After considering research ethics recently, and earlier in the semester our historic attrocities in relation to patient consent and medical research, this article in today's media seems an ideal topic for our Week 8 poll.
This news item also links very closely to the lecture material on autonomy and health care purpose - which reltes closely to th theme of the 2nd assignment.
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'Doctors can legally experiment on adult coma patients in New Zealand without their consent if it's in their 'best interest'.
But that might soon change, given that the Health and Disability Commissioner's consultation on the relevant legislation closes on Sunday 30th April.
Medical experts have welcomed the move because they feel the uncertainty about the repercussions needs to be addressed.
University of Auckland Faculty of Law associate professor Joanna Mary Manning said the current legislation was very restrictive.
'A parent has legal power on behalf of a child under 16, if it is the child's best interest.
'However, there is essentially a legal vacuum, no one can consent on behalf of an adult.'
Manning said a law change would be needed for that.
'There is considerable uncertainty as to whether it is lawful to involve people who are not able to give informed consent in medical research.
'[However] if there is not research, then this class of patients may be deprived access to new medicines.'
Manning said a code of strict safeguards would be needed.
Health and Disability Commissioner Anthony Hill said it was a complex and important issue.
'It is difficult to decide where to draw the line regarding what research is appropriate if the participants are unable to give consent.
'Consumers who are unable to make informed decisions for themselves are particularly vulnerable to abuses of their rights and interests.'
Hill said the law needed to protect people from cases like the infamous Unfortunate Experiment at National Women's Hospital in Auckland.
It involved withholding treatment from women with cervical abnormalities without their knowledge or consent.
University of Otago medical ethics lecturer Dr Angela Ballantyne said it was a balancing act between vulnerable patients and the need for scientifically valid research.
'The reason we have good quality care is because we have a model of evidence-based care.
'If there is no evidence there is not good quality care.
'From a big picture perspective it is a real problem as we don't have good evidence for these patients.'
Ballantyne said most people had no idea they could be subjected to testing and it was an important message to share with the public.
'I think it is the term research that sounds really bad and turns people off.'
She said the Unfortunate Experiment was an outlier and had no reviews by independent authorities.
'[Now] most research in New Zealand goes through a research ethics committee and would be peer reviewed.'
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Read the article in full here: http://www.stuff.co.nz/national/health/92008169/act-allowing-research-to-be-conducted-on-coma-patients-without-their-consent-might-be-amended
So do we allow medical practitioners to continue not just to treat, but to undertake research on ICU patients, 'in their best interests' in the absence of consent so that others may benefit from the research or should we hold patient consent highly, given our 'unfortunate' history?
What do you think?
It is proposed that doctors should be able to continue to legally experiment on adult coma patients in New Zealand without their consent