Monash bioethics review
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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.
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Monash bioethics review · Mar 2009
ReviewThe ethics of expectations: biobanks and the promise of personalised medicine.
Expectations play a major role in 'driving' biotechnology research and development. However, their ethical significance has been largely overlooked. ⋯ The article identifies the claims and practices that support the expectations pertaining to biotechnologies and some of the factors that work against the fulfilment of predicted innovations. It is argued that the role of expectations in shaping thinking and action needs to be taken seriously by those who are concerned about the ethical implications of biotechnologies.
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Monash bioethics review · Jul 2008
Gaining human ethics approval: a strategy for refining research studies.
We argue that developing a human ethics application is an effective method for refining the intent and design of research studies. Our study aimed to investigate the delivery of end-of-life and palliative care nursing to residents of an aged care unit in a Multi-purpose Service/Centre in rural Victoria. We used the ethics application process as a strategy to focus the study, and to refine the data collection and analysis techniques. It is our contention that the process of completing the application and gaining ethics approval is laborious; however, the intellectualising that occurs provides researchers with an opportunity to reflect upon and refine their studies, thus ensuring the ultimate success and timely completion of research investigations.
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Monash bioethics review · Oct 2007
Inside truths: 'truth' and mental illness in the Australian asylum seeker and detention debates.
This article examines some of the key debates and interactions between the Australian government and medical profession in relation to the mental health consequences of the policy of mandatory detention of asylum seekers. It explores how, in a series of episodes between 2001 and 2005, each side claimed to represent accurately the 'true' nature of the detention system through asserting superior 'objectivity' and commitment to 'scientific truth' in their representations of the mental health of asylum seekers. Placing these debates within the particular political objectives of the Liberal Party during John Howard's term as Prime Minister, the article explores how science and medical advocacy have been characterized and made to signify larger conflicts within the Australian political arena. It shows how populist political ideas of 'elitism' have been used by the government to represent as 'elitist untruths' psychiatric research which has demonstrated a direct causal links between government border control policies and mental ill-health.
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Monash bioethics review · Jan 2007
The patient, the doctor and the family as aspects of community: new models for informed consent.
Filial obligation and its implications have been little-debated in ethics. The basis of informed consent in libertarian positions may be challenged by inclusion of others beyond the immediate doctor-patient relationship. ⋯ Although such a position undoubtedly confronts traditional notions of autonomy, it offers an alternative that may positively impact the practice of medicine by providing a more holistic treatment context. New models premised on shared decision-making will be presented as frameworks that may provide a theoretical basis for greater physician input into medical decisions that impact a patient's family members and in more global terms, his or her community.