Monash bioethics review
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Monash bioethics review · Mar 2011
Balancing the act: The international migration of medical graduates.
In this article I examine the phenomenon of international migration of medical graduates. The debate involving the ethical aspects of medical migration as well as the obstacles faced by doctors to practice unreservedly in their host countries are addressed. ⋯ This commentary favours a reform in the way institutions and society respond to the process of medical migration and to the needs of migrant doctors. Continued research on this health care topic is required in order to identify the major factors that play a role in this process.
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Ethical tensions are recognised as part of the everyday practice of conducting research and practising genetic counselling. What are the conceptual frameworks that can assist researchers and genetic counsellors to deal with ethical tensions when conducting research? How might the overlap that arises from being a researcher and clinical genetic counsellor be dealt with? This article uses a case study to consider the ethical tensions between conducting research in genetic counselling and maintaining a clinical practice as a genetic counsellor. It examines the reconciliation of the dual roles of researcher and genetic counsellor. It explores conceptual frameworks that can combine the needs of ethical research practice, while maintaining ethical clinical practice.
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Monash bioethics review · Sep 2010
How much weight should we give to parental interests in decisions about life support for newborn infants?
Life-sustaining treatment is sometimes withdrawn or withheld from critically ill newborn infants with poor prognosis. Guidelines relating to such decisions place emphasis on the best interests of the infant. However, in practice, parental views and parental interests are often taken into consideration. ⋯ Secondly, the interests of the infant in her future are relatively reduced by her developmental immaturity. In some situations parents' welfare interests outweigh those of the infant. However, I argue that this would not justify treatment limitation except in the setting of severe impairment.
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Monash bioethics review · Mar 2010
Waiver of informed consent in prehospital emergency health research in Australia.
Informed consent is a vital part of ethical research. In emergency health care research environments such as ambulance services and emergency departments, it is sometimes necessary to conduct trial interventions or observations without patient consent. At times where treatment is time critical, it may be impossible or inappropriate to seek consent from next of kin. ⋯ The unusual circumstances encountered in the prehospital ambulance environment will also be discussed, including the dependent and coercive relationship between patients and ambulance professionals, and a lack of alternatives for care and transport for patients who refuse consent. The conflict arising from differences in medical culture and values between patients and health care professionals will also briefly be discussed. It will be argued that, while emergency care research should not require informed consent due to the restrictions of time and dependent nature of the relationship between patient and health professional, emergency health researchers still have a responsibility to consider the patients' perspective when considering the ethical issues of an emergency research project, particularly in the prehospital environment.
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Monash bioethics review · Jun 2009
A case for increased caution in end of life decisions for disorders of consciousness.
Disorders of consciousness include coma, the vegetative state and the minimally conscious state. Such patients are often regarded as unconscious. This has consequences for end of life decisions for these patients: it is much easier to justify withdrawing life support for unconscious than conscious patients. ⋯ Additionally, we argue that if their lives are to be ended, then increased caution should be exercised to avoid undue suffering. As a consequence, the already difficult ethical and clinical questions surrounding these patients are made even more difficult with regard to making and acting on end of life decisions, as well as with regard to quality of life prognoses. The best we can hope for is that research both on disorders of consciousness and on the neural correlates of consciousness will progress more and make these kinds of questions easier to address in the future.