94 e-Letters

published between 2007 and 2010

  • patient/doctor care
    bob ratcliffe

    I'm sure you are aware of a simple and inexpensive test for heart failure and pulmonary patients called a six minute walk test. It has many useful outcomes (e.g. maximum oxygen uptake and possibility of a fairly certain prediction of mortality in 18 months if the distance walked is less than 300m). Clearly, over a period, periodic tests show if a patient's exercise capacity is falling (- 45m) and at least provide some war...

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  • The fallacy of the phimotic child and other lingering ignorance
    Heather Frances Dalgleish

    Dear editor,

    I am currently in an ongoing discussion on Richard Dawkins' forum with a young man who claims to be in an administrative position in an NHS clinic in London where male circumcisions are performed. He took it upon himself to quote anonymously some of the referral letters from GPs that it was his job to process. I suspect his aim was to try to legitimise the circumcision referrals that he deals with....

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  • We should not eliminate coercive measures in psychiatry. The priority of the good on the just.
    Maurizio Soldini
    We do good not eliminating coercive measures in psychiatry.

    The priority of the good on the just one

    Prinsen and van Delden ask if we can justify eliminating coercive measures in psychiatry, because the practice of coercive measures in psychiatry is controversial. They say also that because there are conflict between autonomy and beneficence/non-maleficence, human dignity, the experiences of patients and the eff...

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  • Psychiatric coercion
    Thomas Szasz

    Asking “Can we justify eliminating coercive measures in psychiatry?” underscores the importance of paying attention to our moral and political presumptions and illustrates the social value and moral wickedness of psychiatry as a system of social control. The question implies that eliminating psychiatric deprivations of liberty needs to be justified but continuing to inflict such deprivations in the name of mental illness...

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  • 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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