ORCID Profile
0000-0002-0061-4315
Current Organisation
Queen's University
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Publisher: Wiley
Date: 22-05-2018
DOI: 10.1111/BIOE.12466
Publisher: Wiley
Date: 02-06-2014
DOI: 10.1111/BIOE.12104
Publisher: Elsevier BV
Date: 02-2015
Publisher: Informa UK Limited
Date: 1998
Publisher: Informa UK Limited
Date: 1998
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2015
Publisher: Wiley
Date: 21-11-2011
Publisher: BMJ
Date: 31-10-2016
DOI: 10.1136/MEDETHICS-2016-103883
Abstract: We respond in this paper to various counter arguments advanced against our stance on conscientious objection accommodation. Contra Maclure and Dumont, we show that it is impossible to develop reliable tests for conscientious objectors' claims with regard to the reasonableness of the ideological basis of their convictions, and, indeed, with regard to whether they actually hold they views they claim to hold. We demonstrate furthermore that, within the Canadian legal context, the refusal to accommodate conscientious objectors would not constitute undue hardship for such objectors. We reject concerns that refusing to accommodate conscientious objectors would limit the equality of opportunity for budding professionals holding particular ideological positions. We also clarify various misrepresentations of our views by respondents Symons, Glick and Jotkowitz, and Lyus.
Publisher: Cambridge University Press (CUP)
Date: 2017
Abstract: Using the case of Ebola Virus Disease as an ex le, this paper shows why patients at high risk for death have a defensible moral claim to access unregistered medical interventions (UMI), without having to enrol in randomized placebo controlled trials. A number of jurisdictions permit and facilitate such access under emergency circumstances. One controversial question is whether patients should only be permitted access to UMI after trials investigating the interventions are fully recruited. It is argued that regulatory regimes should not prioritise trial recruitment over patient access, even if this results in drug research and development delays. We describe how the moral duty to rescue impacts on others' duties to oblige patients seeking emergency access to unregistered medical interventions. The view that eligible patients are owed the provision of access to UMI regardless of their willingness to enrol in a randomised controlled trial (RCT) is defended.
Publisher: Wiley
Date: 03-2005
DOI: 10.1111/J.1471-8847.2005.00104.X
Abstract: The objective of this module is to cover ground that was not covered in-depth in any of the other modules, including: scientific misconduct, issues concerning the publication and ownership of research results (authorship guidelines - who is eligible to be considered an author, or contributor to a scientific paper etc.), special problems occurring in social science and epidemiological research, and the problems pertaining to conflicts of interest the various players in biomedical research activities could encounter.
Publisher: Wiley
Date: 13-09-2014
DOI: 10.1111/BIOE.12118
Publisher: Informa UK Limited
Date: 11-1998
Publisher: Springer Science and Business Media LLC
Date: 02-1995
DOI: 10.1007/BF02197191
Publisher: Elsevier
Date: 2001
Publisher: Wiley
Date: 06-1998
DOI: 10.1002/(SICI)1099-1042(199806)6:2<168::AID-HCA3271>3.0.CO;2-Q
Publisher: Wiley
Date: 08-07-2010
Publisher: Wiley
Date: 03-2017
DOI: 10.1111/DEWB.12142
Publisher: Wiley
Date: 16-12-2002
Publisher: BMJ
Date: 07-12-1996
Publisher: Cambridge University Press (CUP)
Date: 1996
DOI: 10.1017/S0963180100007209
Abstract: Today's clinical AIDS research is in trouble. Principal investigators are confronted with young and frequently highly knowledgeable patients. Many of these people with AIDS (PWAs) are often unwilling to adhere to the trial protocols. These PWAs believe they are ethically justified in breaching trial protocols because they do not consider themselves true volunteers in such trials. PWAs argue that they do not really volunteer because existing legislation prevents them from buying and using experimental drugs or from testing alternative treatment strategies. Their only access to such agents is participation in clinical trials.
Publisher: Informa UK Limited
Date: 11-2003
Publisher: Wiley
Date: 19-01-2012
Publisher: Wiley
Date: 10-2009
Publisher: BMJ
Date: 02-05-2015
DOI: 10.1136/MEDETHICS-2014-102458
Abstract: Competent patients suffering from treatment-resistant depressive disorder should be treated no different in the context of assisted dying to other patients suffering from chronic conditions that render their lives permanently not worth living to them. Jurisdictions that are considering, or that have, decriminalised assisted dying are discriminating unfairly against patients suffering from treatment-resistant depression if they exclude such patients from the class of citizens entitled to receive assistance in dying.
