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[PMID]: 28536727 [Au] Autor: Lederman Z [Ad] Endereço: Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. [Ti] Título: Comment on: What to do during inflight medical emergencies? Practice pointers from a medical ethicist and an aviation medicine specialist. [So] Source: Singapore Med J;58(5):282, 2017 05. [Is] ISSN: 0037-5675 [Cp] País de publicação: Singapore [La] Idioma: eng [Mh] Termos MeSH primário: Medicina Aeroespacial Eticistas [Mh] Termos MeSH secundário: Aviação Emergências Seres Humanos [Pt] Tipo de publicação: LETTER; COMMENT [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170830 [Lr] Data última revisão: 170830 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170525 [St] Status: MEDLINE [do] DOI: 10.11622/smedj.2017041

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[PMID]: 28417516 [Au] Autor: Finder SG; Bartlett VL [Ti] Título: Discovering What Matters: Interrogating Clinician Responses to Ethics Consultation. [So] Source: Bioethics;31(4):267-276, 2017 May. [Is] ISSN: 1467-8519 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Against the background assumptions that (a) knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and (b) the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service. These evaluations were collected through a quality assessment effort at our institution. Drawing from the qualitative elements of our survey instrument, we describe unexpected variations among the requests for ethics consultation and the retrospective reports from those colleagues making the requests. Focusing on just one aspect - the reason for request - raised several core questions about how we should evaluate those retrospective reports, what could be learned from the differences that we were now encountering, and what we could learn about the process of evaluating our practices. Working through these questions, we suggest several issues to consider in ongoing efforts to describe and evaluate clinical ethics consultation: the role of time and memory in evaluating retrospective evaluations, the importance of attending to the language of moral shift or disruption with which our colleagues describe their experiences, and how to understand the role of ethics consultation in creating 'moral space' (a la Margaret Urban Walker's conception) for colleagues to process their moral experiences. [Mh] Termos MeSH primário: Atitude do Pessoal de Saúde Análise Ética Consultoria Ética Ética Médica Estudos de Avaliação como Assunto Motivação Resolução de Problemas [Mh] Termos MeSH secundário: Eticistas Ética Clínica Seres Humanos Linguagem Memória Princípios Morais Avaliação de Programas e Projetos de Saúde Estudos Retrospectivos Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170913 [Lr] Data última revisão: 170913 [Sb] Subgrupo de revista: E; IM [Da] Data de entrada para processamento: 170419 [St] Status: MEDLINE [do] DOI: 10.1111/bioe.12345

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[PMID]: 28361722 [Au] Autor: Arnason G [Ti] Título: Synthetic Biology between Self-Regulation and Public Discourse: Ethical Issues and the Many Roles of the Ethicist. [So] Source: Camb Q Healthc Ethics;26(2):246-256, 2017 Apr. [Is] ISSN: 1469-2147 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: This article discusses the roles of ethicists in the governance of synthetic biology. I am particularly concerned with the idea of self-regulation of bioscience and its relationship to public discourse about ethical issues in bioscience. I will look at the role of philosophical ethicists at different levels and loci, from the "embedded ethicist" in the laboratory or research project, to ethicists' impact on policy and public discourse. In a democratic society, the development of governance frameworks for emerging technologies, such as synthetic biology, needs to be guided by a well-informed public discourse. In the case of synthetic biology, the public discourse has to go further than merely considering technical issues of biosafety and biosecurity, or risk management, to consider more philosophical issues concerning the meaning and value of "life" between the natural and the synthetic. I argue that ethicists have moral expertise to bring to the public arena, which consists not only in guiding the debate but also in evaluating arguments and moral positions and making normative judgments. When ethicists make normative claims or moral judgments, they must be transparent about their theoretical positions and basic moral standpoints. [Mh] Termos MeSH primário: Análise Ética Eticistas Biologia Sintética/ética [Mh] Termos MeSH secundário: Comitês Consultivos Seres Humanos Princípios Morais Filosofia Biologia Sintética/legislação & jurisprudência Biologia Sintética/tendências [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171109 [Lr] Data última revisão: 171109 [Sb] Subgrupo de revista: E; IM [Da] Data de entrada para processamento: 170401 [St] Status: MEDLINE [do] DOI: 10.1017/S0963180116000840

