Ministry of Ethics.co.uk is a non-commercial student-run project aiming to bring learning about Medical Ethics and Law (MEL) into the Web 2.0 era. The website has revision notes, MCQs & EMQs, case videos and scenarios, and allows discussions with other students and professors or lecturers from across the UK and beyond. The website is the perfect revision resource for medical students, clinical students and juniors doctors to learn more about MEL. Doctors are so much more than walking books of facts; they are faced with ethically and legally challenging situations throughout their professional lives. Medical ethics education helps make students aware of the situations that they will face in the clinical setting and suggests appropriate ways of approaching them. In the long term, it aids the development of moral and ethical reasoning that will allow student doctors to understand other people's views, helping them to become more empathetic and caring clinicians. Since it's creation, our website has won a number of prizes including: - Winning Presentation at the 2011 Fifth Conference on Medical Ethics and Law - 2011 BMA Book Awards Highly Commended - 2011 BMJ onExamination Best National E-Learning Resource Prize We hope you enjoy looking at our site and in particular the case scenarios and interactive question bank.
over 5 years ago
An essay I wrote for my course, with which I received an Honours grade (75%). I have an interest in Medical Ethics, and this essay discusses the possible physiology and ethics surrounding the controversial topic. **Introduction** (taken from the essay): My topic is designer babies. A designer baby is defined by the Oxford Dictionary of English as, “a baby whose genetic make-up has been selected in order to eradicate a particular defect, or to ensure that a particular gene is present” (1). In this essay, I shall be exploring the arguments and ideas surrounding the selection of a baby’s genes, which in modern times has become a highly controversial subject. This essay will start by describing the methods by which designer babies may be produced, namely pre-implantation genetic diagnosis (PGD) and pro-nuclear transfer, also coined the ‘three-parent baby’ by some (2). Once these procedures have been presented, ethical considerations forming both sides of the debate will be discussed. Whilst the typical argument used is ‘autonomy vs. playing god’, other ideas include whether such procedures will have a drastic effect on the future, and change the world as we know it, as suggested in the science-fiction film Gattaca (3). The ‘nature vs. nurture’ debate is also described: whether we are defined by our genes as shown in Gattaca, or if the environmental influence we are subjected to can cause our genotype to be negligible, i.e. our genes have no impact on our traits; personality, looks etc. The expectations placed upon our offspring; the definition of disease and disability; the fear of the rate of medical development – will all be discussed in this essay. The conclusion will summarise the arguments of both sides, and will attempt to answer the following question: should we be allowed to design our babies?
almost 5 years ago
The epidemic of substance abuse continues to pose a significant challenge to clinicians nationwide. Although there is a tendency to simply associate drug abuse with poverty, the problem affects every social stratum gender and race; and pregnant women are no exception. Caring for pregnant, substance-using women and their infants presents complex legal and ethical issues. Debate is ongoing about whether criminal penalties should be imposed on women based solely on their use of alcohol and other drugs during pregnancy. Furthermore, controversies persist about the rights and wishes of pregnant women versus the interests of their fetuses. For health professionals, conflict arises when the pregnant woman chooses behaviors that have the potential to harm the developing fetus. The ethical dilemma arises from competing autonomy-based and beneficence-based obligations to the maternal-fetal dyad. This chapter explores the ethics-based conflicts in the delivery of health care to drug abusing pregnant women.
over 2 years ago
An account of the talks given on 24th March 2011, by Professors Joe Collier and John Wyatt , during "Ethical Perspective on Dying": an event organised collaboratively by the Ethics Society and the Christian Union, St. George's, University of London.
over 6 years ago
Speaker: Anne Tamar-Mattis An estimated 1 in 2,000 babies is born with a Difference of Sex Development (DSD or intersex condition). Currently, there is much controversy regarding the best course of treatment for those children with DSD born with atypical genitals. However, little attention has gone to the process of decision-making, or to other important questions such as sterilization of children with DSD or protecting privacy rights. This workshop begins with an overview of the biology of DSD and the basic legal and ethical principles of surrogate consent in pediatric cases. We will then discuss some key legal and ethical questions. Participants will become familiar with key legal and ethical issues in the treatment of children with DSDs, with special attention to unsettled questions of law and uncertain medical outcomes. Participants will deepen their understanding of the ethics and law of surrogate decision-making for children. Participants will be able to identify potential situations in the treatment of children with DSDs where additional legal or ethical consultation may be indicated.
almost 4 years ago
Shrink Rap: Does Watch-Your-Words Political Correctness in Universities Contribute to Mental Illness?
Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists. A place to talk; no one has to listen. All patient vignettes are confabulated; the psychiatrists, however, are mostly real. --Topics include psychotherapy, humor, depression, bipolar, anxiety, schizophrenia, medications, ethics, psychopharmacology, forensic and correctional psychiatry, psychology, mental health, chocolate, and emotional support ducks. Don't ask. (It's not Shrink Wrap.)
over 2 years ago
Ryan,Nice choice of article. I think people would be genuinely staggerred to believe how easy it would be for one to fabricate data. In general, there are no "journal police." This says nothing of the inappropriate spin a sponsored trial might undertake with appropriate data.Brian
over 2 years ago
Ministry of Ethics.co.uk is a non-commercial student-run project aiming to bring learning about Medical Ethics and Law (MEL) into the Web 2.0 era. The website has revision notes, MCQs & EMQs, case videos and scenarios, and allows discussions with other students and professors or lecturers from across the UK and beyond. The website is the perfect revision resource for medical students, clinical students and juniors doctors to learn more about MEL. Doctors are so much more than walking books of facts; they are faced with ethically and legally challenging situations throughout their professional lives. Medical ethics education helps make students aware of the situations that they will face in the clinical setting and suggests appropriate ways of approaching them. In the long term, it aids the development of moral and ethical reasoning that will allow student doctors to understand other people's views, helping them to become more empathetic and caring clinicians. Since it's creation, our website has won a number of prizes including: - Winning Presentation at the 2011 Fifth Conference on Medical Ethics and Law, 2011 BMA Book Awards Highly Commended, 2011 BMJ onExamination Best National E-Learning Resource Prize. We hope you enjoy looking at our site and in particular the case scenarios and interactive question bank.
over 5 years ago
In the initial interviews with patients who suffer psychotic symptoms, it might be striking that the usage of terminology of descriptive psychopathology lingers on an arbitration of knowledge of 'truth' by using terms like delusions or hallucinations with their definition as false beliefs or false perceptions (Casey & Kelly 2007). These terms can cause annihilation of value to patient's experience, which may pose an initial strain on the egalitarian patient-doctor relationship. In an era, where deference to experts is dead, it might be worthy on agreeing on the effect of these experiences prior to lablelling them. Delusions can not be objectively detected and described, because it evolves and exists within subjective and interpersonal dimensions. Severe psycopathological symptoms share the fact that they are statistically deviant, and thus can be labeled as 'unshared'. Symptoms may be perceived as 'distressing' and they might be 'disabling' to them. The outcome behaviour which may raise concern can be a 'dysfunctional' behaviour (Adams & Sutker 2004). Jaspers considered the lack of understandability of how the patient reached conclusion to be the defining factor of a delusional idea. The notion of defining 'delusion' as false belief was challenged by Jaspers. Sims gives the example of a man who believed his wife was unfaithful to him because the fifth lamp-post alone on the left was unlit. What makes it a delusion is the methodology not the conclusion which may be right (Sims 1991). Some delusions might be mundane in their content, others may not be falsifiable. Dereistic thinking is not based on logic but rather on feelings. It is possible to find ways to evade falsification; an ad hoc hypotheses may also be part of the presentation. Fish stated that delusional elaboration may follow delusion and/or hallucination which may have convergence with the concept of the ad hoc hypothesis. Absence of verification from the patient's side does not lead to deductive falsification (Casey & Kelly 2007). Otherwise, the doctor-patient relationship carry the risk to transform to detective-suspect relationship, where the latter may perceive the need to present evidence of innocence. Mental health professionals are usually encountered by people who suffer to various degrees or make others suffer, and not because of various degrees of conviction. The primary role of the therapist is to be defined as some one who tries to alleviate the sufferings of others rather than correcting their beliefs. Communicating with patients in terms of how functional is their belief rather than it's truth may prove to be more egalitarian and clinically tuned. This may provide some middle ground in communication, without having to put an effort on defining the differences between what is 'true' and what is 'real'. The criterion for demarcation between what is real and what is pathologic may be different in the patient-doctor relationship. The assertion on the clinician's part on the falsity of a belief or experience can have the risk of dogmatism. The statistical deviance of symptoms, their distressing nature, disabling consequences, the resultant dysfunctional behaviour and apparent leap from evidence to conclusion may be a more