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DTSTART;TZID=Europe/London:20220326T150000
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CREATED:20220224T152043Z
LAST-MODIFIED:20220409T105141Z
UID:556-1648306800-1648314000@medethicsalliance.org.uk
SUMMARY:Your Right to Treatment .... the use and misuse of the R E S P E C T form
DESCRIPTION:A Joint Meeting of the Catholic Medical Association and the Medical Ethics Alliance  on Saturday 26th. March\,   was well attended. The speaker was  Dr Adrian Farrell.  \n\n\n\n                                     ” The use and misuse of the ReSPECT form. \n\n\n\nMany Trusts are now using this form.  It stands for.. “Recommended Summary Plan for Emergency Care and Treatment.” \n\n\n\nPatients with mental  capacity\, can make choices about their future treatment. \n\n\n\n If accompanied by a unhurried\, thoughtful and accurate understanding of their illness it can empower patients. \n\n\n\nWhere a decision is made to not attempt cardio pulmonary resuscitation ( DNACPR )\,  higher legal requirements apply.  \n\n\n\nThe tick box approach \, which the form makes can be deleterious to proper medical care and may be open to challenge. \n\n\n\nAt worse\, some patients lives may be undervalued. “ \n\n\n\nAll Welcome
URL:https://medethicsalliance.org.uk/event/your-right-to-treatment-the-use-and-misuse-of-the-r-e-s-p-e-c-t-form/
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=Europe/London:20181015T000000
DTEND;TZID=Europe/London:20181015T235900
DTSTAMP:20210928T160059Z
CREATED:20210204T161902Z
LAST-MODIFIED:20210928T160059Z
UID:96-1539561600-1539647940@medethicsalliance.org.uk
SUMMARY:Futile treatment- Futile lives?
DESCRIPTION:A joint meeting between the Medical Ethics Alliance and the Catholic Medical Association was held in Birmingham on 20th October 2018 at Newman House. It was well attended by members of both associations and other interested parties. \nUnder the chairmanship of the M E A attendees contributed under Chatham House rules on the topic “Futile treatment? Futile Lives?”It began with a brief presentation of some patients who may have thought to have futile lives. These included a child with persistent vegetative state who was part of a ward community where he was greatly loved by the staff and “when all he had to offer was his humanity\, it was very appealing”. Another child who was almost an organ donor\, made an unexpected and complete recovery from post cardiac arrest cerebral oedema. \nA nurse also mentioned a case they had cared for who was thought to be dying and denied fluids\, but who made a rapid recovery. Nurses\, in general\, were troubled that patients for whom they regarded themselves as advocates\, were being denied the essentials of life such as food and water. \nA participant described her own experience of being in a virtual locked in state\, unable to communicate other than by winking. She too made a considerable recovery and is now campaigning for life\, especially in the latest climate of withholding or withdrawing food and fluids. She also had experience of poor nursing which led to a wide discussion of nurse training and selection. It was accepted that there will always be nurses with character faults and there was a further discussion of society`s attitude towards the disabled and the way that that could influence the attitude of healthcare staff towards the profoundly disabled patients who`s life might be characterised as “futile”. \nThere followed a detailed discussion of recent high profile cases of children with incurable diseases and recent judgements including the Supreme Court judgement in the case of “Y” which removed the necessity of the Court of Protection involvement in decisions concerning the withdrawing of food and fluids if provided by tube.This was\, in any event contrary\, to Catholic teaching. The Royal College of Physicians working party on the palliation of thirst was considered to be a regime that was incompatible with survival and therefore\, euthanasia in all but name. \nThere was a discussion on the working of the Mental Capacity Act ( 2005 ) which made “best interests” the criterion for clinical decision making. It was pointed out that this construct was eminently corruptible and in any event based on uncertainties in diagnosis and prognosis. Yet it would become determinative in matters of life and death. The Mental Capacity Act did not define “best interests” but only how to approach making a “best interests” decision. It was an attempt to inform how clinical decisions should be made in those who lack capacity. In effect it could make clinical decisions more difficult and in an extreme case\, the administration of artificially give food and fluids\, illegal. \nThe meeting closed with a comparison between Scottish law and the Mental Capacity Act. The former making the ultimate criterion not “best interests” but treatment justified if it was deemed “beneficial”.It was hoped that a more informed public awareness\, publicity and case histories\, especially from the viewpoint of relatives\, could lead to improvements in medical [practice and ultimately the law. \nWe will be publishing a paper on the challenges of the Mental Capacity Act soon\, entitled “Would you deny a dying man water?”