Publisher: BMJ
Date: 24-04-1999
Publisher: Informa UK Limited
Date: 03-10-2017
Publisher: BMJ
Date: 23-03-2016
DOI: 10.1136/MEDETHICS-2016-103506
Abstract: Canada's Supreme Court decided in February 2015 that the criminalisation of assisted dying in the country violates the country's citizens and residents constitutional rights. This paper reviews policy recommendations produced by a special expert advisory panel appointed by Canada's provinces and territories, where the responsibility for the provision of health care lies. It also reviews a similar document produced by a special federal parliamentary committee. Based on the review of these two milestone documents it is argued that a Canadian consensus seems to emerge that foreshadows a permissive regulatory regime in that country.
Publisher: Springer Science and Business Media LLC
Date: 21-11-2019
DOI: 10.1007/S11017-019-09510-Y
Abstract: Conscience-based refusals by health care professionals to provide care to eligible patients are problematic, given the monopoly such professionals hold on the provision of such services. This article reviews standard ethical arguments in support of conscientious refuser accommodation and finds them wanting. It discusses proposed compromise solutions involving efforts aimed at testing the genuineness and reasonability of refusals and rejects those solutions too. A number of jurisdictions have introduced policies requiring conscientious refusers to provide effective referrals. These policies have turned out to be unworkable. They subject patients to a health care delivery lottery, which is incompatible with the fundamental values of medical professionalism. This paper sheds light on transnational efforts aimed at undermining progress made in reproductive health by means of conscientious refusal accommodation claims. The view that the accommodation of conscientious refusers is indefensible on consequentialist ethical grounds, as well as on grounds related to medical professionalism itself, is defended.
Publisher: Wiley
Date: 19-06-2018
DOI: 10.1111/BIOE.12459
Abstract: Hughes offers a consequentialist response to our rejection of accommodation of conscientious objection in medicine. We argue here that his compromise proposition has been tried in many jurisdictions and has failed to deliver unimpeded access to care for eligible patients. The compromise position, entailing an accommodation of conscientious objection provided there is unimpeded access, fails to grasp that the objectors are both determined not to provide services they object to as well as to subvert patient access to the objected to services. Unpredictable future developments in drug R&D and resulting treatment and prevention options in medicine make the compromise position unrealistic.
Publisher: Wiley
Date: 19-10-2015
DOI: 10.1111/BIOE.12215
Publisher: Wiley
Date: 06-09-2015
DOI: 10.1111/BIOE.12214
Publisher: Wiley
Date: 05-2008
Publisher: Wiley
Date: 03-2007
Publisher: BMJ
Date: 22-04-2011
Publisher: Wiley
Date: 09-07-2012
Publisher: BMJ
Date: 05-2013
DOI: 10.1136/MEDETHICS-2012-100801
Abstract: This article analyses, from a bioethics journal editor's perspective, the threats to academic freedom and freedom of expression that academic bioethicists and academic bioethics journals are subjected to by political activists applying pressure from outside of the academy. I defend bioethicists' academic freedom to reach and defend conclusions many find offensive and 'wrong'. However, I also support the view that academics arguing controversial matters such as, for instance, the moral legitimacy of infanticide should take clear responsibility for the views they defend and should not try to hide behind analytical philosophers' rationales such as wanting to test an argument for the sake of testing an argument. This article proposes that bioethics journals establish higher-quality requirements and more stringent mechanisms of peer review than usual for iconoclastic articles.
Publisher: Informa UK Limited
Date: 17-10-2014
Publisher: BMJ
Date: 02-2004
Abstract: This article describes how a small but vocal group of biomedical scientists propagates the views that either HIV is not the cause of AIDS, or that it does not exist at all. When these views were rejected by mainstream science, this group took its views and arguments into the public domain, actively c aigning via newspapers, radio, and television to make its views known to the lay public. I describe some of the harmful consequences of the group's activities, and ask two distinct ethical questions: what moral obligations do scientists who hold such minority views have with regard to a scientifically untrained lay audience, and what moral obligations do mainstream newspapers and government politicians have when it comes to such views. The latter question will be asked because the "dissidents" succeeded for a number of years in convincing the South African government of the soundness of their views. The consequences of their stance affected millions of HIV infected South Africans severely.
Publisher: Wiley
Date: 14-11-2013
DOI: 10.1111/DEWB.12041
Publisher: BMJ
Date: 11-11-2004
Publisher: Wiley
Date: 03-10-2010
Publisher: Wiley
Date: 14-07-2008
Publisher: Springer-Verlag
Date: 2005
Publisher: Wiley
Date: 15-06-2006
Publisher: Wiley
Date: 21-10-2016
DOI: 10.1111/BIOE.12301
Publisher: Wiley
Date: 05-2001
Publisher: American Public Health Association
Date: 07-2007
Abstract: We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach.
