Declaration of Helsinki turns 60 – how this foundational document of medical ethics has stood the test of time; The Conversation, October 24, 2024

Dominic Wilkinson, Consultant Neonatologist and Professor of Ethics, University of Oxford , The Conversation; Declaration of Helsinki turns 60 – how this foundational document of medical ethics has stood the test of time

"If you’re not familiar with the declaration – adopted by the World Medical Association on October 19 1964 – here is an explainer on this highly influential document: how it emerged, how it evolved and where it may be heading.

What is the declaration of Helsinki?

The World Medical Association was set up in the late 1940s in response to atrocities committed in the name of medical research during the second world war. It was focused on promoting and safeguarding medical ethics and human rights. 

Agreed at a meeting in Finland in 1964, the first version of the declaration included principles that have become the cornerstone of global research ethics. These include the importance of carefully assessing the risks and benefits of research projects, and seeking informed consent from those taking part in research."

The Nuremberg Code isn’t just for prosecuting Nazis − its principles have shaped medical ethics to this day; The Conversation, August 29, 2024

 George J Annas, Director of the Center for Health Law, Ethics & Human Rights, Boston University, The Conversation; The Nuremberg Code isn’t just for prosecuting Nazis − its principles have shaped medical ethics to this day

"I remain a strong supporter of the Nuremberg Code and believe that following its precepts is both an ethical and a legal obligation of physician researchers. Yet the public can’t expect Nuremberg to protect it against all types of scientific research or weapons development. 

Soon after the U.S. dropped atomic bombs over Hiroshima and Nagasaki – two years before the Nuremberg trials began – it became evident that our species was capable of destroying ourselves. 

Nuclear weapons are only one example. Most recently, international debate has focused on new potential pandemics, but also on “gain-of-function” research, which sometimes adds lethality to an existing bacteria or virus to make it more dangerous. The goal is not to harm humans but rather to try to develop a protective countermeasure. The danger, of course, is that a super harmful agent “escapes” from the laboratory before such a countermeasure can be developed.

I agree with the critics who argue that at least some gain-of-function research is so dangerous to our species that it should be outlawed altogether. Innovations in artificial intelligence and climate engineering could also pose lethal dangers to all humans, not just some humans. Our next question is who gets to decide whether species-endangering research should be done, and on what basis?"

Leaving Your Legacy Via Death Bots? Ethicist Shares Concerns; Medscape, August 21, 2024

Arthur L. Caplan, PhD, Medscape ; Leaving Your Legacy Via Death Bots? Ethicist Shares Concerns

"On the other hand, there are clearly many ethical issues about creating an artificial version of yourself. One obvious issue is how accurate this AI version of you will be if the death bot can create information that sounds like you, but really isn't what you would have said, despite the effort to glean it from recordings and past information about you. Is it all right if people wander from the truth in trying to interact with someone who's died? 

There are other ways to leave memories behind. You certainly can record messages so that you can control the content. Many people video themselves and so on. There are obviously people who would say that they have a diary or have written information they can leave behind. 

Is there a place in terms of accuracy for a kind of artificial version of ourselves to go on forever? Another interesting issue is who controls that. Can you add to it after your death? Can information be shared about you with third parties who don't sign up for the service? Maybe the police take an interest in how you died. You can imagine many scenarios where questions might come up about wanting to access these data that the artificial agent is providing. 

Some people might say that it's just not the way to grieve.Maybe the best way to grieve is to accept death and not try to interact with a constructed version of yourself once you've passed. That isn't really accepting death. It's a form, perhaps, of denial of death, and maybe that isn't going to be good for the mental health of survivors who really have not come to terms with the fact that someone has passed on."

Medical Residents Are in an Uproar Over the 'Ethics' of The Last of Us Finale; Time, March 15, 2023

LAURA ZORNOSA, Time ; Medical Residents Are in an Uproar Over the 'Ethics' of The Last of Us Finale

[Spoilers in linked article]

"“What TLOU story wants you to do is a great deal of suspension of disbelief for quite a lot of your medical/ethical knowledge,” they continued. “This is simply because it wasn’t written for people like us who have a great deal of this knowledge.”"

