Journal of medical ethics
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Journal of medical ethics · Apr 2009
Informed choice requires information about both benefits and harms.
A study found that women participating in mammography screening were content with the programme and the paternalistic invitations that directly encourage participation and include a pre-specified time of appointment. We argue that this merely reflects that the information presented to the invited women is seriously biased in favour of participation. Women are not informed about the major harms of screening, and the decision to attend has already been made for them by a public authority. ⋯ Screening invitations must present both benefits and harms in a balanced fashion, and should offer, not encourage, participation. It should be stated clearly that the choice not to participate is as sensible as the choice to do so. To allow this to happen, the responsibility for the screening programmes must be separated from the responsibility for the information material.
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Journal of medical ethics · Apr 2009
Multicenter StudyFrench hospital nurses' opinion about euthanasia and physician-assisted suicide: a national phone survey.
Hospital nurses are frequently the first care givers to receive a patient's request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses' opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. ⋯ Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call "good" euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia.
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Journal of medical ethics · Mar 2009
Combating junior doctors' "4am logic": a challenge for medical ethics education.
Undergraduate medical ethics education currently focuses on ethical concepts and reasoning. This paper uses an intern's story of an ethically challenging situation to argue that this emphasis is problematic in terms of ensuring students' ethical practice as junior doctors. The story suggests that it is aligning their actions with the values that they reflectively embrace that can present difficulties for junior doctors working in the pressures of the hospital environment, rather than reasoning to an ethically appropriate action. I argue that junior doctors need skills for implementing their ethical decisions and that these ought to form a central component of undergraduate medical ethics education.
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Journal of medical ethics · Mar 2009
Preferential publication of editorial board members in medical specialty journals.
Publication bias and discrimination are increasingly recognised in medicine. A survey was conducted to determine if medical journals were more likely to publish research reports from members of their own than a rival journal's editorial board. ⋯ There was a significant excess of publications from medical journals' own editorial boards, although it is not possible to determine whether this is due to bias in the peer review process or selective submission by editors.
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Journal of medical ethics · Mar 2009
What does the British public think about human-animal hybrid embryos?
In the recent UK debate on the Human Fertilisation and Embryology Bill, there have been conflicting claims about the extent of public support for, or opposition to, human-animal hybrids. Self-selecting polls tend to show opposition to hybrids. Representative-sample polling shows spontaneous opposition but can elicit conditional approval of research, combined with underlying unease. Public opinion is very finely divided, with people generally opposed to this research unless it is likely to lead to medical advances.