Publisher: Elsevier BV
Date: 2011
DOI: 10.2139/SSRN.1961111
Publisher: Wiley
Date: 09-01-2018
DOI: 10.1111/BIOE.12429
Publisher: Cambridge University Press (CUP)
Date: 09-2011
DOI: 10.1017/S1744552311000140
Abstract: Existing policies on HIV testing were developed decades ago when HIV infection led nearly inevitably to AIDS and death. Since then rapid clinical progress has occurred. HIV infected people with access to life-preserving care and treatment no longer experience an existential threat to their life and wellbeing. HIV infection today, at least in North America and Western Europe, represents a chronic but manageable illness. Moreover, with treatment most infected people are rendered, to all intents and purposes, non-infectious. In this paper, we discuss the ethical, policy and legal implications of the changing clinical picture of HIV/AIDS. In particular, we propose significant changes to existing HIV testing policies as well as to policies pertaining to the criminalisation of infected people's sexual behaviour in North America and Western Europe.
Publisher: Springer Science and Business Media LLC
Date: 07-1997
DOI: 10.1038/NBT0797-613
Publisher: Wiley
Date: 10-09-2009
Publisher: BMJ
Date: 22-04-2016
DOI: 10.1136/MEDETHICS-2016-103560
Abstract: We describe a number of conscientious objection cases in a liberal Western democracy. These cases strongly suggest that the typical conscientious objector does not object to unreasonable, controversial professional services—involving torture, for instance—but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive. We analyse the conflict between these patients' access rights and the conscientious objection accommodation demanded by monopoly providers of such healthcare services. It is implausible that professionals who voluntarily join a profession should be endowed with a legal claim not to provide services that are within the scope of the profession's practice and that society expects them to provide. We discuss common counterarguments to this view and reject all of them.
Publisher: BMJ
Date: 04-2000
DOI: 10.1136/JME.26.2.148
Publisher: Wiley
Date: 04-1996
DOI: 10.1111/J.1467-8519.1996.TB00110.X
Abstract: This article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that 'women are the fastest growing group' -- whether of HIV-infected or of AIDS patients -- is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women AIDS cases in order to support these feminists' claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seems wrong. Particularly disturbing in this c aign is the fact that the theme of 'risky sex' has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non-existent to miniscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of 'educating' women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV-tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of 'victim ideology' that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists.
Publisher: Elsevier BV
Date: 2008
DOI: 10.2139/SSRN.1311469
Publisher: Wiley
Date: 19-01-2016
DOI: 10.1111/DEWB.12102
Publisher: Forum for Medical Ethics Society
Date: 07-03-2017
Publisher: Wiley
Date: 02-10-2009
Publisher: Wiley
Date: 10-09-2009
Publisher: BMJ
Date: 04-08-2021
DOI: 10.1136/MEDETHICS-2021-107493
Abstract: The question of whether problems with the social determinants of health that might impact decision-making justify denying eligibility for assisted dying has recently come to the fore in debates about the legalisation of assisted dying. For ex le, it was central to critiques of the 2021 amendments made to Canada’s assisted dying law. The question of whether changes to a country’s assisted dying legislation lead to descents down slippery slopes has also come to the fore—as it does any time a jurisdiction changes its laws. We explore these two questions through the lens of Canada’s experience both to inform Canada’s ongoing discussions and because other countries will confront the same questions if they contemplate changing their assisted dying law. Canada’s Medical Assistance in Dying (MAiD) law has evolved through a journey from the courts to Parliament, back to the courts, and then back to Parliament. Along this journey the eligibility criteria, the procedural safeguards, and the monitoring regime have changed. In this article, we focus on the eligibility criteria. First, we explain the evolution of the law and what the eligibility criteria were at the various stops along the way. We then explore the ethical justifications for Canada’s new criteria by looking at two elements of the often-corrosive debate. First, we ask whether problems with the social determinants of health that might impact decision-making justify denying eligibility for assisted dying of decisionally capable people with mental illnesses and people with disabilities as their sole underlying medical conditions. Second, we ask whether Canada’s journey supports slippery slope arguments against permitting assisted dying.
