ORCID Profile
0000-0002-7910-5117
Current Organisation
University of Tasmania
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 29-05-2020
DOI: 10.1111/JPC.14946
Publisher: Elsevier BV
Date: 2022
Publisher: BMJ
Date: 02-2007
Publisher: Cambridge University Press (CUP)
Date: 2020
DOI: 10.1017/DAP.2020.14
Abstract: Health data have enormous potential to transform healthcare, health service design, research, and in idual health management. However, health data collected by institutions tend to remain siloed within those institutions limiting access by other services, in iduals or researchers. Further, health data generated outside health services (e.g., from wearable devices) may not be easily accessible or useable by in iduals or connected to other parts of the health system. There are ongoing tensions between data protection and the use of data for the public good (e.g., research). Concurrently, there are a number of data platforms that provide ways to disrupt these traditional health data siloes, giving greater control to in iduals and communities. Through four case studies, this paper explores platforms providing new ways for health data to be used for personal data sharing, self-health management, research, and clinical care. The case-studies include data platforms: PatientsLikeMe, Open Humans, Health Record Banks, and unforgettable.me. These are explored with regard to what they mean for data access, data control, and data governance. The case studies provide insight into a shift from institutional to in idual data stewardship. Looking at emerging data governance models, such as data trusts and data commons, points to collective control over health data as an emerging approach to issues of data control. These shifts pose challenges as to how “traditional” health services make use of data collected on these platforms. Further, it raises broader policy questions regarding how to decide what public good data should be put towards.
Publisher: SAGE Publications
Date: 12-2010
Abstract: This article explores the attitudes of consultants in a large UK teaching hospital to the need for formal clinical ethics support. Data obtained through an anonymous online questionnaire illustrate the ways in which consultants deal with clinical ethical dilemmas and their confidence in such decision-making. In the absence of formal ethics support a large proportion of consultants who took part in the survey said that they would consult with colleagues when faced with a clinical ethical dilemma and the majority considered that this satisfactorily resolved the issue. However, 80% of respondents stated that they would find a form of ethics support within the Trust to be useful. Consultants also noted the reasons for, and barriers to, using ethics support. The response rate to the survey was low, perhaps indicating a lack of interest in the topic or that clinical ethics discussion is of low priority.
Publisher: BMJ
Date: 12-12-2013
DOI: 10.1136/MEDETHICS-2012-100916
Abstract: In W v M and Others (Re M) the Court of Protection considered whether withdrawal of artificial nutrition and hydration was in the best interests of a person in minimally conscious state. The Mental Capacity Act 2005 states that in determining best interests the decision-maker must consider, so far as is reasonably ascertainable, the patient's wishes, feelings, beliefs and values. Baker J. indicated that a high level of specificity is required in order to attribute significant weight to these factors. It is preservation of life which carries substantial weight in the best interests' balance sheet. Could the (prior) values of a patient ever meet the probative standard necessary to offset the weight accorded to preservation of life? Rather than referencing the patient's values to specific circumstances and treatments they could be more effectively considered as part of the patient narrative, how the patient would want her life story to continue/cease.
Publisher: Wiley
Date: 29-05-2022
DOI: 10.5694/MJA2.51546
Publisher: Routledge
Date: 05-12-2022
Publisher: Cambridge University Press (CUP)
Date: 09-2014
DOI: 10.1111/LEST.12031
Abstract: The Mental Capacity Act 2005 introduced a statutory framework for advance decisions, thus promoting autonomous healthcare decision making in advance of loss of capacity. In order to be valid and applicable, and so binding on healthcare professionals, advance decisions refusing treatment (ADRT) must specify treatments to be refused and the circumstances of refusal. Recent case-law indicates that a high level of specificity is required for advance refusals of life-sustaining treatment and, in contrast to a presumption of capacity for contemporaneous decisions, in some circumstances capacity must be demonstrated at the time of making the advance decision. In comparison with the ‘stringent’ requirements for ADRT, the more generic Advance Care Planning (ACP) is gaining more prominence in end of life decision making. The paper explores recent case-law and its impact on the effectiveness of ADRT in practice and compares with ACP.
