GPs’ representatives voted overwhelmingly this week for a system in which patients opt in to any sharing of medical data with third parties—rather than one in which their consent is assumed unless they opt out, the system favoured by the Department of Health. Clinical confidentiality depends on GPs being the prime data holder of their patients’ medical records, said the BMA’s annual conference of local medical committee representatives in London. It also strongly opposed using implied consent as justification for releasing information on named patients.
With a national shortage of organ donors, the dilemma faced by surgeons is whether a transplant with what are called "marginal" organs from donors who could be higher risk, such as the elderly or patients with a history of cancer or drug abuse, is better than leaving a patient on a waiting list where they could die before a suitable donor can be found. Figures disclosed to File on 4 reveal that in 1998 13% of donor organs were "marginal", 10 years later this percentage had doubled. Everyone in the transplant field who has talked to the programme agreed the quality of organs from deceased donors was declining, accepting this meant added risks connected to the hearts, lungs, livers and kidneys used for transplants. As one doctor put it, this is a calculated gamble. Arising out of this comes the issue of informed consent. Who should have the final say whether an organ from a dead donor should be used, the professional or the patient?
Cash incentives and the payment of funeral expenses are two ideas being put forward to encourage people to donate human organs and tissue. The Nuffield Council on Bioethics is asking the public if it is ethical to use financial incentives to increase donations of organs, eggs and sperm. Paying for most types of organs and tissue is illegal in the UK. The public consultation will last 12 weeks and the council's findings will be published in autumn 2011.
Doctors will be allowed forcibly to sedate the 55-year-old woman in her home and take her to hospital for surgery. She could be forced to remain on a ward afterwards. The case has sparked an intense ethical and legal debate. Experts questioned whether lawyers and doctors should be able to override the wishes of patients and whether force was ever justified in providing medical care.
A cancer patient who has a phobia of hospitals should be forced to undergo a life-saving operation if necessary, a High Court judge has ruled. Sir Nicholas Wall, sitting at the Court of Protection, ruled doctors could forcibly sedate the 55-year-old woman - referred to as PS. PS lacked the capacity to make decisions about her health, he said. Doctors at her NHS Foundation trust had argued PS would die if her ovaries and fallopian tubes were not removed. Evidence presented to Sir Nicholas, head of the High Court Family Division, said PS was diagnosed with uterine cancer last year.
Three women in Namibia are suing the state for allegedly being sterilised without their informed consent after being diagnosed as HIV positive. The women say the doctors and nurses should have informed them properly about what was happening. The rights group representing them, the Legal Assistance Centre, says it has documented 15 cases of alleged HIV sterilisation in hospitals since 2008. A march in their support is taking place in Windhoek as the case begins.
A cardiac surgeon with an international reputation has been given a formal warning by the General Medical Council for undertaking an “adventurous” procedure for which he was not adequately trained and for which he did not obtain informed consent.
More than 60,000 Americans were sterilised, many against their will, as part of a eugenics movement that finished in 1979, aimed at keeping the poor and mentally ill from having children. Now, decades on, one state is considering compensation.
At least 83 Guatemalans are thought to have died after being deliberately infected with syphilis and gonorrhoea in the 1940s, a presidential commission in the United States has heard. US government scientists infected hundreds of Guatemalan prisoners, psychiatric patients and orphans to study the effects of penicillin. None of those infected consented. The head of the commission, Amy Gutmann, called the research a "shameful piece of medical history". The Presidential Commission for the study of Bioethical Issues is due to publish its report in September. President Obama set up the commission when the research came to light last year.
Nicola Wilding, 35, lost the use of her right arm in a car crash 12 years ago. Nerve transplants have returned some movement to her upper arm, but she's been told she'll never be able to use her hand again. Now, having seen a Newsnight film on the work of Austrian surgeon Oskar Aszmann, she is actively considering having her hand cut off and replaced with a bionic prosthesis.
A lawyer who advised doctors that they must let a 22-year-old Jehovah's Witness die even though he wanted to live has spoken of the agonising scenes before the young man's death.