Publisher: Wiley
Date: 02-10-2009
Publisher: Wiley
Date: 02-10-2009
Publisher: Wiley
Date: 10-07-2006
Publisher: Wiley
Date: 13-09-2012
Publisher: Wiley
Date: 18-10-2017
DOI: 10.1111/BIOE.12405
Publisher: Elsevier BV
Date: 09-2000
DOI: 10.1016/S0277-9536(00)00075-7
Abstract: This paper describes a number of historical breaches of research ethics. Typically the victims of such breaches belong to vulnerable populations, such as prisoners, mentally disabled people, women and people in developing countries. This article provides a brief introduction to the main ethical approaches in bioethics. Subsequently it looks at a number of currently discussed ethical issues in clinical research ethics, notably the ethics standards of clinical trials in developing countries, the use of prisoners and incompetent people in clinical research, and the modus operandi of research ethics committees.
Publisher: Informa UK Limited
Date: 25-09-1996
Publisher: Informa UK Limited
Date: 09-2004
Publisher: Wiley
Date: 11-2001
Publisher: JSTOR
Date: 07-1997
DOI: 10.2307/3528773
Publisher: Elsevier BV
Date: 06-2015
Publisher: Wiley
Date: 13-04-2014
DOI: 10.1111/BIOE.12099
Publisher: Oxford University Press (OUP)
Date: 13-11-2008
DOI: 10.1093/BMB/LDN048
Abstract: The advent of AIDS brought about a group of patients unwilling to accept crucial aspects of the methodological standards for clinical research investigating Phase 1 drugs, surgeries or devices. Their arguments against placebo controls in trials, which depended--at the time--on the terminal status of patient volunteers led to a renewed discussion of the ethics of denying patients with catastrophic illnesses access to last-chance experimental drugs, surgeries or devices. Existing ethics and health policy literature on the topic of access to experimental drugs. The positions of those arguing for or against free access to experimental drugs for terminally ill patients are irreconcilable. At stake are questions about the kinds of personal sacrifices society can reasonably expect patients in clinical trials to make to ensure statistically predictive results. These would benefit by necessity a much larger number of current and future patients--the conflict is about in idual versus public interests. It is also about the question of whether or not the state can legitimately prevent patients with terminal illnesses from unfettered access to experimental drugs, surgeries or devices in order to motivate them to participate in clinical trials. We review the ethical arguments for and against the provision of access to Phase 1 agents for terminally ill patients. Finding a compromise between providing free or no access to Phase 1 drugs for terminally ill patients. We ought to investigate means to increase access to experimental drugs for terminally ill patients without sacrificing necessary clinical trials' sounds scientific methods.
Publisher: Wiley
Date: 2007
Publisher: Springer Science and Business Media LLC
Date: 09-1994
DOI: 10.1007/BF02251028
Publisher: Wiley
Date: 02-2013
DOI: 10.1002/9781444367072.WBIEE373
Abstract: Acquired immunodeficiency syndrome (AIDS), which is caused by the human immunodeficiency virus (HIV), has emerged as the paradigmatic disease for ethical analyses addressing issues in infectious disease control and public health. The ethical issues surrounding HIV/AIDS are best ided conceptually into two parts: life prior to and after the advent of life‐preserving therapies. This ision not only provides a natural way to categorize how ethical issues were dealt with historically compared to recent times, but also in terms of mapping out the ethical relevance of HIV/AIDS in relation to developed and developing nations.
Publisher: Cambridge University Press (CUP)
Date: 28-05-2015
Publisher: BMJ
Date: 02-07-2015
Publisher: Informa UK Limited
Date: 02-06-2010
Publisher: Wiley
Date: 09-2022
DOI: 10.1111/DEWB.12364
Publisher: BMJ
Date: 04-2001
DOI: 10.1136/JME.27.2.142
Publisher: Springer Science and Business Media LLC
Date: 05-1995
DOI: 10.1007/BF02198219
Publisher: BMJ
Date: 04-2004
Abstract: It is argued by Lie et al in the current issue of the Journal of Medical Ethics that an international consensus opinion has formed on the issue of standards of care in clinical trials undertaken in developing countries. This opinion, so they argue, rejects the Declaration of Helsinki's traditional view on this matter. They propose furthermore that the Declaration of Helsinki has lost its moral authority in the controversy in research ethics. Although the latter conclusion is supported by this author, it will be demonstrated in this paper that there is not such a thing as an international consensus opinion, and that the authorities used by Lie et al as evidence in support of their claim should not be relied upon as authorities or final arbiters in this debate. Furthermore, it will be shown that arguments advanced substantively to show that lower standards of care are ethically acceptable in the developing world, conflate scientific with economic reasons, and ultimately fail to bolster the case they are designed to support.
