45 found
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  1.  67
    Computer Knows Best? The Need for Value-Flexibility in Medical AI.Rosalind J. McDougall - 2019 - Journal of Medical Ethics 45 (3):156-160.
    Artificial intelligence is increasingly being developed for use in medicine, including for diagnosis and in treatment decision making. The use of AI in medical treatment raises many ethical issues that are yet to be explored in depth by bioethicists. In this paper, I focus specifically on the relationship between the ethical ideal of shared decision making and AI systems that generate treatment recommendations, using the example of IBM’s Watson for Oncology. I argue that use of this type of system creates (...)
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  2.  50
    Overriding Parents’ Medical Decisions for Their Children: A Systematic Review of Normative Literature.Rosalind J. McDougall & Lauren Notini - 2014 - Journal of Medical Ethics 40 (7):448-452.
    This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question ‘when health professionals and parents disagree about the appropriate course of medical treatment for a child, under what circumstances is the health professional ethically justified in overriding the parents’ wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. (...)
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  3.  6
    Forever Young? The Ethics of Ongoing Puberty Suppression for Non-Binary Adults.Lauren Notini, Brian D. Earp, Lynn Gillam, Rosalind J. McDougall, Julian Savulescu, Michelle Telfer & Ken C. Pang - 2020 - Journal of Medical Ethics 46 (11):743-752.
    In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical defensibility (...)
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  4.  40
    Systematic Reviews in Bioethics: Types, Challenges, and Value.R. Mcdougall - 2014 - Journal of Medicine and Philosophy 39 (1):89-97.
    There has recently been interest in applying the techniques of systematic review to bioethics literature. In this paper, I identify the three models of systematic review proposed to date in bioethics: systematic reviews of empirical bioethics research, systematic reviews of normative bioethics literature, and systematic reviews of reasons. I argue that all three types yield information useful to scholarship in bioethics, yet they also face significant challenges particularly in relation to terminology and time. Drawing on my recent experience conducting a (...)
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  5.  10
    Indeterminacy and the Normative Basis of the Harm Threshold for Overriding Parental Decisions: A Response to Birchley.Rosalind J. McDougall - 2016 - Journal of Medical Ethics 42 (2):119-120.
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  6.  15
    Reviewing Literature in Bioethics Research: Increasing Rigour in Non‐Systematic Reviews.Rosalind McDougall - 2015 - Bioethics 29 (7):523-528.
    The recent interest in systematic review methods in bioethics has highlighted the need for greater transparency in all literature review processes undertaken in bioethics projects. In this article, I articulate features of a good bioethics literature review that does not aim to be systematic, but rather to capture and analyse the key ideas relevant to a research question. I call this a critical interpretive literature review. I begin by sketching and comparing three different types of literature review conducted in bioethics (...)
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  7.  25
    Pandemic Medical Ethics.Jennifer Blumenthal-Barby, Kenneth Boyd, Brian D. Earp, Lucy Frith, Rosalind J. McDougall, John McMillan & Jesse Wall - 2020 - Journal of Medical Ethics 46 (6):353-354.
    The COVID-19 pandemic will generate vexing ethical issues for the foreseeable future and many journals will be open to content that is relevant to our collective effort to meet this challenge. While the pandemic is clearly the critical issue of the moment, it’s important that other issues in medical ethics continue to be addressed as well. As can be seen in this issue, the Journal of Medical Ethics will uphold its commitment to publishing high quality papers on the full array (...)
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  8.  97
    Acting Parentally: An Argument Against Sex Selection.R. McDougall - 2005 - Journal of Medical Ethics 31 (10):601-605.
    The Human Fertilisation and Embryology Authority’s recent restrictive recommendations on sex selection have highlighted the need for consideration of the plausibility of ethical arguments against sex selection. In this paper, the author suggests a parental virtues approach to some questions of reproductive ethics as a superior alternative to an exclusively harm focused approach such as the procreative liberty framework. The author formulates a virtue ethics argument against sex selection based on the idea that acceptance is a character trait of the (...)
