NHMRC releases updated assisted reproductive technology guidelines

NHMRC, 20 April 2017
“The National Health and Medical Research Council (NHMRC) today released the Ethical guidelines on the use of assisted reproductive technology in clinical practice and research, 2017 (ART guidelines). This update replaces the 2007 ART guidelines and provides contemporary ethical guidance for the conduct of ART in the clinical setting. The ART guidelines articulate ethical principles and, when read in conjunction with federal and state or territory legislation, create a robust framework for the conduct of ART in Australia.”
Find media release and guideline here.

Lectures on Inhumanity: Teaching Medical Ethics in German Medical Schools Under Nazism

Ann Intern Med. 2017;166(8):591-595.
Authors: Florian Bruns; Tessa Chelouche
“Nazi medicine and its atrocities have been explored in depth over the past few decades, but scholars have started to examine medical ethics under Nazism only in recent years. Given the medical crimes and immoral conduct of physicians during the Third Reich, it is often assumed that Nazi medical authorities spurned ethics. However, in 1939, Germany introduced mandatory lectures on ethics as part of the medical curriculum.”
Find article here.

Discovering What Matters: Interrogating Clinician Responses to Ethics Consultation

Bioethics, 2017, 31: 267–276. doi:10.1111/bioe.12345
Authors: Finder, S. G. and Bartlett, V. L.
“Against the background assumptions that (a) knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and (b) the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service.”
Find article here.

The Deadly Business of an Unregulated Global Stem Cell Market

BMJ Blog, 30 March 2017
Authors: Tereza Hendl, Tamra Lysaght
“In our paper, we report on the case of a 75-year old Australian woman who died in December 2013 from complications of an autologous stem cell procedure. This case was tragic and worth reporting to the medical ethics community because her death was entirely avoidable and the result of a pernicious global problem – doctors exploiting regulatory systems in order to sell unproven and unjustified stem cell interventions.”
Find article here.

Family Presence During Resuscitation: Extending Ethical Norms from Pediatrics to Adults

JME Blog, 28 March 2017
Authors: Christine Vincent, Zohar Lederman
“Family presence during resuscitation is an important ethical issue for discussion within the medical community. Currently, family presence is more commonly accepted in paediatric cardiopulmonary resuscitation (CPR) than adult CPR. However, we argue that this fact is not morally justified and that the case for family presence during adult CPR is indeed morally stronger. In our paper we provide an ethical argument for accepting both family presence during adult CPR and pediatric CPR.
Find article here.

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.”
Find article here.

Doctors Consider Ethics Of Costly Heart Surgery For People Addicted To Opioids

NPR, 21 March 2017
Author: Jack Rodolico
“Milford is part of a group of opioid addicts whom doctors describe as the sickest of the sick: intravenous drug users, mostly people who use heroin, who get endocarditis. Some aspects of their treatment present an ethical dilemma for doctors. Cardiologists, surgeons and infectious disease doctors can fix the infection, but not the underlying problem of addiction.”
Find article here.

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.”
Find article here.

Response to ‘A matter of life and death: controversy at the interface between clinical and legal decision-making in prolonged disorders of consciousness’

BMJ Blogs, 3 March 2017
Author: Julian Sheather
“The law has to work in generalities. The prohibitions it imposes and the liberties it describes are set for all of us, or for large classes of us. But we live – like we sicken and die – as individuals. Lynne Turner-Stokes gives a vivid account of an area of clinical practice where these truisms come into conflict. Practice Direction 9E (PD9E) doesn’t sound like much, a piece of dry-as-dust procedure for the Court of Protection, but it governs an area of keen moral concern: for our purposes, decisions relating to the withdrawing or withholding of clinically-assisted nutrition and hydration (CANH) from patients in a persistent vegetative state (PVS) or a minimally conscious state (MCS). According to PD9E, all such decisions should be bought before the Court of Protection.”
Find article here.