Publisher: Wiley
Date: 09-2006
Publisher: BMJ
Date: 08-12-2005
Publisher: Wiley
Date: 14-08-2006
DOI: 10.1111/J.1471-8847.2006.00149.X
Abstract: Most pharmaceutical research carried out today is focused on the treatment and management of the lifestyle diseases of the developed world. Diseases that affect mainly poor people are neglected in research advancements in treatment because they cannot generate large financial returns on research and development costs. Benefit sharing arrangements for the use of indigenous resources and genetic research could only marginally address this gap in research and development in diseases that affect the poor. Benefit sharing as a strategy is conceptually problematic, even if one, as we do, agrees that impoverished indigenous communities should not be exploited and that they should be assisted in improving their living conditions. The accepted concept of intellectual property protection envisages clearly defined originators and owners of knowledge, whereas the concept of community membership is fluid and indigenous knowledge is, by its very nature, open, with the originator(s) lost in the mists of time. The delineation of 'community' presents serious conceptual and practical difficulties as few communities form discrete, easily discernable groups, and most have problematic leadership structures. Benefit sharing is no substitute for governments' responsibility to uplift impoverished communities. Benefit sharing arrangements may be fraught with difficulties but considerations of respect and equity demand that prior informed consent and consultation around commercialisation of knowledge take place with the source community and their government.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2013
DOI: 10.1007/S10912-013-9211-2
Abstract: This paper discusses a number of critical ethical problems that arise in interactions between queer patients and health care professionals attending them. Using real-world ex les, we discuss the very practical problems queer patients often face in the clinic. Health care professionals face conflicts in societies that criminalise same sex relationships. We also analyse the question of what ought to be done to confront health care professionals who propagate falsehoods about homosexuality in the public domain. These health care professionals are more often than not motivated by strong religious convictions that conflict with mainstream medical opinion on homosexuality. We argue that they ought to be held accountable for their conduct by their professional statutory bodies, given that they abuse their professional standing to propagate sectarian views not representative of their profession. Lastly, we propose that medical schools have special responsibilities in training future health care professionals that will enable them to respond professionally to queer patients seeking health care.
Publisher: Springer Science and Business Media LLC
Date: 07-1999
DOI: 10.1007/BF03351226
Publisher: Fundacao Oswaldo Cruz
Date: 08-12-2008
Publisher: Elsevier
Date: 2012
Publisher: Wiley
Date: 22-12-2010
DOI: 10.1111/J.1467-8519.2010.01878.X
Abstract: This article by one of the Editors of Bioethics, published in the 25th anniversary issue of the journal, describes some of the revolutionary changes academic publishing has undergone during the last decades. Many humanities journals went from typically small print-runs, counting by the hundreds, to on-line availability in thousands of university libraries worldwide. Article up-take by our subscribers can be measured efficiently. The implications of this and other changes to academic publishing are discussed. Important ethical challenges need to be addressed in areas such as the enforcement of plagiarism-related policies, the so-called 'impact factor' and its impact on academic integrity, and the question of whether on-line only publishing can currently guarantee the integrity of academic publishing histories.
Publisher: Springer Science and Business Media LLC
Date: 06-1998
DOI: 10.1007/BF02678123
Publisher: Oxford University Press (OUP)
Date: 29-10-2009
DOI: 10.1093/PHE/PHP032
Publisher: Springer Science and Business Media LLC
Date: 04-2000
DOI: 10.1007/BF03351234
Publisher: Wiley
Date: 31-01-2008
Publisher: Wiley
Date: 02-2013
DOI: 10.1002/9781444367072.WBIEE367
Abstract: Research ethics came into its own as an ongoing academic and regulatory concern in the aftermath of the Nuremberg Trials. Knowledge of the Nazi experiments led to the first international guidelines stipulating basic ethics standards for research involving human participants (Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law 1994 [1949]). Subsequent scandals – including but not limited to the Tuskegee syphilis study – led to further and improved ethics guidelines such as the World Medical Association's Declaration of Helsinki (World Medical Association 1964–2008) as well as such national documents as the landmark Belmont Report in the USA (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research 1979).
Publisher: Wiley
Date: 05-2006
Publisher: Springer Science and Business Media LLC
Date: 09-1998
DOI: 10.1007/BF02678112
Publisher: Wiley
Date: 09-05-2015
DOI: 10.1111/BIOE.12167
Publisher: Wiley
Date: 22-09-2016
DOI: 10.1111/BIOE.12288
Publisher: Informa UK Limited
Date: 1998
Publisher: Wiley
Date: 09-04-2012
Publisher: Wiley
Date: 06-2006
Publisher: BMJ
Date: 2006
Publisher: Springer Science and Business Media LLC
Date: 03-2014
DOI: 10.1007/S40592-014-0005-8
Abstract: In recent years policy makers and public health professionals have described obesity and its associated diseases as a major global public health problem. Bioethicists have tried to address the normative implications of proposed public health interventions by developing guidelines or proposing ethical principles that ethically grounded health policy responses should take into consideration. We are reviewing here relevant literature and conclude that while there are clearly health (and health care cost) implications resulting from the increasing number of seriously obese people across the globe, there appear to be legitimate questions about the scope of the problem as well as questions about whether particular demonstrable correlations are indicative of causations. These empirical questions require further clinical and epidemiological research. We then review currently discussed public health ethics guidance documents and proposals. Suffering from the same conceptual problems that are known features of principle-based bioethics, insofar as their capacity to ground ethically justifiable policies is concerned, they are unsuitable for actual policy development. Even if the empirical questions were resolved, health policy makers could not rely on currently existing prominent public health ethics guidance documents to develop ethically defensible policies. Further empirical and ethics research is necessary to develop ethically defensible public health policies targeting obesity.
