Journal of medical ethics
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Journal of medical ethics · Sep 2014
Improving biomedical journals' ethical policies: the case of research misconduct.
Scientific journals may incur scientific error if articles are tainted by research misconduct. While some journals' ethical policies, especially those on conflicts of interest, have improved over recent years, with some adopting a uniform approach, only around half of biomedical journals, principally those with higher impact factors, currently have formal misconduct policies, mainly for handling allegations. Worryingly, since a response to allegations would reasonably require an a priori definition, far fewer journals have publicly available definitions of misconduct. ⋯ Although each case may need an individual approach, I argue that posting highly visible, readily accessible, comprehensive, consistent misconduct policies could prevent the publication of fraudulent papers, increase the number of retractions of already published papers and, perhaps, reduce research misconduct. Although legally problematic, a concerted approach, with sharing of information between editors, which is clearly explained in journal websites, could also help. Ideally, journals, editors' associations, and publishers should seek consistency and homogenise misconduct policies to maintain public confidence in the integrity of biomedical research publications.
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The forced circumcision of men is a widespread human rights abuse that often accompanies other human rights violations. It occurs in clashes between circumcising and non-circumcising cultures, or when individuals in circumcising cultures reject circumcision. This article documents the forced circumcision of men against their will, shows how evidence of forced circumcision has been downplayed and discounted, and outlines and discusses some measures that could help to reduce its prevalence.
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Journal of medical ethics · Jul 2014
Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool.
To compare assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool. ⋯ Our findings demonstrate those physicians, nurses and the patients' relatives have difficulty in identifying patients lacking decision-making competence. Therefore, an objective competence assessment tool should be used along with the assessments of physicians and nurses, both of whom can provide clinical data, as well as those of relatives, who can offer insights into the patient's moral values and expectations.
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Journal of medical ethics · Jul 2014
Overriding parents' medical decisions for their children: a systematic review of normative literature.
This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question 'when health professionals and parents disagree about the appropriate course of medical treatment for a child,under what circumstances is the health professional ethically justified in overriding the parents' wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. Each of these frameworks centred on a different key moral concept including harm,constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality.
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Journal of medical ethics · Jul 2014
The dead donor rule: effect on the virtuous practice of medicine.
The President's Council on Bioethics in 2008 reaffirmed the necessity of the dead donor rule and the legitimacy of the current criteria for diagnosing both neurological and cardiac death. In spite of this report,many have continued to express concerns about the ethics of donation after circulatory death, the validity of determining death using neurological criteria and the necessity for maintaining the dead donor rule for organ donation. I analysed the dead donor rule for its effect on the virtuous practice of medicine by physicians caring for potential organ donors. ⋯ The dead donor rule, while ethically powerful in theory, loses its force during translation to the bedside. This is so because the rule mandates simultaneous life and death within the same body for organ donation, a biological status that is inherently contradictory. The rule should be rejected as an ethical norm governing vital organ transplantation at the end of life. Its elimination will strengthen the doctor–patient relationship and foster trustworthiness in organ procurement.