Two New York nurses charged with forging Covid vaccine cards to earn more than $1.5 million; CNBC, January 29, 2022

Jessica Bursztynsky, CNBC ; Two New York nurses charged with forging Covid vaccine cards to earn more than $1.5 million

"Two nurses on New York’s Long Island are being charged with forging Covid-19 vaccination cards and entering the fake jabs in the state’s database, a scam that allegedly raked in more than $1.5 million."

Pig heart transplants: ethics, regulations and why we shouldn't expect to see them in Australia soon; ABC Science News, January 21, 2022

Belinda Smith, ABC Science News; Pig heart transplants: ethics, regulations and why we shouldn't expect to see them in Australia soon

"So what are some of these ethical quandaries around the practice of transplanting organs and tissues between species — a technique called xenotransplantation — and can we expect to see pig hearts in chests in Australia soon?"

The top 10 most-read medical ethics articles in 2021; American Medical Association (AMA), December 29, 2021

 

Kevin B. O'Reilly ,  American Medical Association (AMA); The top 10 most-read medical ethics articles in 2021

"Each month, the AMA Journal of Ethics^® (@JournalofEthics) gathers insights from physicians and other experts to explore issues in medical ethics that are highly relevant to doctors in practice and the future physicians now in medical schools, as well as the other health professionals who constitute the health care team.

Below, find the 10 most popular AMA Journal of Ethics articles published this year."

Privacy laws need updating after Google deal with HCA Healthcare, medical ethics professor says; CNBC, May 26, 2021

Emily DeCiccio, CNBC; Privacy laws need updating after Google deal with HCA Healthcare, medical ethics professor says

"Privacy laws in the U.S. need to be updated, especially after Google struck a deal with a major hospital chain, medical ethics expert Arthur Kaplan said Wednesday.

“Now we’ve got electronic medical records, huge volumes of data, and this is like asking a navigation system from a World War I airplane to navigate us up to the space shuttle,” Kaplan, a professor at New York University’s Grossman School of Medicine, told “The News with Shepard Smith.” “We’ve got to update our privacy protection and our informed consent requirements.”

On Wednesday, Google’s cloud unit and hospital chain HCA Healthcare announced a deal that — according to The Wall Street Journal — gives Google access to patient records. The tech giant said it will use that to make algorithms to monitor patients and help doctors make better decisions."

Pandemic serves up new questions of medical right and wrong; American Medical Association, April 13, 2020

Timothy M. Smith, American Medical Association; Pandemic serves up new questions of medical right and wrong

"The COVID-19 pandemic is posing unfamiliar challenges for front-line physicians while also casting new light on longstanding health equity issues. An episode of the “AMA COVID-19 Update” explores several underlying ethical questions. Among these: How much risk is too much for physicians? Which patients should get priority access to scarce resources? And how do socioeconomic factors affect quality of care in an emergency?

In a conversation with the AMA’s chief experience officer, Todd Unger, three experts from the AMA delved into relevant ethical guidance.

The AMA and the Centers for Disease Control and Prevention are closely monitoring the COVID-19 global pandemic. Learn more at the  AMA COVID-19 resource center. Also check out pandemic resources available from the AMA Code of Medical Ethics, JAMA Network™, AMA Journal of Ethics®, and consult the  AMA’s physician guide to COVID-19."

Circumcision, patient trackers and torture: my job in medical ethics; The Guardian, April 8, 2019

Julian Sheather, The Guardian; Circumcision, patient trackers and torture: my job in medical ethics

"Monday

Modern healthcare is full of ethical problems. Some are intensely practical, such as whether we can withdraw a feeding tube from a patient in a vegetative state who could go on living for many years, or whether a GP should give a police officer access to patient records following a local rape. 

