The limits of informed consent.

Abstract:

:The patient, a 59-year-old man, was referred to a psychiatric hospital with what appeared initially to be the signs and symptoms of mental disorder. In hospital a lesion of the brain was diagnosed and surgery was proposed to relieve the condition. The patient, however, during this and subsequent admissions to hospital, refused operation. His refusal to consent was regarded as valid as he seemed to have good insight into his condition. Finally, under section 26 of the Mental Health Act, he was treated surgically. Unfortunately the patient died six weeks later of intracranial haemorrhage. Three comments are made on this case - two by psychiatrists, Dr K Davison and Dr Ashley Robin, the other by a professor of Christian ethics, Professor F C Blackie. Both psychiatrists argue that when a patient's mind is affected by mental or organic illness to the degree that 'he cannot bring a rational and conscious mind' to the question of his treatment then the doctor, in consultation with the relatives, making clear to them the likely course of events if an operation is not performed, must take whatever is the proper course of action, in this case surgery. In this view, such an operation performed immediately the diagnosis was confirmed might not have been so complicated. Professor Blackie, commending 'the attempt to regard the patient as a responsible human being' with a 'moral right to be consulted on all aspects of treatment', questions in this patient the limits to which the appeal to reason was carried. He concludes that 'in this situation the advice and consent of the family must weigh more heavily than the statements of the patient'.

journal_name

J Med Ethics

authors

doi

10.1136/jme.1.3.146

subject

Has Abstract

pub_date

1975-09-01 00:00:00

pages

146-9

issue

3

eissn

0306-6800

issn

1473-4257

journal_volume

1

pub_type

杂志文章
  • Issues of consent and the primary-school medical.

    abstract::This article discusses what level of consent is needed from a child or parent before a primary-school medical can take place (i.e. where children are aged under 12). It also considers whether there are occasions when a doctor can see a child if the parents have failed to give consent or have explicitly refused consent...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.26.6.469

    authors: Bradley P

    更新日期:2000-12-01 00:00:00

  • Advance commitment: an alternative approach to the family veto problem in organ procurement.

    abstract::This article tackles the current deficit in the supply of cadaveric organs by addressing the family veto in organ donation. The authors believe that the family veto matters-ethically as well as practically-and that policies that completely disregard the views of the family in this decision are likely to be counterprod...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2009.032912

    authors: De Wispelaere J,Stirton L

    更新日期:2010-03-01 00:00:00

  • Psychotropic drugs and paediatrics: a critical need for more clinical trials.

    abstract::Many children in the USA are prescribed psychotropic drugs that have not been fully investigated in paediatric clinical trials. The common practice of prescribing psychotropic drugs off-label poses unknown and potentially serious short- and long-term consequences for these children. This paper briefly reviews the fact...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章,评审

    doi:10.1136/medethics-2011-100003

    authors: Tishler CL,Reiss NS

    更新日期:2012-04-01 00:00:00

  • After Cologne: male circumcision and the law. Parental right, religious liberty or criminal assault?

    abstract::Non-therapeutic circumcision violates boys' right to bodily integrity as well as to self-determination. There is neither any verifiable medical advantage connected with the intervention nor is it painless nor without significant risks. Possible negative consequences for the psychosexual development of circumcised boys...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2012-101284

    authors: Merkel R,Putzke H

    更新日期:2013-07-01 00:00:00

  • True and false concerns about neuroenhancement: a response to 'Neuroenhancers, addiction and research ethics', by D M Shaw.

    abstract::In his critical comment on our paper in this journal, Shaw argues that 'false assumptions' which we have criticised are in fact correct ('Neuroenhancers, addiction and research ethics'). He suggests that the risk of addiction to neuroenhancers may not be relevant, and that safety and research in regard to neuroenhance...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/medethics-2013-101317

    authors: Heinz A,Kipke R,Müller S,Wiesing U

    更新日期:2014-04-01 00:00:00

  • Autonomy in the face of a devastating diagnosis.

    abstract::Literary accounts of traumatic events can be more informative and insightful than personal testimonials. In particular, reference to works of literature can give us a more vivid sense of what it is like to receive a devastating diagnosis. In turn this can lead us to question some common assumptions about the nature of...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.24.2.123

    authors: Spriggs M

    更新日期:1998-04-01 00:00:00

  • What (or sometimes who) are organoids? And whose are they?

    abstract::In terms of ethical implications, Boers, van Delden and Bredenoord (2018) have made an interesting step forward with their model of organoids as hybrids, which seeks to find a balance between subject-like value and object-like value. Their framework aims to introduce effective procedures not to exploit donors and to i...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/medethics-2018-105268

    authors: Lavazza A

    更新日期:2019-02-01 00:00:00

  • The justificatory power of moral experience.

    abstract::A recurrent issue in the vast amount of literature on reasoning models in ethics is the role and nature of moral intuitions. In this paper, we start from the view that people who work and live in a certain moral practice usually possess specific moral wisdom. If we manage to incorporate their moral intuitions in ethic...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2008.026559

    authors: van Thiel GJ,van Delden JJ

    更新日期:2009-04-01 00:00:00

  • Death and reductionism: a reply to John F Catherwood.

