Clinical Research and Statistics from an Ethical Point of View

1983 ◽  
pp. 388-397
Author(s):  
G. Csomós ◽  
B. Schneider
Keyword(s):  
Clinical Research ◽  
Point Of View ◽  
Ethical Point

Medical care or clinical research on humans? Contaminated anti-D immunoglobulin in the GDR and its consequences

2020 ◽  
Vol 58 (02) ◽  
pp. 127-132
Author(s):  
Maximilian Schochow ◽  
Florian Steger
Keyword(s):  
Hepatitis C ◽  
Clinical Research ◽  
Medical Care ◽  
Point Of View ◽  
Medical Attention ◽  
Sufficient Information ◽  
Historical Sources ◽  
Ethical Point ◽  
Disease Diagnostics ◽  
Liver Biopsies

Abstract Background In 1978 and 1979, contaminated anti-D immunoglobulin was used in the German Democratic Republic (GDR). As a result, several thousand women were, in the end, infected with hepatitis C. These women received medical attention, part of which was research on hepatitis C. Up to now, results of the research and data are being published in international journals. It remains unclear whether the affected women were asked to be subjects of the clinical research. Methods The authors analyzed historical sources and conducted interviews with contemporary witnesses. Results In the GDR, these women were compulsorily treated by physicians without sufficient information about the disease, diagnostics, and therapy. If the women refused medical care, they were coerced into it by the physicians. Medical care and research were inseparable. Without the knowledge of the women and without their consent, research was carried out on the blood samples and liver biopsies acquired from them.After the German reunification, the same physicians continued to conduct research on the same group of patients. Beginning in 1990, interferon therapy was offered to the women. Parallel to the medication with interferon, studies on the effects of the therapy were carried out. In this case as well, the women were not informed about the use of collected data, nor did they agree to it. Conclusions Physicians should clearly define the border between medical care and scientific interest. Exclusively, data obtained from studies performed correctly under ethical point of view should be accepted for publication.

The ethics of pandemic preparedness revisited - autonomy, quarantine, transferability and trust

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Schröder-Bäck ◽  
T Schloemer ◽  
K Martakis ◽  
C Brall
Keyword(s):  
Crisis Management ◽  
Ethical Issues ◽  
Lessons Learned ◽  
Point Of View ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Ethical Aspects ◽  
Outbreak Management ◽  
Ethics Framework ◽  
Ethical Point

Abstract Background The outbreak of SARS in 2002 lead to a public health ethics discourse. The crisis management of that time was ethically analysed and lessons to be learned discussed. Scholarship and WHO, among others, developed an ethics of pandemic preparedness. The current “corona crisis” also faces us with ethical challenges. This presentation is comparing the two crises from an ethical point of view and a focus on Europe. Methods An ethics framework for pandemic preparedness (Schröder et al. 2006 and Schröder-Bäck 2014) is used to make a synopsis of ethical issues. Ethical aspects of 2002 and 2020 that were discussed in the literature and in the media are compared. For 2020, the focus is on interventions in Italy, Germany, Switzerland, and the Netherlands. Results Topics that emerged from the 2002 crisis were, among others, revolving around aspects of stigmatisation and fair distribution of scarce resources (esp. vaccines, antivirals). Currently, most urgent and ethically challenging aspects relate to social distancing vs. autonomy: Isolation and quarantine are handled differently across Europe and the EU. Questions of transferability of such interventions prevail. Contexts vary vertically over time (2002 vs. 2020) and horizontally (e.g. between Italy and Germany at the same time). Furthermore, trust in authorities, media and health information is a key issue. Conclusions Ethical aspects are key for good pandemic preparedness and management. The context of the crises between 2002 and 2020 has slightly changed, also based on “lessons learned” from 2002. This has implications on ethical issues that are being discussed. New lessons will have to be learned from the 2020 crisis. Key messages Pandemic preparedness and outbreak management entail many ethical tensions that need to be addressed. Currently, questions of trust and transferability are key to the crisis management, further ethical issues could still emerge.

