The Minnesota Starvation Experiment and Force Feeding of Prisoners —Relying on Unethical Research to Justify the Unjustifiable
This article poses a response to one argument supporting the force feeding of political prisoners. This argument assumes that prisoners have moral autonomy and thus cannot be force fed in the early stages of their hunger strike. However, as their fasting progresses, their cognitive competence declines, and they are no longer autonomous. Since they are no longer autonomous, force feeding becomes justified. This article questions the recurrent citation of a paper in empirical support of the claim that hunger strike causes mental disorders or cognitive impairments. The paper, written by Daniel Fessler, partially relies on the...
Source: Journal of Bioethical Inquiry - May 3, 2021 Category: Medical Ethics Source Type: research

Lee (a Pseudonym) v Dhupar [2020] NSWDC 717
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - April 29, 2021 Category: Medical Ethics Source Type: research

Conditions of Global Health Crisis Decision-Making —An Ethical Analysis
AbstractThe circumstances of a public health emergency (PHE) shape reasoning and decision-making in ways that deviate from routine circumstances, where adherence to established values, principles, and methodologies is expected. Understanding what drives these deviations is critical to assessing their ethical consequences. In this paper we describe four conditions that influence decision-making during PHEs, in particular regarding the deployment and conduct of research on experimental or novel biomedical interventions. These four conditions are politicization, urgency, uncertainty, and fear. We argue that taken together the...
Source: Journal of Bioethical Inquiry - April 16, 2021 Category: Medical Ethics Source Type: research

The Shifts in Human Consciousness
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - April 9, 2021 Category: Medical Ethics Source Type: research

Lead Essay —Institutional Racism, Whiteness, and the Role of Critical Bioethics
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - April 6, 2021 Category: Medical Ethics Source Type: research

Human Germline Gene Editing from Maslahah Perspective: The Case of the World ’s First Gene Edited Babies
The objective, procedure, and output of the research were assessed against the conditions ofmaslahah. It can be concluded that the experiment did not meet the conditions; it is inconsistent with the objectives of shariah (maqasid al-shariah) and some fundamental Islamic teachings that it did not preserve greater benefit, hence it could be considered impermissible. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - March 24, 2021 Category: Medical Ethics Source Type: research

Evaluating an Adolescent ’s Decision-Making Capacity Whilst in the Harsh World of Detention
We present an amalgamated case of a fourteen-year-old adolescent who refused to consent to medical reversal of her hunger strike protest. The medical team became the final arbiter when her parents, who were also in detention, could not agree with each other even after mediation. The case explores the complexity of evaluating the adolescent’s capacity to provide informed consent while influenced by the opinions of co-detainees in this extreme setting. We argue that the parents and the child had compromised decisional capacity due to the effects of detenti on. The challenges to the medical team are recognized and discu...
Source: Journal of Bioethical Inquiry - March 18, 2021 Category: Medical Ethics Source Type: research

A Critique of Contemporary Islamic Bioethics
AbstractLast year marked a decade since the publication of the book “Islamic Biomedical Ethics” by religious studies professor Abdulaziz Sachedina in which he called for a critical and rigorous analytical approach to the ethical inquiry of biomedical issues from an Islamic perspective. Since the publication of this landmark work, some authors have continued to c all into question the ways in which Islam as a religious tradition is engaged with in the secular bioethics literature. This paper describes common argumentative issues with current Islamic bioethics scholarship and offers general pearls and strategies ...
Source: Journal of Bioethical Inquiry - March 4, 2021 Category: Medical Ethics Source Type: research

