Medical Ethical Aspects
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Protection of Vulnerable Populations: Research Involving Prisoners Albert J
June 2005 Center for Mental Health Services Research Vol 2, Issue 6 University of Massachusetts Medical School Issue Brief Protection of Vulnerable Populations: Research Involving Prisoners Albert J. Grudzinskas, Jr., JD and Jonathan C. Clayfield, MA, LMHC he attitude that, “it is not cruel to inflict The Belmont Report identified three basic on a few criminals, sufferings which ethical principles critical to any research conducted may benefit multitudes of innocent with human subjects and, in particular, prisoners: T respect for persons, beneficence and justice. people through all centuries,” has prevailed in the area of research involving prisoners Respect for persons holds that each individual is through history.1 The very nature of incarceration autonomous and should be treated as free to make – controlled diet and living conditions, subject his or her own choices. The nature of prison, availability, etc. – make prisoners an attractive however, leads to restrictions on autonomy. For example, while paying subjects to participate population to study. There are, however, special in research is considered ethically acceptable, considerations when prisoners participate in prisoners may be unduly influenced or enticed research that must be addressed to ensure their by the monetary gain of participation given that protection as human subjects. This brief will prisoners typically earn far less for other “work” explore some of the issues critical to working activities. Careful consideration should be given with prisoners in research, will discuss the to an individual’s ability to make autonomous standards of informed consent and competency, decisions in light of the possible coercion inherent in a specific environment or setting. -
A Philosophical Investigation of Principlism and the Implications Raised by the Treatment of the Mentally Ill
Aporia vol. 24 no. 1—2014 A Philosophical Investigation of Principlism and the Implications Raised by the Treatment of the Mentally Ill BENJAMIN FOSTER Introduction he objective of this investigation is to identify reasonable and relevant problems and issues posed for Principlism by the mentally T ill. Two concepts of Principlism will be presented: a normative con- ceptualization of the bioethical theory and a descriptive conceptualization. In reference to both, two philosophical questions will be asked: can we know the natures of other minds and, if so, how? These two questions have theoretical and practical implications for the treatment of the mentally ill. And, in so far as the questions have implications for the treatment of the mentally ill, they have implications for the bioethical theory of Principlism. There is a lack of concurrence on the meaning, nature, and function of mental phenomena, producing conceptual difficulties concerning the common morality that provides Principlism its normative authority. Similarly, a contradiction appears to arise when one considers the imaginative leap of predicting another’s desires, feelings, and thoughts, a maneuver that professionals participating in the treatment of the mentally ill must perform. There is also significant ambiguity surrounding the concept of mental illness, which produces pragmatic problems when professionals attempt to diagnose and treat an individual in conjunction Benjamin Foster graduated with a degree in philosophy and a minor in biology from the University of Alaska Fairbanks. While there he served as president of the univer- sity’s philosophy club, The Socratic Society. His primary philosophical interests include ethics and epistemology. He currently plans to attend medical school. -
Position on Bioethics
Position on Bioethics Background Bioethics refers to the application of ethical principles to address potential ethical questions arising from biological research, science and medicine. Bioethics may include ethical dimensions of medical research, clinical trials, use of different forms of technology in healthcare, public policy, prioritization of research and resources, and much more. For any company involved in healthcare, bioethics questions frequently arise and require resolutions based on accepted bioethics principles. The four commonly accepted principles of bioethics1 are: • Autonomy: Requires that the patient have autonomy of thought, intention and action when making decisions regarding healthcare procedures and must give fully informed consent with knowledge of all risks and benefits of the procedure and the likelihood of success. • Justice: Requires that procedures uphold the spirit of existing laws and are fair to all players involved, ensuring that no population be overly burdened or overly valued in research and scientific progress. • Beneficence: Requires that the procedure be provided with the intent of doing good for the patient involved, considers individual circumstances of all patients and strives for net benefit. • Non-maleficence: Requires that a procedure does not harm the patient involved or others in society. Relevance Bioethics plays a critical role in the advancement of human health by ensuring safe, ethical and just applications of new science and technological and therapeutic breakthroughs. As the world’s largest and most broadly based healthcare company, reaching patients and consumers each day with our medicines, consumer care products and medical devices, Johnson & Johnson is a leader in healthcare research and development. We employ significant resources in the development of new medicines and medical devices and their application. -