Publisher: Informa UK Limited
Date: 09-2005
Publisher: BMJ
Date: 07-02-1998
Publisher: Wiley
Date: 12-06-2012
Publisher: Wiley
Date: 09-1998
DOI: 10.1002/(SICI)1099-1042(199809)6:3<269::AID-HCA287>3.0.CO;2-D
Publisher: Springer Science and Business Media LLC
Date: 2001
DOI: 10.1007/BF03351253
Publisher: Wiley
Date: 03-2005
DOI: 10.1111/J.1471-8847.2005.00099.X
Abstract: This module will introduce you to the ethical concepts underlying applied ethical decision-making in the area of research involving human participants. We will also learn what the issues are that people involved in research on research ethics are concerned with. Ethics without an understanding of historical and legal context makes arguably little sense. It is for this reason that this module will begin with a brief history of research ethics and ends with a brief overview of the relevant national and international guidelines pertaining to ethical issues in research involving human participants.
Publisher: American Medical Association (AMA)
Date: 27-05-1998
Publisher: Wiley
Date: 10-1998
Publisher: BMJ
Date: 08-02-2023
Abstract: We argue that, in certain circumstances, doctors might be professionally justified to provide abortions even in those jurisdictions where abortion is illegal. That it is at least professionally permissible does not mean that they have an all-things-considered ethical justification or obligation to provide illegal abortions or that professional obligations or professional permissibility trump legal obligations. It rather means that professional organisations should respect and indeed protect doctors’ positive claims of conscience to provide abortions if they plausibly track what is in the best medical interests of their patients. It is the responsibility of state authorities to enforce the law, but it is the responsibility of professional organisations to uphold the highest standards of medical ethics, even when they conflict with the law. Whatever the legal sanctions in place, healthcare professionals should not be sanctioned by the professional bodies for providing abortions according to professional standards, even if illegally. Indeed, professional organisation should lobby to offer protection to such professionals. Our arguments have practical implications for what healthcare professionals and healthcare professional organisations may or should do in those jurisdictions that legally prohibit abortion, such as some US States after the reversal of Roe v Wade .
Publisher: Oxford University Press (OUP)
Date: 28-03-2018
DOI: 10.1093/BMB/LDY007
Abstract: In recent years questions have arisen about the moral justification for the accommodation of health care professionals who refuse, on conscience grounds as opposed to professional grounds, to provide particular professional services to eligible patients who request that kind of service. Literature review. Central to concerns about the accommodation claims of conscientious objectors is that health care professionals volunteer to join their professions that typically they are the monopoly providers of such services and that a health care professional's refusal to provide professional services on grounds that are not professional judgements amounts to unprofessional conduct. Defenders of conscientious objection maintain that in a liberal society respect for a professional's conscience is of sufficient importance that conscientious objectors ought to be accommodated. To deny conscientious objectors accommodation would reduce ersity in the health care professions, it would deny objectors unfairly equality of opportunity, and it would constitute a serious threat to the moral integrity of conscientious objectors. The legal literature on the subject is growing due to the impossibility of satisfactory compromises.