Reflective Learning of Palliative Care by Secondary Healthcare and Sociosanitary Students Using Two Videoclips on the Experience of Cameron Duncan: “DFK6498” and “Strike Zone”
AbstractEducating young people about how to interact with patients at the end of their lives is challenging. A qualitative study based on Husserl ’s phenomenological approach was performed to describe the learning experience of secondary education students after watching, analysing, and reflecting on two videoclips featuring Cameron Duncan, a young man suffering from terminal cancer (DFK6498 and Strike Zone). Students from three vocational centres providing training in ancillary nursing, pharmacy, and dependent care in the Community of Madrid visited the Palliative Care (PC) Hospital. A total of 110 students (102 fem...
Source: Journal of Bioethical Inquiry - March 1, 2021 Category: Medical Ethics Source Type: research

Hidden in Plain Sight: The Moral Imperatives of Hippocrates ’ First Aphorism
AbstractThis historiographic survey of extant English translations and interpretations of the renowned Hippocratic first aphorism has demonstrated a concerning acceptance and application of ancient deontological principles that have been used to justify a practice of medicine that has been both paternalistic and heteronomous. Such principles reflect an enduring Hippocratism that has perpetuated an insufficient appreciation of the moral nature of the aphorism ’s second sentence in the practice of the art of medicine. That oversight has been constrained by a philological discourse that has centred on the meanings of th...
Source: Journal of Bioethical Inquiry - February 26, 2021 Category: Medical Ethics Source Type: research

Reframing the Australian Medico-Legal Model of Infertility
AbstractAustralian law affirms a binary construction of fertility/infertility. This model is based upon the medical categorization of infertility as a disease. Law supports medicine in prioritizing technology, such as in vitro fertilization, as treatment for infertility. This prioritization of a medico-legal model of infertility in turn marginalizes alternative means of family creation such as adoption, fostering, traditional surrogacy, and childlessness. This paper argues that this binary model masks the impact of medicalization upon reproductive choice and limits opportunity for infertile individuals to create families. ...
Source: Journal of Bioethical Inquiry - February 26, 2021 Category: Medical Ethics Source Type: research

Understanding the Reasons Behind Healthcare Providers ’ Conscientious Objection to Voluntary Assisted Dying in Victoria, Australia
AbstractDuring the debates about the legalization of Voluntary Assisted Dying (VAD) in Victoria, Australia, the presence of anti-VAD health professionals in the medical community and reported high rates of conscientious objection (CO) to VAD suggested access may be limited. Most empirical research on CO has been conducted in the sexual and reproductive health context. However, given the fundamental differences in the nature of such procedures and the legislation governing it, these findings may not be directly transferable to VAD. Accordingly, we sought to understand how CO operates in the context of VAD. Prior to the impl...
Source: Journal of Bioethical Inquiry - February 26, 2021 Category: Medical Ethics Source Type: research

The Dubious Practice of Sensationalizing Anatomical Dissection (and Death) in the Humanities Literature
AbstractPast anatomical dissection practice has received recent attention in the humanities and social science literature, especially in a number of popular format books. In these works, past ethically dubious dissection practices (mostly from the 1700 to 1800s, though they had their origins much earlier on) are again  revisited, including stealing the dead for dissection. There are extremely simple, yet very important, lessons to be had in these analyses, including: do not exploit the dead and treat the dead with dignity, respect, and reverence. In this paper, we highlight that these principles apply not just t o ana...
Source: Journal of Bioethical Inquiry - February 26, 2021 Category: Medical Ethics Source Type: research

Ethics Consultation for Adult Solid Organ Transplantation Candidates and Recipients: A Single Centre Experience
AbstractSystematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (65.0 per cent) for candidates and twenty-one (35.0 per cent ...
Source: Journal of Bioethical Inquiry - February 26, 2021 Category: Medical Ethics Source Type: research

Exploitation, Criminalization, and Pecuniary Trade in the Organs of Living People
AbstractIt is often maintained that, since the buying and selling of organs —particularly the kidneys—of living people supposedly constitutes exploitation of the living vendors while the so-called “altruistic” donation of them does not, the former, unlike the latter, should be a crime. This paper challenges and rejects this view. A novel account of exploitation, inf luenced by but different from those of Zwolinski and Wertheimer and of Wilkinson, is developed. Exploitation is seen as a sort of injustice. A distinction is made between justice and fairness. To exploit someone is to take advantage of h...
Source: Journal of Bioethical Inquiry - February 22, 2021 Category: Medical Ethics Source Type: research

