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Beneficence in Medical Ethics

Edited by Ruchika Mishra (Program in Medicine and Human Values, California Pacific Medical Center)
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  1. Elmer D. Abbo & Angelo E. Volandes (2006). Rare but Routine: The Physician's Obligation to Protect Third Parties. American Journal of Bioethics 6 (2):34 – 36.
  2. Tineke A. Abma (2005). Struggling with the Fragility of Life: A Relational-Narrative Approach to Ethics in Palliative Nursing. Nursing Ethics 12 (4):337-348.
    In nursing ethics the role of narratives and dialogue has become more prominent in recent years. The purpose of this article is to illuminate a relational-narrative approach to ethics in the context of palliative nursing. The case study presented concerns a difficult relationship between oncology nurses and a husband whose wife was hospitalized with cancer. The husband’s narrative is an expression of depression, social isolation and the loss of hope. He found no meaning in the process of dying and death. (...)
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  3. Felicia Ackerman (1991). The Significance of a Wish. Hastings Center Report 21 (4):27-29.
  4. Terrence F. Ackerman (1982). Why Doctors Should Intervene. Hastings Center Report 12 (4):14-17.
  5. Terrence F. Ackerman (1980). The Limits of Beneficence: Jehovah's Witnesses & Childhood Cancer. Hastings Center Report 10 (4):13-18.
  6. Samuel Bard (1769/1996). A Discourse Upon the Duties of a Physician: With Some Sentiments, on the Usefulness and Necessity of a Public Hospital: Delivered Before the President and Governors of King' College, Held on the 16th of May 1769: As Advice to Those Gentlemen Who Then Received the First Medical Degrees Conferred by That University. [REVIEW] Applewood Books.
    This classic essay on the responsibilities of a doctor was first published in New York in 1769. It remains a perfect gift for a young doctor just starting out or for one who is older and wiser. This classic will be an inspiration to any who read its timeless message.
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  7. Tom Beauchamp, The Principle of Beneficence in Applied Ethics. Stanford Encyclopedia of Philosophy.
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  8. Tom L. Beauchamp (2009). Principles of Biomedical Ethics. Oxford University Press.
    This edition represents a thorough-going revision of what has become a classic text in biomedical ethics. Major structural changes mark the revision. The authors have added a new concluding chapter on methods that, along with its companion chapter on moral theory, emphasizes convergence across theories, coherence in moral justification, and the common morality. They have simplified the opening chapter on moral norms which introduces the framework of prima facie moral principles and ways to specify and balance them. Together with the (...)
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  9. Tom L. Beauchamp (1994). Principles of Biomedical Ethics / Tom L. Beauchamp, James F. Childress. Oxford University Press.
    This is an extremely thorough revision of the leading textbook of bioethics. The authors have made many improvements in style, organization, argument and content. These changes reflect advances in the bioethics literature over the past five years. The most dramatic expansions of the text are in the comprehensiveness with which the authors treat different currents in ethical theory and the greater breadth and depth of their discussion of public policy and public health issues. In every chapter, readers will find new (...)
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  10. Rebecca Bennett (2009). The Fallacy of the Principle of Procreative Beneficence. Bioethics 23 (5):265-273.
    The claim that we have a moral obligation, where a choice can be made, to bring to birth the 'best' child possible, has been highly controversial for a number of decades. More recently Savulescu has labelled this claim the Principle of Procreative Beneficence. It has been argued that this Principle is problematic in both its reasoning and its implications, most notably in that it places lower moral value on the disabled. Relentless criticism of this proposed moral obligation, however, has been (...)
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  11. Frederic Bretzner, Frederic Gilbert, Françoise Baylis & Robert M. Brownstone (2011). Target Populations for First-In-Human Embryonic Stem Cell Research in Spinal Cord Injury. Cell Stem Cell 8 (5):468-475.
    Geron recently announced that it had begun enrolling patients in the world's first-in-human clinical trial involving cells derived from human embryonic stem cells (hESCs). This trial raises important questions regarding the future of hESC-based therapies, especially in spinal cord injury (SCI) patients. We address some safety and efficacy concerns with this research, as well as the ethics of fair subject selection. We consider other populations that might be better for this research: chronic complete SCI patients for a safety trial, subacute (...)