    abstract::This reply to John F Catherwood's criticism of brain-related criteria for death argues that brainstem criteria are neither reductionist nor do they presuppose a materialist theory of mind. Furthermore, it is argued that brain-related criteria are compatible with the majority of religious views concerning death. ...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/jme.18.1.40

    authors: Lamb D

    更新日期:1992-03-01 00:00:00

  • Dealing with the brain-damaged old--dignity before sanctity.

    abstract::The present and future rapid increase in the hospital population of geriatric patients is discussed with particular reference to the problem of advanced brain degeneration. The consequences of various clinical management options are outlined and it is suggested that extreme attempts either to preserve or terminate lif...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.8.4.173

    authors: Robertson GS

    更新日期:1982-12-01 00:00:00

  • Post-recruitment confirmation of informed consent by SMS.

    abstract:BACKGROUND:To allow patients to reflect about a decision to participate in a clinical trial, guidelines suggest a 24-h delay from when they are informed about the trial to when they give consent. In certain clinical settings, this is likely to hamper recruitment. METHOD:After oral and written information about the tri...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2009.033456

    authors: Gulbrandsen P,Jensen BF

    更新日期:2010-02-01 00:00:00

  • The ethics of clinical trials.

    abstract::In summary, the discussion by Professors Helmchen and Müller-Oerlinghausen of the morality of clinical trials has emphasized a point that is frequently overlooked. It is an essential to consider those situations in which it might be unethical not to conduct a trial as it is to be concerned about the ways in which tria...

    journal_title:Journal of medical ethics

    pub_type: 临床试验,杂志文章

    doi:10.1136/jme.1.4.174

    authors: Wing JK

    更新日期:1975-12-01 00:00:00

  • Medical mismanagement or patient vacillation?

    abstract::One theme of London University lawyer Ian Kennedy's 1980 Reith Lectures on medical ethics was the need to change the emphasis in physician patient relations from paternalism on the part of doctors to self determination on the part of patients. Bamford, a specialist in obstetrics and gynecology, demonstrates how reali...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.7.4.179

    authors: Bamford PN

    更新日期:1981-12-01 00:00:00

  • Withdrawing life-sustaining treatment: a stock-take of the legal and ethical position.

    abstract::This article, prompted by an extended essay published in the Journal of Medical Ethics by Charles Foster, and the current controversy surrounding the case of Vincent Lambert, analyses the legal and ethical arguments in relation to the withdrawal of life-sustaining treatment from patients with prolonged disorders of co...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2019-105599

    authors: Ruck Keene ACE,Lee A

    更新日期:2019-12-01 00:00:00

  • The teaching of medical ethics.

    abstract::Students at Newcastle are exposed to patients during their first week at medical school and attached to a family within the first month. The object is to sensitise them to patients as people rather than vehicles of disease. Medical ethics is introduced as part of the multidisciplinary Human Development, Behaviour and ...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.11.1.35

    authors: Smith A

    更新日期:1985-03-01 00:00:00

  • "Why aren't you doing what we want?" Cultivating collegiality and communication between specialist and generalist physicians and residents.

    abstract::Developing residents' communication skills has been a goal of residency training programmes since the Accreditation Council for Graduate Medical Education codified it as a core competency. In this article, a case that features problematic communication between a generalist and specialist physician is drawn upon, and i...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2006.016162

    authors: Rentmeester CA

    更新日期:2007-05-01 00:00:00

  • Ethical reasoning in mixed nurse-physician groups.

    abstract:OBJECTIVES:To study the ethical reasoning of nurses and physicians, and to assess whether or not modified focus groups are a valuable tool for this purpose. DESIGN:Discussion of cases in modified focus groups, each consisting of three physicians and three nurses. The discussion was taped and analysed by content analys...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.22.3.168

    authors: Holm S,Gjersøe P,Grode G,Hartling O,Ibsen KE,Marcussen H

    更新日期:1996-06-01 00:00:00

  • Developing ethics guidance for HIV prevention research: the HIV Prevention Trials Network approach.

    abstract::More than 25 years into the HIV epidemic, in excess of 2 million new infections continue to occur each year. HIV prevention research is crucial for groups at heightened risk for HIV, but the design and conduct of HIV prevention research with vulnerable populations worldwide raises considerable ethical challenge...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2010.035444

    authors: Rennie S,Sugarman J

    更新日期:2010-12-01 00:00:00

  • The medical student global health experience: professionalism and ethical implications.

    abstract::Medical student and resident participation in global health experiences (GHEs) has significantly increased over the last decade. In response to growing student interest and the proven impact of such experiences on the education and career decisions of resident physicians, many medical schools have begun to establish p...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2006.019265

    authors: Shah S,Wu T

    更新日期:2008-05-01 00:00:00

  • The moral status of babies.

