Journal of medical ethics
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Journal of medical ethics · Dec 2009
Participants' perceptions of motivation, randomisation and withdrawal in a randomised controlled trial of interventions for prevention of depression.
Little is known about how participants perceive prevention trials, particularly trials designed to prevent mental illness. This study examined participants' motives for participating in a trial and their views of randomisation and the ability to withdraw from a randomised controlled trial (RCT) for prevention of depression. ⋯ The findings suggest that participants enrolled in prevention trials for mental illness are likely to hold positive attitudes (eg, high commitment, low expectation of personal gain) towards research trials. The identification of relationships between key person factors and trial-related attitudes enabled profiling of participant groups, which can inform recruitment strategies and interactions of participants and research projects in future prevention trials.
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The Mental Capacity Act (2005) is an impressive piece of legislation that deserves serious ethical attention, but much of the commentary on the Act has focussed on its legal and practical implications rather than the underlying ethical concepts. This paper examines the approach that the Act takes to best interests. The Act does not provide an account of the underlying concept of best interests. ⋯ The checklist includes items that are unhelpful. Furthermore, neither the Act nor its Code of Practice provides sufficient guidance to carers faced with difficult decisions concerning best interests. This paper suggests ways in which the checklist can be developed and discusses cases that could be used in an updated Code of Practice.
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Bioethicists disagree over methods, theories, decision-making guides, case analyses and public policies. Thirty years ago, the thinking of many scholars coalesced around a principlist approach to bioethics. That mid-level mode of moral reasoning is now one of many approaches to moral deliberation. Significant variation in contemporary approaches to the study of ethical issues related to medicine, biotechnology and health care raises the question of whether bioethics exists as widely shared method, theory, normative framework or mode of moral reasoning.