Aid-in-Dying Laws and the Physician’s Duty to Inform

JME Blog, 22 March 2017
Author: Mara Buchbinder
“Why do so many people assume that any clinical communication about aid-in-dying (AID, also known as assisted suicide), where it is legal, ought to be patient-initiated? Physician participants in my ongoing study tend to assume that physicians should wait for patients to initiate discussions of AID. The clinical ethics literature on communication about AID has reinforced this expectation by focusing on how to respond to patient requests. Consequently, bioethics has largely remained silent on whether there is a professional duty to inform terminally ill patients about AID laws and their clinical and legal requirements.”
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Beyond cultural stereotyping: views on end-of-life decision making among religious and secular persons in the USA, Germany, and Israel

BMC Medical Ethics 2017 18:13
Authors: Mark Schweda, Silke Schicktanz, Aviad Raz, Anita Silvers
“End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes.”
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Human genome editing report strikes the right balance between risks and benefits

The Conversation, 16 February 2017
Author: Merlin Crossley
“If you recognise the words “CRISPR-mediated gene editing”, then you’ll know that our ability to alter DNA has recently become much more efficient, faster and cheaper. This has inevitably led to serious discussions about gene therapy, which is the direct modification of someone’s DNA to rectify a genetic disorder, such as sickle cell anaemia or haemophilia. And you may also have heard of deliberate genetic enhancement, to realise a healthy person’s dreams of improving their genome.”
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Human Gene Editing Receives Science Panel’s Support

NYT Health, 14 February 2017
Author: Amy Harmon
“An influential science advisory group formed by the National Academy of Sciences and the National Academy of Medicine on Tuesday lent its support to a once-unthinkable proposition: the modification of human embryos to create genetic traits that can be passed down to future generations. This type of human gene editing has long been seen as an ethical minefield. Researchers fear that the techniques used to prevent genetic diseases might also be used to enhance intelligence, for example, or to create people physically suited to particular tasks, like serving as soldiers.”
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Making headway against low value services

MJA Insight, 13 February 2017
Author: Nicole Mackee
“The push to address the use of low value, or potentially harmful, medical services is continuing to gain pace in Australia, say experts, after the Lancet published an article describing the overuse of medical services worldwide. Professor Adam Elshaug, professor of Health Policy at the University of Sydney, codirector of the Menzies Centre for Health Policy and a coleader of a Lancet series, Right Care, said Australia’s clinical community had pulled together to drive initiatives aimed at tackling inappropriate care.”
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The doctor’s dilemma: is it ever good to do harm?

The Guardian, 9 February 2017
Author: Gwen Adhsead
“Medical knowledge changes swiftly, and technological changes make new and expensive investigations and treatments possible that were only theoretical a few years ago. Life has been extended in length, but not in quality, and the debates about end?of?life decisions show us how much the notion of a “good life” is bound up with the absence of disease, illness and suffering.”
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Epistemic Authority and Genuine Ethical Controversies

Bioethics, 2017. doi:10.1111/bioe.12341
Author: Adam James Roberts
“In ‘Professional Hubris and its Consequences’, Eric Vogelstein claims that ‘that there are no good arguments in favor of professional organizations taking genuinely controversial positions on issues of professional ethics’. In this response, I defend two arguments in favour of organisations taking such positions: that their stance-taking may lead to better public policy, and that it may lead to better practice by medical professionals. If either of those defences succeeds, then Vogelstein’s easy path to his conclusion – that professional organisations should not take such stances – is blocked. He or others must instead look to establish that the reasons against stance-taking on genuine ethical controversies are more compelling than those for it: plausibly a more challenging task.”
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Is Mitochondrial Donation Germ-Line Gene Therapy? Classifications and Ethical Implications

Bioethics, Volume 31, Issue 1, January 2017, p55–67
Authors: Ainsley J. Newson, Anthony Wrigley
“The classification of techniques used in mitochondrial donation, including their role as purported germ-line gene therapies, is far from clear. These techniques exhibit characteristics typical of a variety of classifications that have been used in both scientific and bioethics scholarship. This raises two connected questions, which we address in this paper: (i) how should we classify mitochondrial donation techniques?; and (ii) what ethical implications surround such a classification? First, we outline how methods of genetic intervention, such as germ-line gene therapy, are typically defined or classified. We then consider whether techniques of mitochondrial donation fit into these, whether they might do so with some refinement of these categories, or whether they require some other approach to classification.”
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