Publisher: Springer Science and Business Media LLC
Date: 08-1995
DOI: 10.1007/BF02197684
Publisher: Springer Science and Business Media LLC
Date: 08-1995
DOI: 10.1007/BF02197683
Publisher: Wiley
Date: 09-2007
Publisher: Wiley
Date: 11-2011
Publisher: Wiley
Date: 02-2013
DOI: 10.1002/9781444367072.WBIEE558
Abstract: Since the middle of the twentieth century, people have experienced remarkable gains in health. Life expectancy has almost doubled (World Health Organization 2003: 3) and child mortality rates have decreased by 60 percent (Moser et al. 2005: 203). Despite these positive trends, health disparities between those who are financially well off and those who are not continue to widen. In developing world countries these disparities are particularly pronounced. For ex le, an estimated nine million children under the age of 5 die globally each year, 50 percent of which are easily preventable (World Health Organization 2009). Many of these deaths can be attributed to the health resource gap between the developed and the developing world. At the same time, global wealth has increased to such an extent that it is now feasible to significantly reduce health‐related illness, suffering, and premature death. Many of the world's health problems that result in the large‐scale avoidable loss of quality‐adjusted life‐years are the foreseeable consequence of poverty caused by the world economic order. High drug prices protected by the international patent regime put medicines out of the reach of many of the world's citizens, and a paucity of health research funding, for diseases that primarily affect citizens living in poorer countries, results in unnecessary illness and premature death. These are two of the many factors that contribute to poor living conditions for the majority of the world's citizens that are not just tragic but unjust. A growing body of literature addresses our moral obligations to improve health globally in light of our material capacity to do so. This essay draws on this emerging ethics literature to describe two contending accounts of global health obligations. We then highlight four prominent ethical issues in global health ethics that include (1) sharing the benefits of research carried out through developing country collaborations, (2) the growing trend of patients traveling across national borders in pursuit of healthcare, (3) the migration of healthcare workers to wealthier from poorer communities, and (4) international infectious disease control.
Publisher: Oxford University Press (OUP)
Date: 04-2002
DOI: 10.1076/JMEP.27.2.179.2989
Abstract: Recent economic and political advances in developing countries on the African continent and South East Asia are threatened by the rising death and morbidity rates of HIV/AIDS. In the first part of this paper we explain the reasons for the absence of affordable access to essential AIDS medication. In the second part we take a closer look at some of the pivotal frameworks relevant for this situation and undertake an ethical analysis of these frameworks. In the third part we discuss a few of the proposed solutions to the problem and conclude with an argument in support of our preferred course of action. In this article we argue for compulsory licensing of essential AIDS medications in the current conditions of public health emergency. We argue on broadly consequentialist grounds that compulsory licensing is preferable both morally and pragmatically to the alternatives, notably the currently offered price cuts and drug donation schemes.
Publisher: Springer Science and Business Media LLC
Date: 04-2003
DOI: 10.1007/BF03351391
Publisher: Wiley
Date: 06-08-2016
DOI: 10.1111/BIOE.12275
Publisher: SAGE Publications
Date: 10-04-2018
Abstract: Canada is approaching its federal government’s review of whether patients should be eligible for medical assistance in dying (MAID) where mental illness is the sole underlying medical condition, and when “natural death” is not “reasonably foreseeable”. For those opposed, arguments involve the following themes: capacity, value of life, vulnerability, stigma, irremediability, and the role of physicians. It has also been suggested that those who are able-bodied should have to kill themselves, even though suicide may be painful, lonely, and violent. Opponents of MAID for severe, refractory suffering due to mental illness imply that it is acceptable to remove agency from such patients on paternalistic grounds. After years of efforts to destigmatise mental illness, these kinds of arguments effectively declare all patients with mental illness, regardless of capacity, unable to make considered choices for themselves. The current paper argues that decisions about capacity must be made on an in idual-patient basis. Given the rightful importance granted to respect for patient autonomy in liberal democracies, the wholesale removal of agency advocated by opponents of a permissive MAID regime is difficult to reconcile with Canadian constitutional values.
Publisher: Wiley
Date: 12-2007
DOI: 10.1111/DEWB_210.X
Publisher: Wiley
Date: 10-2008
Publisher: Elsevier BV
Date: 2013
DOI: 10.2139/SSRN.2354544
Publisher: Wiley
Date: 14-05-2013
DOI: 10.1111/BIOE.12036
Publisher: BMJ
Date: 18-10-2013
Publisher: American Public Health Association
Date: 02-2008
Publisher: Wiley
Date: 03-2018
DOI: 10.1111/DEWB.12184
Publisher: Wiley
Date: 10-09-2009
Publisher: Wiley
Date: 10-11-2009
Publisher: Springer Science and Business Media LLC
Date: 04-02-2010
Publisher: Wiley
Date: 07-2008
Publisher: Elsevier BV
Date: 1996
DOI: 10.1016/S0140-6736(96)90445-6
Abstract: Chromosome 22q11.2 deletion syndrome (22q11DS) is characterized by congenital cardiac abnormalities, hypoplastic thymus, palatal abnormalities, and hypocalcemia, although other clinical features are frequent such as autoimmune and psychiatric disorders. One-third of the patients have psychotic disorders, frequently followed by developmental regression and long-term cognitive disturbances. Despite humoral and cellular immunodeficiency are common in 22q11DS, it is associated with an increased prevalence of autoimmune disorders such as idiopathic thrombocytopenic purpura and juvenile idiopathic arthritis, likely due to immune dysregulations associated with thymic abnormalities, which plays a major role in self-tolerance. We report an unique case of a 14-year-old girl with 22q11DS that presented with subacute psychotic symptoms, intolerance to antipsychotics, CSF pleocytosis, and EEG abnormalities, that was successfully treated with empiric immunotherapy after fulfilling criteria for probable seronegative autoimmune encephalitis and probable autoimmune psychosis. The autoimmune etiology of these clinical features of 22q11DS has never been postulated despite the predisposition of this syndrome to present autoimmune disorders. We suggest the systematic evaluation with serum and CSF neuronal antibodies, MRI, and EEG of patients with 22q11DS that develop subacute psychotic symptoms or rapidly progressive cognitive decline. Early immunomodulatory therapies should be carefully considered if criteria of probable autoimmune psychosis or possible autoimmune encephalitis are fulfilled, as it may prevent long-term disabilities. Further studies are required to assess the autoimmune origin of psychosis and cognitive impairment associated with 22q11DS.