scholarly journals Psychotic symptoms in the general population – an evolutionary perspective

2010 ◽  
Vol 197 (3) ◽  
pp. 167-169 ◽  
Author(s):  
Ian Kelleher ◽  
Jack A. Jenner ◽  
Mary Cannon
Keyword(s):  
General Population ◽  
Clinical Research ◽  
Clinical Phenotype ◽  
Population Based ◽  
Point Of View ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Evolutionary Perspective ◽  
Evolutionary Context ◽  
Research Population

SummaryOur ideas about the intrinsically pathological nature of hallucinations and delusions are being challenged by findings from epidemiology, neuroimaging and clinical research. Population-based studies using both self-report and interview surveys show that the prevalence of psychotic symptoms is far greater than had been previously considered, prompting us to re-evaluate these psychotic symptoms and their meaning in an evolutionary context. This non-clinical phenotype may hold the key to understanding the persistence of psychosis in the population. From a neuroscientific point of view, detailed investigation of the non-clinical psychosis phenotype should provide novel leads for research into the aetiology, nosology and treatment of psychosis.

scholarly journals Williams on Ethics, Knowledge, and Reflection

Philosophy ◽  
2003 ◽  
Vol 78 (3) ◽  
pp. 337-354 ◽  
Author(s):  
A. W. Moore
Keyword(s):  
Moral Philosophy ◽  
Final Section ◽  
Point Of View ◽  
The Other ◽  
Ethical Knowledge ◽  
Ethical Point ◽  
The One

The author begins with an outline of Bernard William's moral philosophy, within which he locates William's notorious doctrine that reflection can destroy ethical knowledge. He then gives a partial defence of this doctrine, exploiting an analogy between ethical judgements and tensed judgements. The basic idea is that what the passage of time does for the latter, reflection can do for the former: namely, prevent the re-adoption of an abandoned point of view (an ethical point of view in the one case, a temporal point of view in the other). In the final section the author says a little about how reflection might do this.

scholarly journals Comentarios a la propuesta del Parlamento Europeo y del Consejo del certificado verde digital. Protección de datos sanitarios y análisis ético jurídico

Bioderecho.es ◽  
2021 ◽  
Author(s):  
Gloria María González Suárez
Keyword(s):  
European Union ◽  
European Commission ◽  
Health Data ◽  
Current Situation ◽  
Point Of View ◽  
Free Movement ◽  
The European Union ◽  
Legal Questions ◽  
Ethical Point ◽  
The Right

Con motivo de la situación actual a la que nos enfrentamos por la pandemia de la COVID-19 se ha planteado en diversas ocasiones la implantación de un certificado verde digital. El 17 de marzo de 2021 la Comisión Europea presentó una propuesta de creación del certificado con el fin de facilitar el ejercicio del derecho a la libre circulación dentro de la Unión Europea durante la pandemia. Todo ello plantea diversas cuestiones jurídicas en cuanto a la protección de datos sanitarios, el derecho a la libre circulación y la eficacia y proporcionalidad de medidas que deben ser objeto de análisis tanto desde el punto de vista jurídico como del punto de vista ético ya que, en ciertas ocasiones la aplicación de medidas puede afectar al derecho a la igualdad de los ciudadanos. Due to the current situation we are facing due to the COVID-19 pandemic, the implementation of a digital green certificate has been proposed on several occasions. On March 17, 2021, the European Commission presented a proposal to create the certificate in order to facilitate the exercise of the right of free movement within the European Union during the pandemic. All this raises various legal questions regarding the protection of health data, the right of free movement and the efficacy and proportionality of measures that must be analyzed from both the legal and ethical point of view since, on certain occasions the application of measures may affect the right of equality of citizens.

