ORCID Profile
0000-0002-0432-2854
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Social Program Evaluation | Research, Science and Technology Policy | Professional Ethics (incl. police and research ethics) | Policy and Administration
Publisher: Wiley
Date: 09-2011
DOI: 10.1111/J.1440-1754.2011.02166.X
Abstract: Paediatric research is essential for improving health outcomes of children. Waiting for adult studies before conducting paediatric studies will prolong the denial of effective treatment for children. If we rely on information from adult studies rather than conducting studies with children, we risk causing harm to children. In this paper, we identify and examine ethical issues unique to conducting research with children. These include the function and the value of a child's assent and the criteria that should guide a proxy in making decisions about a child's involvement in research, offering payment to children for research participation and acceptable levels of risk for paediatric research. Justice demands that children not be denied the benefits of research, and it is the role of the paediatric medical community to advocate not only for more research for children but also to ensure that the research conducted is of the highest quality.
Publisher: Wiley
Date: 09-09-2019
DOI: 10.1111/JPC.14209
Abstract: When parents ask doctors not to disclose certain information to a child, doctors are challenged to articulate ethical reasons for giving information to children. This paper maps out the professional and legal landscape in which information-giving to children is taking place and identifies the key ethical arguments that have been made for disclosure of information to the child patient. We focus on pre-adolescent children, who have not reached a developmental stage that would see them regarded as 'mature minors'. While doctors can be relatively certain that professional and legal requirements will endorse their disclosure of information to the 'mature minor', guidelines are not clear on information-giving to pre-adolescents (immature minors). We identify six ethical reasons for telling the truth to younger children. It is noteworthy that there are good reasons to tell the truth to children, which are independent of any question of the child's capacity to be involved in decision-making.
Publisher: BMJ
Date: 04-12-2013
DOI: 10.1136/MEDETHICS-2013-101618
Abstract: The aim of this article is to draw attention to an under-recognised but ethically important phenomenon involving the deception of children in research. The type of deception we are referring to is not planned deception that is part of the research design. Instead it is deception that occurs in in idual cases where parents ask researchers not to reveal something about the research to their child. Our focus is children who do not have ultimate decisional authority--children around the ages of 7-14 years old who may have the cognitive capacity to understand but not to consent for themselves children whose agreement is required but not sufficient to authorise research. We provide three illustrative scenarios for analysis. Then, we identify circumstances in which non-disclosure might be justified and set out reasons why providing information to non-competent children is ethically required. On this basis, we argue that non-planned deception requested by parents is very unlikely to be ethically acceptable. Finally, we recommend that guidelines should (a) require researchers to consider what to do if parents do not want to disclose information to a child and (b) clarify that the most ethical response is to simply not include that child in the research.
Publisher: Wiley
Date: 19-05-2022
DOI: 10.1111/BIOE.13048
Abstract: How should clinicians respond when parents will not allow their child to know the truth about their medical condition and treatment? There is wide consensus amongst clinicians and ethicists that children should be given "honest" information delivered in a developmentally appropriate manner. However, the basis in ethical theory is not clear, especially for pre-adolescents. These children are old enough to understand some information, but are not yet "mature minors" capable of making their own health care decisions. We take the position that thinking in terms of a child's "right to know" is not the most helpful in dealing with the ethical complexity of these situations. We propose that questions of truth-telling are best addressed in terms of how a child's interests are promoted or set back by being told the truth. Our first step is to give an account of the concept of children's interests in general. Then we relate that account specifically to truth-telling. In doing so, we use a relatively straightforward hypothetical but realistic case, in order to illustrate how ethical deliberation using interests would proceed. The case is not intended to be particularly contentious or difficult, so that the focus is on the nature of the ethical reasoning, rather than any complexities of the case.
Publisher: Wiley
Date: 09-09-2016
DOI: 10.1111/BIOE.12278
Abstract: Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery (specifically labioplasty) for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are (1) that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has and (2) even if there is valid parental consent, the presence of Body Dysmorphic Disorder means that cosmetic surgery will fail in its aims. In this article, we challenge, in an evidence-based way, the standard view that Body Dysmorphic Disorder is a contraindication for genital cosmetic surgery in adolescents. Our argument gathers together and unifies a substantial amount of disparate research in the context of an ethical argument. We focus on empirical questions about benefit and harm, because these are ethically significant. Answers to these questions affect the answer to the ethical question. We question the claim that there would be no benefit from surgery in this situation, and we consider possible harms that might be done if treatment is refused. For an adolescent with Body Dysmorphic Disorder, the most important thing may be to avoid harm. We find ourselves arguing for the ethical justifiability of cosmetic labioplasty for an adolescent with Body Dysmorphic Disorder, even though we recognize that it is a counter intuitive position. We explain how we reached our conclusion.
