Medicine and Health Sciences Commons^™

Ethical Aspects Of Prenatal Genetic Diagnostics, Hille Haker

Hille Haker

Starting with some basic distinctions, i.e. the distinction between an ethics of human self-fulfilment ,of individual and social values and of virtues on one hand, and an ethics of individual rights, of obligation and of social justice on the other, this paper explores the manifold scenario of the problems of prenatal diagnosis with respect to these different aspects of ethical analysis. This is followed by a normative evaluation of the status of the human embryo, and by an elaboration of different adressees of responsibility in the field of biomedicine and, especially, of prenatal genetic diagnosis. The author comes to the …

Professionalism Under Fire: Conflict, War And Epidemics, Michelle Mclean, Vikram Jha, John Sandars

Michelle McLean

Today’s medical students (tomorrow’s doctors) will be entering a world of conflict, war and regular outbreaks of infectious diseases. Despite numerous international declarations and treaties protecting human rights, the last few decades has been fraught with reports of ‘‘lapses’’ in medical professionalism involving torture and force-feeding of detainees (e.g. captured during the War on Terror) and health care professionals refusing to treat infected patients (e.g. HIV and Ebola). This paper provides some historical background to the changing status of a physician’s duty to treat and how medical practitioners came to be involved in the inhumane treatment of detainees during the …

Teaching Of Biostatistics And Epidemiology In Medical Schools: How Do We Fare Compared With Developed Countries, Vijay Tiwari, Kuldeep Kumar, Sherin Raj

Kuldeep Kumar

Background Biostatistics is taught in almost all medical schools at the undergraduate and the postgraduate levels as a core course and is a prerequisite to epidemiology, public health and evidence-based medicine. However, it has to be taught in a different way in medical schools as compared with how it is taught to the students studying MSc (Biostatistics) or in the Statistics Department in universities. Objectives (1) To review the experience of teaching biostatistics in medical schools in India and compares the same with abroad (2) How best the curriculum can be designed as per the need of the medical students …

Regulating The Placebo Effect In Clinical Practice, Tracey Chan

Tracey E Chan

Recent research and ethical analysis have forced a clinical and ethical reappraisal of the utility of placebos in medical practice. The main concern of ethics and law is that using placebos in health care involves deception, which is antithetical to patient autonomy and trust in the physician-patient relationship. This paper reviews the various, more nuanced scientific conceptions of the placebo effect, and evaluates the ethical and legal objections to deploying placebos in clinical practice. It argues that the placebo effect may be legitimately accommodated on the basis that it does not engage the requirement for material or quasi-fiduciary disclosures of …

Toxicology Screening Ethical Issues Of Interventions, Marna Greenberg

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Harms And Responsibilities Associated With Battery-Operated Implants (Boi): Who Controls Postmortem Explantation?, Katrina Bramstedt

Katrina A. Bramstedt

The postmortem issues raised by battery-operated implants (BOI) are complex and issues of consent, setting (clinical vs research), and environmental risks have received little attention in bioethics literature. Analyzing the issues, the following are argued: (1) Patients receiving BOIs should sign a consent form that includes a requirement for postmortem explant of the device; (2) BOI consent forms should require the explanted devices be returned to their manufacturers for Returned Product Analysis; (3) Failure to explant and analyze devices from the research setting fails the research goal of generation of knowledge for the benefit of future patients; (4) Failure to …

Informed Consent For Facial Transplantation, Katrina Bramstedt

Katrina A. Bramstedt

Here, we outline the ethical presentation of patients’ informed consent.

The Silence Of Good Samaritan Kidney Donation In Australia: A Survey Of Hospital Websites, Katrina Bramstedt, Sameer Dave

Katrina A. Bramstedt

It is common for living donor candidates to use the Internet as a tool to enhance their decision-making process. Specifically, the websites of transplant hospitals can potentially be a vital source of information for those contemplating living donation. In an effort to explore the low incidence of Good Samaritan kidney donation (donations to strangers) in Australia, two raters conducted a nine-attribute website content analysis for all hospitals which participate in these transplants (n = 15). Overall, the concept of living donation is relatively silent on Australian hospital websites. Only four hospitals mention their living donor program, and only one mentions …

Family Refusals Of Registered Consents: The Disruption Of Organ Donation By Double-Standard Surrogate Decision-Making, Katrina Bramstedt

Katrina A. Bramstedt

Some countries such as Australia, Spain, Norway, Italy and Canada allow next of kin to override the consent of registered organ donor candidates if they personally do not concur with the donation desire of their relative. This form of surrogate decision-making represents a double standard in terms of the principle of substituted judgment (the surrogate's duty). Further, double-standard surrogate decision-making in the setting of organ donation is a slippery slope to unethical surrogate decision-making while patients are alive. Concerns about family distress and donor candidate revocation of consent can still be managed without permitting double-standard surrogate decision-making.

