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 discussed...
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 to facil...
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 female ...
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 the ap...
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 anatomi...
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 him or her unjust...
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 related to re...
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 health agencies have been instr...
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 of th...
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 situation of the Black within the health sy...
Source: Journal of Bioethical Inquiry - January 15, 2021 Category: Medical Ethics Source Type: research
