When surgeons unwittingly don’t obtain informed consent

The BMJ Opinion, 6 October 2017
Authors: Fraser Smith and David Locke
“It is our belief that many patients with rectal cancer are (probably unwittingly) not being informed about potential treatment options which may be available to them that could allow them to avoid radical surgery and a stoma. In effect this is rendering informed consent invalid and represents a failure to safeguard patient autonomy.”
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Nudge me, help my baby: on other-regarding nudges

Journal of Medical Ethics 2017; 43: 702-706.
Authors: Hafez Ismaili M’hamdi, Medard Hilhorst, Eric A P Steegers, Inez de Beaufort
“In the period surrounding pregnancy, maternal choice behaviour has a significant influence on perinatal morbidity and mortality as well as the development of chronic diseases later in life. One’s health is thus a matter of one’s own as well as one’s maternal choices. Therefore, self-regarding and other-regarding nudges should be considered as viable strategies to promote health. In this article, we introduce the concept of other-regarding nudges. We use the harm principle and the principle of beneficence to justify these other-regarding nudges. We conclude by stressing the importance of a fair assessment of expectations towards the nudgee, when determining whether a nudge is aimed at preventing harm or promoting a good.”
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The ethics of compromise: third party, public health and environmental perspectives

Journal of Medical Ethics 2017; 43:267-268.
Author: Marks JH
“In their chapter entitled ‘Compromise as a Template’, Lepora and Goodin contend that ‘[i]t is only when the intra-personal conflict forces an agent to choose among items of principled concern … to her that a compromise is genuinely involved’ (p. 19). The authors are right to emphasise the ethical significance of setting aside, forsaking or violating one’s principles to reach an agreement. There may be serious implications for the integrity of an individual or an institution that makes such a compromise. But we should ensure that the intrapersonal focus does not lead to the neglect of other important ethical dimensions.”
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On normative judgments and ethics

BMC Medical Ethics 2016 17:75
Author: Ognjen Arandjelovi
“Recent rapid technological and medical advance has more than ever before brought to the fore a spectrum of problems broadly categorized under the umbrella of ‘ethics of human enhancement’. Some of the most contentious issues are typified well by the arguments put forward in a recent article on human cognitive enhancement authored by Garasic and Lavazza. Herein I analyse some of the assumptions made in their work and highlight important flaws. In particular I address the problems associated with the distinction between ‘treatment’ and ‘enhancement’, and ‘natural’ vs. ‘non-natural’ therapies.”
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The Ethics of Hunting Down ‘Patient Zero’

NYT, 29 October 2016
Author: Donald G McNeil Jr
“The alleged “Patient Zero” of the American AIDS epidemic — a French Canadian flight attendant named Gaétan Dugas, who died of AIDS in 1984 — was exonerated last week. The debunking of the Dugas myth raises a moral question: Is it right to hunt down the first case in any outbreak, to find every Patient Zero?”
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Assisted Suicide in Switzerland: Clarifying Liberties and Claims

Bioethics. doi:10.1111/bioe.12304
Authors: Samia A. Hurst, Alex Mauron
“Assisting suicide is legal in Switzerland if it is offered without selfish motive to a person with decision-making capacity. Although the ‘Swiss model’ for suicide assistance has been extensively described in the literature, the formally and informally protected liberties and claims of assistors and recipients of suicide assistance in Switzerland are incompletely captured in the literature. In this article, we describe the package of rights involved in the ‘Swiss model’ using the framework of Hohfeldian rights as modified by Wenar. After outlining this framework, we dissect the rights involved in suicide assistance in Switzerland, and compare it with the situation in England and Germany.”
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Misplaced Paternalism and other Mistakes in the Debate over Kidney Sales

Bioethics. doi:10.1111/bioe.12303
Author: Luke Semrau
“Erik Malmqvist defends the prohibition on kidney sales as a justifiable measure to protect individuals from harms they have not autonomously chosen. This appeal to ‘group soft paternalism’ requires that three conditions be met. It must be shown that some vendors will be harmed, that some will be subject to undue pressure to vend, and that we cannot feasibly distinguish between the autonomous and the non-autonomous. I argue that Malmqvist fails to demonstrate that any of these conditions are likely to obtain.”
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Permitting patients to pay for participation in clinical trials: the advent of the P4 trial

Med Health Care and Philos (2016). doi:10.1007/s11019-016-9741-2
Authors: David Shaw, Guido de Wert, Wybo Dondorp, David Townend, Gerard Bos, Michel van Gelder
“In this article we explore the ethical issues raised by permitting patients to pay for participation (P4) in clinical trials, and discuss whether there are any categorical objections to this practice. We address key considerations concerning payment for participation in trials, including patient autonomy, risk/benefit and justice, taking account of two previous critiques of the ethics of P4. We conclude that such trials could be ethical under certain strict conditions, but only if other potential sources of funding have first been explored or are unavailable.”
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