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Get the facts right: time for evidence-based ethics
  1. David MacKintosh
  1. Correspondence to Dr David MacKintosh, Department of Palliative Care, Long Jetty Health Care Centre, P.O. Box 6088, Long Jetty, NSW 2261, Australia; drdmac1{at}gmail.com

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How much should ethicists know about the topics they comment on? Is it enough to have a vague idea? Should they be required to demonstrate an understanding of the subject matter? Are they required to pay attention to available evidence?

In response to Schuklenk's and Vathorst's proposal that individuals with treatment-resistant depression should have access to assisted dying,1 Christopher Cowley has presented a contrary argument based on comparison with the situation faced by patients with motor neurone disease (MND).2 In Cowley's view, MND is a “non-terminal but untreatable debilitating disease(s)” which “… does not affect the brain”. The basis for using MND for comparison is, presumably, that patients with MND have access to assisted dying despite its ‘non-terminal’ nature.

This argument raises a number of points. Probably the most important of these is that while MND is incurable some treatment with admittedly modest disease-modifying effect is available. It is, however, quite incorrect to say that MND is “non-terminal” and “… does not affect the brain”, as will be demonstrated below.3 This then begs the question of whether or not Cowley's argument is damaged by this invalid comparison, and if so, to what extent. Additionally, there is the problem of discourse outside one's primary area of expertise. To what extent is somebody in Cowley's position required to verify the matters of fact regarding their assertions? What is the duty of the reviewer or editor in this …

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