Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

JME Blog, 15 November 2017
Authors: Rosalind J McDougall, Lynn Gillam, Clare Delany, Yasmin Jayasinghe
“These were the kinds of questions that doctors brought to our clinical ethics service. They wanted ethical advice about offering surgical procedures for young children with cancer, aimed at preserving fertility. This is an area of rapidly developing science, but there is currently little evidence that the fertility preservation process works for very young patients.”
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Children can decide their medical treatments under Victoria’s unique advance directive laws

The Conversation, 4 October 2017
Author: Carolyn Johnston
“Writing an advance care directive is part of the planning process, but a directive means the person’s preferences are bound to be followed by law. All states and territories have varying laws enabling adults to make advance care plans or directives. In Victoria, new legislation will come into effect in March 2018, creating clear obligations for health practitioners to respect advance directives.”
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Mother who refuses to follow court order to vaccinate son: ‘Most likely, I’ll be going to jail’

SMH, 30 September 2017
Author: Kristine Phillips
“The American Medical Association has long decried allowing parents to decline vaccination for nonmedical reasons and has cited vaccines’ ability to prevent diseases such as measles, mumps and other infectious diseases. Still, a majority of states allow religious exemptions for vaccinations. Nearly 20, including Michigan, provide exemption for religious and personal reasons. Only three, California, Mississippi and West Virginia, don’t allow nonmedical exemptions.”
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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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Homeopathy company investigated over ebook advocating treatment of babies

The Guardian, 30 June 2017
Author: Melissa Davey
“Australia’s drug regulator is investigating the promotion of an ebook that advocates homeopathic treatment for babies and toddlers, against all scientific evidence. Brauer, one of Australia’s largest homeopathy companies, promotes the Little Book of Natural Medicines for Children on its website. The book is available for download, and the website promotes the efficacy of homeopathic products. In 2015 the National Health and Medical Research Council reviewed 225 research papers on homeopathy and found it was not effective for treating any health condition.”
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France to legislate on assisted reproduction: spokesman

Reuters, 28 June 2017
Authors: Jean-Baptiste Vey, Brian Love and Andrew Roche
“The French government wants to give lesbian couples and single women access to assisted reproduction, a government spokesman said on Wednesday, setting the scene for a major extension of gay rights under new President Emmanuel Macron. French law currently restricts techniques such as artificial insemination using donated sperm to heterosexual couples. The National Consultative Committee on Ethics (CCNE) said on Tuesday it was in favor of extending medically assisted procreation to female couples and single women.”
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Court rules hospital can withdraw life support for sick baby

KFOR, 27 June 2017
Author: Nadia Judith Enchassi
“The European Court of Human Rights ruled Tuesday a hospital can discontinue life support to a baby suffering from a rare genetic disease. Born in August, Charlie Gard has a rare genetic disorder caused by a genetic mutation that leads to weakened muscles and organ dysfunction, among other symptoms, with a poor prognosis for most patients. Charlie is on life support and has been in the intensive care unit at the Great Ormond Street Hospital for Children in London since October. His doctors wish to take him off life support, but his parents disagreed.”
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Polio outbreaks in DRC set back global efforts to eradicate the disease

The Guardian, 15 June 2017
Author: Ruth Maclean
“Two separate outbreaks of polio in the Democratic Republic of the Congo have set back global efforts to eradicate the debilitating disease. The World Health Organisation last week said the virus had also come back in Syria. But the known cases could be just the tip of the iceberg: for every case of polio that is diagnosed, epidemiologists say there are 200 “silent infections” – people who have no symptoms but can pass the disease on to others.”
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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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Charlie Gard’s parents make emergency appeal to European judges

The Guardian, 9 June 2017
Author: Owen Bowcott
“Established human rights law dictates that the rights of a child should take precedence over the rights of their parent, Hale stressed in her decision. “The child’s interests must prevail,” she said. Lawyers for the child’s guardian appointed by the court have argued against sending Charlie to the US, saying that the proposed treatment would be futile.”
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