By Dominic Wilkinson @Neonatalethics and Michael Dunn @ethical_mikey Originally posted on PRACTICAL ETHICS In a high court case reported last week, a judge strongly criticised a London hospital’s clinical ethics committee (CEC). The case related to disputed treatment for a gravely ill nine-year old child. There had been a breakdown in the relationship between the […]
Category: clinical ethics
Ongoing puberty suppression should be an available treatment option for non-binary adults, but case-by-case analysis is also needed
By Lauren Notini The use of medications to suppress puberty (puberty suppression or puberty blockers) in young people who identify as transgender (trans) or gender diverse (TGD) has generated ongoing debate in the media and bioethics literature. Puberty blockers are typically recommended as a treatment option for TGD young people who are experiencing gender dysphoria […]
Challenging cognitive biases in the intensive care unit
By Harleen Kaur Johal & Christopher Danbury Unsurprisingly, the intensive care unit (ICU) is an “intense” environment, for staff, patients, and their families. These busy, 24-hour units provide care for the most unwell patients in a hospital. As many of these patients are incapacitated, due to the effects of their illness or sedation, decisions must […]
Utilizing parents to hand-bag ventilate when resources are scarce: Is it ethical?
By Emily E. Barsky and Sadath Sayeed Amidst the COVID-19 pandemic, many nations are coping with what resource limited settings are all too familiar with—ventilator scarcity. In low-income countries, people— and particularly children— frequently die of reversible, acute respiratory failure due to across-the-board resource scarcity. Some such settings have responded to this by allowing parents […]
Toward enhanced consent for psychedelic psychiatry
By William R Smith. and Dominic Sisti. Imagine living with treatment-resistant depression. You’ve already tried several lines of medication, electroconvulsive therapy, and psychotherapy to no avail. You might have even have used augmentation strategies such as transcranial magnetic stimulation. Maybe you have spent years of your life struggling with this disease despite these attempts; maybe […]
It’s a complex world in primary care, and it changes medical ethics!
By Sanjiv Ahluwalia, Rupal Shah & John Spicer. In this post, we want to challenge to the idea that ethical decision making exists independently of context or of the interactions that influence us. We propose that social complexity offers an alternative perspective to our existing normative frameworks; a perspective which validates our subjective experience of […]
Be careful what you wish for: ICU is no panacea
By Angela Ballantyne, Wendy Rogers, Vikki Entwistle, Cindy Towns In current debates about allocation of scarce ICU resources, we suggest there is undue optimism about the ‘good’ of intensive care unit (ICU) access. Most critical COVID-19 patients who receive access to a ventilator will still die. The minority who survive will likely leave with significant […]
Prioritizing justice in ventilator allocation
By L. Syd M Johnson As the Covid-19 pandemic intensified worldwide, grim reports out of Italy’s embattled and overwhelmed hospitals foretold the need to plan for rationing ventilators in the event that the number of patients requiring them exceeded the number available. Hospitals, ethics committees, and government agencies around the US began planning for the […]
Towards meaningful human control. Using artificial intelligence in clinical decision making
By Matthias Braun, Patrik Hummel, Susanne Beck, Peter Dabrock Clinical decision-making can be challenging. The subject matter is complex. Decisions can have incisive, long-lasting consequences. There is imperfect evidence and informational asymmetries between those involved. Time constraints and economic restrictions complicate the process further. In view of difficulties like these, it is tempting to deploy […]
DNACPRs and advance care planning in the COVID19 pandemic: key lessons
By Catriona McMillan and Victoria Sobolewska Patient-doctor discussions surrounding do not attempt cardio-pulmonary resuscitation (DNACPR) orders amidst the COVID-19 pandemic have caused widespread, understandable panic in the UK, set against a backdrop of proportionately higher elderly deaths, discussions surrounding resource allocation (particularly with reference to ventilators), and emerging stories of rising care home deaths. Here, […]