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  9. Parental Virtue: A New Way of Thinking About the Morality of Reproductive Actions.Rosalind Mcdougall - 2007 - Bioethics 21 (4):181–190.
  10.  4
    The Value of Open Deliberation in Clinical Ethics, and the Role of Parents’ Reasons in the Zone of Parental Discretion.Rosalind McDougall, Clare Delany & Lynn Gillam - 2018 - American Journal of Bioethics 18 (8):47-49.
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  11.  15
    Can Families Have Interests?Rosalind McDougall - 2017 - American Journal of Bioethics 17 (11):27-29.
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  12.  16
    The Zone of Parental Discretion and the Complexity of Paediatrics: A Response to Alderson.Rosalind McDougall, Lynn Gillam, Merle Spriggs & Clare Delany - 2018 - Clinical Ethics 13 (4):172-174.
    Alderson critiques our recent book on the basis that it overlooks children’s own views about their medical treatment. In this response, we discuss the complexity of the paediatric clinical context and the value of diverse approaches to investigating paediatric ethics. Our book focuses on a specific problem: entrenched disagreements between doctors and parents about a child’s medical treatment in the context of a paediatric hospital. As clinical ethicists, our research question arose from clinicians’ concerns in practice: What should a clinician (...)
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  13.  11
    Collaboration in Clinical Ethics Consultation: A Method for Achieving “Balanced Accountability”.Rosalind McDougall, Clare Delany, Merle Spriggs & Lynn Gillam - 2014 - American Journal of Bioethics 14 (6):47-48.
  14.  21
    No We Shouldn’T Be Afraid of Medical AI; It Involves Risks and Opportunities.Rosalind J. McDougall - 2019 - Journal of Medical Ethics 45 (8):559-559.
    In contrast to Di Nucci’s characterisation, my argument is not a technoapocalyptic one. The view I put forward is that systems like IBM’s Watson for Oncology create both risks and opportunities from the perspective of shared decision-making. In this response, I address the issues that Di Nucci raises and highlight the importance of bioethicists engaging critically with these developing technologies.
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  15.  20
    Should Parental Refusal of Puberty-Blocking Treatment Be Overridden? The Role of the Harm Principle.Lauren Notini, Rosalind McDougall & Ken C. Pang - 2019 - American Journal of Bioethics 19 (2):69-72.
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  16.  34
    Understanding Doctors' Ethical Challenges as Role Virtue Conflicts.Rosalind Mcdougall - 2013 - Bioethics 27 (1):20-27.
    This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral (...)
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  17.  13
    Making Concepts Work.Rosalind J. McDougall - 2019 - Journal of Medical Ethics 45 (9):569-570.
    The articles in this issue direct our attention to the role of concepts in medical ethics. The issue includes research that defines a concept,1 research that applies concepts to illuminate the moral aspects of various elements of medicine,2 3 and research investigating the appropriate set of concepts to teach medical students.4 In their in-depth exploration of the concept of disease in this issue, Powell and Scarffe argue that our understanding of a concept should be ‘tailored to the role that the (...)
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  18.  33
    Conflicts Between Parents and Health Professionals About a Child’s Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.Rosalind McDougall, Lauren Notini & Jessica Phillips - 2015 - Journal of Bioethical Inquiry 12 (3):429-436.
    Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child’s (...)
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  19.  5
    What Kinds of Cases Do Paediatricians Refer to Clinical Ethics? Insights From 184 Case Referrals at an Australian Paediatric Hospital.Rosalind J. McDougall & Lauren Notini - 2016 - Journal of Medical Ethics 42 (9):586-591.
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  20.  43
    Developing “Ethical Mindfulness” in Continuing Professional Development in Healthcare: Use of a Personal Narrative Approach.Marilys Guillemin, Rosalind Mcdougall & Lynn Gillam - 2009 - Cambridge Quarterly of Healthcare Ethics 18 (2):197.