URL:https://medethicsalliance.org.uk/event/futile-treatment-futile-lives/
LOCATION:Newman House
CATEGORIES:Bioethics
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END:VEVENT
BEGIN:VEVENT
DTSTART;VALUE=DATE:20131101
DTEND;VALUE=DATE:20131102
DTSTAMP:20210928T155834Z
CREATED:20210213T120137Z
LAST-MODIFIED:20210928T155834Z
UID:137-1383264000-1383350399@medethicsalliance.org.uk
SUMMARY:Abortions on Mental Health Grounds "Probably Illegal"
DESCRIPTION:Report of the Medical Ethics Alliance Meeting on Abortion and Maternal Mental Health in London\, November 2013\nThe overwhelming majority of Britain’s abortions are “probably illegal”\, a senior psychologist has said. \nLiverpool-based Dr Michael Scott said that the 99 per cent of abortions in Britain performed each year to protect the mental health of the mother could not be scientifically justified. \nThe consultant pyschologist\, who is often called as an “expert witness” by Merseyside Police and has worked with the families of the Hillsborough disaster\, said a “charade” is operating around the working of the 1967 Abortion Act. \nAbortions on mental health grounds were so dishonest that they were effectively illegal\, said Dr Scott\, a Catholic. \nAt a conference in London he called for the total abolition of Ground C\, the section that permits abortion when the “continuance of the pregnancy would involve risk to the life of the pregnant woman\, greater than if the pregnancy were terminated.” \nIt is under Ground C that nearly all of about 200\,000 abortions are performed annually in Britain\, most of them for so-called “social” reasons. According to Keir Starmer\, the outgoing Director of Public Prosecutions\, Ground C could also have been used to legally justify the sex-selective abortions of female foetuses because of their gender. \nIn his speech at the Royal Society of Medicine\, Dr Scott\, an expert on post-traumatic stress disorder and the author of 10 books on Psychology\, said the bogus mental health reasons for abortions under Ground C also made the law impossible to either police or regulate. \nHe argued that in his view any attempted justification of abortion on Ground C “should be treated with great suspicion.” adding that the section was not “fit for purpose.” “Ground C ought to go\,” said Dr Scott. “It is not evidence-based and isn’t based on anything that in my view can stand up to rigorous examination\,” he told the conference on abortion and mental health. \n“I see about four or five patients a week and perform medico-legal assessments\, usually for cases of extreme trauma\, in which I have to include if they have post-traumatic stress disorder or whatever\, and that can be contested by an expert witness from the other side. \n“Occasionally it goes to court where there is great debate about the reliability of my assessment so the methodology is very important. But there is nothing like that with regard to terminations yet they are taking place within this mental health framework. \n“You have two universes that don’t meet – the universe of reliable medico-legal assessments and the way abortions are being justified … strictly speaking\, to me they seem illegal.” \nHe said it was also no longer scientifically acceptable simply to allow abortions after two doctors decided “in good faith” that the abortion is necessary\, as stipulated by the Act. \n“We are at the level of evidence-based medicine and unbridled clinical judgement is not acceptable any longer\,” Dr Scott said. \n“There has to be the following of an evidence-based protocol. We cannot allow the following of unbridled clinical judgement.” \nDr Scott said the Act was located in a “mental health framework” but “we don’t actually know the mental health status of patients who have terminations under Ground C.” \n“We don’t know what we are dealing with because it hasn’t actually been reliably assessed\,” he said.\n“So at one level\, the terminations under Ground C are probably illegal.” \nHe said: “The effects on mental health are unproven. If mental health effects are unproven\, why is the Act based around mental health criteria? People are playing fast and loose with the concept of mental health. \n“There is a charade going on.” \nHe continued: “I feel there is a lot of dishonesty in the area of abortion. It is not only people opposed to abortion who are saying this. It is also people who are pro-abortion. They are saying exactly the same thing and we need an open discussion.” \n\n‘We Have De Facto Abortion on Demand’\nOf the “thousands” of abortion cases he said he had studied not one had involved a woman seeking to end her pregnancy on mental health grounds. \n“It’s just not a concept that people operate in\,” he said\, adding that he believed that the real reason most women request abortions is they perceive their pregnancy would permanently and catastrophically harm an