440 e-Letters

  • The Rights of Terrible People
    susanne stevens

    There are surely situations where responses of disgust and other reactions to extreme violence must be respected. How much they effect the justice system as well as the medical professionals' ability to act strictly according to laws and ethical guidelines is probably difficult to investigate. The case of Peter Sutcliffe - a violent mass murderer in UK is not quite the same scenario as the article describes but it is...

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  • Prostitution is not justified by sexual "needs": an alternative to full legalisation
    Nathan Hodson

    Earp and Moen demonstrate the absence of a relevant difference between the use of prostitutes by disabled people and by shy, ugly, libidinous, able-bodied people, and the impossibility of circumscribing the latter[1]. This is incorporated into a case for the full legalisation of prostitution based on: (a) the absence of a justification for its prohibition; and (b) the "needs" it meets. We posit that (b) misrepresents pro...

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  • Kissing Paediatric Patients
    P K Coulson-Smith

    From the beginnings of our lives as doctors, we are taught about professionalism. Professionalism encourages and enables doctors to maintain focus on the patient's needs and treatment.

    Kissing a child oversteps the boundary of professionalism. Such contact shifts thinking from the patient to the professional and meets the professional's emotional needs rather than the patient's.

    Physical contact with p...

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  • Medical aid in dying in Quebec and Canada: facts matter
    Michele Marchand

    As an active participant in the debate that took place in the province of Quebec concerning medical aid in dying (MAID), I would like to take the liberty of commenting on an article by Udo Shuklenk published recently in your journal: "Canada on course to introduce permissive assisted dying regime". In my view, some of the factual information given in this text needs more precision.

    First of all, the chronology...

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  • Response to Holland
    Derick T. Wade
    Dear Sir, I thank Dr Holland for his commentary [1] on my article [2]. I am replying to correct a possible misunderstanding he may have about the brain in people with prolonged disorders of consciousness.

    He argues that there are people who are definitely permanently unaware without fluctuation because they have no brain, citing "Tony Bland, whose higher brain had effectively liquefied'". I assume that he bases this statemen...

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  • Proposed FGM 'compromise' illuminates medical complicity with non-therapeutic fee-paying surgery on infants
    Susan Bewley

    The JME's peer reviewers failed to press the clinical issues before publication of this flawed paper(1). The unoriginal idea of a 'ritual nick' performed by health professionals in a harm limitation approach to female genital mutilation (FGM) was proposed by the American Academy of Pediatrics back in 2010(2), who rapidly replaced their statement(3) in the face of worldwide condemnation(4) by the World Health Organisation...

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  • Ethical Discrimination?
    susanne stevens

    A properly worded consent form must make risks transparent but if the person has not even been asked to participate, discrimination is too easily slipping in. Even giving the reason as duty of care can be mis/used to eliminate some people - but their participation may be valuable as well as ethical. There can be an unconscious bias to avoid difficulties for researchers but discrimination will miss opportunities for the...

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  • A devil's advocate outflanked by demons: Is it really time to stop talking to anti-vaxxers?
    Jacob M Kolman

    Brennan offers an interesting strategy in "A libertarian case for mandatory vaccination," though in form it is the common "devil's advocate." The apparently least charitable bases for one's own position (in this case libertarian premises) are granted for the sake of argument; one's position is nevertheless found defensible (mandatory vaccination); and thus the harshest critics are answered without having to pay out a fu...

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  • A hierachy of access to information/ knowledge is unethical
    susanne stevens

    There is a hierarchy of means to access opinions and information published in journals. This is unethical in a democracy which uses citizens' information to contribute to debates- from which they are then excluded. This to some extent mirrors my position that it is unethical to with hold information from clients in therapy. It is taking advantage of vulnerability however it is dressed up but also creates a hierarchy of...

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  • Response to Roberts
    Patricia N Neville

    Dear Editors, I read with interest the recent article on the ethics of doctor's strikes.1 I accept most of the arguments expressed in the article, however, there is one shortcoming to the framework: its under-analysis of the role that the social context can have when evaluating the ethics of doctors strikes.2 I contend that there is a need to contextualise industrial disputes of this nature, namely, reflecting on and ev...

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