Others are more speculative and future-oriented: will robots become carers, and would that be a bad thing? And then there are the political questions, like whether the Home Office should have access to patient records. My job is to advise the British Medical Association on how we navigate these issues and make sure the theory works in practice for patients and healthcare professionals."

Rethinking Medical Ethics; Forbes, February 11, 2019

FORBES INSIGHTS With Intel AI , Forbes; Rethinking Medical Ethics

"Even so, the technology raises some knotty ethical questions. What happens when an AI system makes the wrong decision—and who is responsible if it does? How can clinicians verify, or even understand, what comes out of an AI “black box”? How do they make sure AI systems avoid bias and protect patient privacy?

In June 2018, the American Medical Association (AMA) issued its first guidelines for how to develop, use and regulate AI. (Notably, the association refers to AI as “augmented intelligence,” reflecting its belief that AI will enhance, not replace, the work of physicians.) Among its recommendations, the AMA says, AI tools should be designed to identify and address bias and avoid creating or exacerbating disparities in the treatment of vulnerable populations. Tools, it adds, should be transparent and protect patient privacy.

None of those recommendations will be easy to satisfy. Here is how medical practitioners, researchers, and medical ethicists are approaching some of the most pressing ethical challenges."

Medicine and ethics: Will we learn to take research scandals seriously?; Star Tribune, October 29, 2018

Carl Elliott, Star Tribune; Medicine and ethics: Will we learn to take research scandals seriously?

"“The Experiments” is a cautionary tale of how the refusal of institutional leaders to look honestly at ethical problems can lead to the deaths of unsuspecting patients. And while the jury is still out as to whether the Karolinska Institute will reform itself, at least the Swedish public and concerned politicians are trying to hold the institution accountable. 

That is more than we can claim for Minnesota. As they say in the rehabilitation units: The first step to recovery is admitting you have a problem."

The U.S. government recruited black men to watch them die; The Washington Post, July 3, 2018

[Podcast]  Retropod, The Washington Post; The U.S. government recruited black men to watch them die 

"The Tuskegee syphilis experiment is a horrific piece of American history."

A Failed Trial in Africa Raises Questions About How to Test H.I.V. Drugs; New York Times, 2/4/15

Donald G. McNeil Jr., New York Times; A Failed Trial in Africa Raises Questions About How to Test H.I.V. Drugs:

"The surprising failure of a large clinical trial of H.I.V.-prevention methods in Africa — and the elaborate deceptions employed by the women in it — have opened an ethical debate about how to run such studies in poor countries and have already changed the design of some that are now underway."

Medical Ethics Have Been Violated at Detention Sites, a New Report Says; New York Times, 11/4/13

Denise Grady and Benedict Carey, New York Times; Medical Ethics Have Been Violated at Detention Sites, a New Report Says: "A group of experts in medicine, law and ethics has issued a blistering report that accuses the United States government of directing doctors, nurses and psychologists, among others, to ignore their professional codes of ethics and participate in the abuse of detainees in Afghanistan, Iraq and Guantánamo Bay, Cuba. The report was published Monday by the Institute on Medicine as a Profession, an ethics group based at Columbia University’s College of Physicians and Surgeons, and the Open Society Foundations, a pro-democracy network founded by the billionaire George Soros. The authors were part of a 19-member task force that based its findings on a two-year review of public information. The sources included documents released by the government, news reports, and books and articles from professional journals."

'Conditioned on' kidney donation, sisters' prison release prompts ethics debate; Washington Post, 12/30/10

Krissah Thompson, Washington Post; 'Conditioned on' kidney donation, sisters' prison release prompts ethics debate:

"Mississippi Gov. Haley Barbour's decision to commute the prison sentences of two sisters drew wide attention in part because their cause has been embraced by civil rights activists. But an unusual aspect of the arrangement is also drawing scrutiny: Barbour said his action was "conditioned on" one sister donating a kidney to the other."