Top 50 Bioethics Journals and Top 250 Most Cited Bioethics Articles Since 2011, 2016 Edition May 23, 2016 | BRL Blog, Featured
U a Top 50 Bioethics Journals and Top 250 Most Cited Bioethics Articles Since 2011, 2016 Edition May 23, 2016 | BRL Blog, Featured This 2016 edition of the “top bioethics journals and articles” list includes updated rankings for bioethics journals and new citation metrics for articles published in 2015, as well as updates for previous years’ top articles. Links to the publisher pages are included for each article as well as links to their citation page on Google Scholar. The average H5 index for the top fifty-two journals is 13.38, with a tied high of 28 and a minimum of 6. Here are the top top 52 journals and 252 most cited articles from the top bioethics journals published in 2009 through 2015. View the Top Articles by Year: 2015, 2014, 2013, 2012, 2011. About this Analysis This is an updated citation analysis for 2011 through 2015 of the top 100 bioethics journals. I’ve included the top 50 journals and the top cited articles per year including the h5 ranking. Just over 20,000 articles were analyzed in this dataset, shared here as a spreadsheet. If you’re interested in using this study in a publication or presentation please let me know so I can share a link to your research on this blog post. I utilized Harzing’s Publish or Perish software over a period of 10 days to gather this new data in May, 2016. The citation metrics are from Google Scholar’s index. Author: Mark Hakkarinen, M.A. Kennedy Institute of Ethics, Georgetown University. -
Occupational Therapy Code of Ethics and Ethics Standards (2010)
Occupational Therapy Code of Ethics and Ethics Standards (2010) PREAMBLE The American Occupational Therapy Association (AOTA) Occupational Therapy Code of Ethics and Ethics Standards (2010) ("Code and Ethics Standards") is a public statement of principles used to promote and maintain high standards of conduct within the profession. Members of AOTA are committed to promoting inclusion, diversity, independence, and safety for all recipients in various stages of life, health, and illness and to empower all beneficiaries of occupational therapy. This commitment extends beyond service recipients to include professional colleagues, students, educators, businesses, and the community. Fundamental to the mission of the occupational therapy profession is the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of participation in roles and situations in home, school, workplace, community, and other settings. "Occupational therapy addresses the physical, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect health, well being, and quality of life" AOTA, 2004). Occupational therapy personnel have an ethical responsibility primarily to recipients of service and secondarily to society. The Occupational Therapy Code of Ethics and Ethics Standards (2010) was tailored to address the most prevalent ethical concerns of the profession in education, research, and practice. The concerns of stakeholders including the public, consumers, students, colleagues, employers, research participants, researchers, educators, and practitioners were addressed in the creation of this document. A review of issues raised in ethics cases, member questions related to ethics, and content of other professional codes of ethics were utilized to ensure that the revised document is applicable to occupational therapists, occupational therapy assistants, and students in all roles. -
Informed Consent and Refusal
CHAPTER 3 Informed Consent and Refusal Evolution of the doctrine of informed consent Elements of informed consent and refusal The nature of informed consent Exceptions to the consent requirement Mrs. Stack is a 67- year- old woman admitted with rectal bleeding, chronic renal in- sufficiency, diabetes, and blindness. On admission, she was alert and capacitated. Two weeks later, she suffered a cardiopulmonary arrest, was resuscitated and intu- bated, and was transferred to the medical intensive care unit (MICU) in an unrespon- sive and unstable state. Consent for emergency dialysis was obtained from her son, who is also her health care agent. Dialysis was repeated two days later. During the past several years, Mrs. Stack has consistently stated to her family and her primary care doctor that she would never want to be on chronic dialysis and she has refused it numerous times when it was recommended. The physician, who has known and treated Mrs. Stack for many years, also treated her daughter who had been on chronic dialysis for some time and had died after suffering a heart attack. According to the physician and the patient’s family, Mrs. Stack’s refusal of dialysis has been based on her conviction that her daughter died as a result of the dialysis treatments. Mrs. Stack’s mental status has cleared considerably and, despite the ventilator, she is able to communicate nonverbally. Although she appears to understand the benefits of dialysis and the consequences of refusing it, including deterioration and eventual death, she has consistently and vehemently refused further treatments. Her capacity to make this decision is not now in question. -
