Journal of medical ethics
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Journal of medical ethics · Jul 2008
The ethics of non-heart-beating donation: how new technology can change the ethical landscape.
The global shortage of organs for transplantation and the development of new and better medical technologies for organ preservation have resulted in a renewed interest in non-heart-beating donation (NHBD). This article discusses ethical questions related to controlled and uncontrolled NHBD. It argues that certain preparative measures, such as giving anticoagulants, should be acceptable before patients are dead, but when they have passed a point where further curative treatment is futile, they are in the process of dying and they are unconscious. ⋯ Such technological development can be used to transform cases of non-controlled NHBD to controlled NHBD. In our view, this is a step forward since the ethical difficulties related to controlled NHBD are easier to solve than those related to non-controlled NHBD. However, such technological developments also evoke other ethical questions.
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Journal of medical ethics · Jun 2008
ReviewNurses' attitudes towards artificial food or fluid administration in patients with dementia and in terminally ill patients: a review of the literature.
Although nurses have an important role in the care process surrounding artificial food or fluid administration in patients with dementia or in terminally ill patients, little is known about their attitudes towards this issue. The purpose of this study was to thoroughly examine nurses' attitudes by means of a literature review. ⋯ The interaction between clinical facts and ethical reflections makes the findings of this review extremely relevant for clinical ethics. A large need exists to clearly communicate to nurses the latest clinical evidence and the main results of ongoing ethical debates.
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Journal of medical ethics · Jun 2008
A pilot study of bullying and harassment among medical professionals in Pakistan, focussing on psychiatry: need for a medical ombudsman.
The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation. ⋯ It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level.
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Journal of medical ethics · Jun 2008
The "future like ours" argument and human embryonic stem cell research.
The most closely argued and widely discussed case against abortion in the philosophical literature today is Don Marquis's "future like ours" argument. The argument moves from an analysis of why there is a serious presumption against killing someone "like us" to the conclusion that most abortions are seriously wrong for the same reason: they deprive "an individual" of a future of valuable experiences and activities, a "future like ours". Julian Savulescu has objected that "preventing" such a future could not be as seriously presumptively wrong as Marquis contends for if it were, even contraception and failure to engage in reproductive cloning would be seriously presumptively wrong. ⋯ Marquis defends his strong anti-abortion stance against Savulescu's "contraception" and "failure to clone" objections but surprisingly says nothing about the implications of the "future like ours" argument for the controversy surrounding human embryonic stem cell research. I argue that key features of Marquis's response actually support the view that embryos used in stem cell research are not included within the protective scope of the "future like ours" argument. It is significant that the most philosophically rigorous anti-abortion case thus far presented does not entail that human embryonic stem cell research is even presumptively wrong.
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Payment for research participation has raised ethical concerns, especially with respect to its potential for coercion. We argue that characterising payment for research participation as coercive is misguided, because offers of benefit cannot constitute coercion. In this article we analyse the concept of coercion, refute mistaken conceptions of coercion and explain why the offer of payment for research participation is never coercive but in some cases may produce undue inducement.