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  12. Emma C. Bullock (2014). Free Choice and Patient Best Interests. Health Care Analysis:1-19.
    In medical practice, the doctrine of informed consent is generally understood to have priority over the medical practitioner’s duty of care to her patient. A common consequentialist argument for the prioritisation of informed consent above the duty of care involves the claim that respect for a patient’s free choice is the best way of protecting that patient’s best interests; since the patient has a special expertise over her values and preferences regarding non-medical goods she is ideally placed to make a (...)
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  13. Stephen M. Campbell (2013). An Analysis of Prudential Value. Utilitas 25 (03):334-54.
    This essay introduces and defends a new analysis of prudential value. According to this analysis, what it is for something to be good for you is for that thing to contribute to the appeal or desirability of being in your position. I argue that this proposal fits well with our ways of talking about prudential value and well-being; enables promising analyses of the related concepts of luck, selfishness, self-sacrifice, and paternalism; preserves the relationship between prudential value and the attitudes of (...)
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  14. Vanessa Carbonell (2013). Interactive Capacity, Decisional Capacity, and a Dilemma for Surrogates. AJOB Neuroscience 4 (4):36-37.
  15. B. D. Earp (2014). Hymen 'Restoration' in Cultures of Oppression: How Can Physicians Promote Individual Patient Welfare Without Becoming Complicit in the Perpetuation of Unjust Social Norms? Journal of Medical Ethics 40 (6):431-431.
    In this issue, Ahmadi1 reports on the practice of hymenoplasty—a surgical intervention meant to restore a presumed physical marker of virginity prior to a woman's marriage. As Mehri and Sills2 have stated, these women ‘want to ensure that blood is spilled on their wedding night sheets.’ Although Ahmadi's research was carried out in Iran specifically, this surgery is becoming increasingly popular in a number of Western countries as well, especially among Muslim populations.3 What are the ethics of hymen restoration?Consider the (...)
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  16. Farah Focquaert (2013). Deep Brain Stimulation in Children: Parental Authority Versus Shared Decision-Making. Neuroethics 6 (3):447-455.
    This paper discusses the use of deep brain stimulation for the treatment of neurological and psychiatric disorders in children. At present, deep brain stimulation is used to treat movement disorders in children and a few cases of deep brain stimulation for psychiatric disorders in adolescents have been reported. Ethical guidelines on the use of deep brain stimulation in children are therefore urgently needed. This paper focuses on the decision-making process, and provides an ethical framework for (future) treatment decisions in pediatric (...)
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  17. Joseph Franklin (1978). The Role of Physicians in the Disability Programs of the Social Security Administration or The Care and Feeding of A Beneficent Monster. Journal of Law, Medicine & Ethics 6 (3):4-4.
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  18. Frederic Gilbert (2012). The Burden of Normality: From 'Chronically Ill' to 'Symptom Free'. New Ethical Challenges for Deep Brain Stimulation Postoperative Treatment. Journal of Medical Ethics 8 (7):408-412.
    Although an invasive medical intervention, Deep Brain Stimulation (DBS) has been regarded as an efficient and safe treatment of Parkinson’s disease for the last 20 years. In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery. Clinical studies of epileptic patients who have undergone an anterior temporal lobectomy have identified a range of side effects and complications in a number of domains: psychological, (...)
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  19. Frederic Gilbert, Andrej Vranic & Samia Hurst (2013). Involuntary & Voluntary Invasive Brain Surgery: Ethical Issues Related to Acquired Aggressiveness. [REVIEW] Neuroethics 6 (1):115-128.
    Clinical cases of frontal lobe lesions have been significantly associated with acquired aggressive behaviour. Restoring neuronal and cognitive faculties of aggressive individuals through invasive brain intervention raises ethical questions in general. However, more questions have to be addressed in cases where individuals refuse surgical treatment. The ethical desirability and permissibility of using intrusive surgical brain interventions for involuntary or voluntary treatment of acquired aggressiveness is highly questionable. This article engages with the description of acquired aggressiveness in general, and presents a (...)
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  20. J. J. Giordano (2010). From a Neurophilosophy of Pain to a Neuroethics of Pain Care. In James J. Giordano & Bert Gordijn (eds.), Scientific and Philosophical Perspectives in Neuroethics. Cambridge University Press.
