Is suicide different from physician assisted death?

Bioethicists have for several decades discussed whether Physician Assisted Death (PAD) can be distinguished from other forms of suicide. The question is of critical importance for suicide prevention initiatives in countries where PAD is legal, as it may be the case that the practice of PAD is undermining the work of organisations committed to reducing suicide rates.

A major intervention into the debate was made late last year by the American Society for Suicidology (ASS) -- the peak association in the United States that advocates for suicide prevention -- when the organisation released a… MORE

New guidelines seek to address misdiagnosis of disorders of consciousness

About four in 10 people who are thought to be unconscious are actually aware, according to new clinical guidelines for disorders of consciousness published in the journal Neurology.  

The guidelines, which outline best practice for managing patients in vegetative and minimally conscious states, are the product of an extensive consultation process with members of three speciality societies -- the American Academy of Neurology (AAN), American Congress of Rehabilitation Medicine and the National Institute on Disability, Independent Living, and Rehabilitation Research.

Among its key recommendations, the document advocates for a careful evaluation… MORE

UK’s equality watchdog insists on transgender fertility services

The UK’s equality watchdog has demanded that the country’s National Health Service offer scarce fertility services to transitioning transgender people.

At the moment, 208 clinical commissioning groups around the UK decide whether to provide the “gamete extraction and storage” services to patients, but the Equality and Human Rights Commission (EHRC) claims that many will not provide these to transgender patients.

EHRC chief executive Rebecca Hilsenrath said: “Our laws and our values protect those who seek treatment for gender dysphoria. This means that where appropriate, treatment should be made available in order to ensure that access to health services is free… MORE

Embryo research: why not make it the “one month rule”?

Since the 1980s, research on embryos in vitro has been governed by what is known as the “14 day rule”. The 14 day rule is a legal and regulatory precept  -- based on the consensus of experts from a range of academic backgrounds -- according to which embryos should not be grown in vitro for longer than two weeks. The notion of a 14 day limit on embryo research was first proposed by committees in the UK and the US, and later adopted in Europe and other countries such as Australia and Canada.

While… MORE

Capital punishment stumbles ahead in US

Three news items this week illustrate the patchwork of capital punishment legislation in the United States.

On Thursday, a 59-year-old man, Billy Irick, was executed in the state of Tennessee for the rape and murder of a 7-year-old, a crime he had committed in 1985.

Tennessee, whose last execution took place in 2009, uses a cocktail of drugs to sedate and then kill the prisoner. Lawyers for prisoners on Tennessee’s death row described this as inhumane, but the challenge was dismissed by the State Supreme Court. A last-minute challenge on grounds of mental incapacity failed in the US Supreme Court… MORE

Argentina narrowly rejects abortion bill

Argentina’s upper house this week narrowly rejected a bill that would have legalised abortion up to 14 weeks. The 38 to 31 vote means that the country will retain its tight restrictions on abortion. Currently, abortion is only permitted in cases of rape, when the mother is mentally disabled or if there is serious risk to her health.

An estimated two million protesters gathered outside of of Congress in Buenos Aires as politicians debated the proposal on Wednesday and Thursday, and groups of protesters clashed with police following the announcement of the result.


Is death by dehydration in a patient’s ‘best interest’?

The UK’s Supreme Court has ruled that court orders are not necessarily needed before withdrawing hydration and nutrition from a comatose patient. If doctors and the patient’s family agree that on-going treatment is not in his best interests, it may be stopped without applying for a court order.

Lady Black, a Supreme Court justice, said:

“Having looked at the issue in its wider context as well as from a narrower legal perspective, I do not consider that it has been established that the common law or the ECHR (European Convention on Human Rights), in combination or separately,… MORE

Abortion activists unveil strategy for attacking conscientious objection

An “expert group” of abortion activists has launched a strong attack on the concept and practice of conscientious objection (CO) in healthcare. “The practice of refusing to provide legal and essential health care due to a doctor's personal or religious beliefs is a violation of medical ethics and of patients' right to health care,” says the International Women's Health Coalition in conjunction with Mujer y Salud en Uruguay.

A 46-page report, Unconscionable: When Providers Deny Abortion Care, argues that “the practice of refusing to provide legal and essential health care due to a doctor's personal or religious… MORE

UK cosmetic surgery ads criticised as ‘unscrupulous”

ITV, a commercial TV channel in the UK, will review its policy of screening advertisements for breast enlargement and diet pills during its wildly successful show “Love Island”.

It has been roundly criticised by the head of the National Health Service and feminists.

Love Island is a reality TV show in which attractive singles wander around, mostly in swimwear. Critics claim that advertisers are exploiting the insecurities of young women.

The companies whose ads were criticised include MYA Cosmetic Surgery, which offers loans for tummy tucks, breast enlargements and nose jobs, and Skinny Sprinkles, a diet supplement which describes itself… MORE

Doctors’ well-being is suffering because of ‘moral injury’

In trying to understand post-traumatic stress disorders amongst soldiers, psychologists have developed the notion of “moral injury”. This is an injury to an individual's moral conscience after a moral transgression which leads to deep shame. In war, this might happen after soldiers have killed civilians or child soldiers.

In a recent article on Stat, two doctors argue that something similar is happening to American doctors. “Failing to consistently meet patients’ needs has a profound impact on physician wellbeing — this is the crux of consequent moral injury.” With the increasing complexity of medical practice, the potential for moral injury… MORE

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