important role that they have. \nDr Scott\, who works out of Rodney Street and also lectures in Psychology at Manchester University\, also suggested that GPs should also be legally obliged to try\, as a minimum\, to determine if the continuation of a pregnancy may cause harm that might be both catastrophic and permanent before agreeing for the procedure to go ahead. \n“We have de facto abortion on demand\,” he said. “I doubt it was the intent of most of the supporters of the Act. How do we move on from abortion being treated like a visit to the dentist to a more appropriate societal response?” \nHe said: “There is a credibility gap between the spirit of the 1967 Act and what actually happens in practice.” \nThe London conference\, organised by the Medical Ethics Alliance\, was also addressed by Dr Gregory Gardner\, a Birmingham GP who lectures in General Practice at Birmingham University. \nHe provided latest evidence to show that\, rather than protecting the mental health of women abortions might cause psychological harm\, especially among women with underlying mental health problems. \nStudies reveal that this was true even of women who had conceived from an act of rape\, he explained.\nBritish research includes “Induced Abortion and Mental Health\,” a systematic review of the mental health outcomes of abortion which was published in December 2011. A definitive meta-analysis of all the available evidence\, it was developed for the Academy of Medical Royal Colleges by the National Collaborating Centre for Mental Health and funded by the Department of Health. \nThe review concluded that mental health outcomes for women with unwanted pregnancy “were the same whether they had an abortion or gave birth.” \nBut if the woman had a history of mental health problems\, or been under pressure from others to have the abortion or had “negative attitudes towards abortion” then the procedure was more dangerous. \n(Photo of Dr Scott by Simon Caldwell) \n  First  Published in the Catholic Medical Quarterly
URL:https://medethicsalliance.org.uk/event/abortions-on-mental-health-grounds-probably-illegal/
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END:VEVENT
BEGIN:VEVENT
DTSTART;VALUE=DATE:20010628
DTEND;VALUE=DATE:20010629
DTSTAMP:20210213T141221Z
CREATED:20210213T121532Z
LAST-MODIFIED:20210213T141221Z
UID:142-993686400-993772799@medethicsalliance.org.uk
SUMMARY:Human Cloning; Scientific Aspects and a World Faiths Perspective
DESCRIPTION:MEDICAL ETHICS ALLIANCE CONFERENCE\nHuman Cloning; Scientific Aspects and\nWorld Faiths Perspective\n28th June\, Wiseman Conference\, London \nIntroduction\nDr J Qureshi\nPsychiatrist\, Director\, Woodbourne Priory Hospital\, Birmingham \nPure science without faith will have pitfalls. Blending faith and science is required. This conference is to encourage clinicians\, scientists and people of faith. Cloning is an enormous subject of which only a little is known. The frontiers are immense. Human endeavours must be in accordance with the principles of faith\, should serve humanity and be in line with divine principles. \nEmbryo Research Past\, Present and Future\nDr John McLean Embryologist\,\nAdviser to the Bishops Conferences Committee on Bioethics. \nThe early research\, dating from the end of the 19th century\, was descriptive. Embryos were obtained from miscarriages and hysterectomies. The first 8 weeks after fertilisation completes embryogenesis\, implantation occurring between 6-10 days when the embryo forms an intimate relationship with the maternal circulation. \nThe Human Fertilisation and Embryology Act 1990 permitted research up to 14 days in vitro for specified reasons. These included studying the causes of miscarriage\, infertility\, congenital abnormalities\, inherited diseases and the development of contraceptives. An analysis of the 27 current licences for research reveals that 4 are for the study of implantation. These may lead to the development of substances\, which although likely to be described as “contraceptives”\, are in fact abortifacients. Pre implantation diagnosis of inherited diseases is also being licensed. To date there has been no new treatment of maternal infertility from the research and concerning congenital abnormalities: these arise outside of the 14 day limit allowed. In any case embryos rarely continue to live outside the body beyond 6 days: the 14 day limit is meaningless. \nSome progress has been made with intracellular micro-insemination\, but this technique having been developed now appears to be successful at about 20% per treatment cycle for the last three years. IVF rates have not improved beyond a maximum 15% per treatment cycle. \nThe future\, following the recent amendment to the Human Fertilisation and Embryology Act\, allows experimentation\, including the creation ot cloned embryos for treatment or therapeutic purposes. Claims