the ultimate outcomes are.”
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Development of a consensus operational definition of child assent for research

BMC Medical Ethics 2017 18:41
Authors: Alan R Tait, Michael E Geisser
“While research participation for most children requires the permission of parent(s)/guardian(s), the bioethical principle of “respect for persons” requires that children also provide their assent to participate to the degree that they are deemed “capable of providing it,” taking into account the child’s “age, maturity, and psychological state”. While this regulatory framework is designed to allow children to express their burgeoning autonomy, foster moral growth, and develop decision-making skills, it provides absolutely no practical guidance with respect to what actually constitutes assent and which children are capable of providing it.”
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No Pain, All Gain: The Case for Farming Organs in Brainless Humans

JME Blog, 10 June 2017
Authors: Ruth Stirton, David Lawrence
“It is widely acknowledged that there is a nationwide shortage of organs for transplantation purposes. In 2016, 400 people died whilst on the organ waiting list. Asking for donors is not working fast enough. We should explore all avenues to alleviate this problem, which must include considering options that appear distasteful. As the world gets safer, and fewer young people die in circumstances conducive to the donation of their organs, there is only so much that increased efficiency in collection (through improved procedures and storage) can do to increase the number of human organs available for transplantation. Xenotransplantation – the transplantation of animal organs into humans – gives us the possibility of saving lives that we would certainly lose otherwise.”
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Our so-called ‘universal’ healthcare: the well waste money and the poor get sicker

The Guardian, 11 June 2017
Author: Amy Corderoy
“The waste of wellness dollars is an ethical issue when health inequality in Australia is a life-or-death issue. While the worried well shell out great amounts stockpiling placebos, the poor get sicker. What if all those billions of dollars were poured into some real wellness? Perhaps along with our tobacco tax, we need to introduce a snake-oil tax as well. We need to start thinking of this waste of wellness dollars as an ethical issue. Because the money is needed elsewhere. And desperately.”
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Comments on the Lambert case: the rulings of the French Conseil d’Etat and the European Court of Human Rights

Med Health Care and Philos (2017) 20:187
Author: Denard Veshi
“This study examines the decisions of the French Conseil d’Etat (Supreme Administrative Court) and the European Court of Human Rights in the Lambert case concerning the withdrawal of life-sustaining treatments. After presenting the facts of this case, the main legal question will be analyzed from an ethical and medical standpoint. The decisions of the Conseil d’Etat and then of the European Court of Human Rights are studied from a comparative legal perspective. This commentary focuses on the autonomous will of an unconscious patient and on the judicial interpretation of the right to life as recognized in article 2 of the European Convention on Human Rights. Furthermore, it medically classifies artificial nutrition and hydration (ANH) as a ‘treatment’ which has ethical and legal implications.”
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Offending in theatre: the case of Ian Paterson

BMJ 2017; 357: j2583
Author: Gwen Adshead
“This highly trained and experienced doctor seems to have deliberately conned people into having surgery that they did not need, and in doing so convinced them that they were seriously ill and he was saving their lives. The question has been raised as to what his motivation could be.”
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Ethics Survey: Drug testing remains a clinical tug of war

Behavioural Net, 18 May 2017
Author: Julie Miller
“In recent weeks, the American Society of Addiction Medicine (ASAM) prepared comprehensive guidelines on drug testing within the continuum of care. The goal is to present evidence-based recommendations for the frequency and application of testing, which payers and providers can adopt as best practices. It’s significant because up until now, there was no true consensus. And there’s also no denying that some treatment operators have aimed to maximize their profit streams through the overuse of testing and subsequent billing of insurance companies.”
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