Difficult Decisions: A Critical Analysis Of Consent To High-risk Medical Procedures
Funder
National Health and Medical Research Council
Funding Amount
$320,918.00
Summary
Consent is the cornerstone of ethics as applied to healthcare and is central to the relationship between healthcare and the law. Whilst no-one would deny the importance of seeking consent to high-risk medical procedures, much depends on the practical manner in which this is done. By studying consent for high-risk procedures with the participation of patients and their health care providers, we will both test the limits of consent and find practical ways to address those limits. In doing so, the ....Consent is the cornerstone of ethics as applied to healthcare and is central to the relationship between healthcare and the law. Whilst no-one would deny the importance of seeking consent to high-risk medical procedures, much depends on the practical manner in which this is done. By studying consent for high-risk procedures with the participation of patients and their health care providers, we will both test the limits of consent and find practical ways to address those limits. In doing so, the project will re-cast consent processes in a way that better accommodates the contingencies of clinical practice in high-risk settings in which patient autonomy is often compromised. Because this reformulation of consent will be grounded in the realities of high-risk clinical practice, our findings will reflect the needs and values of relevant stakeholders (patient and health professionals) and more likely to make a significant contribution to patient care and health policy. This project also addresses what the High Court of Australia has acknowledged as widespread weaknesses in the common formulation of consent in medicine. Finally this project, which operates in an important area of overlap between the law and medicine, will show how these disciplines can work jointly to serve the interests of all Australians, and Australian society.Read moreRead less
Ethical And Legal Issues Surrounding The Decision-making Process For Donating And Banking Umbilical Cord Blood
Funder
National Health and Medical Research Council
Funding Amount
$417,550.00
Summary
Altruistic donation of umbilical cord blood (UCB) is essential to provide a source of stem cells to treat various cancers and blood-immune disorders. However, parents can instead, bank UCB for personal use. This project will determine if parents are aware and understand differences between UCB donation and banking, as well as analysing the legal issues surrounding both processes. We aim to make recommendations to improve the decision-making process with the hope of increasing UCB donation rates.
Reconceptualising Health Promotion: The Role Of Values, Ethics And Evidence In Obesity Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$485,103.00
Summary
Obesity and overweight are public health priorities. Population-level programs, campaigns and regulations are required to prevent and reduce obesity. How should these interventions proceed? What is effective? What is ethical? How can we avoid doing harm? At present, we do not know. By studying current interventions in detail, and working with experts and practitioners in health promotion and ethics, this project will develop a new framework to guide overweight and obesity intervention in future.
An Ethical Analysis Of The Disclosure Of Surgeons' Performance Data To Patients Within The Informed Consent Process
Funder
National Health and Medical Research Council
Funding Amount
$148,937.00
Summary
For over a decade, hospitals in the American state of New York have been collecting information about the mortality rates of surgeons conducting Coronary Artery Bypass Grafts, and making this information available to patients. The United Kingdom is set to make these and other performance indicators on the ability of surgeons ('report cards') available from 2004. There are good reasons to think a similar system may be introduced in Australia in the near future. Patients can use the information co ....For over a decade, hospitals in the American state of New York have been collecting information about the mortality rates of surgeons conducting Coronary Artery Bypass Grafts, and making this information available to patients. The United Kingdom is set to make these and other performance indicators on the ability of surgeons ('report cards') available from 2004. There are good reasons to think a similar system may be introduced in Australia in the near future. Patients can use the information contained in report cards when deciding whether or not to consent to have a particular surgeon conduct an operation on them. Contemporary bioethicists stress the importance of a proper informed consent process in medicine. This is a process in which a doctor advises a patient of relevant information and ensures that the patient comprehends that information, before the patient consents to an operation. Currently report cards in America are publicly disseminated on the internet, however there is no systematic attempt to incorporate the information contained in report cards into the informed consent process. We do not know if patients understand the information they are given, or if they incorporate it into their decision making procedures appropriately. In our study we will consider how information that is contained in report cards could best be used in the informed consent process. We will keep in mind the importance of helping patients to make their own informed decisions to consent to operations, the importance of respecting the professional integrity of surgeons and the importance of providing the best possible standard of care for patients. The result of our study will be a revised model of the informed consent process that incorporates report cards in an ethically acceptable way.Read moreRead less
