Ebola Virus in West Africa: Waiting for the Owl of Minerva
Abstract The evolving Ebola epidemic in West Africa is unprecedented in its size and scope, requiring the rapid mobilization of resources. It is too early to determine all of the ethical challenges associated with the outbreak, but these should be monitored closely. Two issues that can be discussed are (1) the decision to implement and evaluate unregistered agents to determine therapeutic or prophylactic safety and efficacy and (2) the justification behind this decision. In this paper, I argue that it is not compassionate use that justifies this decision and suggest three lines of reasoning to support the decision...
Source: Journal of Bioethical Inquiry - October 8, 2014 Category: Medical Ethics Source Type: research

Disease, Risk, and Contagion: French Colonial and Postcolonial Constructions of “African” Bodies
Abstract In this article, we explore how sub-Saharan African immigrant populations in France have been constructed as risk groups by media sources, in political rhetoric, and among medical professionals, drawing on constructs dating to the colonial period. We also examine how political and economic issues have been mirrored and advanced in media visibility and ask why particular populations and the diseases associated with them in the popular imagination have received more attention at certain historical moments. In the contemporary period we analyze how the bodies of West African women and men have become powerfu...
Source: Journal of Bioethical Inquiry - October 7, 2014 Category: Medical Ethics Source Type: research

The Legacy of the Cartwright Report: “Lest It Happen Again”
Abstract The 1987 Cartwright Report into events at New Zealand’s National Women’s Hospital catalysed sweeping changes to promote and protect patients’ rights. A generation on, it is comfortable to believe that such sustained and deliberate violations of patient rights “couldn’t happen here” and “couldn’t happen now.” And yet, contemporary examples beg a different truth. Three of Cartwright’s messages hold an enduring relevance for health practitioners and patients: the need for patients to be respected as people; to be supported to make informed choices; ...
Source: Journal of Bioethical Inquiry - October 2, 2014 Category: Medical Ethics Source Type: research

Bioethics: The Basics
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - October 1, 2014 Category: Medical Ethics Source Type: research

Property in Tissue (Again) and Negligent Conception
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 26, 2014 Category: Medical Ethics Source Type: research

Expert Perspectives on Western European Prison Health Services: Do Ageing Prisoners Receive Equivalent Care?
Abstract Health care in prison and particularly the health care of older prisoners are increasingly important topics due to the growth of the ageing prisoner population. The aim of this paper is to gain insight into the approaches used in the provision of equivalent health care to ageing prisoners and to confront the intuitive definition of equivalent care and the practical and ethical challenges that have been experienced by individuals working in this field. Forty interviews took place with experts working in the prison setting from three Western European countries to discover their views on prison health care....
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Malign Neglect: Assessing Older Women’s Health Care Experiences in Prison
This study explores older incarcerated women’s perceptions of prison health care policies and their day-to-day survival experiences. Aggregate data obtained from a sample of 327 older women (mean age = 56) residing in prison facilities in five Southern states were used to identify a baseline of health conditions and needs for this vulnerable group. With an average of 4.2 chronic health conditions, frequently histories of victimization, and high rates of mental health issues, the women’s experiences of negotiating health care was particularly challenging. By incorporating the voices of older women,...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Disclosure of Past Crimes: An Analysis of Mental Health Professionals’ Attitudes Towards Breaching Confidentiality
This article describes the attitudes of mental health professionals (MHPs) when patients disclose past crimes unknown to the justice system. Twenty-four MHPs working in Swiss prisons were interviewed. They shared their experiences concerning confidentiality practices and attitudes towards breaching confidentiality in prison. Qualitative analysis revealed that MHPs study different factors before deciding whether a past crime should be disclosed, including: (1) the type of therapy the prisoner-patient was seeking (i.e., whether it was court-ordered or voluntary), (2) the type of crime that is revealed (e.g., a serious crime,...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Ageing Prisoners’ Views on Death and Dying: Contemplating End-of-Life in Prison
Abstract Rising numbers of ageing prisoners and goals on implementing equivalent health care in prison raise issues surrounding end-of-life care for prisoners. The paucity of research on this topic in Europe means that the needs of older prisoners contemplating death in prison have not been established. To investigate elderly prisoners’ attitudes towards death and dying, 35 qualitative interviews with inmates aged 51 to 71 years were conducted in 12 Swiss prisons. About half of the prisoners reported having thought about dying in prison, with some mentioning it in relation with suicidal thoughts and others ...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Contextualising Professional Ethics: The Impact of the Prison Context on the Practices and Norms of Health Care Practitioners
We describe the results of a qualitative study of the experiences of doctors and nurses working within two women’s prisons in the state of New South Wales (NSW), Australia. Their accounts make clear how the provision and ethics of health care may be compromised by the physical design of the prison, the institutional policies and practices restricting movement of prisoners and practitioners, the focus on maintaining control and security, and the very purpose of the prison and prison system itself. The results of this study make clear the impact that context has on professional practice and illustrate the importance of...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Understanding Death in Custody: A Case for a Comprehensive Definition
Abstract Prisoners sometimes die in prison, either due to natural illness, violence, suicide, or a result of imprisonment. The purpose of this study is to understand deaths in custody using qualitative methodology and to argue for a comprehensive definition of death in custody that acknowledges deaths related to the prison environment. Interviews were conducted with 33 experts, who primarily work as lawyers or forensic doctors with national and/or international organisations. Responses were coded and analysed qualitatively. Defining deaths in custody according to the place of death was deemed problematic. Experts...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