How to Think About Wild Animal Suffering
How to Think About Wild Animal Suffering ! m a g e + J i m b o o m b a P o l i c e , T h e T i m e s ( A free lecture by Dale Jamieson, PhD Professor of Environmental Studies and Philosophy, New York University Director, Center for Environmental and Animal Protection Monday, February 3rd, 4:00 – 5:20 p.m. David Strong Building, Rm. # C126 It has been widely reported that more than a billion animals have been killed in Australia in the fires that have been raging since late last year. The Australian grandmother who risked her life to save a Koala from a burning tree is widely seen as a hero. Yet in the normal course of events billions of animals die every day (including about 150 million for food). Are we obliged to do what we can to save them all? The logic of at least some animal protection philosophies seems to say “yes:” We should eliminate suffering whenever and wherever we can, whether it is caused by human action, by the predation of one animal on another, or by the impersonal workings of nature. But to many environmentalists and others, this vision of “policing nature” seems mad or worse. Questions about wild animal suffering not only threaten to disrupt alliances between animal protectionists and environmentalist, but go to the very heart of what it is to be human living in a natural world. While I do not purport to provide the correct answers to the many questions in this area, I do hope to clarify some of the issues and contribute to thinking clearly about them. -
Informed Consent
Christine Grady Department of Bioethics NIH Clinical Center The views expressed here are mine and do not necessarily represent those of the CC, NIH, or Department of Health and Human Services Informed consent is the bedrock principle on which most of modern research ethics rest…This was at the heart of the crucial ethical provision stated in the first words of the Nuremberg Code, and it remains equally compelling a half century later. Menikoff J, Camb Quarterly 2004 p 342 Authorization of an activity based on understanding what the activity entails. A legal, regulatory, and ethical requirement in health care and in most research with human subjects A process of reasoned decision making (not a form or an episode) One aspect of conducting ethical clinical research “Every human being of adult years and sound mind has a right to determine what will be done with his body… Justice Cardozo, 1914 Respect for autonomy or for an individual’s capacity and right to define own goals and make choices consistent with those goals. Well entrenched in American values, jurisprudence, medical practice, and clinical research. “Informed consent is rooted in the fundamental recognition…that adults are entitled to accept or reject health care interventions on the basis of their own personal values and in furtherance of their own personal goals” Presidents Commission for the study of ethical problems…1982 Informed consent in medical practice …informed consent in clinical practice is frequently inadequate… Physicians receive little training… Misunderstand requirements and legal standards… Time pressures and competing demands… Patient comprehension is often poor… Recent studies have demonstrated improvement in patient understanding of risks after communication interventions Schenker et al 2010; Matiasek et al. -
Code Gray.Pub
Written by Christine Mitchell, RN, FAAN and Ben Achtenberg with a historical commentary by Susan Reverby, PhD and assistance from Joan Sawyer and Karen Wolf, RN, MS Contents INTRODUCTION ....................................................................................... 3 Background ............................................................................................3 Synopsis of the Film ..............................................................................3 Suggested Uses .......................................................................................4 Scheduling ..............................................................................................4 FILM AS A TOOL FOR DISCUSSION .......................................................4 WHAT IS NURSING ETHICS? ...................................................................5 GLOSSARY ...................................................................................................5 SOME GENERAL DISCUSSION QUESTIONS ........................................6 CASE 1: BENEFICENCE ............................................................................7 Description of the Case .........................................................................7 The Principle: Beneficence ...................................................................7 Questions for Discussion ......................................................................8 CASE 2: AUTONOMY ................................................................................9 Description -
Biobanks for Europe
