94 e-Letters

published between 2007 and 2010

  • Religion and discussion of end of life care: The hunt for the hidden confounder must begin
    Richard Body

    Dear Editor,

    I would first like to congratulate Dr. Seale for producing a thought- provoking piece of research that has captured the imagination of the nation's media. I would also like to point out an interesting discordance that I have noted with regard to the findings of this important research, which ought to stimulate further discussion.

    Although religious doctors were significantly less likely tha...

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  • Evidence, Equipoise & Endocarditis: Reply to Mohindra
    David M Shaw


    RK Mohindra's recent paper criticises NICE's decision-making regarding the use of antibiotic prophylaxis to prevent infective endocarditis. He is also critical of our defence of NICE, but does not actually engage with our argument, stating simply that he was "surprised" to see a philosophical defence of something that should be decided by evidence. We find it surprising that Mohindra believes that...

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  • Problems on ethical review: problem of no standard and need for management for developing countries
    professor viroj wiwanitkit

    Dear Editor

    I read the recent report on the non-equivalent stringency of ethical review with a great interest [1]. Gefenas proposed that, for two identified problems, (1) there is an "asymmetry between rather strict regulations of clinical drug trials and relatively weaker regulations of other types of clinical biomedical research" and that (2) there are "gaps in ethical review in the area of non- biomedical human rese...

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  • Lack of alternative to rectal artesunate for pre-referral treatment of malaria ? Rectal quinine as an available and effective health tool
    Hubert Barennes

    In developing countries, most cases of malaria occur in rural areas far from hospitals, where health care providers cannot adequately manage severe malaria cases. Hospital referral causes treatment delays. Most deaths occur during the first 24 hours, highlighting the need for earlier actions to reduce mortality. Gomes and colleagues reported recently the benefits of pre-referral rectal artesunate.(1) A single pre-referra...

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  • Social obligation of cadaveric organ donation for transplantation: Obfuscation of principles for a utilitarian medical practice
    Mohamed Y Rady

    Aksoy applied Islam principles for ethically justifying and endorsing obligatory cadaveric organ donation for transplantation. "That maxim means that when there is no other way to save a life, forbidden means become permitted; this includes the removal of organs from a cadaver [1]".

    The most fundamental questions that Aksoy has not asked or answered:

    (1) Are transplantable organs removed from the truly...

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  • Ethical stories or moral tales?
    Carlo V Bellieni

    Sir, I read carefully the paper about popular television medical dramas (1), and I think that these stories cannot be analyzed only from the point of view of professionalism or of an ethical behavior. House is not a story, it is a tale: it does not deal with real medicine (it is full of factotum doctors, absent nurses, violence unto patients); nevertheless, it gives moral teachings. A tale is something unrealistic but inspiring...

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  • Ethical committees in developing countries: risk of biases
    professor viroj wiwanitkit

    Dear Editor, I read the recent publication by Rwabihama et al with a great interest. I was impressed by the conclusion that "The process of establishing ethics committees could affect their functioning and compromise their independence in some African countries and in North America [1]." The problem of the reliability of ethical committees for biomedical research in developing countries is important and should be raised. Some...

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  • Medical drama, role as physician and other ethical concerns
    professor viroj wiwanitkit

    Editor, I read the report by Czarny et al with a great interest [1].

    I agree that there might be some issues to reflect upon with respect to bioethics and professionalism in television medical dramas. In my country, there are also many non-medical dramas in which the roles of physicians and other medical personnel are shown. Relevant ethical concerns extend to wider issues than professionalism, such as the promotio...

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  • First, Do No Harm
    Michael Potts

    The practice of living organ donation requires living persons to be willing to donate and medical practitioners to perform the surgical interventions. In the case of the vast majority of kidney donors, there is no doubt of their altruistic motives; indeed one could argue that donating their kidneys constitutes a supererogatory act on their part. The moral difficulty, however, lies with the medical practitioner performing a...

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  • Transplantable organs don't come from cadavers
    David W Evans

    However else they might be described, the obviously living, functioning, bodies of 'brain stem dead' organ donors are certainly not cadavers - which are dead bodies, corpses (OED). The perpetuation of their misrepresentation, unfortunately propagated by the Department of Health[1] in 1983, prejudices all attempts to assess the true level of public acceptance of organ transplantation practice.

    1. Cadaveric organs for...

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