  21.  37
    The Ethics of Fertility Preservation for Paediatric Cancer Patients: From Offer to Rebuttable Presumption.Rosalind McDougall - 2015 - Bioethics 29 (9):639-645.
    Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I argue that the starting point (...)
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  22.  17
    What Ethical Resources Are Available to Alcohol and Other Drug Practitioners? A Systematic Review.David Silkoff, Marilys Guillemin, Richard Chenhall & Rosalind McDougall - 2018 - Clinical Ethics 13 (1):34-52.
    Clinical work in Alcohol and Other Drugs has not generally been an area of focus for ethicists. Likewise, ethics is not usually part of Alcohol and Other Drugs training or practice. This means that resources available to Alcohol and Other Drugs clinicians navigating ethical challenges are not widely available. This paper describes a systematic review of literature at the intersection of ethics and clinical practice in Alcohol and Other Drugs. The review will potentially benefit Alcohol and Other Drug practitioners by (...)
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  23.  17
    Ethics of Fertility Preservation for Prepubertal Children: Should Clinicians Offer Procedures Where Efficacy is Largely Unproven?Rosalind J. McDougall, Lynn Gillam, Clare Delany & Yasmin Jayasinghe - 2018 - Journal of Medical Ethics 44 (1):27-31.
    Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion (...)
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  24.  7
    Therapeutic Appropriation: A New Concept in the Ethics of Clinical Research.Rosalind McDougall, Dominique Martin, Lynn Gillam, Nina Hallowell, Alison Brookes & Marilys Guillemin - 2016 - Journal of Medical Ethics 42 (12):805-808.
    Ethical concerns about therapeutic misconception have been raised since the early 1980s. This concept was originally described as research participants' assumptions that decisions relating to research interventions are made on the basis of their individual therapeutic needs. The term has since been used to refer to a range of ‘misunderstandings’ that research participants may have. In this paper, we describe a new concept—therapeutic appropriation. Therapeutic appropriation occurs when patients, or clinicians, actively reframe research participation as an opportunity to enhance patients' (...)
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  25.  41
    Intrinsic Versus Contingent Claims About the Harmfulness of Prostitution.Rosalind J. McDougall - 2014 - Journal of Medical Ethics 40 (2):83-83.
    Moen targets a view about the intrinsic harmfulness of prostitution that he sees as widespread in healthcare, academia and public policy.1 He argues that the exchange of sex for money is not intrinsically harmful by systematically rejecting various possible proposed harms. He further suggests that it is the social context of discriminating laws and stigma that accounts for the harms experienced by prostitutes, rather than any intrinsic feature of exchanging sex for money.One striking aspect of his argument is the particular (...)
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  26.  10
    Making Meaning From Experience: A Working Typology for Pediatrics Ethics Consultations.Lynn Gillam, Rosalind McDougall & Clare Delany - 2015 - American Journal of Bioethics 15 (5):24-26.
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  27.  15
    Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?R. J. McDougall, L. Gillam, C. Delany & Y. Jayasinghe - 2017 - Journal of Medical Ethics Recent Issues 44 (1):27-31.
    Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion (...)
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  28.  2
    The Practice of Balancing in Clinical Ethics Case Consultation.Rosalind McDougall, Cade Shadbolt & Lynn Gillam - 2020 - Clinical Ethics 15 (1):49-55.
    Models for clinical ethics case consultation often make reference to ‘balancing’ or ‘weighing’ moral considerations, without further detail. In this paper, we investigate balancing in clinical ethics case consultation. We suggest that, while clinical ethics services cannot resolve ongoing deep philosophical debates about the nature of ethical reasoning, clinical ethicists can and should be more systematic and transparent when balancing considerations in case consultations. We conceptualise balancing on a spectrum from intuitive to deliberative, and argue that good balancing in case (...)
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  29.  10
    Combating Junior Doctors' "4am Logic": A Challenge for Medical Ethics Education.R. McDougall - 2009 - Journal of Medical Ethics 35 (3):203-206.
