Are general practitioners prepared to share information about their patients and their work?

A questionnaire survey of the 44 general practices in Central Nottinghamshire Health District elicited 43 responses. Ten scenarios on sharing information were graded on a five point scale by each practice according to its willingness to share the information. Responses varied from 41 practices that would at least "probably" give the number of their young chronic sick patients to the local district health authority to 17 practices that were positive towards sharing with a local charity the names of elderly patients living alone. This second example raises profound issues of confidentiality. The extent to which practices were prepared theoretically to share practice generated information with outside bodies was generally high and showed a willingness to do so if the reasons were sound and the requesting body was acceptable.     

Are antidepressants safe to use in children and adolescents?

The Food and Drug Administration is investigating 10 antidepressants to determine possible increase of depression or suicidality in children and adolescents while on the medication. Results of the data analysis should be available in the summer of 2004.     

Are patients morally responsible for their errors?

Amid neglect of patients' contribution to error has been a failure to ask whether patients are morally responsible for their errors. This paper aims to help answer this question and so define a worthy response to the errors. Recent work on medical errors has emphasised system deficiencies and discouraged finding people to blame. We scrutinize this approach from an incompatibilist, agent causation position and draw on Hart's taxonomy of four senses of moral responsibility: role responsibility; capacity responsibility; causal responsibility; and liability responsibility. Each sense is shown to contribute to an overall theoretical judgment as to whether patients are morally responsible for their errors (and success in avoiding them). Though how to weight the senses is unclear, patients appear to be morally responsible for the avoidable errors they make, contribute to or can influence.     

Should patients be allowed to veto their participation in clinical research?

Patients participating in the shared benefits of publicly funded health care enjoy the benefits of treatments tested on previous patients. Future patients similarly depend on treatments tested on present patients. Since properly designed research assumes that the treatments being studied are-so far as is known at the outset-equivalent in therapeutic value, no one is clinically disadvantaged merely by taking part in research, provided the research involves administering active treatments to all participants. This paper argues that, because no other practical or moral considerations count decisively against so doing, we could and should oblige patients to agree to receive indicated treatment within the terms of any concurrent research protocols. This ensures their treatment will benefit not only themselves but also future patients through contributing to new knowledge. By analogy with the paying of income tax, patients should not be allowed to "veto" their social responsibility to take part in clinical research.     

Are MDs more intent on maintaining their elite status than in promoting public good?

The message that philosopher John Ralston Saul delivered during a recent CMA policy conference may have been unpopular with many physicians, but it wasn't intended to win their support. Instead, organizers wanted him to provide food for thought. Charlotte Gray reports that he did just that.     

Are attempts to have impaired children justifiable?

In a recent case, artificial insemination was employed by a couple in an attempt to ensure the birth of a deaf child. In response to this, I argue that individuals should not be allowed to select for or against deafness. While I establish that preferences for deaf children can be inherently just, allowing individuals to secure these preferences may have unacceptable consequences for existing persons who are deaf. I show that these follow even granting this couple's contestable understanding of the deaf as a minority group.