The Future Of Tobacco Control: Exploring The Feasibility, Acceptability And Cost-effectiveness Of New Policy Directions
Funder
National Health and Medical Research Council
Funding Amount
$495,752.00
Summary
We will examine the practical feasibility, ethical and public acceptability, and likely cost effectiveness of a number of different ways of reducing tobacco smoking and the harm caused by smoking in Australia. These policy options will include: (1) more restrictive policies towards tobacco products (such as prohibiting tobacco smoking and creating a government monopoly on the manufacture and supply of tobacco); (2) encouraging smokers to switch from smoking cigarettes to less harmful ways of usi ....We will examine the practical feasibility, ethical and public acceptability, and likely cost effectiveness of a number of different ways of reducing tobacco smoking and the harm caused by smoking in Australia. These policy options will include: (1) more restrictive policies towards tobacco products (such as prohibiting tobacco smoking and creating a government monopoly on the manufacture and supply of tobacco); (2) encouraging smokers to switch from smoking cigarettes to less harmful ways of using nicotine, such as using nicotine patches or gum ; (3) using new biotechnologies to improve smokers chances of quitting (e.g. genetic screening of smokers to select the most effective way of helping them to stop smoking and vaccinating ex-smokers against the effects of nicotine); and (4) new biotechnologies that may prevent nonsmokers from beginning to smoke (e.g. vaccinating nonsmokers against the effects of nicotine) or reduce the chances of their developing tobacco-related diseases (e.g. screening the population for genes that predict an increased susceptibility to nicotine dependence and tobacco-related diseases). The project will provide important information that will assist government in formulating policies to reduce the rate of cigarette smoking in the Australian population below current levels.Read moreRead less
Certain Death In Uncertain Time: A Qualitative Study Of The Experience Of Advanced Ovarian Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$221,755.00
Summary
Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful termi ....Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful terminology to describe it. The absence of discussion exacerbates patients' social isolation. Also, the quality of their remaining life, and the quality of the care they get, depends heavily on the quality of understanding and communication within the social systems that support them. A growing proportion of patients in developed countries fall into this category, including the 1200 Australian women who are diagnosed each year with advanced ovarian cancer. This study aims to increase our understanding of the experience of certain death in uncertain time by recruiting a group of 20 women with advanced ovarian cancer, and interviewing them every few months over three years. The study will explore all aspects of the experience of having advanced ovarian cancer, and generate a terminology for it - one that grows out of the women's own language. The study will inform the organisation and delivery of clinical care and services to women with ovarian cancer. It will also inform patient education programs, and help to tune medical education to the particular needs and perceptions of patients who are experiencing the certainty of death in uncertain time. Finally, the researchers will also explore the implications of the findings for medical ethics and health law, and for communication, information and decision-making in cancer medicine.Read moreRead less
An Investigation Of The Relationship Between The Pharmaceutical Industry, Medical Profession And Medical Practitioners
Funder
National Health and Medical Research Council
Funding Amount
$186,449.00
Summary
In recent years there has been a rapid expansion in the number and range of interactions between the pharmaceutical industry and the medical profession. While this has the potential to advance research, education and health care, there are risks that such interactions may inappropriately serve commercial objectives and ultimately compromise the best interests of patients and society in general. Most major medical and pharmaceutical organisations have released guidelines of policy statements on t ....In recent years there has been a rapid expansion in the number and range of interactions between the pharmaceutical industry and the medical profession. While this has the potential to advance research, education and health care, there are risks that such interactions may inappropriately serve commercial objectives and ultimately compromise the best interests of patients and society in general. Most major medical and pharmaceutical organisations have released guidelines of policy statements on the relationship between the medical profession and the pharmaceutical industry. To date most debate has taken the form of personal observations or professional opinion , and there has been little objective research into medical industry interactions. This project aims to examine the relationship between the pharmaceutical industry, the medical profession and the medical practitioners. Specifically, the aim of this project is to establish whether this relationship as it currently exists, and as stated in guidelines from professional bodies, is appropriate in terms of justifiable ethical standards, empirical research and social perspectives. The results of this research will enable assessment of current guidelines and the development of further guidelines and regular process where appropriate.Read moreRead less