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- Jacob M. Appel (2005). Organ Solicitation on the Internet: Every Man for Himself: Commentary. Hastings Center Report 35 (3):14-15.
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In 2008 a young man committed suicide while his webcam was running. 1,500 people apparently watched as the young man lay dying: when people finally made an effort to call the police, it was too late. This closely resembles the case of Kitty Genovese in 1964, where 39 neighbours supposedly watched an attacker assault and did not call until it was too late. This paper examines the role of internet mediation in cases where people may or may not have been good Samaritans and what their responsibilities were. The method is an intuitive one: intuitions on the various potentially morally relevant differences when it comes to responsibility between offline and online situations are examined. The number of onlookers, their physical nearness and their anonymity have no moral relevance when it comes to holding them responsible. Their perceived reality of the situation and ability to act do have an effect on whether we can hold people responsible, but this doesn’t seem to be unique to internet mediation. However the way in which those factors are intrinsically connected to internet mediation does seem to have a diminishing effect on responsibility in online situations.
In this article, consultation via the Internet and the use of the Internet as a source of medical information is examined from an ethical point of view. It is argued that important ethical aspects of the clinical interaction, such as dialogue and trust will be difficult to realise in an Internet-consultation. Further, it is doubtful whether an Internet doctor will accept responsibility. However, medical information via the Internet can be a valuable resource for patients wanting to know more about their disease and, thus, it is a means to enhancing their autonomy.
This paper considers two arguments that are common in the literature on organ sales. First, organ sales are exploitative and therefore should not be permitted. Second, it doesn't matter whether organ sales are exploitative or not; the only thing that matters is that we do what is in the interests of those who need to be protected.In this paper, I argue that both of these arguments are too simplistic. My intention, however, is not to argue for or against organ sales. My conclusion, rather, is simply that we cannot hope to address the issue of organ sales if we lack a good understanding of exploitation. We should not attempt to answer the question of whether or not organ sales should be banned on the grounds that they are exploitative without acknowledging and addressing the nuances involved in understanding exploitation.
The development of ethical and practice guidelines related to mental health service on the Internet has lagged behind the movement of practitioners into this area. Even for clinicians who are not offering services on the Web, the Internet has led to confusion and concern about proper roles and responsibilities. This article discusses an actual experience we had with a self-described rationally suicidal man with multiple sclerosis (MS). After presenting some background on MS, we report initial interactions with the man verbatim and summarize subsequent correspondence in an analysis of the man's claim that his decision to die was well reasoned and that he should be allowed a physician's assistance.
Background Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent. Methods An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. Content scores were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent. Results There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20–47), 79% (57–86), and 75% (50–100), respectively. The informed consent score was 0% (0–33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing. Conclusion The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent.
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