A doctor’s sexual advances towards a patient are never ok, even if ‘consensual’

The Conversation, 20 April 2017
Author: Ron Paterson
“In a recent independent review, I recommended chaperones no longer be used as an interim protective measure to keep patients safe while allegations of sexual misconduct by a doctor are investigated. The Medical Board of Australia and AHPRA have accepted my recommendations that the current system of using chaperones is outdated and paternalistic. Sadly, cases of sexual misconduct are likely to continue. It’s important patients know the warning signs and where to seek help if they suspect their doctor is behaving inappropriately.”
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A critique of the regulation of data science in healthcare research in the European Union

BMC Medical Ethics 2017 18:27
Authors: John M. M. Rumbold, Barbara K. Pierscionek
“The EU offers a suitable milieu for the comparison and harmonisation of healthcare across different languages, cultures, and jurisdictions (albeit with a supranational legal framework), which could provide improvements in healthcare standards across the bloc. There are specific ethico-legal issues with the use of data in healthcare research that mandate a different approach from other forms of research. The use of healthcare data over a long period of time is similar to the use of tissue in biobanks. There is a low risk to subjects but it is impossible to gain specific informed consent given the future possibilities for research. Large amounts of data on a subject present a finite risk of re-identification.”
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Inconsistent state laws may complicate medical decision-making

EurekAlert, 12 April 2017
Source: University of Chicago Medical Center
“A patchwork of state laws creates a labyrinth that can make it confusing to navigate incapacitated patients’ medical wishes. Without clear national standards, the problem may worsen as the nation’s 75 million baby boomers continue to age, according to medical ethics research published in the New England Journal of Medicine. On average, 40 percent of hospitalized adults can’t make their own medical decisions. In some intensive care units, that figure skyrockets to 90 percent.”
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How consent requirements may shape teen mental health research

Reuters, 6 April 2017
Author: Lisa Rapaport
“Requiring teens to get permission from their parents to participate in studies about behavioral health may make it harder to understand adolescent psychology – especially when drugs and alcohol are involved. “Requiring parental consent may introduce a systematic bias that excludes certain segments of our population,” said lead study author Chao Liu of Oklahoma State University in Stillwater. In the U.S., minors under age 18 generally need permission from their parents to get medical treatment or participate in research.”
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Smart homes, private homes? An empirical study of technology researchers’ perceptions of ethical issues in developing smart-home health technologies

BMC Medical Ethics 2017 18:23
Authors: Giles Birchley, Richard Huxtable, Madeleine Murtagh, Ruud ter Meulen, Peter Flach, Rachael Gooberman-Hill
“Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology’s potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community.”
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A qualitative study of participants’ views on re-consent in a longitudinal biobank

BMC Medical Ethics 2017 18:22
Authors: Mary Dixon-Woods, David Kocman, Liz Brewster, Janet Willars, Graeme Laurie, Carolyn Tarrant
“Biomedical research increasingly relies on long-term studies involving use and re-use of biological samples and data stored in large repositories or ‘biobanks’ over lengthy periods, often raising questions about whether and when a re-consenting process should be activated. We sought to investigate the views on re-consent of participants in a longitudinal biobank.”
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da HORTA -v- PODIATRY BOARD OF AUSTRALIA [2017] WASC 82

Delivered: 24 March 2017
“On about 30 November 2016, the Board notified the applicant that it had decided under s 178 and s 179 of the Health Practitioner Regulation National Law to caution him. The Board gave brief reasons for its action, finding certain failings in the applicant’s treatment of a named patient, including that he should have communicated risks and likely success or failure rates of any proposed treatment more clearly, should have conducted a more through ‘consenting process’, and that his clinical records were inadequate. It stated his professional performance ‘is or may be unsatisfactory’.”
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Pelvic mesh devices hit by allegations of research fraud, experimental surgery on thousands of women

SMH, 14 March 2017
Author: Joanne McCarthy
“Pelvic devices developed in Australia from the 1980s and 1990s are at the centre of a global medical scandal that includes regulatory failure, and allegations of research fraud and experimental surgery on women in multiple countries.”
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Presumed consent: licenses and limits inferred from the case of geriatric hip fractures

BMC Medical Ethics 2017 18:17
Authors: Joseph Bernstein, Drake LeBrun, Duncan MacCourt, Jaimo Ahn
“Hip fractures are common and serious injuries in the geriatric population. Obtaining informed consent for surgery in geriatric patients can be difficult due to the high prevalence of comorbid cognitive impairment. Given that virtually all patients with hip fractures eventually undergo surgery, and given that delays in surgery are associated with increased mortality, we argue that there are select instances in which it may be ethically permissible, and indeed clinically preferable, to initiate surgical treatment in cognitively impaired patients under the doctrine of presumed consent.”
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Donation after brain circulation determination of death

BMC Medical Ethics 2017 18:15
Authors: Anne L. Dalle Ave, James L. Bernat
“In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation may resume after the determination of death; 3] complete circulatory cessation is verified; and 4] the cessation of brain function is permanent and complete. Death should be determined by the confirmation of the cessation of systemic circulation; the use of brain death tests is invalid and unnecessary. Because this concept differs from current standards, consensus should be sought among stakeholders. The patient or surrogate should provide informed consent for organ donation by understanding the basis of the declaration of death.”
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