498 e-Letters

  • A very difficult area
    Malcolm Kendrick

    A very difficult area indeed. My view is that that, once you have decided to stop fluids and/or nutrition, then the patient will certainly die. Whether or not they will suffer whilst starving, or dehydrating, is unclear. However, prolonging life in such cases extends suffering for relatives, staff, and possibly/probably the patient.

    A lethal injection at this point is surely more humane than extending life and,...

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  • Is it ethical for scarce research funding to be diverted to overzealous policing of low risk observational studies?
    Joseph Ting

    To the Editor:

    A substantial proportion of medical research funding in advanced health economies are diverted to the overzealous policing of low risk observational studies.

    As we plea and wait for the resumption of competitive funding to the research endeavour so necessary to maintaining Australia's global stature as a science and innovation based economy, the haemorrhage could be stemmed re- allocati...

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  • The use of placebos in Ebola treatment trials
    Joseph Ting

    The argument for substantial benefit conferred by the placebo effect in treatment trials has been around for a while. Clinical triallists do not deny that inactive sugar pills and IV medications or sham surgery have some quantifiable benefit when compared with doing nothing at all. Patients who consent to participate in treatment studies tend to be more motivated and confident that they will get better than those who ref...

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  • Teaching medical students rational prescribing and improving opportunities for doctors to appraise new treatments enhances rational prescribing
    Joseph Y Ting

    Greater transparency and regulatory oversight in disclosing gifts and payments to physicians from drug and medical device companies could well reduce their influence on a doctor's prescribing habits and medical management recommendations. The threat of a very public loss of professional reputation among peers and patients is likely to discourage a physician accepting drug and medical device company generosity. However, a m...

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  • When guideline aren't enough
    Matthew K Jackson

    Dear Editor,

    Muirhead argues that Beauchamp and Childress' principalist approach to ethics is of little practical relevance to the majority of commonly occurring clinical ethical scenarios. Through analysis of three cases which involve conflict between the principles of autonomy and benefice, he demonstrates that many scenarios are well rehearsed with the "correct" answers enshrined in guideline and statute. His pap...

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  • There is still an unethical failure of democracy
    susanne stevens

    I feel a huge debt of gratitude towards the Journal of Medical Ethics for showing that it can be possible for outsiders to contribute to what can seem like a closed circle of people talking to themselves. Just to point out though that there is not an equality of democracy when the Journal of Medical Ethics and others are still largely unknown to the public; that work carried out in the name of 'the public good' is unkn...

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  • Utilitarianism in disguise will remain unconvincing to many
    Toni C Saad

    The authors submit an ethical theory which rejects categorical conceptions of right and wrong, and adopts a scaled view of rightness, believing that it can depolarise the debate over the use of human embryonic stem cells (hESC) in medical research. I will argue that their proposal is unsuccessful.

    They argue that binary ethics must be forgone in preference of a non- binary understanding of rightness and wrongnes...

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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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  • Contempt for Conscience, Contempt for the Profession
    Toni Saad

    A major conceptual problem this paper suffers from is the suggestion that those whose views do not accord with the majority are, by default, not tolerable.

    Such people, whom the authors assume are exclusively religious, are twice said to possess an idiosyncratic view of the universe. These remarks exclude the possibility that there might be good, even non-religious, reasons for conscientious objections. Moreover...

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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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