A Better Half: The Ethics of Hemicorporectomy Surgery
Abstract This paper discusses the ethical issues related to hemicorporectomy surgery, a radical procedure that removes the lower half of the body in order to prolong life. The literature on hemicorporectomy (HC), also called translumbar amputation, has been nearly silent on the ethical considerations relevant to this rare procedure. We explore five aspects of the complex landscape of hemicorporectomy to illustrate the broader ethical questions related to this extraordinary procedure: benefits, risks, informed consent, resource allocation and justice, and loss and the lived body. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Patenting Treatment Methods
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Ethics, Rhetoric, and Expectations: Responsibilities and Obligations of Health Care Systems
This article suggests that such advertising and marketing be subject to the same advertising standards as other businesses. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Crime and Punishment, Rehabilitation or Revenge: Bioethics for Prisoners?
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Ethics, the Law, and Prisoners: Protecting Society, Changing Human Behavior, and Protecting Human Rights
Abstract Restricting a person’s liberty presents society with many inherent ethical challenges. The historical purposes of confinement have included punishment, penitence, containment, rehabilitation, and habilitation. While the purposes are indeed complex, multifaceted, and at times ambiguous or contradictory, the fact of incarceration intrinsically creates many ethical challenges for psychiatrists working in correctional settings. Role definition of a psychiatrist may be ambiguous, with potential tensions between forensic and therapeutic demands. Privacy may be limited or absent and confidentiality may be...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Global Health Case: Questioning Our Contributions
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Conducting Ethics Research in Prison: Why, Who, and What?
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Scientific Integrity in Brazil
This article focuses on scientific integrity and the identification of predisposing factors to scientific misconduct in Brazil. Brazilian scientific production has increased in the last ten years, but the quality of the articles has decreased. Pressure on researchers and students for increasing scientific production may contribute to scientific misconduct. Cases of misconduct in science have been recently denounced in the country. Brazil has important institutions for controlling ethical and safety aspects of human research, but there is a lack of specific offices to investigate suspected cases of misconduct and policies t...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

A Lasting Effect: Reflections on Music and Medicine
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Procedure
Abstract This piece examines the diagnostic procedures for breast cancer from the patient’s point of view, trying to establish the importance of communication and reassurance, while showing how the absence of these can lead to greater distress than necessitated. (Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

A Role for Research Ethics Committees in Exchanges of Human Biospecimens Through Material Transfer Agreements
Abstract International transfers of human biological material (biospecimens) and data are increasing, and commentators are starting to raise concerns about how donor wishes are protected in such circumstances. These exchanges are generally made under contractual material transfer agreements (MTAs). This paper asks what role, if any, should research ethics committees (RECs) play in ensuring legal and ethical conduct in such exchanges. It is recommended that RECs should play a more active role in the future development of best practice MTAs involving exchange of biospecimens and data and in monitoring compliance. (...
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Erratum to: Genetic Research and Aboriginal and Torres Strait Islander Australians
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - September 1, 2014 Category: Medical Ethics Source Type: research

Deficiencies and Missed Opportunities to Formulate Clinical Guidelines in Australia for Withholding or Withdrawing Life-Sustaining Treatment in Severely Disabled and Impaired Infants
Abstract This paper examines the few, but important legal and coronial cases concerning withdrawing or withholding life-sustaining treatment from severely disabled or critically impaired infants in Australia. Although sparse in number, the judgements should influence common clinical practices based on assessment of “best interests” but these have not yet been adopted. In particular, although courts have discounted assessment of “quality of life” as a legitimate component of determination of “best interests,” this remains a prominent component of clinical guidelines. In addition,...
Source: Journal of Bioethical Inquiry - August 31, 2014 Category: Medical Ethics Source Type: research

Is Premenstrual Dysphoric Disorder Really a Disorder?
Abstract Premenstrual dysphoric disorder (PMDD) was recently moved to a full category in the DSM-5 (the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders). It also appears set for inclusion as a separate disorder in the ICD-11 (the upcoming edition of the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems). This paper argues that PMDD should not be listed in the DSM or the ICD at all, adding to the call to recognise PMDD as a socially constructed disorder. I first present the argument ...
Source: Journal of Bioethical Inquiry - August 28, 2014 Category: Medical Ethics Source Type: research