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Medical ethics

Watch your words! The challenges of law around the end of life

by Dominic Wilkinson

Here in South Australia last week, a bill has been proposed to clarify the legal status of advance directives. One very small part of that bill involves a modification to an older palliative care act. The modification corrects an ambiguity in wording in the earlier act. The ambiguity is subtle. However, that choice of words has had major consequences for seriously ill children and adults in South Australia and for health practitioners. It is a salutary reminder of how hard it is to enact good laws in the area of end of life, and how easily such laws can make things worse rather than better.

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Religious vs. secular ethics and a note about respect

By Brian Earp See Brian’s most recent previous post by clicking here. See all of Brian’s previous posts by clicking here. Follow Brian on Twitter by clicking here. This is a rough draft of a lecture delivered on October 1st, 2012, at the 12th Annual International Symposium on Law, Genital Autonomy, and Children’s Rights (Helsinki, Finland). It… Read More »Religious vs. secular ethics and a note about respect

Why strongly encouraging or legally enforcing bike helmets is not necesserily a good idea

In Australia and New Zealand wearing bike helmets is compulsory. In the United States, bike helmets are strongly promoted. The message in these countries is clear – not wearing a bike helmet is stupid because it can significantly damage your health. The stigma attached to cycling without a helmet may even be comparable to that… Read More »Why strongly encouraging or legally enforcing bike helmets is not necesserily a good idea

Focus on the important things: reforming medical trials

As Ben Goldacre reveals, the status quo in drug testing is nothing less than a scandal. Pharmaceutical companies are suppressing and blocking information, perfectly legally, that is causing adults and children to die. Reforming the system wouldn’t be too hard – a registry for all drug trials, before they begin, should be enough to get rid of… Read More »Focus on the important things: reforming medical trials

Dangerous Doctors and Immoral Doctors

In general, if you know someone to be a danger to others you have a duty to do something about it. Exactly what you are obliged to do depends on the person, the situation and you. At the very least you ought to warn others.

In general, and apart from such basic duties as not to interfere with others (more pompously, to respect their autonomy), to keep your promises to them, not to harm them and not to burden them, your strongest duties are those you take on voluntarily, such as those you acquire by taking up a profession.

The professions hold themselves out to us as entitled to special privileges because of their special knowledge. We trust them, we rely on them, we place ourselves in their hands for specific purposes, because when paid for their work they promise to look after our interest before their own. Part of that promise is a special duty to hold members of the profession accountable to professional standards and to exclude persons who fail those standards.

So members of the medical profession have both a very strong duty and a special duty to protect us from dangerous doctors. A book has come out showing that doctors are grossly— indeed, grotesquely —derelict in this duty.Read More »Dangerous Doctors and Immoral Doctors

Refusing Treatment to the Overweight: A Case Analysis

It was recently reported that a doctor in Shrewsbury Massachusetts refused to treat a patient named Ida Davidson because she was overweight. Dr. Helen Carter recently decided to stop admitting patients who weighed over 200 pounds to her practice, justifying her decision by citing three incidents in which her co-workers were injured in the course of caring for obese patients. These incidents led Carter to claim that the office in which she carries out her consultations is “unable to accommodate a certain weight”. She also pointed out that the nearby University of Massachusetts has a dedicated obesity centre which is far better equipped and better staffed to deal with obese patents.Read More »Refusing Treatment to the Overweight: A Case Analysis

The Continuing Tragedies of Home Birth and the Rights of the Future Child

By Lach De Crespigny and Julian Savulescu

Windsor Coroner’s Court has heard that a mother died within hours of giving birth at home after a private midwife committed a horrifying catalogue of errors . According to reports, the woman had previously delivered twins by emergency caesarean section, one of which later died. Her husband said his wife was ‘brainwashed’ into having a home birth by the midwife, who insisted it was safe. The Royal College of Obstetricians and Gynaecologists advise delivery in hospital after caesarean section so that an emergency caesarean delivery can be carried out if necessary. The midwife denied trying to persuade the couple to have a home birth. However she has greater responsibilities than this; as professionals we should try to persuade women to deliver in hospital if this is a safer option. But the midwife seems to have prioritized homebirth over life itself when she reportedly stated:

“Claire had a great pregnancy, she had a really lovely spontaneous birth at home and I hope Simon in time will remember that”

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The AAP report on circumcision: Bad science + bad ethics = bad medicine

By Brian D. Earp See Brian’s most recent previous post by clicking here. See all of Brian’s previous posts by clicking here. Follow Brian on Twitter by clicking here.   UPDATED as of 27 May, 2013. See the bottom of the post. The AAP report on circumcision: Bad science + bad ethics = bad medicine For… Read More »The AAP report on circumcision: Bad science + bad ethics = bad medicine

How not to save the world

By Charles Foster

Y chromosomes are on the way out, thinks Aarathi Prasad, a geneticist from Imperial College, London: they’re degenerating. If they go, then so do humans – unless an alternative method of reproduction can be devised. It can, says Prasad. In fact the basic technology is already here, and is bound to get better. In 2004 a mouse was conceived using synthetic sperm made by modifying ova. Technological virgin birth (I’ll call it TVB) might be the salvation of the human race.

This is all very interesting. But Prasad isn’t content merely to describe the science. She seems to think that we ought to drop all our taboos against the idea. ‘By all reasonable estimates, in the near future we will conquer the tyranny of the womb. The question remains if we can also conquer the tyranny of human prejudice….’

It’s not clear from this whether she is advising us to conquer our tyrannous prejudice on simply practical grounds –  (because, if we don’t overcome our squeamishness, we won’t develop or embrace the technology, so dooming humanity) or whether she thinks that there is something philosophically wrong with a distaste for TVB. I suspect the latter.

If this suspicion is right, why might she (or anyone else) think that?Read More »How not to save the world