scholarly journals SOMEONE BETWEEN: ETHICAL AND MEDICAL PROBLEMS OF HUMAN AND (NON)HUMAN ANIMAL ENHANCEMENT

2020 ◽  
Vol 3 (3) ◽  
pp. 179-191 ◽  
Author(s):  
AGNIESZKA ŻOK ◽  
EWA BAUM
Keyword(s):  
Immune System ◽  
Side Effects ◽  
Medical Technology ◽  
Point Of View ◽  
Medical Problems ◽  
Healthy Life ◽  
Incurable Illness ◽  
Ethical Point ◽  
Human Animal ◽  
Personalised Therapy

Human dreams of a long and healthy life are becoming increasingly real. The advancement of medical technology allows to modify the genome or personalised therapy in order to avoid troublesome side effects. This process also leads to the blurring of boundaries between humans and animals. Rats with induced human diseases are used for testing drugs for incurable illness; humanised pigs can donate organs that are compatible with the genome and immune system of the recipient. A brave new human is approaching, and new “human” animals are making this possible. The main objective of the article is to show the differences between the refinement of people and other animals and to analyse this phenomenon from an ethical point of view.

scholarly journals Problemi morali nel trattamento della preeclampsia e della corioamnionite

2008 ◽  
Vol 57 (3) ◽  
Author(s):  
Maurizio P. Faggioni
Keyword(s):  
19Th Century ◽  
Double Effect ◽  
Point Of View ◽  
Alternative Solution ◽  
Ethical Point ◽  
Principle Of Double Effect ◽  
Catholic Tradition ◽  
The 19Th Century ◽  
Difficult Situations

Fra le patologie della gravidanza la corioamnionite e la preeclampsia rappresentano situazioni difficili sia dal punto di vista clinico sia dal punto di vista etico. L’articolo affronta con particolare attenzione il problema dell’anticipazione del parto prima che il feto abbia raggiunto la soglia della viabilità. Vengono esaminate le posizioni principali della Tradizione cattolica e le risposte a specifici quesiti date dal Sant’Uffizio tra la fine del XIX secolo e l’inizio del XX. L’Autore ritiene che l’applicazione del principio del duplice effetto a queste situazioni non sia del tutto convincente e propone una soluzione alternativa nella individuazione del solo bene possibile. ---------- Chorioamnionitis and preeclampsy represent difficult situations among pregnancy pathologies both from a clinical and from an ethical point of view. The article treats with particular attention the issue of induced preterm parturition before fetus has reached the threshold of viability. The main positions of the Catholic Tradition and the answers given by the Holy Office at the end of the 19th century and the beginning of the 20th are examined. The author believes that the application of the principle of double effect to such situations is non completely convincing and he proposes as an alternative solution the identification of the only possible good.

e-Health Technologies in Home Care Nursing

2011 ◽  
pp. 154-178 ◽  
Author(s):  
Hartmut Remmers ◽  
Manfred Hülsken-Giesler
Keyword(s):  
Home Care ◽  
Technical Assistance ◽  
The Elderly ◽  
Point Of View ◽  
Health Technologies ◽  
Nursing Science ◽  
Home Care Nursing ◽  
Rights Protection ◽  
Ethical Point ◽  
Identity Privacy

The innovative impact of advancing e-Health technologies is more frequently being discussed in nursing science. Nurses play an important role in collecting data and giving support to other users, especially in home care. Since issues of acceptance play a major role, the following article, which presents findings based on a focus group consisting of the elderly, caretaking relatives and professional nurses, is discussed from an ethical point of view in the context of international debate. It is interesting to note, that to some extent there is substantial ambivalence in the willingness to integrate such technologies into daily care. A need for technical assistance is clearly recognizable, however, limits as well. The authors’ findings indicate that a fundamental discussion on the relevance of e-Health methods in professional nursing needs to be held. It should address the ethical questions of often conflicting interests and rights (protection of identity, privacy and safety) in situations of high vulnerability.

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