Bioethics In Canada, Charles Weijer, Anthony Skelton, Samantha Brennan

Samantha Brennan

This comprehensive introduction to bioethical issues emphasizes Canadian policies, issues, and scholars. Using the human lifespan as an organizing narrative, Bioethics in Canada explores ethical theories through a diverse selection of readings discussing traditional and cutting-edge topics in the field.

Readership : Bioethics in Canada is a core text for bioethics courses, generally offered in second- or third-year through philosophy departments at Canadian universities.

http://www.oupcanada.com/catalog/9780195440157.html

The Bad Habit Of Bearing Children, H Theixos, S.B. Jamil

H Theixos

Procreation – the act of having and raising biological children – is generally not a life choice that is subject to moral scrutiny; there is a standing assumption that parents act morally when they bring or intend to bring new life into existence with the intent of fostering and nurturing the future child(ren). We argue that this assumption is not morally justifiable under present societal conditions, and basic tenets of moral decency obligate prospective parents, under certain defeasibility conditions, to prioritize adoption over procreation. We conclude that for the subset of prospective parents who are unaffected by the defeasibility conditions, …

Book Review: Pathological Altruism, Katrina Bramstedt

Katrina A. Bramstedt

In my work as a transplant ethicist I have always been interested in the topic of altruism. Thus, when a book appeared with the title, Pathological Altruism, I was very intrigued to read it. An exceedingly heavy book, however, arrived in my mailbox, and I admit I was taken aback. But upon reading Pathological Altruism, edited by Barbara Oakley, Ariel Knafo, GuruprasadMadhavan, and David SloanWilson, I was not disappointed. In fact, chapter 1 baited me with the line, “Altruism can be the back door to hell.”

Art Review: Edo-Kingyo's Coolness And The Night Aquarium Museum Lounge, Katrina Bramstedt

Katrina A. Bramstedt

Extract:As with circuses, aquariums have been the subject of concern for animal welfare experts (Tilikum, Katina, Corky, Kasatka, and Ulises v. SeaWorld 2011): Is captivity the best place for these animals? Are these settings merely entertainment venues? If they provide an educational experience for viewers, does the learning experience outweigh the risks to the animals? Could the education be gained by other modes? What are the elements of animal welfare in the setting of an aquarium? After viewing the Edo—Kingyo’s Coolness Tokyo art exhibit online using the creator’s YouTube video (Kimura 2011), the importance of all of these questions becomes …

Finding Your Way: A Medical Ethics Handbook For Patients And Families, Katrina Bramstedt

Katrina A. Bramstedt

A medical ethics book geared for the lay audience. Current books in the marketplace are for medical professionals, academics, or students. This book is meant as a handbook for patients, families, and caretakers. The book will be of interest to those patients and families confronting major health-care decisions and to the professionals who work with these patients and families.

Health Care Ethics In Canada, Françoise Baylis, Barry Hoffmaster, Susan Sherwin, Kirstin Borgerson

C. Barry Hoffmaster

No abstract provided.

Managing Patients Whose Family Members Are Physicians, Katrina Bramstedt, M. Popovich

Katrina A. Bramstedt

The ethical complexities involving physicians who treat their own family members are well known and it is generally accepted that such practice should not occur. We present three anonymous cases in which patient family members who worked as physicians complicated the medical care of their hospitalized relatives. When a health care worker’s family member becomes a hospital patient, the situation can be emotionally charged due to the medical insight the multiple parties have, as well as the desire of relatives to be protective of their family members. Clinician-relatives need to allow the medical team to assume the role of caretaker …

The Nature Of Suffering: Moving Beyond Definition To Understanding, Barry Hoffmaster

C. Barry Hoffmaster

No abstract provided.

