Covert video surveillance continues to provoke debate. (17/409)

When the editor invites comment on a response to an analysis of a criticism of a protocol already defended by the author in this journal, the issue is clearly contentious. I will comment briefly on Thomas's paper in this issue of the journal, and look at points of agreement as well as dissent.  (+info)

Covert video surveillance -- a response to Professor Southall and Dr. Samuels. (18/409)

In their reply to my recent paper on Munchausen's syndrome by proxy, Professor Southall and Dr. Samuels concede that some things may be learned from my observations. They do not attend to the main argument of the paper, however, that the proportion of research interest in their use of covert video surveillance merits consideration of the research protocol by an independent research ethics committee. It will not do simply to assert that the use of this technology for the purposes outlined in their accounts is not research. I formulated arguments based on facts divulged in those published accounts for regarding their work as containing a considerable proportion of research activity. Unfortunately their reply did not address these arguments. Until such points are adequately answered the protection of patients calls for satisfactory judgments to be made on certain important issues which any research ethics committee would be obliged to consider in an evaluation of their activities. I suggest that some of these features will create more difficulties for approval of such a protocol than others.  (+info)

Annual report of Council, 1983-1984: medical ethics.(19/409)

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Annual report of Council, 1985-1986: medical ethics.(20/409)

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Annual report of Council, 1986-1987: medical ethics.(21/409)

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What is a medical experiment? (22/409)

Innovative therapy may appear to coincide with medical experimentation, raising ethical and legal issues, for instance on informed consent and institutional review. Medical treatments may be classified, however, to distinquish novel procedures from experimentation.  (+info)

A surgeon's obligations when performing new procedures. (23/409)

A junior member of the vascular surgery faculty has done two robotic abdominal aneurysmectomies. Although he attended a standard 2-day training course conducted by the instrument manufacturer, performed several similar procedures in the animal laboratory, and read all the recent pertinent literature, technical errors resulted in significant morbidity in his first two patients. He proposes to use the technique once again on a hospitalized patient. His troubled chairman has called you for an opinion on whether an ethical question has now arisen. There are no specific credentialling standards for robotic surgery at this institution. Where might we most expect to see an ethical problem in the surgeon's management of the new case?  (+info)

International variation in ethics committee requirements: comparisons across five Westernised nations. (24/409)

BACKGROUND: Ethics committees typically apply the common principles of autonomy, nonmaleficence, beneficence and justice to research proposals but with variable weighting and interpretation. This paper reports a comparison of ethical requirements in an international cross-cultural study and discusses their implications. DISCUSSION: The study was run concurrently in New Zealand, UK, Israel, Canada and USA and involved testing hypotheses about believability of testimonies regarding alleged child sexual abuse. Ethics committee requirements to conduct this study ranged from nil in Israel to considerable amendments designed to minimise participant harm in New Zealand. Assessment of minimal risk is a complex and unreliable estimation further compounded by insufficient information on probabilities of particular individuals suffering harm. Estimating potential benefits/ risks ratio and protecting participants' autonomy similarly are not straightforward exercises. SUMMARY: Safeguarding moral/humane principles should be balanced with promotion of ethical research which does not impede research posing minimal risk to participants. In ensuring that ethical standards are met and research has scientific merit, ethics committees have obligations to participants (to meet their rights and protect them from harm); to society (to ensure good quality research is conducted); and to researchers (to treat their proposals with just consideration and respect). To facilitate meeting all these obligations, the preferable focus should be promotion of ethical research, rather than the prevention of unethical research, which inevitably results in the impediment of researchers from doing their work. How the ethical principles should be applied and balanced requires further consideration.  (+info)