  21. Martin Gluchman (2012). Issues of Humanity in Medical Ethics. Ethics and Bioethics (in Central Europe) 2 (3-4):172-180.
    Bioethics has been a very disputable field of applied ethics in the past years, which is caused by the frequency with which the term bioethics is used and, primarily, by the importance of the questions solved and increasing public interest. Many contemporary ethical and moral problems are based and rest upon conflicts stemming in bioethics. In the presented article, I will focus on the principle of humanity as a part of one of the most complex fields of bioethics. I will (...)
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  22. Daniel Groll (forthcoming). Medicine & Well-Being. In Guy Fletcher (ed.), The Routledge Handbook of Philosophy of Well-Being. Routledge.
    The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one where a (...)
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  23. Daniel Groll (2014). Medical Paternalism - Part 1. Philosophy Compass 9 (3):194-203.
    Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? -/- This paper deals with the first question, with a special focus on paternalism (...)
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  24. Daniel Groll (2014). Medical Paternalism – Part 2. Philosophy Compass 9 (3):194-203.
    Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? In Medical Paternalism Part 1, I answered the first question. This paper answers the (...)
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  25. Daniel Groll (2014). Four Models of Family Interests. Pedatrics 134:S81-S86.
    In this article, I distinguish between 4 models for thinking about how to balance the interests of parents, families, and a sick child: (1) the oxygen mask model; (2) the wide interests model; (3) the family interests model; and (4) the direct model. The oxygen mask model – which takes its name from flight attendants' directives to parents to put on their own oxygen mask before putting on their child's – says that parents should consider their own interests only insofar (...)
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  26. L. Hawryluck (2002). Neuromuscular Blockers--A Means of Palliation? Journal of Medical Ethics 28 (3):170-172.
    As we die, our respiratory pattern is altered and we seem to gasp and struggle for each breath. Such gasping is commonly seen as a clear sign of dyspnoea and suffering by families and loved ones, however, it is unclear whether it is perceived at all by the dying person. Narcotics and sedatives do not seem to affect these gasping respirations. In this issue of the Journal of Medical Ethics, we are asked to consider whether the last gasp of a (...)
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  27. Andrew Hotke (2014). The Principle of Procreative Beneficence: Old Arguments and A New Challenge. Bioethics 28 (5):255-262.
    In the last ten years, there have been a number of attempts to refute Julian Savulescu's Principle of Procreative Beneficence; a principle which claims that parents have a moral obligation to have the best child that they can possibly have. So far, no arguments against this principle have succeeded at refuting it. This paper tries to explain the shortcomings of some of the more notable arguments against this principle. I attempt to break down the argument for the principle and in (...)
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  28. Nora Jacobson & Diego Silva (2010). Dignity Promotion and Beneficence. Journal of Bioethical Inquiry 7 (4):365-372.
    The concept of dignity has occasioned a robust conversation in recent healthcare scholarship. When viewed as a whole, research on dignity in healthcare has engaged each of the four bioethical principles popularized by Beauchamp and Childress, but has paid the least attention to beneficence. In this paper, we look at dignity and beneficence. We focus on the dignity promotion component of a model of dignity derived from a grounded theory study. After describing the study and presenting a précis of the (...)
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  29. Yusuke Kaneko (2012). THE MAXIM OF SUICIDE: ONE ANGLE ON BIOMEDICAL ETHICS. ASIAN JOURNAL OF SOCIAL SCIENCES and HUMANITIES 1 (3).
    Addressing the question in the form of Kant’s maxim, this paper moves on to a more controversial topic in biomedical ethics, physician-assisted suicide. However, my conclusion is tentative, and what is worse, negative: I partially approve suicide. It does not imply a moral hazard. The situation is opposite: in the present times, terminal patients seriously wish it. I, as an author, put an emphasis on this very respect. Now suicide is, for certain circles, nothing but justice. The arguments of thinkers (...)
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  30. Adam J. Kolber (2007). A Limited Defense of Clinical Placebo Deception. Yale Law & Policy Review 26:75-134.