Real Ethics, Barry Hoffmaster

C. Barry Hoffmaster

No abstract provided.

The Nature Of Moral Compromise: Principles, Values, And Reason, Cliff Hooker, Barry Hoffmaster

C. Barry Hoffmaster

No abstract provided.

The Ethical Complexities Of Online Organ Solicitation Via Donor-Patient Websites: Avoiding The "Beauty Contest"., E. Neidich, A. Neidich, J Cooper, Katrina Bramstedt

Katrina A. Bramstedt

The proliferation of the Internet has spurred the creation of websites dedicated to facilitating living directed organ donations. We argue that such sites potentially devolve into “beauty contests” where patients in need are evaluated on the basis of their personal appearance and biography—variables which should have no relevance to organ allocation. Altruism should be the guiding motivation for all donations, and when it does, there is no place for a beauty contest. The power of the Internet is optimally used when it facilitates Good Samaritan donations—donations to any stranger, rather than handpicked ones. Social networking sites which aim to match …

Anorexia: In The Grip Of A Passion, Louis Charland

Louis C. Charland

No abstract provided.

Re-Reasoning Ethics, Cliff Hooker, Barry Hoffmaster

C. Barry Hoffmaster

No abstract provided.

The Organ Donor Experience: Good Samaritans And The Meaning Of Altruism, Katrina Bramstedt

Katrina A. Bramstedt

With a current US need of over 115,000 organs one would think that Good Samaritan donors would be welcomed with open arms by transplant centers and society in general; however, this is often not the case. Tell someone that you have donated an organ to a stranger and the reaction is likely to be one of astonishment and disbelief. Some doctors even consider people who offer their organs to strangers crazy. Why would anyone do that? Who are these people so committed to helping others-strangers-that they would undergo surgery, discomfort, and disruption of their lives? This book profiles donors who …

Moral Undertow And The Passions: Two Challenges For Contemporary Emotion Regulation, Louis Charland

Louis C. Charland

No abstract provided.

Decision-Making Capacity And Responsibility In Addiction, Louis Charland

Louis C. Charland

No abstract provided.

Stranger Donors: A Key Link In Transplant Chains, Christopher Veys, Katrina Bramstedt

Katrina A. Bramstedt

Living donation to strangers is a complex issue that has caused some transplant centers to ban the practice altogether. Most prominent of the troublesome issues is the common source of these donors; namely, the Internet. These "stranger donors," however, are critical to both paired kidney transplants and chain kidney transplants. This article presents the ethical complexities of donors in these transplant arrangements and offers 2 case examples from our facility. Rigorous donor screening and informed consent processes are crucial, and together they help make transplant pairs and chains ethically feasible.

Probing Transplant And Living Donor Candidates About Their Participation In Organ Vending, Katrina Bramstedt

Katrina A. Bramstedt

The selling of human organs for transplant is illegal in the United States and in most countries; however, such transactions still occur. Transplant hospitals and their personnel have multiple ethical duties, including (1) protecting the safety of their living donors and transplant recipients and (2) protecting the integrity of living donation and transplantation as clinical practices. To date, few psychosocial screening tools exist that pertain specifically to a person's risk or intent of pursuing organ vending (buying or selling). This article presents a series of transplant ethics case consultations that spawned the creation of a set of behavioral prompts for …

Science And Morals In The Affective Psychopathology Of Philippe Pinel, Louis Charland

Louis C. Charland

No abstract provided.

Reinstating The Passions: Lessons From The History Of Psychopathology, Louis Charland

Louis C. Charland

No abstract provided.

Too Poor For Transplant: Finance And Insurance Issues In Transplant Ethics, Kyle Laurentine, Katrina Bramstedt

Katrina A. Bramstedt

Context: Donor organs are a scarce gift. Additionally, transplantation is very expensive and the United States lacks universal health insurance for all citizens. These facts combine to make personal finance and insurance some of the criteria for wait listing at US transplant centers. Previous research has shown that the poor and the uninsured (as well as women and nonwhites) are less likely to receive a transplant. Living donor candidates are also limited by the US insurance system. Objective: To determine the effect of finance and insurance variables on access to transplant and living donation. Design: A qualitative descriptive study of …