are being made for benefits for virtually all diseases\, but in fact only 2% of cloned animal embryos come to birth and many of these have congenital abnormalities. The reasons why the other 98% fail are unknown. \nEmbryos produce chemicals for the organisation and development of tissues. It is thought that the principal use of cloned embryos is to produce these chemicals in amounts that can validate their function and be manufactured by the biotechnology industries. \nMuslim Perspective on Biogenetics\nDr Abid Sharif\nGeneticist\, City hospital Nottingham. \nMan was ordained to live in harmony with nature. Recent times have seen unprecedented challenges to religious values. Islam should be considered within the context of Islamic jurisprudence\, that is “Sharia”. \nMuslim scripture\, the Koran and teachings of the prophet\, are the guiding principles of this law. One important way of coming to the truth is by consensus of the scholars or “ijma”. If there is unanimity or near unanimity on a point\, then they have the assurance of faith\, that the believers will not be misled. Revelation ended long ago but scholarly commentaries continue to guide and inform the believer. Sharia allows space for free movement\, and is a guiding force\, its objects being the preservation of faith\, soul and mind in a unity. Some questions are left to conscience and common sense. \nIn Muslim scriptures man s origin is in stages. He progresses from sperm to a clot\, to bone sheathed with tissue\, to a foetus. Before 40 days there is no ensoulment. The faithful are only God s ambassadors holding everything in trust and must seek to preserve the balance created by God. Ultimately Allah has dominion. \nThere are strong scriptural statements which are relevant to cloning a baby\, the most important and direct of which is “There is no altering the laws of Allah s creation”. Cloned babies would be contrary to the natural order and family relationships. It would also disrupt the social order. Islam is concerned about the social order and the impact of cloning beyond those who may feel the need of a family. Stem cell research would be allowable if it led to treatment of diseases\, because to relieve affliction is to bring a blessing. \nThere is a consensus against cloning a baby. Scholars also condemn germline manipulation. Plant cloning is permissible\, and on animals there is still uncertainty: the balance of advantage and disadvantage will only emerge in time. \nIslam does not impose a restriction on science\, but not anything that is practical is necessarily applicable. All knowledge is a blessing and can be used\, but family life is preeminent. It is agreed cloning babies would disrupt life and bring about chaos in the natural order. \nHuman Cloning; A Catholic Perspective\nDr Anthony Cole Paediatrician\,\nDirector\, The Lejeune Clinic\, London \nIn this talk the clone referred to is a genetic copy of another individual. A cloned embryo is created by cell nuclear transfer from an adult cell into an enucleated oocyte. “Therapeutic cloning” is a misnomer as the cloned embryo is used as a source of stem cells only. Other stem cells occur in umbilical cord blood\, or the tissues after birth. \nThe Human Fertilisation and Embryology Act 1990 was primary legislation debated in both houses. The Warnock Report\, which preceded it\, said that the human embryo had a special status. The recent parliamentary debate however\, was on an unamendable statutory instrument\, or a simple yes or no to extending the permitted use of embryos\, and the creation of cloned embryos. Government documents wherever possible use euphemisms and avoid the word “clone”. \nThe Catholic position has always been that human life is to be respected from the moment of its beginning till natural death. Even the Warnock Committee had a minority report which regarded the human embryo as unsuitable for destructive experimentation. Nevertheless hundreds of thou sands of embryos have been created most of which would be destroyed\, and the talk of the useful research into diseases made in the 1990 debate has been spurious. \nThere is no official Catholic pronouncement on the status of a human cloned embryo. If it embarks on normal embryonic development it is arguably of equal status to a normal embryo and\, therefore\, not exploitable as a commodity. The alternative view amongst some Christians\, that prenatal life is “a value adding process”\, does not in fact help us with questions of when it is scientifically exploitable\, or when after implantation it is too valuable to abort. These questions are never answered. Even the point of viability is changing. \nIf human cloning techniques are published\, they will be taken up elsewhere to create a cloned baby. At present there is a weak consensus against cloned babies because of the very high incidence of deformities\, twisted limbs\, squashed faces and enlarged tongues seen in cloned animals. They can be grossly oversized and show premature ageing. \nThere is a fundamental injustice if one generation chooses whom it will copy for the next\, a distortion of kinship; and there will be problems of identity and legal complications over inheritance. \nMan is made in the image and likeness of God. This is his dignity. Parents have the privilege of co operating with the creator in procreation. This is incompatible with human cloning. \nHuman Cloning; A Jewish Perspective\nProf David Katz.