The Role of Physicians in Expanded Access to Investigational Drugs: A Mixed-Methods Study of Physicians ’ Views and Experiences in The Netherlands
This study is the first to explore physicians ’ experiences and moral views, with the aim of understanding the conditions under which doctors decide to pursue expanded access for their patients and the obstacles and facilitators they encounter in the Netherlands. In this mixed-methods study, semi-structured interviews (n = 14) and a questionn aire (n = 90) were conducted with medical specialists across the country and analysed thematically. Typically, our respondents pursue expanded access in “back against the wall” situations and broadly support its classic requirements. They indicate practical hurdles r...
Source: Journal of Bioethical Inquiry - February 15, 2021 Category: Medical Ethics Source Type: research

Conscientious Objection, Conflicts of Interests, and Choosing the Right Analogies. A Reply to Pruski
AbstractIn this response paper, we respond to the criticisms that Michal Pruski raised against our article “Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.” We defend our original position against conscientious objection in healthcare by suggesting that the analogies Pruski uses to criticize our paper miss the relevant point and that some of the analogies he uses and the implications he draws are misplaced. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - February 4, 2021 Category: Medical Ethics Source Type: research

Biopower of Colonialism in Carceral Contexts: Implications for Aboriginal Deaths in Custody
This article argues that criminal justice and health institutions under settler colonialism collude to create and sustain “truths” about First Nations lives that often render them as “bare life,” to use the term of Giorgio Agamben (1998). First Nations peoples ’ existence is stripped to its sheer biological fact of life and their humanity denied rights and dignity. First Nations people remain in a “state of exception” to the legal order and its standards of care (Agamben 1998). Zones of exception place First Nations people in a separate and diminish ed legal order. Medical and...
Source: Journal of Bioethical Inquiry - January 29, 2021 Category: Medical Ethics Source Type: research

This Wasn ’t a Split-Second Decision”: An Empirical Ethical Analysis of Transgender Youth Capacity, Rights, and Authority to Consent to Hormone Therapy
AbstractInherent in providing healthcare for youth lie tensions among best interests, decision-making capacity, rights, and legal authority. Transgender (trans) youth experience barriers to needed gender-affirming care, often rooted in ethical and legal issues, such as healthcare provider concerns regarding youth capacity and rights to consent to hormone therapy. Even when decision-making capacity is present, youth may lack the legal authority to give consent. The aims of this paper are therefore to provide an empirical analysis of minor trans youth capacity to consent to hormone therapy and to address the normative questi...
Source: Journal of Bioethical Inquiry - January 27, 2021 Category: Medical Ethics Source Type: research

The Final Act: An Ethical Analysis of Pia Dijkstra ’s Euthanasia for a Completed Life
AbstractAmongst other countries, the Netherlands currently allows euthanasia, provided the physician performing the procedure adheres to a strict set of requirements. In 2016, Second Chamber member Pia Dijkstra submitted a law proposal which would also allow euthanasia without the reason necessarily having any medical foundation; euthanasia on the basis of a completed life. The debate on this topic has been ongoing for over two decades, but this law proposal has made the discussion much more immediate and concrete. This paper considers the moral permissibility of Pia Dijkstra ’s law proposal, focusing on the ethics o...
Source: Journal of Bioethical Inquiry - January 15, 2021 Category: Medical Ethics Source Type: research

Being Seen by the Doctor: A Meditation on Power, Institutional Racism, and Medical Ethics
AbstractThe following pages sketch the outlines of “a Canaanite reading” of the health system. Beginning with the Black person—African, Afro-diasporic, Aboriginal, and Torres Strait Islander—who is seen by a health professional, the functions and effects of the racializing gaze are examined. I wrestle with Al Saji’s understanding of “col onial disregard,” Whittaker’s insights into the extractive disposition of settler institutions vis-à-vis Indigenous peoples, and Saidiya Hartman and Fred Moten’s struggle with the spectacular. This leads me to conclude that the s...
Source: Journal of Bioethical Inquiry - January 15, 2021 Category: Medical Ethics Source Type: research

