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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What can we Learn from Patients’ Ethical Thinking about the right ‘not to know’ in Genomics? Lessons from Cancer Genetic Testing for Genetic Counselling

Bioethics,August 2016
Author: Lorraine Cowley
“This study aimed to explore interviewees’ experiences of genetic testing and how these influenced their family relationships. A key finding was that participants framed the decision to be tested as ‘common sense’; the idea of choice around the decision was negated and replaced by a moral imperative to be tested. Those who did not follow ‘common sense’ were judged to be imprudent. Family members who declined testing were discussed negatively by participants. The article addresses what is ethically problematic about how test decliners were discussed and whether these ethical concerns extend to others who are offered genetic testing.”
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Ethical issues in nanomedicine: Tempest in a teapot?

Med Health Care and Philos (2016)
Authors: Irit Allon, Ahmi Ben-Yehudah, Raz Dekel, Jan-Helge Solbakk, Klaus-Michael Weltring, Gil Siegal
“As methods in nanomedicine advance, ethical questions conjunctly arise. Nanomedicine is an exceptional niche in several aspects as it reflects risks and uncertainties not encountered in other areas of medical research or practice. Nanomedicine partially overlaps, partially interlocks and partially exceeds other medical disciplines. Some interpreters agree that advances in nanotechnology may pose varied ethical challenges, whilst others argue that these challenges are not new and that nanotechnology basically echoes recurrent bioethical dilemmas. The purpose of this article is to discuss some of the ethical issues related to nanomedicine and to reflect on the question whether nanomedicine generates ethical challenges of new and unique nature.”
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Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers

The American Journal of Bioethics, Volume 16, Issue 5, 2016
Authors: Jaro Kotalik & Gerry Martin
“Contemporary bioethics recognizes the importance of the culture in shaping ethical issues, yet in practice, a process for ethical analysis and decision making is rarely adjusted to the culture and ethnicity of involved parties. This is of a particular concern in a health care system that is caring for a growing Aboriginal population. We raise the possibility of constructing a bioethics grounded in traditional Aboriginal knowledge. As an example of an element of traditional knowledge that contains strong ethical guidance, we present the story of the Gifts of the Seven Grandfathers.”
Find abstract here and related commentaries here.

Bioethicists Can and Should Contribute to Addressing Racism

The American Journal of Bioethics, Volume 16, Issue 4, 2016
Authors: Marion Danis, Yolonda Wilson & Amina White
“The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems.”
Find abstract here and links to related commentaries here.