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[PMID]: 28361720 [Au] Autor: Holm S [Ti] Título: The Bioethicist Who Cried "Synthetic Biology": An Analysis of the Function of Bioterrorism Predictions in Bioethics. [So] Source: Camb Q Healthc Ethics;26(2):230-238, 2017 Apr. [Is] ISSN: 1469-2147 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: This article analyzes a specter that has haunted bioethics almost since its inception, namely the specter of the misuse of biotechnology by maleficent agents bent on mass destruction, or the complete eradication of human kind and life as we know it. The article provides a general account of why bioethicists cry "catastrophic bioterrorism potential" when new biotechnologies emerge, and an analysis of the arguments that flow from the prediction, especially in relation to synthetic biology. [Mh] Termos MeSH primário: Temas Bioéticos Biotecnologia/ética Bioterrorismo Eticistas Biologia Sintética/ética [Mh] Termos MeSH secundário: Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171109 [Lr] Data última revisão: 171109 [Sb] Subgrupo de revista: E; IM [Da] Data de entrada para processamento: 170401 [St] Status: MEDLINE [do] DOI: 10.1017/S0963180116000827

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[PMID]: 28275086 [Au] Autor: Graf WD; Miller G; Epstein LG; Rapin I [Ad] Endereço: From the Department of Pediatrics (W.D.G.), Division of Neurology, Connecticut Children's Medical Center and the University of Connecticut, Farmington; Department of Pediatrics (G.M.), Yale University School of Medicine, New Haven, CT; Department of Pediatrics (L.G.E.), Northwestern University's Fei [Ti] Título: The autism "epidemic": Ethical, legal, and social issues in a developmental spectrum disorder. [So] Source: Neurology;88(14):1371-1380, 2017 Apr 04. [Is] ISSN: 1526-632X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Classic autism has gradually evolved into the concept of a larger "spectrum disorder." The rising prevalence of autism and autism spectrum disorder (autism/ASD) diagnoses can be largely attributed to broader diagnostic criteria, adoption of dimensional assessment strategies, increased awareness, linking of services to diagnosis, and the inclusion of milder neurodevelopmental differences bordering on normality. The spectrum disorder diagnosis raises numerous bioethical issues for individuals and society. Three groups of caregivers have important ethical, legal, and social obligations to individuals with autism/ASD: (1) families and advocates of individuals with autism/ASD; (2) health care and other professionals; and (3) governments. Each group may have different views of autism/ASD diagnostic criteria, screening, testing, and the effectiveness of various interventions. All see timely diagnosis as desirable, but earlier diagnosis may not be better, morally or practically. The growing practice of genetic testing in milder ASD raises ethical questions because of its uncertain scientific validity and limited clinical utility. Individuals with autism/ASD have various kinds of needs but all want acceptance and most deserve better accommodations. Governments struggle to provide a fair allocation of appropriate special education and supportive services. This article examines the evolving dimensions of the autism/ASD diagnosis, outlines certain bioethics principles related to its evaluation and management, reviews relevant laws and disability rights, and emphasizes the societal obligation to recognize neurodevelopmental variation and human neurodiversity. Future directions in the evaluation and care of autism/ASD should attempt to integrate the roles and responsibilities of all agents caring for each unique autistic individual. [Mh] Termos MeSH primário: Transtorno do Espectro Autista Deficiências do Desenvolvimento Eticistas Comportamento Social [Mh] Termos MeSH secundário: Transtorno do Espectro Autista/epidemiologia Transtorno do Espectro Autista/psicologia Deficiências do Desenvolvimento/epidemiologia Deficiências do Desenvolvimento/psicologia Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170523 [Lr] Data última revisão: 170523 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170310 [St] Status: MEDLINE [do] DOI: 10.1212/WNL.0000000000003791