Caregivers ’ Understanding of Informed Consent in a Randomized Control Trial
This study aimed to explore the effectiveness, and caregivers’ understandings, of the process of informed consent that accompanied their child’s participation i n a dental randomized control trial (RCT). Telephone interviews were conducted with a convenience sample of ten caregivers who each had a child participating in the RCT. Pre-tested closed and open-ended questions were used, and the findings were produced from an inductive analysis of the latter and a descriptive analysis of the former. Participants had limited understanding of the purpose of the RCT and rated the readability of the consent form more hig...
Source: Journal of Bioethical Inquiry - January 15, 2021 Category: Medical Ethics Source Type: research

Why Death Need Not Be “Reasonably Foreseeable”—The Proposed Legislative Response to Truchon and Gladu v Attorney General (Canada) and Attorney General (Quebec) [2019] QCCS 3792
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - January 15, 2021 Category: Medical Ethics Source Type: research

Black bodies and Bioethics: Debunking Mythologies of Benevolence and Beneficence in Contemporary Indigenous Health Research in Colonial Australia
AbstractWe seek to bring Black bodies and lives into full view within the enterprise of Indigenous health research to interrogate the unquestioned good that is taken to characterize contemporary Indigenous health research. We articulate a Black bioethics that is not premised upon a false logic of beneficence, rather we think through a Black bioethics premised upon an unconditional love for the Black body. We achieve this by examining the accounts of two Black mothers, fictional and factual rendering visible the racial violence Black bodies have been subjected to. We call for a Black bioethics that reimagines the Black body...
Source: Journal of Bioethical Inquiry - January 14, 2021 Category: Medical Ethics Source Type: research

Addressing Structural Racism Through Constitutional Transformation and Decolonization: Insights for the New Zealand Health Sector
AbstractIn colonial states and settings, constitutional arrangements are often forged within contexts that serve to maintain structural racism against Indigenous people. In 2013 the New Zealand government initiated national conversations about the constitutional arrangements in Aotearoa. M āori (Indigenous) leadership preceded this, initiating a comprehensive engagement process among Māori in 2010, which resulted in a report by Matike Mai Aotearoa which articulated a collective Māori vision of a written constitution congruent withte Tiriti o Waitangi (the founding document of the colonial state of New Zealand) by 2040.T...
Source: Journal of Bioethical Inquiry - January 11, 2021 Category: Medical Ethics Source Type: research

Bioethics, Race, and Contempt
AbstractThe U.S. healthcare system has a long history of displaying racist contempt toward Black people. From medical schools ’ use of enslaved bodies as cadavers to the widespread hospital practice of reporting suspected drug users who seek medical help to the police, the institutional practices and policies that have shaped U.S. healthcare systems as we know them cannot be minimized as coincidence. Rather, the very fou ndations of medical discovery, diagnosis, and treatment are built on racist contempt for Black people and have become self-perpetuating. Yet, I argue that bioethics and bioethicists have a role in co...
Source: Journal of Bioethical Inquiry - January 7, 2021 Category: Medical Ethics Source Type: research

The Role of Emotion in Understanding Whiteness
AbstractThis paper argues that stoicism as a central element of whiteness shapes, controls, and ultimately limits the experience and expression of emotion in public space. I explore how this may play out in particular medical settings like hospitals in Aotearoa New Zealand. I argue that working in conjunction with other values of whiteness identified by Myser (2003) —hyper-individualism, a contractual view of relationships, and an emphasis on personal control and autonomy—this makes hospitals emotionally unsafe spaces for Māori and other groups who place high importance in the collective sharing of emotion. Us...
Source: Journal of Bioethical Inquiry - January 7, 2021 Category: Medical Ethics Source Type: research