Publisher: Elsevier BV
Date: 05-2005
Publisher: MDPI AG
Date: 20-03-2019
DOI: 10.3390/NANO9030468
Abstract: The compact integration of semiconductor TiO2 nanoparticles (NPs) into the 3D crossed region of stacked plasmonic Ag nanowires (NWs) enhanced the photocatalytic activities through synergistic effects between the strong localized surface plasmon resonance (LSPR) excitation at the 3D cross-points of the Ag NWs and the efficient hot electron transfer at the interface between the Ag NWs and the TiO2 NPs. This paper explored new hybrid nanostructures based on the selective assembly of TiO2 NPs onto 3D cross-points of vertically stacked Ag NWs. The assembled TiO2 NPs directly contacted the 3D Ag NWs therefore, charge separation occurred efficiently at the interface between the Ag NWs and the TiO2 NPs. The composite nanomaterials exhibited high extinction across the ultraviolet-visible range, rendering the nanomaterials high-performance photocatalysts across the full (ultraviolet-visible) and the visible spectral regions. Theoretical simulations clearly revealed that the local plasmonic field was highly enhanced at the 3D crossed regions of the vertically stacked Ag NWs. A Raman spectroscopic analysis of probe dye molecules under photodegradation conditions clearly revealed that the nanogap in the 3D crossed region was crucial for facilitating plasmon-enhanced photocatalysis and plasmon-enhanced spectroscopy.
Publisher: Springer Science and Business Media LLC
Date: 19-10-2018
DOI: 10.1007/S11673-018-9878-1
Abstract: Labiaplasty is a form of genital surgery to reduce large or protruding labia minora. Internationally, the rates of this surgery among women and girls is increasing and is viewed as a worrying trend. Currently, the main clinical strategy is to reassure adolescents that they are normal by talking about the variation of labia size and appearance and showing pictures demonstrating the wide range of normal female genital appearance. For the most part, policy documents recommend against labiaplasty in adolescents, claiming that it is medically non-essential surgery. In this paper, we contrast findings from our interviews with clinicians with the existing literature and policy documents and we point out areas needing more thought. This is qualitative research using semi-structured interviews. We set out to find out on what basis clinicians decide how to treat or manage adolescent patients seeking labiaplasty. We interviewed clinicians who are likely to be approached by under-eighteens requesting labiaplasty. We use interpretive content analysis and thematic analysis to analyse the data. Our findings support the emphasis on education and reassurance as the first step for all patients, but other issues that have not figured previously in the literature that would alter clinical strategies for managing patients emerge as well. Key findings are that reassurance does not always work and that the distinction between functional and appearance concerns is not a solid foundation in itself for deciding whether surgery is ethically appropriate. We conclude that the distinction between functional and appearance concerns is not ethically relevant. It is open to different interpretations and is not regarded by all clinicians as the definitive factor in relation to surgery. The focus of clinicians should be on relieving distress whatever the cause. Appearance reasons may sometimes justify surgery but, also, functional reasons may sometimes not be sufficient justification for surgery.
Publisher: Informa UK Limited
Date: 20-05-2018
Publisher: Informa UK Limited
Date: 04-05-2015
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1016/J.YMGME.2008.02.010
Abstract: Non-ketotic hyperglycinaemia (NKH) is a devastating neurometabolic disorder leading, in its classical form, to early death or severe disability and poor quality of life in survivors. Affected neonates may need ventilatory support during a short period of respiratory depression. The transient dependence on ventilation dictates urgency in decision-making regarding withdrawal of therapy. The occurrence of patients with apparent transient forms of the disease, albeit rare, adds uncertainty to the prediction of clinical outcome and dictates that the current practice of withholding or withdrawing therapy in these neonates be reviewed. Both bioethics and law take the view that treatment decisions should be based on the best interests of the patient. The medical-ethics approach is based on the principles of non-maleficence, beneficence, autonomy and justice. The law relating to withholding or withdrawing life-sustaining treatment is complex and varies between jurisdictions. Physicians treating newborns with NKH need to provide families with accurate and complete information regarding the disease and the relative probability of possible outcomes of the neonatal presentation and to explore the extent to which family members are willing to take part in the decision making process. Cultural and religious attitudes, which may potentially clash with bioethical and juridical principles, need to be considered.
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/00048670701827226
Abstract: Objectives: To suggest ways of testing hypotheses about the impact that information on genetic risk may have on the social stigma of mental disorders and to analyse the implications of these hypotheses for genetic screening for mental disorders. Method: Literature review and critical analysis and synthesis. Results: An optimistic view is that information on the genetic risk for mental disorders will reduce blame and social stigma experienced by in iduals living with mental disorder. A more pessimists view is that genetic risk information and the use of predictive genetic testing will lead to earlier stigmatization of those at risk of mental disorders. Research is identified that is needed to provide a better understanding of the implications of predictive genetic testing for the stigmatization of different mental health disorders. Conclusions: It is essential that research on the genetics of mental disorders is accompanied by social science research on the ways in which genetic findings influence the lives of those who are tested.
Publisher: Informa UK Limited
Date: 08-05-2014
Publisher: Elsevier BV
Date: 06-2017
No related organisations have been discovered for Merle Spriggs.
Start Date: 06-2015
End Date: 06-2018
Amount: $335,500.00
Funder: Australian Research Council
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