John McPhee

Is there an Aboriginal bioethic

It is well recognised that medicine manifests social and cultural values and that the institution of healthcare cannot be structurally disengaged from the sociopolitical processes that create such values. As with many other indigenous peoples, Aboriginal Australians have a lower heath status than the rest of the community and frequently experience the effects of prejudice and racism in many aspects of their lives. In this paper the authors highlight values and ethical convictions that may be held by Aboriginal peoples in order to explore how health practitioners can engage Aboriginal patients in a manner that is more appropriate. In doing so the authors consider how the ethics, values, and beliefs of the dominant white Australian culture have framed the treatment and delivery of services that Aboriginal people receive, and whether sufficient effort has been made to understand or acknowledge the different ethical predispositions that form the traditions and identity of Aboriginal Australia(ns).

Cancer patients’ attitudes towards euthanasia and physician-assisted suicide: The influence of question wording and patients’ own definitions on responses

Objectives: The aims of this study were to: (1) investigate patients’ views on euthanasia and physician-assisted suicide (PAS), and (2) examine the impact of question wording and patients’ own definitions on their responses. Design: Cross-sectional survey of consecutive patients with cancer. Setting: Newcastle (Australia) Mater Hospital Outpatients Clinic. Participants: Patients over 18 years of age, attending the clinic for follow-up consultation or treatment by a medical oncologist, radiation oncologist or haematologist. Main Outcome Measures: Face-to-face patient interviews were conducted examining attitudes to euthanasia and PAS. Results: 236 patients with cancer (24% participation rate; 87% consent rate) were interviewed. Though the majority of participants supported the idea of euthanasia, patient views varied significantly according to question wording and their own understanding of the definition of euthanasia. Conclusions: Researchers need to be circumspect about framing and interpreting questions about support of ‘euthanasia’, as the term can mean different things to different people, and response may depend upon the specifics of the question asked.

Discrimination in medicine: the uncertain role of values

To discriminate means to distinguish, hence not all discrimination is ethically or legally problematic. Indeed, to be ‘discriminating’ in the context of taste may be desirable and in our personal relationships – such as when choosing a partner – it is natural to discriminate between various individuals. However, there are some kinds of discrimination that lead to discord within society, such as discrimination solely on the basis of race or gender, and these may be regarded as unethical because they are based on prejudices or stereotypes or are considered oppressive, unfair or unjust.1

Development of guidelines for the use of complementary medicines in public hospitals. An ethical approach

The extensive community use of complementary medicine (CM) can no longer be overlooked in the practice of hospital medicine. Protocols need to be developed and implemented so that health professionals can deal with the issues surrounding the use of CM. Policy development has generally focussed on the supply of CM in hospital but another approach, which is based on consideration of the ethical and legal context, is presented here. Such an approach demands clarification of institutional policy for individuals who are competent and those who are incapable of self-administration or non-competent.