Teasing out Artificial Intelligence in Medicine: An Ethical Critique of Artificial Intelligence and Machine Learning in Medicine
AbstractThe rapid adoption and implementation of artificial intelligence in medicine creates an ontologically distinct situation from prior care models. There are both potential advantages and disadvantages with such technology in advancing the interests of patients, with resultant ontological and epistemic concerns for physicians and patients relating to the instatiation of AI as a dependent, semi- or fully-autonomous agent in the encounter. The concept of libertarian paternalism potentially exercised by AI (and those who control it) has created challenges to conventional assessments of patient and physician autonomy. The...
Source: Journal of Bioethical Inquiry - January 7, 2021 Category: Medical Ethics Source Type: research

Bioethicists Should Be Helping Scientists Think About Race
AbstractIn this essay, I argue that bioethicists have a thus-far unfulfilled role to play in helping life scientists, including medical doctors and researchers, think about race. I begin with descriptions of how life scientists tend to think about race and descriptions of typical approaches to bioethics. I then describe three different approaches to race: biological race, race as social construction, and race as cultural driver of history. Taking into account the historical and contemporary interplay of these three approaches, I suggest an alternative framework for thinking about race focused on how the idea of race functi...
Source: Journal of Bioethical Inquiry - January 7, 2021 Category: Medical Ethics Source Type: research

We ’re in This Together: A Reflection on How Bioethics and Public Health Can Collectively Advance Scientific Efforts Towards Addressing Racism
AbstractRacism is a key driver of the social, political, and economic injustices that cause and maintain health inequities. Over centuries and across continents, racism has become deeply ingrained within societies. Therefore, we believe that it is our professional and ethical obligation as scientists, and public health scholars specifically, to address racism head on in order to ameliorate racialized health disparities. We argue that greater focus is needed on addressingracism rather thanrace and how race is described or defined. We offer input from public health scholarship to help bioethicists and other scientists contri...
Source: Journal of Bioethical Inquiry - January 7, 2021 Category: Medical Ethics Source Type: research

Race, Reproduction, and Biopolitics: A Review Essay
AbstractThis review essay critically examines Catherine Mills ’sBiopolitics (2018) and Camisha Russell ’sThe Assisted Reproduction of Race (2018). Although distinct works, the centrality of race and reproduction provides a point of connection and an opening into reframing contemporary debates within bioethicsand biopolitics. In reviewing these books together I hope to show how biopolitical theory and critical philosophy of race can be useful in looking at bioethical problems from a new perspective that open up different kinds of analyses, especially around historically embedded problems like institutional racis...
Source: Journal of Bioethical Inquiry - January 6, 2021 Category: Medical Ethics Source Type: research

Conflicts of Interest Result From Relationships But Are Not Resolved by Preventing Relationships
AbstractGoldberg notes that the relationship is a component of Conflicts of Interests (COIs). Networks of relationships and the simultaneous presence of several interests are not negative per se but become so when they generate a conflict that undermines impartiality. The solution to the problem of COIs, therefore, cannot be to abolish relationships and the interests that they necessarily express but rather to verify whether those relationships are such as to unduly affect an individual ’s judgement. The evolution of an Italian legislation about COIs is eloquent in this regard. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - January 6, 2021 Category: Medical Ethics Source Type: research

Reply to: Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests
AbstractGiubilini and Savulescu in their recentJournal of Bioethical Inquiry symposium article presented an account of conscientious objection that argues for its recognition as a non-financial conflict of interest. In this short commentary, I highlight some problems with their account. First, I discuss their solicitor analogy. Second, I discuss some problems surrounding their objectivity claim about standards of medical care. Next, I discuss some issues arising from consistently applying their approach. Finally, I highlight that conscientious objection should be viewed not as a conflict of interest but as something that s...
Source: Journal of Bioethical Inquiry - January 6, 2021 Category: Medical Ethics Source Type: research

