The most recent issue of the Hastings Center Report features two distinct levels of debate about health care reform, both of them set in motion in the feature article by philosopher David DeGrazia. DeGrazia argues for consolidating health insurance in a s
Although palliative care and legalised euthanasia are both based on the medical and ethical values of patient autonomy and caregiver beneficence and non-maleficence,1 they are often viewed as antagonistic causes. A popular perception, for instance, is that palliative care is the province of religiously motivated people and the advocacy of euthanasia that of agnostics or atheists.2 3 The European Association for Palliative Care has voiced concerns that legalising euthanasia would be the start of a slippery slope resulting in harm to vulnerable patients such as elderly and disabled people and that it would impede the development of palliative care by appearing as an alternative.4 Data from the Netherlands and Belgium, where euthanasia is legal, do not provide any evidence of a slippery slope.5 6 Here, we focus on the effect of the process of legalisation of euthanasia on palliative care and vice versa by reviewing the published historical, regulatory, and epidemiological evidence
In this paper, I discuss several arguments against non-therapeutic mutilation. Interventions into bodily integrity, which do not serve a therapeutic purpose and are not regarded as aesthetically acceptable by the majority, e.g. tongue splitting, branding and flesh stapling, are now practised, but, however, are still seen as a kind of 'aberration' that ought not to be allowed. I reject several arguments for a possible ban on these body modifications. I find the common pathologisation of body modifications, Kant's argument of duties to oneself and the objection from irrationality all wanting. In conclusion, I see no convincing support for prohibition of voluntary mutilations.
Modern medicine is built on a long history of medical experimentation. Experiments in the past often exploited more vulnerable patients. Questionable ethics litter the history of medicine. Without such experiments, however, millions of lives would be forfeited. This paper asks whether all the "unethical" experiments of the past were unjustifiable, and do we still exploit the poorer members of the community today? It concludes by wondering if Harris is right in his advocacy of a moral duty to participate in medical research.
Sky Television’s documentary showing an assisted suicide has provoked a storm in UK tabloids, but the medical ethicist Daniel K Sokol says it has reinforced his belief in the moral permissibility of helping people die in exceptional circumstances.
John Coggon The German National Ethics Council has recently published its Opinion on Self- Determination and Care at the End of Life. 1 The Opinion raises and attempts to resolve issues that are troubling many people in many jurisdictions. Perhaps unsurprisingly, given the well-rehearsed range of views on euthanasia, assisted-suicide, suicide, and care for the dying, the Council’s Opinion is neither extreme in its suppositions nor in its proposals. This may not satisfy campaigners and commentators who sit on the polar edges of the debate, but it represents a predictable compromise, and will satisfy medical practitioners and those who are increasingly concerned with the inadequacy of palliative care for the elderly, the dying, and the chronically sick.
This article begins with a discussion of current guidelines regarding Alzheimer disease research so as to lay a foundation for extending these guidelines to more explicitly include research on comorbid medical conditions. The article then justifies including persons with Alzheimer disease in research on comorbid medical conditions, using data from several empirical studies that show treatment of these conditions is not only beneficial to the overall health of the individual, but also may be beneficial in decreasing the symptoms of the disease. Finally, the article uses the framework of social justice as understood in the research ethics literature to examine the inclusion of historically excluded groups in research and to support the conclusion that social justice requires persons with Alzheimer disease to be included in research on comorbid medical conditions unless a robust justification for exclusion is provided.
The purpose of oral presentations in rounds is to tell the patient’s story. The narrative helps the healthcare team make sense of the patient’s situation and provide safe, effective care. Although the stories should be comprehensive, they are often incomplete. The ethical aspects are omitted. At present the healthcare team has to tease these out from a heap of medical information. Sometimes the ethical issues stay buried in the heap, unnoticed. To reduce the risk of the clinical obscuring the ethical, a new section is needed in patients’ notes. The new category, named "ethical issues," would consist of a short list of headings. It would not require much time to complete, nor would it require much knowledge of medical ethics. It would make explicit the key ethical issues of a case, helping to anticipate their emergence or aggravation. The team can then implement strategies to deal with them.