Access to death certificates: What should research ethics committees require for approval?

PURPOSE: To present and discuss the reactions of research ethics committees (RECs) in a number of countries when asked for approval Of a study requiring access to death certificates to identify the physicians signing the certificates and to send them a four-page questionnaire about medical decisions made at the patient's end-of-life that could possibly have hastened death. METHODS: A simple questionnaire were sent to the responsible national investigator in an international study (Australia, Belgium, Denmark, Italy, the Netherlands, Sweden, Switzerland) asking about the interactions between the national research group and the national/regional REC(s). RESULTS: Different laws or guidelines were used by the RECs. Denmark, the Netherlands, and Switzerland did not require an application to a REC. In Australia and Sweden, the RECs wanted changes in the research protocol, and one national research group had to refrain from publishing its results because the attrition rate became too high, probably due to the required changes in the protocol. RECOMMENDATIONS: Generally, similar demands from all RECs in relation to one project are strongly desirable. In epidemiological research, in which Voluntary completion of an anonymous questionnaire demonstrates consent, additional prior informed consent about being approached should not be required.

No pain, no gain? Torture and ethics in the war on terror

Is the use of torture ever justified? This article argues that torture cannot be justified, even in so called ticking bomb cases, but that in such extreme situations it may be necessary. In those situations, judgements about whether the use of torture is legitimate must balance the imminence and gravity of the threat with the need to prevent future occurrences of torture and maintain a normative environment that is hostile to its use. The article begins by observing that the use of torture and/or cruel and degrading treatment has become a core component of the global war on terror. It tests the claim that the use of coercive interrogation techniques does not constitute torture, showing that similar arguments were levelled by both the British and French governments in relation to Northern Ireland and Algeria respectively and found wanting. It then evaluates and rejects Dershowitz's claim for the legalization of torture and the more limited claim that torture may be permissible in ticking bomb scenarios. In the final section, the article questions how we might maintain the prohibition on torture while acknowledging that it may be necessary in some hypothetical cases.

The ethics of paying drug users who participate in research: a review and practical recommendations

THE PAYMENT OF RESEARCH PARTICIPANTS raises ethical and empirical questions that have special importance in addictions research involving drug-dependent participants. Despite a now large literature on human subjects payment, what is still needed is practical guidance for investigators and ethics committees. This paper reviews the literature on: current payment practices and guidelines; defining features of undue and due incentives and fair reimbursement; and the significance of risks and harms that may arise from paying drug using participants. We conclude that research payments are ethically acceptable in most circumstances of addictions research, but should be closely scrutinized in situations where these may exacerbate existing harms or create additional risks for participants and investigators. General principles, key questions and procedural options are highlighted for an applied approach to ethical research payments. Future research directions are identified.

Teaching economic philosophy: Economics, ethics and the search for the right maximand

Economic philosophy is not often taught, and is not necessarily easily taught. It involves enquiry into implicit assumptions within orthodox economics and within alternatives to it. It seeks to highlight why it is that some critics object that neoclassical economics is too atomistic, hedonistic, and rationalistic, or why others lament that there is much hidden metaphysics in Friedman and his Chicago School colleagues. It addresses the issue of whether - in a reversal of the view that economics is the imperialistic social science - significant philosophical assumptions have been silently but inescapably imported into orthodox economics. This paper seeks to facilitate the presentation of such material with illustrations selected from social economics, development economics, and critiques of utilitarianism.

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.