    Undergraduate medical ethics education currently focuses on ethical concepts and reasoning. This paper uses an intern’s story of an ethically challenging situation to argue that this emphasis is problematic in terms of ensuring students’ ethical practice as junior doctors. The story suggests that it is aligning their actions with the values that they reflectively embrace that can present difficulties for junior doctors working in the pressures of the hospital environment, rather than reasoning to an ethically appropriate action. I argue that (...)
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  30.  27
    Restricting Access to ART on the Basis of Criminal Record: An Ethical Analysis of a State-Enforced “Presumption Against Treatment” With Regard to Assisted Reproductive Technologies.Kara Thompson & Rosalind McDougall - 2015 - Journal of Bioethical Inquiry 12 (3):511-520.
    As assisted reproductive technologies become increasingly popular, debate has intensified over the ethical justification for restricting access to ART based on various medical and non-medical factors. In 2010, the Australian state of Victoria enacted world-first legislation that denies access to ART for all patients with certain criminal or child protection histories. Patients and their partners are identified via a compulsory police and child protection check prior to commencing ART and, if found to have a previous relevant conviction or child protection (...)
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  31.  10
    Rethinking the ‘Right Not to Know’.Rosalind McDougall - 2004 - Monash Bioethics Review 23 (1):22-36.
    The idea that an individual has a ‘right not to know’ genetic information about himself or herself is entrenched in both the policy sphere and the genetic counselling ethos. In this paper, I interrogate this idea of a ‘right not to know’, questioning particularly its status as a right. I identify the conception of rights that seems to underlie the posited ‘right not to know’ as a conception of rights in which they are prioritised non-outweighable interests. Turning to a series (...)
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  32.  15
    The Junior Doctor as Ethically Unique.R. McDougall - 2008 - Journal of Medical Ethics 34 (4):268-270.
    This paper argues that the professional situation of junior doctors is unique in ethically important ways and thus that ethics work focusing on junior doctors specifically is necessary. Unlike the medical student or the more senior doctor, the doctor in his or her early postgraduate years is simultaneously a responsible health professional, a subjugate learner and a human resource. These multiple roles generate the set of ethical issues faced by junior doctors, a set that has some overlaps with that faced (...)
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  33.  66
    Being 'One Cog in a Bigger Machine': A Qualitative Study Investigating Ethical Challenges Perceived by Junior Doctors.R. J. McDougall - 2009 - Clinical Ethics 4 (2):85-90.
    There is increasing recognition among bioethicists that health-care practitioners' everyday ethical challenges ought to be the focus of ethical analysis. Interviews were conducted with Australian junior doctors to identify some of the kinds of situations that they found ethically challenging, as a basis for this type of grounded philosophical analysis and for further empirical research into junior doctors' ethical issues. Fourteen doctors in their first to fourth year of work from six hospitals in Melbourne participated. Issues discussed included involvement in (...)
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  34.  17
    Futile Treatment, Junior Doctors and Role Virtues.R. McDougall - 2011 - Journal of Medical Ethics 37 (11):646-649.
    Futile treatment is one ethically challenging situation commonly encountered by junior doctors. By analysing an intern's story using a role virtues framework, I propose a set of three steps for junior doctors facing this problem. I claim that junior doctors ought always to investigate the rationale underlying decisions to proceed with apparently futile treatment and discuss their concerns with their seniors, even if such discussion will be difficult. I also suggest that junior doctors facing this ethical challenge ought always to (...)
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  35.  15
    A Resource-Based Version of the Argument That Cloning is an Affront to Human Dignity.R. McDougall - 2008 - Journal of Medical Ethics 34 (4):259-261.
    The claim that human reproductive cloning constitutes an affront to human dignity became a familiar one in 1997 as policymakers and bioethicists responded to the announcement of the birth of Dolly the sheep. Various versions of the argument that reproductive cloning is an affront to human dignity have been made, most focusing on the dignity of the child produced by cloning. However, these arguments tend to be unpersuasive and strongly criticised in the bioethical literature. In this paper I put forward (...)