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[PMID]: 28122027 [Au] Autor: Dubé K; Taylor J; Sylla L; Evans D; Dee L; Burton A; Willenberg L; Rennie S; Skinner A; Tucker JD; Weiner BJ; Greene SB [Ad] Endereço: University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, United States of America. [Ti] Título: 'Well, It's the Risk of the Unknown… Right?': A Qualitative Study of Perceived Risks and Benefits of HIV Cure Research in the United States. [So] Source: PLoS One;12(1):e0170112, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Biomedical research towards an HIV cure is advancing in the United States and elsewhere, yet little is known about perceptions of risks and benefits among potential study participants and other stakeholders. We conducted a qualitative study to explore perceived risks and benefits of investigational HIV cure research among people living with HIV (PLWHIV), biomedical HIV cure researchers, policy-makers and bioethicists. METHODS: We conducted a qualitative research study using in-depth interviews with a purposive sample of PLWHIV, biomedical HIV cure researchers, policy-makers and bioethicists in 2015-2016. We analysed interview transcripts using thematic analysis anchored in grounded theory. RESULTS: We conducted and analyzed 36 key informant interviews. Qualitative analysis revealed four main findings. 1) Potential HIV cure study volunteers noted needing more information and education about the potential risks of HIV cure research. 2) Biomedical HIV cure researchers, policy-makers and bioethicists showed less awareness of social and financial risks of HIV cure research than PLWHIV. 3) Most respondents across the different categories of informants identified some risks that were too great to be acceptable in HIV cure research, although a subset of PLWHIV did not place an upper limit on acceptable risk. 4) PLWHIV showed a better awareness of potential psychological benefits of participating in HIV cure research than other groups of stakeholders. CONCLUSION: Our research suggests that PLWHIV have a variable understanding of the individual risks, sometimes substantial, associated with participating in biomedical HIV cure research studies. Community engagement and increased research literacy may help improve community understanding. Intensive informed consent procedures will be necessary for ethical study implementation. The current state of HIV cure research offers greater potential benefits to society than to participants. There is likely to be disagreement among regulators, researchers, clinicians, and potential participants about what constitutes acceptable risk for HIV cure studies. [Mh] Termos MeSH primário: Pessoal Administrativo/psicologia Atitude Frente à Saúde Eticistas/psicologia Infecções por HIV/psicologia Pacientes/psicologia Pesquisadores/psicologia [Mh] Termos MeSH secundário: Adulto Fármacos Anti-HIV Ensaios Clínicos como Assunto/psicologia Tratamento Farmacológico/psicologia Feminino Terapia Genética/psicologia Infecções por HIV/tratamento farmacológico Infecções por HIV/terapia Seres Humanos Entrevistas como Assunto Masculino Meia-Idade Pesquisa Qualitativa Pesquisa Medição de Risco Transplante de Células-Tronco/psicologia Estados Unidos Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anti-HIV Agents) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170818 [Lr] Data última revisão: 170818 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170126 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0170112

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[PMID]: 28064252 [Au] Autor: McCullough LB [Ad] Endereço: Weil Medical College of Cornell University, New York, New York, USA Laurence.McCullough@bcm.edu. [Ti] Título: Philosophical Provocation: The Lifeblood of Clinical Ethics. [So] Source: J Med Philos;42(1):1-6, 2017 Feb. [Is] ISSN: 1744-5019 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation. The papers in this clinical ethics issue of the Journal of Medicine and Philosophy provide just such philosophical provocation related to core topics in clinical ethics: the distinction between clinical practice and clinical research; telemedicine, or medicine at a distance; illness narratives; the concept of the placebo effect; and sex reassignment. [Mh] Termos MeSH primário: Eticistas Ética Clínica Filosofia Médica [Mh] Termos MeSH secundário: Pesquisa Biomédica/ética Seres Humanos Procedimentos de Readequação Sexual/ética Telemedicina/ética [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170906 [Lr] Data última revisão: 170906 [Sb] Subgrupo de revista: E; IM [Da] Data de entrada para processamento: 170109 [St] Status: MEDLINE [do] DOI: 10.1093/jmp/jhw034

