(Source: Clinical Ethics)

 

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The Nuffield Council on Bioethics examines ethical issues raised by new developments in biology and medicine. Established by the Nuffield Foundation in 1991, the Council is an independent body, funded jointly by the Foundation, the Medical Research Council and the Wellcome Trust. Independence and quality are the underlining principles of the Council, and the way the Council works has been designed to ensure that its reports are thorough, authoritative and provide a novel, policy-oriented approach to difficult ethical dilemmas. Recent reports have considered the issues raised by public health and critical care decisions in fetal and neonatal medicine. The Council is currently considering the ethical dilemmas surrounding dementia. (Source: Clinical Ethics)

Beauchamp and Childress (1994) elaborated an approach to bioethical deliberations based on four universalistic principles. This framework of ‘principlism’ has been criticized from within biomedical ethics as insufficient and problematic. However, this article considers a more radical sociological critique by John Evans (2002) that rejects the entire approach of defining ‘principles’ a priori. This sociological critique is based on classical sociologist Max Weber's (1925) distinction between instrumental (‘thin’) and substantive (‘thick’) rationality. As an exploratory assessment of Evans' critique, his conceptualization of ‘thin’ versus ‘thick’ rationalization is applied to a large sample of Anglo-American press covera...

Selection in reproductive medicine today relies on normative assessments of what ‘good life’ consists of. This paper explores the terms under which such assessments are made by focusing on three particular concepts of ‘quality’: quality of life, biological quality and population quality. It is suggested that the apparently conflicting hypes, hopes and fears that surround reproductive medicine can co-circulate because of the different forms of normative assessment that these concepts allow. To ensure clarity in bioethical deliberations about selection, it is necessary to highlight how these differing forms of assessment are mobilized and invoked in practices of and debates about reproductive medicine. (Source: Clinical Ethics)

This paper argues that bioethics requires analysis, which is not explicitly ethical in character. The first part of the paper argues the general point, that ethical problems can arise not only on occasions when moral values make conflicting recommendations, but also in understanding the facts. I suggest that this is particularly so where the facts are provided by the biomedical sciences, since it is often not clear how to relate their conceptual framework to that in which we frame our value judgements. In the second part, I illustrate the argument by criticizing the moral conclusions drawn by the authors of a recent widely publicized study of paediatric obesity. There is a failure to translate properly these results into the language we use for moral evaluation. The case therefore illustra...

The aim of this study is to assess patients' recall of their previous research participation. Recall was established during interviews and compared with entries from clinical notes. Participants were 49 patients who had previously participated in different types of research. Of the 49 patients, 45 (92%) interviewees recalled 69 of 109 (63%) study participations. Level of recall varied according to the type of research, some participants clearly recalled the details of research aims, giving consent and research procedures. Others recalled procedures (e.g. DNA testing) but were unclear about their purpose. There was no significant effect of time on recall. Some types of research participation (e.g. DNA testing) may be recalled as clinical care. We argue that such misunderstandings may have t...

 

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Developments in biotechnology present difficult social and ethical challenges that need to be resolved by regulators among others. One crucial problem for regulators of new technologies is to ensure that regulation is both clear and sufficiently flexible to respond to new developments. This is particularly difficult to achieve in contentious fields such as medical biotechnology. In the European Union there is a divergence in the solutions to this problem which has lead to different regulatory frameworks for medical biotechnology. This paper compares and contrasts the British and Dutch regulatory frameworks for the selection of embryos by preimplantation genetic diagnosis as an example of the regulation of medical biotechnology. Some of the outcomes of the regulatory choices and possible re...

I will consider how we can assess the interests of critically ill children who will survive only while aggressive medical support is continued. If aggressive medical support is withdrawn, the child will die shortly afterwards. This is important because when the courts are asked to decide treatments, the standard is that decisions should be made in the best interests of the child. My claim is that this is not a coherent way to consider how some children in this situation should be treated. I will consider two separate aspects of this problem. First, I will argue that there is no objective best interests test and no immediate prospect that we will be able to develop one. Secondly, I will argue that best interests are not a coherent way to consider the interests of children who will die short...

(Source: Clinical Ethics)

(Source: Clinical Ethics)

(Source: Clinical Ethics)

 

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(Source: Clinical Ethics)

Authors: Mahowald MB Advances in reproductive technology and genetic interventions raise questions about the possibility of using these procedures to promote the birth of children with socially advantageous conditions. In Babies by Design, Ronald M. Green supports this goal and accuses its opponents of a "status quo bias." Unfortunately, some of Green's own arguments also show a status quo bias. Moreover, although he attempts to avoid the thorny issue of the moral status of human embryos, he implicitly takes a stand on it by endorsing prenatal interventions that inevitably entail the creation and loss of some human embryos. This essay identifies these and other flaws in Green's account. PMID: 19013852 [PubMed - in process] (Source: Perspectives in Biology and Medicine)

Authors: Lamm E, Jablonka E This volume joins a growing list of books, monographs, and proceedings from scientific meetings that attempt to consolidate the wide spectrum of approaches emphasizing the role of development in evolution into a coherent and productive synthesis, often called evo-devo. Evo-devo is seen as a replacement or amendment of the modern synthesis that has dominated the field of evolution since the 1940s and which, as even its architects confessed, was fundamentally incomplete because development remained outside its theoretical framework (Mayr and Provine 1980). As the volume attests, there is now a strong feeling that the time is ripe for the consolidation of evo-devo, and that the field is mature enough so that mapping the theoretical terrain and experimental appr...

Conclusions: Because no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record for purposes other than clinical care. This could be done, for example, through a web-based patient portal to their electronic health record. Researchers and policy makers should continue to engage the public to promote greater public understanding of the research process and to look for feasible alternatives to existing approaches to project-specific consent for observational research. (Source: BMC Medical Ethics)