    Placebo treatments, like sugar pills and saline injections, are effective in treating pain and perhaps a host of other conditions. To use placebos most effectively, however, doctors must mislead patients into believing that they are receiving active medications. While placebo deception is surprisingly common, its legality has rarely been tested. In November 2006, the American Medical Association (AMA) adopted a new ethics provision categorically prohibiting doctors from using placebos deceptively. In so doing, the AMA shifted the legal landscape, making it (...)
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  31. Katarína Komenská (2012). Respect for Autonomy and Human Dignity in Codes of Conduct of Health Care Professionals (in Slovakia). Ethics and Bioethics (in Central Europe) 2 (3-4):192-200.
    The aim of the paper is to present and reflect on some of the current theories of human dignity and autonomy. The understanding of autonomy in the 4 principles theory of Beauchamp and Childress will be the starting point of this paper as it presents medical ethics and health care ethics as patient-orientated model with special attention paid to the needs and rights of the patient. According to this orientation of health care ethics, the concept of human dignity plays an (...)
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  32. Thaddeus Metz (forthcoming). Life, Meaning Of. In Henk ten Have (ed.), Encyclopedia of Global Bioethics. Springer.
    This entry begins by indicating respects in which the concept of life’s meaning has only recently become salient in English-speaking bioethical discussions and by clarifying what talk of ‘life’s meaning’ and cognate phrases mean, at least to most of the philosophers and bioethicists who have used them. This essay then addresses six major respects in which thought about what makes a life meaningful has influenced bioethics. The first four issues concern life and death matters for human beings, and specifically involve: (...)
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  33. Peter Olsthoorn & Myriame Bollen (2013). Civilian Care in War: Lessons From Afghanistan. In Michael Gross & Don Carrick (eds.), Military Medical Ethics forthe 21st Century. Ashgate. 59-70.
  34. Simon Rippon, Pablo Stafforini, Katrien Devolder, Russell Powell & Thomas Douglas (2010). Resisting Sparrow's Sexy Reductio : Selection Principles and the Social Good. American Journal of Bioethics 10 (7):16-18.
    Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even when (...)
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  35. David Shaw (2011). Homeopathy and Medical Ethics. Focus on Alternative and Complementary Therapies 16 (1):17-21.
    Homeopathy has been the subject of intense academic, media and public debate in recent months. Those opposed to the practice, which treats like with like by using ultra-dilute remedies, argue that it is an ineffective non-treatment that is not supported by evidence and should not be funded on the National Health Service. Its proponents claim that it is effective (although they disagree about whether it is more effective than placebo) and argue its use is appropriate for certain conditions. This paper (...)
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  36. David Shaw (2010). An Extra Reason to Roll the Dice: Balancing Harm, Benefit and Autonomy in 'Futile' Cases. Clinical Ethics 5 (217):219.
    Oncologists frequently have to break bad news to patients. Although they are not normally the ones who tell patients that they have cancer, they are the ones who have to tell patients that treatment is not working, and they are almost always the ones who have to tell them that they are going to die and that nothing more can be done to cure them. Perhaps the most difficult cases are those where further treatment is almost certainly futile, but there (...)
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  37. David Shaw (2009). Prescribing Placebos Ethically: The Appeal of Negatively Informed Consent. Journal of Medical Ethics 35 (2):97-99.
    Kihlbom has recently argued that a system of seeking negatively informed consent might be preferable in some cases to the ubiquitous informed consent model. Although this theory is perhaps not powerful enough to supplant informed consent in most settings, it lends strength to Evans’ and Hungin’s proposal that it can be ethical to prescribe placebos rather than "active" drugs. This paper presents an argument for using negatively informed consent for the specific purpose of authorising the use of placebos in clinical (...)
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  38. David Shaw & David Conway (2010). Pascal’s Wager, Infective Endocarditis and the “No-Lose” Philosophy in Medicine. Heart 96 (1):15-18.
    Doctors and dentists have traditionally used antibiotic prophylaxis in certain patient groups in order to prevent infective endocarditis (IE). New guidelines, however, suggest that the risk to patients from using antibiotics is higher than the risk from IE. This paper analyses the relative risks of prescribing and not prescribing antibiotic prophylaxis against the background of Pascal’s Wager, the infamous assertion that it is better to believe in God regardless of evidence, because of the prospective benefits should He exist. Many doctors (...)
