In the News

Disease Cause Is Pinpointed With Genome

Bioethics.net - Thu, 03/11/2010 - 12:00pm
Two research teams have independently decoded the entire genome of patients to find the exact genetic cause of their diseases. The approach may offer a new start in the so far disappointing effort to identify the genetic roots of major killers like heart disease, diabetes and Alzheimer's.
Categories: In the News

Researchers confirm safety of kidney donations

Bioethics.net - Thu, 03/11/2010 - 10:31am
People who donate a kidney to a sick friend or relative live at least as long as others in the general population and may live somewhat longer because they tend to take better care of themselves after the procedure, researchers reported Tuesday.
Categories: In the News

New tool lets patients call the shots at end of their lives

Bioethics.net - Thu, 03/11/2010 - 10:29am
Doug State entered hospice care two years ago knowing exactly how he wanted to die: at home in Cambridge, Minn., with his wife, Carol, and his dog, Teddy.
Categories: In the News

The balance between legal liability and altruism

Bioethics.net - Thu, 03/11/2010 - 10:28am
Last week the US Ambassador visited the Medical School to meet with Maltese doctors to discuss the US health plan. He came across as a humble person, actually asking us about our system and how they, as Americans, can learn from Europeans, who have managed to create health care systems, which are based on a social justice system different from that in the US.
Categories: In the News

Doctors fail to cut cholesterol enough

Bioethics.net - Thu, 03/11/2010 - 10:27am
Only half of patients at high risk of heart disease are given the right targets for cutting their cholesterol and millions may suffer heart attack or stroke due to doctors' poor advice, scientists said on Thursday.
Categories: In the News

Medicine in the Dark

Bioethics.net - Wed, 03/10/2010 - 2:06am
Some doctors treat patients with early-stage prostate cancer with radiation. Others favor surgery, while some advocate only close monitoring. Which approach is most successful? No one knows.
Categories: In the News

Q&A: Electronic medical records

Bioethics.net - Wed, 03/10/2010 - 2:04am
The doctors' union claims that England's medical records database is being pushed through too fast, with details sometimes being uploaded without patients' knowledge. But those behind the new system say many patients are astonished that hospital doctors still do not have access to basic information, and the process to opt out is very straightforward. What are the issues?
Categories: In the News

Doctor Leads Quest for Safer Ways to Care for Patients

Bioethics.net - Tue, 03/09/2010 - 7:48am
Dr. Peter J. Pronovost, 45, is medical director of the Quality and Safety Research Group at Johns Hopkins Hospital in Baltimore, which means he leads that institution?s quest for safer ways to care for its patients. He also travels the country, advising hospitals on innovative safety measures. The Hudson Street Press has just released his book, ?Safe Patients, Smart Hospitals: How One Doctor?s Checklist Can Help Us Change Health Care from the Inside Out,? written with Eric Vohr. An edited version of a two-hour conversation follows.
Categories: In the News

Money Talks, Nobody Walks on the Medicare Gravy Train

Bioethics.net - Tue, 03/09/2010 - 7:44am
What if Medicare were run like a corporation, with a CEO and a tightly managed budget? That?s the provocative question posed by Daniel Callahan, a healthcare expert at the Hastings Center, a nonpartisan bioethics research institute.
Categories: In the News

Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa

MedWorm: Medical Ethics - Mon, 03/08/2010 - 6:00pm
Conclusion: The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields. (Source: BMC Medical Ethics)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Categories: In the News

University of Michigan Scientists Identify Reservoirs Where HIV-Infected Cells Can Lie in Wait

Bioethics.net - Mon, 03/08/2010 - 12:58pm
University of Michigan scientists have identified a new reservoir for hidden HIV-infected cells that can serve as a factory for new infections. Targeting these reservoirs of latent cells may open a door to new treatments.
Categories: In the News

Defibrillator Implants Often Overlooked in Hospice, End-of-Life Care

Bioethics.net - Mon, 03/08/2010 - 12:53pm
A large percentage of hospices do not account for patients with defibrillator implants, which can lead to unnecessary - and uncomfortable - shocks to patients, new research shows.
Categories: In the News

Washington: First Year Under Legalized Assisted Suicide

Bioethics.net - Mon, 03/08/2010 - 12:00pm
Today is the first anniversary of the law in which Washington legalized the practice through a public referendum, Initiative 1000. Dominican Sister Sharon Park, executive director of the Washington State Catholic Conference, states that the law places vulnerable people at risk of abuse. The legislation, she said, was written to prevent adequate safeguards for persons most in need of care and support.
Categories: In the News