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  36.  18
    Beyond the Waiver: An Ethical Approach to Discharge Against Medical Advice.Jeremy Chin & Rosalind Mcdougall - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (2):348-352.
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  37.  7
    Primary Care Physicians' Views About Gatekeeping in Clinical Research Recruitment: A Qualitative Study.Marilys Guillemin, Rosalind McDougall, Dominique Martin, Nina Hallowell, Alison Brookes & Lynn Gillam - 2017 - Ajob Empirical Bioethics 8 (2):99-105.
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  38. And the Moral Nature of Parenthood.Rosalind Mcdougall - 2009 - In Kimberley Brownlee & Adam Cureton (eds.), Disability and Disadvantage. Oxford University Press.
     
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  39.  5
    Balancing Health Worker Well-Being and Duty to Care: An Ethical Approach to Staff Safety in COVID-19 and Beyond.Rosalind J. McDougall, Lynn Gillam, Danielle Ko, Isabella Holmes & Clare Delany - forthcoming - Journal of Medical Ethics:medethics-2020-106557.
    The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-being. We describe each of these values, and present a decision-making framework (...)
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  40.  15
    Best Interests, Dementia, and End of Life Decision-Making: The Case of Mrs S.Rosalind McDougall - 2005 - Monash Bioethics Review 24 (3):36-46.
    In this paper, I present an ethical analysis of the case of an elderly woman with dementia, Mrs S. The hospital treating Mrs S sought to cease her dialysis treatment despite Mrs S’s family’s protestations that continuing the treatment was in her best interests. Assuming Brock’s framework as a theoretical background, I consider the case in terms of three questions. Firstly, was ‘best interests ’ the appropriate basis for deciding on a course of action in this situation? Secondly, assuming the (...)
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  41.  10
    Diversity of Scholarship in Medical Ethics.Rosalind J. McDougall - 2018 - Journal of Medical Ethics 44 (10):655-656.
    In their essay arguing for ethical review of social research, Sheehan et al write: > Inquiry and human life are intertwined and interdependent. To be human is to be curious, to ask questions about yourself, the world, and your place in the world. This process of inquiry is undertaken individually, but is a social activity.1 As researchers in medical ethics, all the authors in this issue have chosen to ask a particular type of question about the world: questions about ethical (...)
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  42. Impairment, Flourishing and the Moral Nature of Parenthood.Rosalind McDougall - 2009 - In Kimberley Brownlee & Adam Cureton (eds.), Disability and Disadvantage. Oxford University Press.
     
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  43.  2
    Navigating Difficult Decisions in Medical Care and Research.Rosalind J. McDougall - 2020 - Journal of Medical Ethics 46 (6):351-352.
    The articles in this issue explore a number of difficult choices in medical care and research. They investigate ethical complexity in a range of decisions faced by policymakers and clinicians, and offer new evidence or normative approaches for navigating this complexity. In this issue’s feature article, Ford and colleagues engage with an ethical challenge faced by policymakers in relation to health research: should free text data contained in medical records be shared for research purposes?1 While some types of data from (...)
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  44.  2
    Too Much Safety? Safeguards and Equal Access in the Context of Voluntary Assisted Dying Legislation.Rosalind McDougall & Bridget Pratt - 2020 - BMC Medical Ethics 21 (1):1-10.
    BackgroundIn June 2019, the Australian state of Victoria joined the growing number of jurisdictions around the world to have legalised some form of voluntary assisted dying. A discourse of safety was prominent during the implementation of the Victorian legislation.Main textIn this paper, we analyse the ethical relationship between legislative “safeguards” and equal access. Drawing primarily on Ruger’s model of equal access to health care services, we analyse the Victorian approach to voluntary assisted dying in terms of four dimensions: horizontal equity, (...)
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  45.  8
    Do We Need Ethical Theory to Achieve Quality Critical Engagement in Clinical Ethics?Ainsley J. Newson & Rosalind McDougall - 2016 - American Journal of Bioethics 16 (9):43-45.