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  39. David Shaw & Bernice Elger (2013). The Relevance of Relevance in Research. Swiss Medical Weekly.
    A new Swiss law requires that any research involving humans must aim to answer "a relevant research question". This paper explains the relevance of the relevance criterion in research, analyses the Swiss and British guidelines on relevance, and proposes a framework for researchers and REC members that enables a clearer conception of the role of relevance in research. We conclude that research must be either scientifically or societally beneficial in order to qualify as relevant, and RECs therefore cannot avoid reviewing (...)
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  40. Diego S. Silva (2010). Dignity Promotion and Beneficence. Journal of Bioethical Inquiry 7 (4):365-372.
    The concept of dignity has occasioned a robust conversation in recent healthcare scholarship. When viewed as a whole, research on dignity in healthcare has engaged each of the four bioethical principles popularized by Beauchamp and Childress, but has paid the least attention to beneficence. In this paper, we look at dignity and beneficence. We focus on the dignity promotion component of a model of dignity derived from a grounded theory study. After describing the study and presenting a précis of the (...)
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  41. Alexandra Smatanová (2012). Medical Ethics Education in Slovakia: Some of the Problems It Faces and Further Research Suggestions. Ethics and Bioethics (in Central Europe) 2 (1-2):51-59.
    From the 1970s on, much more attention has been given to medical ethics education than ever before. As such, medical ethics education and its importance have started to be accepted and acknowledged by the wider public and by academics as well. Slovakia is not an exception. Also here, considerable amount of attention and concern has been given lately to medical ethics and to medical ethics education. In this article, I will focus on medical ethics education for future physicians, namely on (...)
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  42. Alexandra Smatanová (2012). Ethical Contexts of Physician Profession Preparation. Ethics and Bioethics (in Central Europe) 2 (3-4):181-191.
    This paper focuses on medical ethics from the clinical practice point of view. Of main interest is how pre clinical study years influence modes of thinking of students and consequently influence their acts and decision-making processes in medical practice. Also, the paper proposes some ways how to improve medical ethics education of medical students in Slovakia. For this purpose Nussbaum approaches to education are investigated and explored.
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  43. Simon Peter van Rysewyk & Matthijs Pontier (eds.) (2014). Machine Medical Ethics. Springer.
    In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. -/- As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What (...)
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  44. Simon van Rysewyk & Janneke van Leeuwen (2014). Picturing Mind Machines, An Adaptation by Janneke van Leeuwen. In Simon Peter van Rysewyk & Matthijs Pontier (eds.), Machine Medical Ethics. Springer.
  45. Jukka Varelius (2006). Autonomy, Well-Being, and the Case of the Refusing Patient. Medicine, Health Care and Philosophy 9 (1):117-125.
    A moral problem arises when a patient refuses a treatment that would save her life. Should the patient be treated against her will? According to an influential approach to questions of biomedical ethics, certain considerations pertaining to individual autonomy provide a solution to this problem. According to this approach, we should respect the patient’s autonomy and, since she has made an autonomous decision against accepting the treatment, she should not be treated. This article argues against the view that our answer (...)
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  46. Lucie White (2010). Euthanasia, Assisted Suicide and the Professional Obligations of Physicians. Emergent Australasian Philosophers 3 (1).
    Euthanasia and assisted suicide have proved to be very contentious topics in medical ethics. Some ethicists are particularly concerned that allowing physicians to carry out these procedures will undermine their professional obligations and threaten the very goals of medicine. However, I maintain that the fundamental goals of medicine not only do not preclude the practice of euthanasia and assisted suicide by physicians, but can in fact be seen to support these practices in some instances. I look at two influential views (...)
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  47. Tomasz Żuradzki (2014). Preimplantation Genetic Diagnosis and Rational Choice Under Risk or Uncertainty. Journal of Medical Ethics 40 (11):774-778.
    In this paper I present an argument in favour of a parental duty to use preimplantation genetic diagnosis (PGD). I argue that if embryos created in vitro were able to decide for themselves in a rational manner, they would sometimes choose PGD as a method of selection. Couples, therefore, should respect their hypothetical choices on a principle similar to that of patient autonomy. My thesis shows that no matter which moral doctrine couples subscribe to, they ought to conduct the PGD (...)
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