Medical Mistrust and Enduring Racism in South Africa
AbstractIn this essay, I argue that exploring institutional racism also needs to examine interactions and communications between patients and providers. Exchange between bioethicists, social scientists, and life scientists should emphasize the biological effects —made evident through health disparities—ofracism. I discuss this through examples of patient –provider communication in fertility clinics in South Africa and the ongoing COVID-19 pandemic to emphasize the issue of mistrust between patients and medical institutions. Health disparities and medical mistrust are interrelated problems of racism in hea...
Source: Journal of Bioethical Inquiry - January 5, 2021 Category: Medical Ethics Source Type: research

In Defence of Forgetting Evil: A Reply to Pilkington on Conscientious Objection
AbstractIn a recent article for this journal, Bryan Pilkington (2019) makes a number of critical observations about one of our arguments for non-traditional medical conscientious objectors ’ duty to refer. Non-traditional conscientious objectors are those professionals who object to indirectly performing actions—like, say, referring to a physician who will perform an abortion. In our response here, we discuss his central objection and clarify our position on the role of value conf licts in non-traditional conscientious objection. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - January 5, 2021 Category: Medical Ethics Source Type: research

The Whiteness of Bioethics
AbstractA discussion of whiteness as an “ethos” or “relational category” in bioethics, drawing on examples from medical and historical research. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - January 4, 2021 Category: Medical Ethics Source Type: research

The Costs of Institutional Racism and its Ethical Implications for Healthcare
AbstractThis paper discusses the ethical implications of racism and some of the various costs associated with racism occurring at the institutional level. We argue that, in many ways, the laws, social structures, and institutions in Western society have operated to perpetuate the continuation of historical legacies of racial inequities with or without the intention of individuals and groups in society. By merely maintaining existing structures, laws, and social norms, society can impose social, economic, and health costs on racial minorities that impinge on their well-being and human dignity. Based on a review of multidisc...
Source: Journal of Bioethical Inquiry - January 2, 2021 Category: Medical Ethics Source Type: research

Whittington Hospital NHS Trust v XX [2020] UKSC 14
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - December 1, 2020 Category: Medical Ethics Source Type: research

Beyond Duty: Medical “Heroes” and the COVID-19 Pandemic
AbstractWhen infectious disease outbreaks strike, health facilities acquire labels such as “war zones” and “battlefields” and healthcare professionals become “heroes” on the “front line.” But unlike soldiers, healthcare professionals often take on these dangerous roles without any prior intention or explicit expectation that their work will place them in grave personal dan ger. This inevitably raises questions about their role-related obligations and whether they should be free to choose not to endanger themselves. In this article, I argue that it is helpful to view this situ...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Heralding the Digitalization of Life in Post-Pandemic East Asian Societies
AbstractFollowing the outbreak of what would become the COVID-19 pandemic, social distancing measures were quickly introduced across East Asia —including drastic shelter-in-place orders in some cities—drawing on experience with the outbreak of severe acute respiratory syndrome (SARS) almost two decades ago. “Smart City” technologies and other digital tools were quickly deployed for infection control purposes, ranging from conventio nal thermal scanning cameras to digital tracing in the surveillance of at-risk individuals. Chatbots endowed with artificial intelligence have also been deployed to shift...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