Publisher: Fundacao Oswaldo Cruz
Date: 08-12-2008
Publisher: Wiley
Date: 30-10-2014
DOI: 10.1111/DEWB.12073
Publisher: Wiley
Date: 17-03-2011
Publisher: Wiley
Date: 13-06-2017
DOI: 10.1111/BIOE.12372
Publisher: Springer Science and Business Media LLC
Date: 17-06-2017
DOI: 10.1007/S10728-017-0344-8
Abstract: Some jurisdictions that have decriminalized assisted dying (like Canada) exclude psychiatric patients on the grounds that their condition cannot be determined to be irremediable, that they are vulnerable and in need of protection, or that they cannot be determined to be competent. We review each of these claims and find that none have been sufficiently well-supported to justify the differential treatment psychiatric patients experience with respect to assisted dying. We find bans on psychiatric patients' access to this service amount to arbitrary discrimination. Proponents of banning the practice ignore or overlook alternatives to their proposal, like an assisted dying regime with additional safeguards. Some authors have further criticized assisted dying for psychiatric patients by highlighting allegedly problematic practices in those countries which allow it. We address recent evidence from the Netherlands, showing that these problems are either misrepresented or have straightforward solutions. Even if one finds such evidence troubling despite our analysis, other jurisdictions need not adopt every feature of the Dutch system.
Publisher: WORLD SCIENTIFIC
Date: 03-2004
Publisher: Wiley
Date: 16-04-2018
DOI: 10.1111/HEYJ.12979
Publisher: Wiley
Date: 02-2011
Publisher: Portland Press Ltd.
Date: 25-10-2006
DOI: 10.1042/BST0341151
Abstract: The prolonged concern over the potential for a global influenza pandemic to cause perhaps many millions of fatalities is a chilling one. After the SARS (severe acute respiratory syndrome) scares [1], attention has turned towards the possibility of an avian influenza virus hybridizing with a human influenza virus to create a highly virulent, as yet unknown, killer, on a scale unseen since the Spanish flu outbreak of 1918, which produced more fatalities than the Great War. In deciding how countries should react to this potential pandemic, in idually and collectively, a reasonable and practical balance must be struck between the rights and obligations of in idual citizens and protection of the wider community and, indeed, society as a whole. In this communication, ethical issues are discussed in the context of some of the scientific questions relating to a potential influenza pandemic. Among these issues are the rights and obligations of healthcare professionals, difficulties surrounding resource allocation, policies that have an impact on liberty and trade, when and how to introduce any vaccine or other form of mass treatment, global governance questions and the role of health policies in contemporary society. By considering these issues and questions in advance of an influenza, or indeed any other, pandemic commencing, countries can be better prepared to deal with the inevitably difficult decisions required during such events, rather than dusting down outdated previous plans, or making and implementing policy in an ad hoc manner with a resultant higher risk of adverse consequences.
Publisher: Elsevier BV
Date: 2005
DOI: 10.2139/SSRN.1330588
Publisher: Wiley
Date: 16-08-2013
Publisher: Wiley
Date: 20-07-2015
DOI: 10.1111/DEWB.12086
Publisher: Routledge
Date: 19-12-2007
Publisher: Wiley
Date: 09-2005
Publisher: Springer Science and Business Media LLC
Date: 11-1995
DOI: 10.1007/BF02197089
Publisher: Wiley
Date: 02-2010
Publisher: BMJ
Date: 09-10-2015
Location: No location found
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: South Africa
No related grants have been discovered for udo schuklenk.