agreeable surrogate starting points. This might be more in line with essence of medicine or 'ars medicina' (art of healing). Concordance with patients on their suffering may serve as an egalitarian platform prior to naming the symptoms. The term delusion commonly identified as false fixed belief, when used by a psychiatrist, it does not address only a symptom. It rather puts the interviewer in the position of an all knowing judge. After all, a service-user may argue that how come a doctor who never encountered or experienced any of the service-user's aspects of the problem as being persecuted at work and home, as plainly false. Then, does the psychiatrist know the truth. From a service-user point of view what he/she experience is real; which might not necessarily be true. The same applies for people who lead an average life, people who go to work bearing with them their superstitions, beliefs about ghosts, luck, horoscopes, zodiacs, or various revered beliefs. This term has the risk of creating a temporary crack in the mutual sense of equality between the therapist and the service-user. This may be due to the labelling of certain dysfunctional belief as unreal by one side. It has the potential for a subtle change in the relationship to the mental health professional placing himself/herself in the omniscient position and it contrasts with the essence of medical practice where practitioners assume the truth in what the patients say as in the rest of subjective symptoms as headache for example. The subsequent sequel of this is other labels such as 'bizarre delusions' or 'systematised delusions', further add to the deviation of the role of the professional therapist to an investigator in the domain of 'Truth' and architecture of 'Truth'. Furthermore, it might be strenuous to the relationship when the therapist - based on skeptic enquiry - starts explaining such symptoms. For example, if the service-user believes that Martians have abducted him, implanted a device in his brain and sent him/her back to earth, and the response communicated back is the 'delusional'. It could be argued by the service-user that the therapist who had not seen a Martian or a brain device before, labelled the whole story as 'delusion' in a rather perceived dismissive labelling with no intention to check on the existence of Martians or the device. In other words, the healer became the arbiter of truth, where both lack evidence for or against the whole thing; one member in the relationship stepped into power on basis of subjective view of plausibility or lack of thereof. In the case of hallucinations, the clinician labelling the patient's experience as hallucinations can be imposing fundamental dilemma for the patient. For example, if a patient hears a voice that says that everything is unreal apart from the voice, and the clinician says that the voice is the thing that is unreal. Both do not give evidence to their 'truth' apart from their statement. The clinician's existence to the patient's subjective reality is distorted by the multiple realities of the patient, and arguing on basis of mere existence that the 'voice' is the one that is 'false', does not give the patient a clue of the future methodology to discern from both, since percetption is deceived and/or distorted. In this case, another tool of the mind can be employed to address the patient. The same can be applied to a concept like 'over valued ideas', where the clinician decides that this particular idea is 'over valued', or that this 'idea' is 'over valued' in a pathological way. The value put on these ideas or not the patient values but the clinician's evaulation of 'value' and 'pathology'. The cut of point of 'value' and 'over value' seems to be subjective from the clinician's perspective. Also, 'derailment' pauses the notion of expecting a certain direction of talk. The concepts of 'grooming' and 'eye contact' implicitly entail the reference to a socio-cultural normative values. Thus, deviation from the normative value is reflected to the patient as pathology, which is an ambiguous definition, in comparison to the clarity of pathology. The usage of terms like 'dysfunctional unshared belief' or 'distressing auditory perception' or other related terms that address the secondary effect of a pathologic experience may be helpful to engage with the patient, and may be more logically plausible and philosophically coherent yet require empirical validation of beneficence. Taylor and Vaidya mention that it is often helpful to normalise, but this is not to minimise or be dismissive of patient's delusional beliefs.