Publisher: SAGE Publications
Date: 06-2012
Publisher: Springer Science and Business Media LLC
Date: 2005
Publisher: BMJ
Date: 15-07-2015
DOI: 10.1136/MEDETHICS-2015-102716
Abstract: Medical students experience ethics learning in a wide variety of formats, delivered not just through the taught curriculum. An audit of ethics learning was carried out at a medical school through a secure website over one academic year to determine the quantity and range of medical ethics learning in the undergraduate curriculum and compare this with topics for teaching described by the Institute of Medical Ethics (IME) (2010) and the General Medical Council's (GMC) Tomorrow's Doctors (2009). The online audit captured the participants' reflections on their learning experiences and the impact on their future practice. Results illustrate the opportunistic nature of ethics learning, especially in the clinical years, and highlight the reality of the hidden curriculum for medical students. Overall, the ethics learning was a helpful and positive experience for the participants and fulfils the GMC and IME curriculum requirements.
Publisher: Springer Science and Business Media LLC
Date: 16-08-2021
DOI: 10.1007/S40592-021-00133-5
Abstract: People are using innovative internet of things technologies to gain in idualised management of their type 1 diabetes. The #WeAreNotWaiting movement supports them to build their own hybrid closed loop systems and access their real time blood sugar data via any web connected device. A small number of parents in Australia use such DIY looping systems to manage their child's type 1 diabetes, but these systems have not been approved by the Therapeutic Goods Administration in Australia, creating ethical dilemmas for clinicians about how to respond to the use of medical devices that are not registered on the Australian Register of Therapeutic Goods. This article considers whether the use of DIY looping is in the best interests of the child and, if not, whether intervention in parental decision making is justified to prevent harm to the child. It addresses the ongoing duty of healthcare professionals to provide care to children who are 'looping.' Reference is made to findings from a study, Personalised Closed Loop Systems for Childhood Diabetes, to illustrate stakeholders' perceptions of benefits and harms of DIY looping systems. I conclude that the decision of parents to use DIY looping technology could be considered to be in a child's best interests, broadly defined, and falls within the Zone of Parental Discretion, however healthcare practitioners who support parents may have professional concerns in doing so.
Publisher: BMJ
Date: 15-04-2004
Publisher: SAGE Publications
Date: 03-2015
Abstract: Members of the Student Clinical Ethics Committee discussed whether tube feeding should be instigated for a man who had indicated through his actions that he may be refusing it, although his family stated that he would have wanted to be kept alive in such a situation. The Committee considered the key issues of capacity and best interests, which in this case were confounded by lack of clarity about whether the patient’s actions amounted to a valid refusal of life sustaining treatment, and if his previous views still pertained to his current, yet unforeseen, circumstances. As the discussion progressed, it became apparent that some members were reluctant to accept that non-insertion of clinically assisted feeding could ever be in a patient’s best interests.
Publisher: Wiley
Date: 11-2021
DOI: 10.5694/MJA2.50838
Publisher: BMJ
Date: 03-2009
Publisher: SAGE Publications
Date: 20-01-2015
Abstract: Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – a female patient in her mid-60s, who had a very long history of multiple sclerosis, withdrew her previous consent to treatment following discussion with her son. The case study summarises the reflections of the Committee and focusses on: the meaning and practical application of respect for patient autonomy whether a refusal of clinically indicated treatment may challenge the notion of capacity the role of others in the process of decision-making if the current decision to refuse treatment was the patient’s own and whether, in the circumstances, it should be respected.
Publisher: BMJ
Date: 21-12-2010
Abstract: Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council (GMC) requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC's ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved.
Publisher: Wiley
Date: 18-10-2012
DOI: 10.1111/MEDU.12027
Publisher: SAGE Publications
Date: 06-2014
Abstract: Members of the Student Clinical Ethics Committee discussed the ethical issues arising in a case referred for consideration – a homeless man presenting to the emergency department of a busy London hospital with recent self-reported suicide attempts. Should he be admitted overnight in order to address a short-term shelter problem? The case study summarises the reflections of the Committee and focusses on the doctor’s duty of care and patient responsibility, benefits of admission and resource considerations.
Publisher: BMJ
Date: 07-2007
Publisher: SAGE Publications
Date: 29-12-2016
Abstract: Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – the family of a very elderly non-English speaking Asian lady did not want her to be informed that she had incurable lymphoma. The case study summarises the reflections of the Committee and focusses on: the role of cultural norms in healthcare decision making the extent to which the views of the family about what is best for the patient should be respected, whether the patient should have been informed of her terminal diagnosis and the role of the clinician in navigating complex family dynamics.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Carolyn Johnston.