State's Assisted-Suicide Law Faces Major Test Monday

Bioethics.net - Mon, 03/08/2010 - 12:00pm
Two Connecticut physicians, Gary Blick and Ronald M. Levine, sued the state last year hoping to ensure that doctors who prescribe medication to enable a patient to end his own life will not be charged with second-degree manslaughter under the law. The heart of the case is how suicide will be defined under Connecticut law.
Categories: In the News

The concise argument

Journal of Medical Ethics - Mon, 03/08/2010 - 9:01am
Categories: In the News

Evolution of hospital clinical ethics committees in Canada

Journal of Medical Ethics - Mon, 03/08/2010 - 9:01am

To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour.

Categories: In the News

The ethics of basing community prevention in general practice

Journal of Medical Ethics - Mon, 03/08/2010 - 9:01am

In this paper we argue that the responsibility for systematic community-based preventive medicine should not be made part of the role of the general practitioner (GP). Preventive medicine cannot be shown to be more effective than curative or supportive medicine. Therefore, the allocation of the large amount of general practice staff time and resources required for systematic preventive medicine should not come at the expense of the care of the sick and the suffering. The traditional healing role of the GP requires a cooperative patient-centred approach, whereas systematic preventive medicine is driven by rigid pre-set protocols and is intrinsically paternalistic. Trying to merge the two approaches is detrimental to the doctor-patient relationship. Furthermore, a number of potential pitfalls are identified that may be encountered in the implementation of preventive medicine programmes in general practice: interference with the course of the consultation; inadequate explanation and consent; distortion of practice priorities as reflected in quality indicators; temptation to record inaccurate data; conflict of interests where the doctor is rewarded for performance; patient blaming; exacerbation of the health gap.

We suggest that a more justifiable strategy would be for GPs to identify patients at high risk and offer them specific preventive advice when the opportunity presents itself and at a time when the patient is likely to be most amenable to cooperate. Opportunistic health promotion offers higher expectations of benefit, as well as a more equitable allocation of the risks associated with preventive medicine, than a systematic community-based approach.

Categories: In the News

Understanding risk in living donor nephrectomy

Journal of Medical Ethics - Mon, 03/08/2010 - 9:01am
Objectives

To investigate risk perception relating to living kidney donation, to compare the risk donors would accept with current practice and identify influential factors.

Design

An observational study consisting of questionnaires completed by previous living donors and the general public. Participants selected the risk they would accept from a list of options, in various scenarios. Risk communication was investigated by randomly dividing the sample and presenting risk differently.

Setting

Primary care (two centres) and secondary care (one centre), London.

Participants

175 questionnaires were sent to patients who had previously undergone living-donor nephrectomy and to members of the public consulting a general practitioner. The living-donor sample comprised 77 consecutive donors at Guy's Hospital from May 2003 to January 2005. The general-public sample was recruited from two London healthcare centres. Of the eventual 151 participants, 61 were living donors and 90 were from the general public.

Main outcome measure

The amount of risk a participant would accept to donate a kidney.

Results

74% of participants were willing to accept a risk of death higher than 1/3000. The most commonly accepted risk was 1/2 (29%). Those presented with a ‘chance of survival’ accepted higher risks than those presented with a ‘risk of death’ (p<0.01). Greater risks were accepted when the recipient was closely related and, for some, when the recipient's prognosis was worse. No difference was observed between the living-donor and general-public groups.

Conclusions

Kidney donors will accept a higher risk of death than is currently quoted, especially if risks are presented in terms of chance of survival.

Categories: In the News

The perils of failing to enhance: a response to Persson and Savulescu

Journal of Medical Ethics - Mon, 03/08/2010 - 9:01am

Ingmar Persson and Julian Savulescu argue that non-traditional forms of cognitive enhancement (those involving genetic engineering or pharmaceuticals) present a serious threat to humanity, since the fruits of such enhancement, accelerated scientific progress, will give the morally corrupt minority of humanity new and more effective ways to cause great harm. And yet it is scientific progress, accelerated by non-traditional cognitive enhancement, which could allow us to dramatically morally enhance human beings, thereby eliminating, or at least reducing, the threat from the morally corrupt minority. I argue that this apparently intractable dilemma is less difficult to resolve than Persson and Savulescu suppose. Their analysis of non-traditional cognitive enhancement overstates the risks and undervalues the benefits that such enhancement might provide. Once the benefits are better described, it is clear that non-traditional cognitive enhancement could be the means of our survival, not of our destruction.

Categories: In the News