    abstract::In their controversial paper 'After-birth abortion', Alberto Giubilini and Francesca Minerva argue that there is no rational basis for allowing abortion but prohibiting infanticide ('after-birth abortion'). We ought in all consistency either to allow both or prohibit both. This paper rejects their claim, arguing that ...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/medethics-2012-100629

    authors: McGee A

    更新日期:2013-05-01 00:00:00

  • A comparison of journal instructions regarding institutional review board approval and conflict-of-interest disclosure between 1995 and 2005.

    abstract:OBJECTIVES:To compare 2005 and 1995 ethics guidelines from journal editors to authors regarding requirements for institutional review board (IRB) approval and conflict-of-interest (COI) disclosure. DESIGN:A descriptive study of the ethics guidelines published in 103 English-language biomedical journals listed in the A...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2008.024299

    authors: Rowan-Legg A,Weijer C,Gao J,Fernandez C

    更新日期:2009-01-01 00:00:00

  • Medicine as an essentially contested concept.

    abstract::W B Gallie's notion of essentially contested concepts remains of philosophical interest. I argue that medicine is one such concept and look at the consequences of this as regards the inappropriateness of looking for definitions and necessary and sufficient conditions to settle debates about what medicine is and is not...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.29.4.261

    authors: McKnight C

    更新日期:2003-08-01 00:00:00

  • Towards a specific approach to education in dental ethics: a proposal for organising the topics of biomedical ethics for dental education.

    abstract::Understanding dental ethics as a field separate from its much better known counterpart, medical ethics, is a relatively new, but necessary approach in bioethics. This need is particularly felt in dental education and establishing a curriculum specifically for dental ethics is a challenging task. Although certain topic...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2011-100067

    authors: Gorkey S,Guven T,Sert G

    更新日期:2012-01-01 00:00:00

  • Whatever happened to medical politics?

    abstract::This paper argues the case for coming to see 'medical politics' as a topic or subject within medical education. First, its absence is noted from the wide array of paramedical subjects (medical ethics, history of medicine, the medical humanities, etc) currently given attention in both the medical education literature a...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2010.041277

    authors: Emmerich N

    更新日期:2011-10-01 00:00:00

  • The case for a duty to research: not yet proven.

    abstract::In this commentary on 'Why participating in (certain) scientific research is a moral duty', I take issue with a number of Stjernschantz Forsberg et al's claims. Though abiding by the terms of a contract might be obligatory, this won't show that those terms themselves indicate a duty--even allowing that there's a contr...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/medethics-2013-101370

    authors: Brassington I

    更新日期:2014-05-01 00:00:00

  • Misled and confused? Telling the public about MMR vaccine safety. Measles, mumps, and rubella.

    abstract::The extraordinary events surrounding the measles, mumps, and rubella (MMR) vaccine in the United Kingdom have not only placed in jeopardy the use of this triple vaccine but have also spread concern to other parts of the world. Examination of the public's worry about MMR vaccine reveals they have been exposed to a rang...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.29.1.22

    authors: Clements CJ,Ratzan S

    更新日期:2003-02-01 00:00:00

  • Tobacco regulation: autonomy up in smoke?

    abstract::Over the past few decades, "Big Tobacco" has spread its tentacles across the developing world with devastating results. The global incidence of smoking has increased exponentially in Africa, Asia and South America and it is leading to an equally rapid increase in the incidence of smoking-induced morbidity and mortalit...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2008.027847

    authors: Hooper CR,Agule C

    更新日期:2009-06-01 00:00:00

  • The deadly business of an unregulated global stem cell industry.

    abstract::In 2016, the Office of the State Coroner of New South Wales released its report into the death of an Australian woman, Sheila Drysdale, who had died from complications of an autologous stem cell procedure at a Sydney clinic. In this report, we argue that Mrs Drysdale's death was avoidable, and it was the result of a p...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2016-104046

    authors: Lysaght T,Lipworth W,Hendl T,Kerridge I,Lee TL,Munsie M,Waldby C,Stewart C

    更新日期:2017-11-01 00:00:00

  • Can artificial parthenogenesis sidestep ethical pitfalls in human therapeutic cloning? An historical perspective.

    abstract::The aim of regenerative medicine is to reconstruct tissue that has been lost or pathologically altered. Therapeutic cloning seems to offer a method of achieving this aim; however, the ethical debate surrounding human therapeutic cloning is highly controversial. Artificial parthenogenesis-obtaining embryos from unferti...

    journal_title:Journal of medical ethics

    pub_type: 历史文章,杂志文章,评审

    doi:10.1136/jme.2004.010199

    authors: Fangerau H

    更新日期:2005-12-01 00:00:00

  • Dilemma for appeals to the moral significance of birth.

    abstract::Giubilini and Minerva argue that the permissibility of abortion entails the permissibility of infanticide. Proponents of what we refer to as the Birth Strategy claim that there is a morally significant difference brought about at birth that accounts for our strong intuition that killing newborns is morally impermissib...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2020-106781

    authors: Bobier CA,Omelianchuk A

    更新日期:2020-10-26 00:00:00