KI-NA-25-302-EN-C This expert group report on the ethical and regulatory challenges of international biobank research has been authored by an interdisciplinary group with experts from science, law, governance and ethics. Biobanks for Biobank research is rapidly evolving, and in close interaction with developments in informatics and genomics. The size and breath of the collections of biological samples and associated data that can be Europe assembled has increased exponentially. This opens up a vast range of new options for research and diagnosis, but at the same time also holds an important challenge for the governance of these activities. In this report, the expert group makes speci c recommendations for good A Challenge for Governance governance of Biobanks Research and Innovation policy Research and Innovation ed205134cover_BAT.indd 1-3 11/06/12 09:14 How to obtain EU publications Free publications: • via EU Bookshop (http://bookshop.europa.eu); • at the European Union’s representations or delegations. You can obtain their contact details on the Internet (http://ec.europa.eu) or by sending a fax to +352 2929-42758. Priced publications: • via EU Bookshop (http://bookshop.europa.eu). Priced subscriptions (e.g. annual series of the O cial Journal of the European Union and reports of cases before the Court of Justice of the European Union): • via one of the sales agents of the Publications O ce of the European Union (http://publications.europa.eu/others/agents/index_en.htm). EUROPEAN COMMISSION Directorate-General for Research and Innovation Directorate B — European Research Area Unit B6 — Ethics and gender Contact: Lino PAULA European Commission B-1049 Brussels E-mail: [email protected] ed205134cover_BAT.indd 4-6 11/06/12 09:14 EUROPEAN COMMISSION Biobanks for Europe A challenge for governance Report of the Expert Group on Dealing with Ethical and Regulatory Challenges of International Biobank Research Chair: Herbert Gottweis Rapporteur: Jane Kaye Members: Fabrizia Bignami, Emmanuelle Rial-Sebbag, Roberto Lattanzi, Milan Macek Jr. -
A Comparison of Two Bioethical Theories
A Comparison of Two Bioethical Theories A thesis presented to the faculty of the College of Arts and Sciences of Ohio University In partial fulfillment of the requirements for the degree Master of Arts Gavin G. Enck June 2009 © 2009 Gavin G. Enck. All Rights Reserved. 2 This thesis titled A Comparison of Two Bioethical Theories by GAVIN G. ENCK has been approved for the Department of Philosophy and the College of Arts and Sciences by Arthur Zucker Associate Professor of Philosophy Benjamin M. Ogles Dean, College of Arts and Sciences 3 ABSTRACT ENCK, GAVIN G., M.A., June 2009, Philosophy A Comparison of Two Bioethical Theories (81 pp.) Director of Thesis: Arthur Zucker This thesis compares two bioethical theories in order to determine which theory is better for use by medical professionals. The two theories are Tom L. Beauchamp and James Childress’s “Principlism” and Bernard Gert, K. Danner Clouser, and Charles M. Culver’s “Moral Rules.” The structure of the paper is as follows: an explication of both theories, an examination of the similarities and differences between the theories, an evaluation of criticisms of both theories, and identification of the three advantages the Moral Rules theory has over Principlism. In the conclusion, I claim the Moral Rules is the better bioethical theory for the medical profession. Approved: _____________________________________________________________ Arthur Zucker Associate Professor of Philosophy 4 TABLE OF CONTENTS Page Abstract .............................................................................................................................. -
Bioethics and Informed Consent
Bioethics and Informed Consent Professor Lucy Allais Informed consent is a central notion in bioethics. The emphasis on informed consent in medical practice is relatively recent (20th century). Bioethics is a relatively young field, beginning, in the USA, in the 50s and 60s, maturing in the 80s and 90s. This is different to both medical ethics, and ethics generally. Medical ethics Reflections by doctors and societies on the ethics of medical practice is probably as old as doctoring (Hippocratic oath; the Code of Hammurabi, written in Babylon in 1750 BC). Traditionally focused on the doctor-patient relationship and the virtues possessed by the good doctor. (Kuhse and Singer A Companion to Bioethics 2001:4). Ethics in philosophy: Morality: how should we live? what is right? what is wrong? Ethics: the academic study of morality. Are there objective values? Are there truths about right and wrong? What makes actions wrong? How do we resolve moral disputes? What is the basis of human rights? When (if ever) is euthanasia permissible? Is it morally justifiable to incarcerate MDR TB patients? “in 1972, no American medical school thought medical ethics important enough to be taught to all future physicians.... A decade later, in 1984—after the advent of bioethics—84 percent of medical schools required students to take a course in medical ethics or bioethics during their first two years of instruction.” (Baker 2013) The four core values of autonomy, justice, beneficence and non-maleficence. Autonomy often dominates discussions of bioethics. 6 Informed consent is linked to autonomy. Autonomy means being self-governing. Autonomy is often thought to be at the basis of human rights: human rights protect the capacities of each individual to live their life for themself.