Ethics

Inviolate Patient Confidentiality? – MM1504

The startling details surrounding the crash of Germanwings Flight 9525 in the French Alps on March 24 have led me to re-consider aspects of patient confidentiality.

Modern Medicine – April 2015

Some Considerations Regarding Research Ethics – MM1502

The 70th anniversary of the liberation of the Auschwitz-Birkenhau death camp had me reflecting on the atrocious complicity of some of our medical brethren at this time and the unethical research that they conducted. A consequence of their behaviour was the adoption of the Nuremberg code in 1946 which is usually considered the forerunner of our modern research ethical doctrine.

Modern Medicine – February 2015

Human Rights – MM1410

It could be fairly stated that we live in an age of Human Rights or at least and more correctly, an age when much lip-service is paid to Rights, including Human Rights. The recent “umbrella revolution” in Hong Kong is driven by the demand for universal suffrage and the right to be governed by a democratically elected government.

Modern Medicine – October 2014

Death Certificates 101 – MM1406

One of our readers recently requested clarification on the filling in of death certificates. In this case his query was about two elderly patients who died, unexpectedly, but apparently from natural causes. The doctor was unable to honestly attest to the causes of death but he had no reason to suspect that the deaths were anything but natural. How was he to proceed?

Modern Medicine – June 2014

Litigation Threats to the Clinician – MM1404

Without a doubt, doctors practising clinical medicine in SA are under increasing threat from patients and their lawyers. This adds a new and often unwelcome dimension to the interface where good medicine is practised.

Modern Medicine – April 2014

Impaired Healthcare Practitioners – MM1402

The definitions and perceptions of what constitutes impairment are much easier in the abstract or related to some anonymous individual. It gets quite messy when it is close to home.

Modern Medicine – February 2014

Oh Well, That’s Life…. – MM1310

Bioethics is about the rightness and wrongness of how we, as health care professionals, treat our fellow-beings, especially those who entrust
their medical care to us. As a paediatrician who has been involved with newborns for most of my career, it is essential to decide when my patient
has attained the status of a fellow-being. Most discussions of “when does life begin” are hugely philosophical but there are important practical and pragmatic reasons that need to be addressed. Hence, the subject needs to be aired and our
views challenged at all levels.

Modern Medicine – October 2013

Ethical Aspects of Withdrawing or Withholding Treatment – MM1308

Should health care practitioners (HCPs) preserve all lives, at all cost and for as long as possible? This view is attractive to many theologians and arm-chair philosophers who proclaim the sanctity of life. There is comfort and security for HCPs holding this view as it removes the responsibility for making some very difficult decisions and leaves all in the hands of a “Higher Being”. There is no need to consider others in the decision, costs or the quality of life under review.

Most bioethicists reject this absolutist premise. The duty of care is not an absolute duty to preserve life by all means. There is no obligation to provide life sustaining treatment if:
a) Its use is inconsistent with the aims and objectives of an appropriate treatment plan,
and
b) The benefits of that treatment no longer outweigh the burdens to the patient.

Modern Medicine – August 2013

Circumcision: Is it Still Ethical and Legal? – MM1306

The recent rekindled interest in circumcision as an adjuvant to the prevention of HIV infection warrants another look at this surgical intervention.

Modern Medicine – June 2013