(Taylor & Vaidya 2009). The concept can be extended to cover other terms such as 'autistic thinking, 'apathy', 'blunting of affect', 'poor grooming', 'over-valued ideas', other terms can be applied to communicate these terms with service-users with minimal deviation from the therapeutic relationship. The limitation of these terms in communication of psychopathology are special circumstances as folie a deux, where a dysfunctional belief seems to be shared with others Also, symptoms such as Charles-Bonnet syndrome; usually does not have negative consequences. The proposed terms are not intended for use as a replacement to well carved descriptive psychopathological terms. Terms like 'delusion' or 'hallucination' are of value in teaching psychopathology. However in practice, meaningful egalitarian communication may require some skill in selecting suitable terms that is more than simplifying jargon. They also may carry the burden of having to add to the psychiatric terminology with subsequent effort in learning them. They can also be viewed as 'euphemism' or 'tautology'. However, this has been the case from 'hysteria' to 'medically unexplained symptoms' which seems to match with the zeitgeist of an era where 'Evidence Based Medicine' is its mantra; regardless advances in treatment. Accuracy of terminology might be necessary to match with essence of scientific enquiry; systematic observation and accurate taxonomy. The author does not expect that such proposal would be an easy answer to difficulties in communication during practice. This article may open a discussion on the most effective and appropriate terms that can be used while communicating with patients. Also, it might be more in-line with an egalitarian approach to seek to the opinion of service-users and professional bodies that represent the opinions of service-users. Empirical validation and subjection of the concept to testing is necessary. Patient's care should not be based on logic alone but rather on evidence. Despite the limitations of such proposal with regards to completeness, it's hoped that the introduction of any term may help to add to the main purpose of any classification or labelling that is accurate egalitarian communication. DISCLAIMER This blog is adapted from BMJ doc2doc clinical blogs Philosophical Streamlining of Psychopathology and its Clinical Implications http://doc2doc.bmj.com/blogs/clinicalblog/_philosophical-streamlining-of-psychopathology-its-clinical-implications The blog is based on an article named 'Towards a More Egalitarian Approach to Communicating Psychopathology' which is published in the Journal of Ethics in Mental Health, 2013 http://www.jemh.ca/issues/v8/documents/JEMHVol8Insight_TowardsaMoreEgalitarianApproachtoCommunicatingPsychopathology.pdf Bibliography Adams, H. E., Sutker P.B. (2004). Comprehensive Handbook of Psychopathology. New York: Springer Science Casey, P., Kelly B., (2007). Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry, Glasgow: Bell & Bain Limited Kingdon and Turkington (2002), The case study guide to congitive behavior therapy for psychosis, Wiley Kiran C. and Chaudhury S. (2009). Understanding delusion, Indian Journal of Psychiatry Maddux and Winstead (2005). Psychopathology foundations for a contemporary understanding, Lawrence Erlbaum Associates Inc. Popper (2005) The logic of scientific discovery, Routledge, United Kingdom Sidhom, E. (2013) Towards a More Egalitarian Approach to Communicating Psychopathology, JEMH · 2013· 8 | 1 © 2013 Journal of Ethics in Mental Health (ISSN: 1916-2405) Sims A., Symptoms in the mind, (1991) an introduction to psychopathology, Baillere Tindall Taylor and Vaidya (2009), Descriptive psychopathology, the signs and symptoms of behavioral disorders, Cambridge university press
Dr Emad Sidhom
almost 4 years ago
www.Ministryofethics.co.uk is a student-led, non-profit, free-to-use website aimed at addressing the current resource gap for Medical Ethics and Law learning in the UK. Using the Consensus Statement developed by the Institute of Medical Ethics, we cover MEL topics through a variety of innovative mediums, including videos of clinical scenarios, case notes, self-assessment MCQ tests and uploaded shared resources.
over 6 years ago
Medical School Interview ethics questions & answers by www.AceMedicine.com. For more free hints and tips for the Medical School Interview, UKCAT & UCAS visit www.AceMedicine.com
almost 4 years ago
DAVID BLUMENTHAL: Spending on pharmaceuticals is surging again, up 13% in 2014. Surveys show the public is increasingly concerned about the affordability of drugs.
about 2 years ago
This video consists of two short films, addressing 1) the ethics of screening programes, and 2) the moral and legal issues associated with treating asylum seekers in the NHS. Alex Presland & Aliya Bryce
over 6 years ago
BMA - GMC Unable to Act Over Revalidation Conflict of Interest Claim - 2013 - August | British Medical Association
GMC says accreditation scheme is a 'matter for the faculty' of occupational medicine
over 2 years ago
These slides are from a talk I was invited to give at the Teacher Scientist Network (www.tsn.org.uk) Master Class on Reproductive Technologies. This turns out…
over 2 years ago
As a physician who regularly discusses health news online and in the media, I find myself in a very fortunate position — I am able to quickly reach vast numbers of people and provide them with credible (and hopefully impactful) information on health and wellness. Because of this, just as in clinical interactions, I know I must put patients first, choosing my words carefully so that I can provide people with facts they need to better understand their disease state and treatment options. I also know that I must be aware of the fact that as opposed to clinical encounters, there is no opportunity for patient interaction. What I say must be geared toward stimulating further conversation between members of my audience and their own private physicians. Statements must be clear and evidence-based, and stories must be reported without bias.
over 2 years ago