New paper online: Ethical Hazards in Monitoring and Addressing Patient Decision Capacity in Clinical Practice

Just a little heads-up about a new research paper now being online (free to read and download). This one is lead by my Ph.D. student, Thomas Hartvigsson (presently visiting at Queen's University, Canada) and addresses aspects of his thesis topic about the normative roles of decision competence, for instance, in areas such as law or health care.

Together with Gun Forsander, chief senior clinical consultant at a childhood diabetes clinic, we use studies made in the area of teenage diabetes care, to argue that patient educational interventions meant to monitor and promote patients' intellectual understanding of general facts about their disease and the treatment brings ethical hazards likely to undermine some patient's decision-making capacities rather than enhancing or safeguarding them. At the same time, we find a strong general case for the idea of monitoring and addressing decision competence in patient groups where there is good reason to suspect especially fragile decision capacities, and sketch some challenges regarding staff competence and care organisation related to that.

The paper is freely available online for reading and download here.

New Substantial Entry on Precautionary Reasoning and the Precautionary Principle in (Global) Bioethics Online – and Open Access for a While

I'm happy and proud to announce that a brand new invited 10 page entry by myself in the Encyclopedia of Global Bioethics (edited by Henk ten Have and published by Springer) on the topic of "Precautionary Principle" is now online. Moreover, for some time ahead (though I don't know how long) the entry is so-called open access – that is, it can be freely read online and downloaded by anyone!

Of course, the entry builds on some of my previous work on the ethics of precaution and risk, not least my book The Price of Precaution and the Ethics of Risk and a more brief encyclopedia piece built on that from two years back, as well as my knowledge of a wide variety of fields and issues in bioethics. However, the new entry is much fuller than the previous one and is in many ways a seminal and much broader text: it is the first time that I (and, to my knowledge, anyone) puts these strands of inquiry together in a systematic analytic overview, and I add some fresh thinking on the global aspects of both these areas on top of that. It should therefore offer something of interest for both people interested in bioethics, medical ethics, health care ethics, ethics of the life sciences and research ethics and bordering fields, and those more interested in the general grounding of public policy with regard to technology, science, environment, risk, uncertainty and ignorance, as well as those particularly pondering the global aspects of both these areas; or global ethics or politics in general. This is the abstract:

Precautionary reasoning has deep historical and wide cross-cultural roots in the ethics of health, health care, and medical research. As in general ethics, however, this side of bioethical thinking has not been the subject of focused critical analysis until recently. The emergence of the precautionary principle (PP) in general environmental and technology policy debate has, after an initial period of confusion, resulted in a range of possible ideas about the value of precaution and what sacrifices it may be worth. This has indicated some need for developments in ethical as well as decision theory. In bioethical debates, this process has left only vague traces, however. Although many issues exist where precautionary reasoning has a place, this is either often left unnoticed or arguments developed suffer from elementary flaws. Environmental and general public health ethics, the ethics of evidence-based practice in research, as well as clinical decision-making, management of normative or factual uncertainty, and the nature of clinical ethical virtues are all areas where precautionary ideas seem to have a place. Such reasoning moreover has specific relevance for global approaches to bioethics and health policy issues in a number of ways.

Keywords

Clinical research, Decision-making, Decision theory, Emerging technology, Environmental health, Evidence, Ignorance, Risk assessment, Technology assessment, Uncertainty

 The entry can be accessed and read here, and downloaded here. take your chance quickly, as the free availability may end anytime.