Ethics

Media reporting about suicide may lead to increased suicidal behaviour in at-risk people, or it may operate positively and reduce the risk of suicide. But media representations of suicide are distinct from community discussions. It is time to have a much richer, more honest and more open public discussion about suicide.

Scott J Fitzpatrick BA(Hons) · Ian H Kerridge BA, MPhil, BMed

Guiding principles in the Australian Open Disclosure Framework consultation draft highlight the important roles that health service organisations can play in closing the “disclosure gap” between expected practice regarding disclosure of medical errors and what is actually being done.

Stuart R McLennan MBHL · Robert D Truog MD

Open disclosure (OD) after adverse health care events is the subject of a national standard that has been implemented in state health policy documents, and is included in the Medical Board of Australia’s code of conduct for doctors. Nevertheless, doctors have been slow to embrace the practice of OD. There is a strong ethical case for implementing OD in the primary interests of ...

Angus J F Finlay · Cameron L Stewart BEc, LLB(Hons), PhD · Malcolm Parker MB BS, MLitt, MD

Will Australia’s current regulatory framework protect consumers?

Dianne Nicol PhD(Biology), LLM · Meredith Hagger LLB(Hons)

To the Editor: I share Mahar’s concern regarding any future screening of prospective medical students for signs that they are likely to develop mental or physical impairment.1 Although Wilson and colleagues do acknowledge that screening may not be ethical, the separate issue of their seeming conflation of likelihood of illness with impaired ability to practise in the long term is problematic.2 Mental illness, and particularly ...

Dev A Kevat

CorrectionIncorrect author name: In a letter responding to “Risks of complaints and adverse disciplinary findings against international medical graduates in Victoria and Western Australia” in the Matters Arising section of the 18 March 2013 issue of the Journal (Med J Aust 2013; 198: 256), an error occurred in the second author’s name. The name should have been Tuan V Nguyen. ...

Nguyen D Nguyen · Tuan V Nguyen

To the Editor: In a recent article,1 Elkin and colleagues concluded that, compared with Australian-trained doctors (ATDs), international medical graduates (IMGs) posed a greater risk of attracting complaints to medical boards. However, we think the conclusion is not supported by the data, and might have been compromised by the analytical methods used. Box of the research article1 shows that IMGs accounted for 37% of the total ...

Nguyen D Nguyen · Tran V Nguyen

To the Editor: While using medical board data for research purposes is very welcome, I have some reservations about ethical aspects of the study by Elkin and colleagues.1 Prospective ethics review of human research is intended to protect participants from foreseeable and avoidable harm. I suggest that, in this instance, avoidable harm has resulted, through generalised adverse and possibly unfair publicity about particular groups of ...

Kerry J Breen

If “a good death” is in some way a measure of good health care, how can we help our patients achieve it?

Ann Gregory · Ruth Armstrong

Tasmania is the only Australian jurisdiction to operate a state-funded registry and to require registration of completed enduring guardianship forms, but uptake is low.

Michael A Ashby MD, FRACP, FAChPM · Robert N Thornton BEd, MHPEd, PhD · Robyn L Thomas MB BS, FRACGP, FAChPM

People who are suffering and who will continue to suffer should have the right to request assistance to die gently and, if possible, at a time they choose, say the Doctors for Voluntary Euthanasia Choice.

on behalf of Doctors for Voluntary Euthanasia Choice

Introducing the MJA Ethics series, the series editor outlines some of the ethical challenges for medicine and society in the 21st century. The long-unresolved ethical conflicts surrounding the issue of providing “futile” care are discussed from clinical, ethical and legal perspectives, in this, the first instalment of the series.

Dominic J C Wilkinson MB BS, DPhil, FRACP

Deciding when to stop treatment can be a challenging task for health professionalsWith advances of modern medicine come increased expectations from society, and dilemmas regarding when to stop treatment are becoming increasingly common. The Medical Board of Australia code of conduct explicitly states “you do not have a duty to try to prolong life at all cost. However, you do have a duty to know ...

Bogda Koczwara BM BS, MBioethics, FRACP

We need to pay attention to the reasons why treatment is judged to be futileWhen doctors are confronted with making treatment decisions in the context of a terminally ill patient, the way forward is often difficult and confused. Bringing an ethics perspective to bear on the problem can help to resolve what the essential issues are, in turn enabling a clearer path to appropriate decisions ...

Dominic J C Wilkinson MB BS, DPhil, FRACP

Futility disputes highlight some important legal principles concerning the right to refuse treatment, advance directives and the role of substitute decisionmakersThe need for legal resolution of futility disputes is a rare occurrence in Australia and the jurisprudence is still emerging.1 The legal approach to futility disputes differs in each state jurisdiction, and a full analysis of the Australian law is beyond the scope of this ...

Cameron L Stewart BEc, LLB(Hons), PhD

The recent apology from the German Medical Association is commendable, but it fails to mention many of the victims of Nazi medicine.

George M Weisz MD, FRACS, MA

The challenge is delivering accessible screening services, followed by optimal management, to the community.

Jonathon Q Ng MB BS, BA, PhD · Nigel Morlet MB BS, FRANZCO, FRACS