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[PMID]: 28042147 [Au] Autor: Vallée B [Ad] Endereço: DMV, 455, rue Lacroix, Nicolet (Québec), J3T 1K4, e-mail : bernard.vallee@sogetel.net. [Ti] Título: Emergency care after-hours - Comments on an ethicist's remarks. [So] Source: Can Vet J;58(1):9, 2017 Jan. [Is] ISSN: 0008-5286 [Cp] País de publicação: Canada [La] Idioma: eng [Mh] Termos MeSH primário: Serviços Médicos de Emergência Eticistas [Mh] Termos MeSH secundário: Animais [Pt] Tipo de publicação: JOURNAL ARTICLE; COMMENT [Em] Mês de entrada: 1702 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170103 [St] Status: MEDLINE

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[PMID]: 27708321 [Au] Autor: Ledford H [Ti] Título: UK bioethicists eye designer babies and CRISPR cows. [So] Source: Nature;538(7623):17, 2016 10 06. [Is] ISSN: 1476-4687 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas Eticistas [Mh] Termos MeSH secundário: Animais Sistemas CRISPR-Cas Bovinos Feminino [Pt] Tipo de publicação: NEWS; COMMENT [Em] Mês de entrada: 1611 [Cu] Atualização por classe: 170220 [Lr] Data última revisão: 170220 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161007 [St] Status: MEDLINE [do] DOI: 10.1038/nature.2016.20713

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[PMID]: 27477378 [Au] Autor: Clark-Grill M [Ad] Endereço: Correspondence to: Dr Monika Clark-Grill Department of Primary Health Care and General Practice, Wellington, University of Otago, 45 Melville Street, Dunedin 9016, New Zealand. Email: monika.clark-grill@otago.ac.nz. [Ti] Título: Ethics support for GPs: what should it look like? [So] Source: J Prim Health Care;8(1):75-81, 2016 Mar. [Is] ISSN: 1172-6156 [Cp] País de publicação: Australia [La] Idioma: eng [Ab] Resumo: INTRODUCTION Ethics support services for hospital clinicians have become increasingly common globally but not as yet in New Zealand. However, an initiative to change this is gathering momentum. Its slogan 'Clinical ethics is everyone's business' indicates that the aim is to encompass all of health care, not just the hospital sector. General Practitioners (GPs) deal with ethical issues on a daily basis. These issues are often quite different from ethical issues in hospitals. To make future ethics support relevant for primary care, local GPs were interviewed to find out how they might envisage ethics support services that could be useful to them. METHODS A focus group interview with six GPs and semi-structured individual interviews with three GPs were conducted. Questions included how they made decisions on ethical issues at present, what they perceived as obstacles to ethical reflection and decision-making, and what support might be helpful. FINDINGS Three areas of ethics support were considered potentially useful: Formal ethics education during GP training, access to an ethicist for assistance with analysing an ethical issue, and professional guidance with structured ethics conversations in peer groups. CONCLUSION The complex nature of general practice requires GPs to be well educated and supported for handling ethical issues. The findings from this study could serve as input to the development of ethics support services. KEYWORDS General practice; primary care; ethics; support; education. [Mh] Termos MeSH primário: Atitude do Pessoal de Saúde Medicina Geral/ética Clínicos Gerais/ética Clínicos Gerais/psicologia Apoio Social [Mh] Termos MeSH secundário: Adulto Idoso Eticistas Feminino Grupos Focais Clínicos Gerais/educação Seres Humanos Julgamento/ética Masculino Meia-Idade Nova Zelândia Grupo Associado Papel do Médico Atenção Primária à Saúde/ética Fatores de Tempo [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170713 [Lr] Data última revisão: 170713 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160802 [St] Status: MEDLINE [do] DOI: 10.1071/HC14999

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