151 e-Letters

published between 2005 and 2008

  • The murderer is diabetic (or hypertensive also kills)
    Fernando Verdu

    Dangerousness criteria (1) are another source of discrimination against the mentally ill, but not the greatest.

    There is a statistically and clinically significant association between violence and major mental illness, and some studies have demonstrated that major mental illness is associated with at least a fourfold increase in the chances of violence compared to the general population. (2)

    However, a stu...

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  • An Unethical Treatment Modality
    Jason K. Steele

    Physicians have publicly argued that chemically controlling and surgically altering the natural development of Ashley - who is living with static encephalopathy – is an ethically acceptable option on the basis that her parents would be unable to continuously care for her as she continues to physically mature and that her disability would only lead to further medical complications later in life. One of the purposes for suc...

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  • Comment Buiting et al on the suffering criterion
    Henri Wijsbek

    In a study on the six due care criteria for lawful euthanasia in the Netherlands, H.M. Buiting and others found that the requirement that a physician should convince herself that her patient was suffering hopelessly and unbearably was by far the most difficult to meet. [1] Of the physicians who reported to have experienced problems with the criteria, 79% reported difficulties with that criterion; in particular they foun...

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  • Personality disorder is not grounds to consider a person incompetent to make healthcare decisions
    Christopher J Ryan

    Winburn and Mullen describe a harrowing clinical encounter with a young woman with a severe personality disorder who risked death refusing a blood transfusion. The authors argue that her incompetence to refuse treatment was “on the basis of her personality disturbance”. Their reasoning is flawed.

    If the patient lacked capacity around this decision, it was not because she had a personality disorder; it was becaus...

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  • Response to e letter
    Delan Devakumar

    In response to your comments:

    Ethics is about choices, but I do not agree that health care workers do not have choices. The choices available to us are obviously very varied. Some may well be able to change the number of nurses in a hospital (or have the ability to lobby for that kind of change). Alternatively in your cancer example, your choice may be just to turn the patient or to provide a cushion. The...

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    A write up in the form of a filler by an anonymous author in BMJ1 describes with reference to an Italian philosopher who constructed a scale looking at existence of professional jealousy in different professions and finding doctors among the top two, second after the actors. Doctors have this reputation since a long time and most common presentation is by regarding each other as ‘quacks’. The famous ‘Dr.Alabone’ case as na...

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  • RECs as regulators
    Adam M Hedgecoe

    While I welcome any discussion of the ethics review system in the UK and how it may be developing into a broader regulatory structure, any analysis needs to be based on an accurate understand both of the current academic literature in this area and upon current REC practice. Unfortunately McGuinness’ recent article has problems in both of these departments.

    Given that one of her main conclusions is that provide...

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  • Information sheets for research
    Hugh Davies

    Ponder et al add a useful view to the debate about seeking consent in clinical research but it is important to correct their view that guidance for information sheets produced by the National Resarch Ethics Service might be seen as a proscriptive straight jacket.

    The introduction in our guidance states:

    "We provide this document to guide researchers and reviewers alike but there may be times when variation...

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  • Is "acceptance" really an unethical form of negligence?
    Raymond V Downing

    If I understand ethics correctly, it has to do with "oughts" - what we should do, or ought to do. This assumes that we have a choice. It is not unethical to "let" someone die of a highly aggressive cancer of unknown etiology, for example; we have no choice in the matter. We do have a choice on whether to perform a 1st trimester abortion on demand, or whether to pull the plug on Karen Quinlan. Ethics implies choice. Delan...

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  • International Codes of Sport Medicine
    Fernando Verdu

    Dear Sir:

    To improve the accurate clinical ethics research made by Anderson (1) about confidentiality in sport medicine, we must take into consideration the existence of two international codes on the issue.

    First, the World Medical Association Declaration on Principles of Health Care For Sports Medicine (2), adopted by the 34th World Medical Association General Assembly in Lisbon, Portugal, in 1981 and...

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