Residents' rights and nurses' ethics in the Australian nursing home

Background: This article is derived from a more extensive review of literature for a qualitative study that explored the meaning of truth-telling within the care provider-aged resident dyad in high-level (nursing home) aged care. Aim: This paper describes through the literature, work practices and the culture of the nursing home as promoting instrumental care, therefore prioritizing doing-for over being-with. The nursing home, starved of time and staff, silences and isolates the aged care resident in an environment that is, arguably, rarely homelike. Conclusion: The appraisal of the nursing home offered here means that a number of residents' rights are at risk and care providers (notably registered nurses and the personal care assistants) risk contravening the Code of Ethics for Nurses in Australia.

The ethics of germ line gene manipulation - A five dimensional debate

Contributors to the debate surrounding the ethics of germ line gene manipulation have by and large concentrated their efforts on discussions of the potential risks that are associated with the use of this technology. Many international advisory committees have ruled out the acceptability of germ line gene manipulation at least for the time being. The purpose of this work is to generate much needed discussion on the many other ethical issues concerning the implementation of not only germ line gene manipulation but also other related biotechnologies. In this paper I systematically investigate and analyse the most salient issues put forward by proponents and opponents alike. I argue that if germ line manipulation proves to be a safe and effective procedure, then the principle of beneficence imposes on the medical profession a moral duty to pursue the technology.

Eating ethically: Emmanuel Levinas and Simone Weil (Exploring the ethical realms of anorexia and so-called states of grace)

Emmanuel Levinas's work on the ethical responsibility of the face-to-face relation offers an illuminating context or clearing within which we might better appreciate the work of Simone Weil. Levinas's subjectivity of the hostage, the one who is responsible for the other before being responsible for the self, provides us with a way of re-encountering the categories of gravity and grace invoked in Weil's original account. In this paper I explore the terrain between these thinkers by raising the question of eating as, in part, an ethical act. Weil's conception of grace refers to the state of decreation in which the utter humility of the self moves toward a kind of disintegration and weightlessness. this weightlessness, which Weil contrasts to the gravity of terrestrial weight, might be thought of in terms of the subject's fundamental responsibility for the other, especially in terms of the injunction Thou shalt neither kill nor take the food of thy neighbour. Taking the place of the other, taking the food from the mouth of the other, is the ethical dilemma facing the subject as hostage and an elaboration of this situation may provide us with steps toward a radical questioning of anorexia as - at least in part - an ethical rather than purely medical condition.

Public policy and the prevention of substance-use disorders

Drug prevention has traditionally focused on influencing individual attitudes and behaviours. In particular, efforts have been directed towards adolescents in the school setting. However, evaluations of school-based drug education have identified limited success. There is increasing recognition that drug abuse is one of a number of risk behaviours, including truancy, delinquency and mental health problems, which share common antecedents that begin in the early years of childhood. Furthermore, these behaviours are shaped by macroenvironmental influences including the economic, social, cultural, and physical environment. Drug prevention needs to adopt a broader perspective: with greater collaboration in related programmes such as crime prevention and suicide prevention; with greater attention to the macroenvironmental influences on problem behaviours; and with greater attention to healthy development in the first years of childhood. (C) 2002 Lippincott Williams Wilkins.

Laws of nature and laws of ecology

We address the question of whether there are laws in ecology. Although there has been a great deal of recent interest in this topic, much of the relevant debate has been conducted under some common misconceptions about what laws of nature are. Once these misconceptions are cleared up, the case for ecology having laws is much stronger. Indeed, we suggest that the case for laws in ecology is no better or worse than the case for laws in physics.

Blowing the virtue-ethics whistle: Response to Faunce

The author elaborates some issues raised in the theoretical basis of whistleblowing put forward by Faunce. The author considers the relationship between bioethics teaching and professional behaviour and the role of principlism in teaching bioethics and medical ethics.

Assisted reproductive technologies and equity of access issues

In Australia and other countries, certain groups of women have traditionally been denied access to assisted reproductive technologies (ARTs). These typically are single heterosexual women, lesbians, poor women, and those whose ability to rear children is questioned, particularly women with certain disabilities or who are older. The arguments used to justify selection of women for ARTs are most often based on issues such as scarcity of resources, and absence of infertility ( in lesbians and single women), or on social concerns: that it goes against nature''; particular women might not make good mothers; unconventional families are not socially acceptable; or that children of older mothers might be orphaned at an early age. The social, medical, legal, and ethical reasoning that has traditionally promoted this lack of equity in access to ARTs, and whether the criteria used for client deselection are ethically appropriate in any particular case, are explored by this review. In addition, the issues of distribution and just gatekeeping'' practices associated with these sensitive medical services are examined.