A Global Ecological Ethic for Human Health Resources
AbstractCOVID 19 has highlighted with lethal force the need to re-imagine and re-design the provisioning of human resources for health, starting from the reality of our radical interdependence and concern for global health and justice. Starting from the structured health injustice suffered by migrant workers during the pandemic and its impact on the health of others in both destination and source countries, I argue here for re-structuring the system for educating and distributing care workers around what I call a global ecological ethic. Rather than rely on a system that privileges nationalism, that is unjust, and that sus...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Interview: Mourning Is a Political Act Amid the Pandemic and Its Disparities (Republication)
AbstractThis conversation between a feminist and a critical whiteness scholar addresses the politics of vulnerability to COVID-19 and the questions of what it means to mobilize and learn from private grief and mass mourning and the role of academia and intellectuals in the current crisis. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Mental Capacity Assessments for COVID-19 Patients: Emergency Admissions and the CARD Approach
AbstractThe doctrine of consent (or informed consent, as it is called in North America) is built upon presumptions of mental capacity. Those presumptions must be tested according to legal rules that may be difficult to apply to COVID-19 patients during emergency presentations. We examine the principles of mental capacity and make recommendations on how to assess the capacity of COVID-19 patients to consent to emergency medical treatment. We term this the CARD approach (Comprehend, Appreciate, Reason, and Decide). (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Healthcare Professional Standards in Pandemic Conditions: The Duty to Obtain Consent to Treatment
This article explores whether the legal duty on healthcare practitioners to disclose the material risks of a proposed medical treatment to a patient should be upheld during pandemic conditions or whether the pre-eminence of patient autonomy should be partly sacrificed in such exceptional circumstances. We argue that measures to protect public health and to respect autonomous decision-making are not mutually exclusive and that there are good reasons to maintain professional standards in obtaining consent to treatment even during acute pressures on public health systems. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

COVID-19, Moral Conflict, Distress, and Dying Alone
AbstractCOVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect healthcare providers and cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Telling the Truth to Child Cancer Patients in COVID-19 Times
AbstractA notable feature of the COVID-19 pandemic is that children are less at risk of becoming infected or, if infected, less likely to become seriously unwell, so ethical discussions have consequently focused on the adult healthcare setting. However, despite a lower risk of children becoming acutely ill with COVID-19, there nevertheless may be significant and potentially sustained effects of COVID-19 on the physical, psychological, and emotional health and well-being of children. Focusing on the context of children ’s cancer care, and specifically bone marrow transplant (BMT), we describe some of these effects and...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Ethical Challenges in Clinical Research During the COVID-19 Pandemic
AbstractThe sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public,  patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies f ocusing on other diseases. Difficult decisions we...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Risk Communication Should be Explicit About Values. A Perspective on Early Communication During COVID-19
This article explores the consequences of failure to communicate early, as recommended in risk communication scholarship, during the first stage of the COVID-19 pandemic in Australia and the United Kingdom. We begin by observing that the principles of risk communication are regarded as basic best practices rather than as moral rules. We argue firstly, that they nonetheless encapsulate value commitments, and secondly, that these values should more explicitly underpin communication practices in a pandemic. Our focus is to explore the values associated with the principle of communicating early and often and how use of this pr...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

COVID-19 from Wellington New Zealand
AbstractThis paper examines the role of bioethics in the successful control of COVID-19 in New Zealand. After the severe acute respiratory syndrome (SARS) coronavirus episode in Toronto researchers developed a framework of values and principles to articulate values that were already commonly accepted “in the community of its intended users,” to be used to inform decision-making. New Zealand subsequently developed its own framework that was embedded in its Pandemic Influenza Plan. These formed the basis of the New Zealand response to COVID-19. This paper illustrates the ways in which the bioe thical framework wa...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research

Preserving Bodily Integrity of Deceased Patients From the Novel SARS-CoV-2 Pandemic in West Africa
AbstractThe outbreak of the novel coronavirus pandemic, otherwise known as COVID-19 brought about the use of new terminologies —new lexical items such as social distancing, self-isolation, and lockdown. In developed countries, basic social amenities to support these are taken for granted; this is not the case in West African countries. Instead, those suggested safeguards against contracting COVID-19 have exposed the infra structural deficit in West African countries. In addition, and more profoundly, these safeguards against the disease have distorted the traditional community-individuality balance. The enforcement o...
Source: Journal of Bioethical Inquiry - November 9, 2020 Category: Medical Ethics Source Type: research