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  1. P. L. Bright & R. M. Nelson (2012). A Capacity-Based Approach for Addressing Ancillary Care Needs: Implications for Research in Resource Limited Settings. Journal of Medical Ethics 38 (11):672-676.
    A paediatric clinical trial conducted in a developing country is likely to encounter conditions or illnesses in participants unrelated to the study. Since local healthcare resources may be inadequate to meet these needs, research clinicians may face the dilemma of deciding when to provide ancillary care and to what extent. The authors propose a model for identifying ancillary care obligations that draws on assessments of urgency, the capacity of the local healthcare infrastructure and the capacity of the research infrastructure. The (...)
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  2. J. Rossi & R. M. Nelson (2012). Is There an Objective Way to Compare Research Risks? Journal of Medical Ethics 38 (7):423-427.
    Determining whether a research risk meets or exceeds a regulatory standard of risk acceptability is difficult. Recently a framework called the systematic evaluation of research risks (SERR) has been proposed as a method of comparing research risks with predetermined standards of acceptability. SERR purports to offer a systematic and largely determinate (definite) way to compare risks and say whether a specific research risk falls below or above an acknowledged standard of acceptable risk. Here the authors review some philosophical problems with (...)
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  3. A. T. Nathan, K. S. Hoehn, R. F. Ittenbach, J. W. Gaynor, S. Nicolson, G. Wernovsky & R. M. Nelson (2010). Assessment of Parental Decision-Making in Neonatal Cardiac Research: A Pilot Study. Journal of Medical Ethics 36 (2):106-110.
    Objective To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Study Design Quantitative interviews using study-specific MacCAT-CR tools. Hypothesis Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents (...)
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  4. R. Charon, H. Brody, M. W. Clark, D. Davis, R. Martinez & R. M. Nelson (1996). Literature and Ethical Medicine: Five Cases From Common Practice. Journal of Medicine and Philosophy 21 (3):243-265.
    This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...)
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  5. R. M. Nelson & T. Drought (1992). Justice and the Moral Acceptability of Rationing Medical Care: The Oregon Experiment. Journal of Medicine and Philosophy 17 (1):97-117.
    The Oregon Basic Health Services Act of 1989 seeks to establish universal access to basic medical care for all currently uninsured Oregon residents. To control the increasing cost of medical care, the Oregon plan will restrict funding according to a priority list of medical interventions. The basic level of medical care provided to residents with incomes below the federal poverty line will vary according to the funds made available by the Oregon legislature. A rationing plan such as Oregon's which potentially (...)
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