Indian journal of medical ethics
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Indian J Med Ethics · Jan 2019
EditorialThe crisis of ethics and integrity in Evidence Based Medicine and scientific practice.
This issue of IJME carries three essays and a letter on the current crisis in Cochrane, earlier known as the Cochrane Collaboration. Cochrane expelled one of its founder members, Peter Gotzsche, on September 13, 2018, and in protest, four other Governing Board Members resigned. The essays show that what happened was not merely a clash within an organisation, but involved some basic differences on approach to Evidence Based Medicine. While these issues had been simmering for a long time, the expulsion brought them sharply into focus in the public domain.
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Indian J Med Ethics · Oct 2018
CommentSustaining for-profit emergency healthcare services in low resource areas.
The Bawaskars in their Comment "Emergency care in rural settings: Can doctors be ethical and survive?" raise a context-specific question about the sustainability of emergency care in rural, low resource areas. This could be broadened to "What efforts are needed to sustain emergency care systems run by the private sector in rural, low resource areas without catastrophically affecting patients or healthcare providers?" There are enough constitutional, legal and ethical imperatives to state that all emergency care should be available to everyone irrespective of paying capacity. ⋯ Even if that arrangement is not viable, private sector providers cannot expect the community to underwrite the sustainability of such services and the return on investment in their training. Finally, we suggest that the principles of ethics cannot be invoked for justifying the financial viability and sustainability of the private sector in an unequal world.
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India's approach to disseminating information about the first three cases of the Zika virus was criticised nationally and internationally after the issue came to light in May 2017 through a World Health Organization news release. We analyse the incident from a risk communication perspective. ⋯ We use Peter Sandman's risk = hazard + outrage framework - also adopted by India's risk communication planners - to analyse India's risk communication response and contextualise it against the mandate of the National Risk Communication Plan and Integrated Disease Surveillance Programme. We conclude with recommendations for India's risk communication policymakers, including the need to develop capacity for risk communication research and scholarship in the country.
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Indian J Med Ethics · Jan 2018
Historical ArticleHenry Molaison's operation for epilepsy: a case study in medical ethics.
Dr. William Beecher Scoville, an eminent American neurosurgeon of the 1940s, offered to treat Mr Molaison for his intractable epilepsy. During the operation, he removed large portions of both of Mr. ⋯ Molaison's brain against the background of neurosurgery in the 1940s. This essay discusses the ethical aspects of Dr. Scoville's operation in the light of current understanding and practice.
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Indian J Med Ethics · Oct 2017
Observational StudyAccelerated approval of drugs: ethics versus efficacy.
To analyse the post-marketing status of molecules approved through the expedited review process in the last quintile. ⋯ Drug approval by accelerated review should be stringent. Beneficence and non-maleficence are applicable to the global population, and should apply equally to subjects involved in trials. Approving drugs on the basis of trivial evidence is non-scientific and absolutely unethical, since it can lead to clinical failure and produce serious adverse events.