\nDepartment of Immunology\, University College\, London \nThe term “clone” has been applied to a cell line that is derived from a single cell\, and has been used in this way for many years. An example of this are the cells that are used to study how immunity is control led\, the “T cell clone”. Another example of clones are the cells that have been used to make monoclonal antibodies\, where originally the nuclei of tumour cell and normal cell were fused within the same cell. Today many of these monoclonal antibodies are part man\, part animal (usually mouse) in origin. Yet another use of the term is when genes themselves are “cloned” working down to the level of a single gene\, let alone a single cell\, and then amplifying that gene (and / or its product protein) (i.e. making many identical copies ) so that they can be studied and used. \nIt is in this context that “human cloning” deriving an entire human from a single cell in vitro\, basically by a technique known as nuclear transfer has to be considered. Cloned individuals would be derived by taking the nucleus of one selected person and transferring it into a germline cell. In Judaism there is already a growing body of secondary literature on the topic. The most important dialogue has thus far taken place in the US and Israel. Most of these new secondary sources refer to the fact that the question of the generation of a “humanoid”\, a “Frankinstein -like creature of human fabrication” has been fore shadowed in the Talmudic discussions about the creature of this kind of life form\, known as a “golem”. Should a golem be admitted as part of a quorum for worship? Is one guilty of homicide if one kills a golem? The popular version of the debate is associated with the Maharal\, the famous Rabbi of Prague\, who lived in the 16th century; but in fact discussion about the topic dates back many centuries. However\, these theoretical debates are moving closer to reality\, maybe before we have had time to resolve some of the ethical issues. \nA key question in Judaism is whether or not producing a cloned offspring can be regarded as a fulfilment of the obligation “to be fruitful and multiply”. If so\, then it may fall into the category of a “mitsva chiyuvit”\, i.e. a positive duty to found a family and have children. Alternatively\, is this a procedure which is permissible (“mutar” ) but not obligatory? If so\, other variables effects on society\, on the role of the individual in society\, and practical problems and chances of success – all need to be taken into account in formulating a Jewish response. Do the benefits outweigh the drawbacks? \nThe other form of cloning that has been discussed relates increasingly to questions where stem cells\, derived either from embryos or adults\, are the starting points. Here again there has already been considerable debate. Using cell lines as “cell factories”\, as exemplified by the production of monoclonal antibodies (which have great commercial value)\, has not been regarded as in conflict with the basic tenets of Judaism. Core concepts of Judaism include not only the obligation to care for the sick in the best possible way\, but also that one should use the best possible methods (technology) that we can devise. We have a partnership with God in creation\, and this includes the acquisition of knowledge which helps us fulfil obligation. A notable example of how this is embedded in Judaism is that the blessing we say when we eat bread refers to “bringing forth bread from the ground” when we know that the wheat comes from the ground and requires man to convert it to bread. \nAlthough Judaism thus does not have an inherent problem with the technology of nuclear transfer in principle\, and can see intrinsic value in some forms of the procedure\, this should not be taken to imply blanket agreement with all that is possible. The need to use embryonic rather than adult cells must be carefully evaluated. Whilst Judaism takes a positive view of steps that will resolve some of the problems posed by current approaches to organ retrieval\, “organ farming” and subsequent “organ marketing” raises significant quandaries. Since the product of such cloning would become a commodity\, there is considerable misgiving about the concept. Furthermore possible acceptance of nuclear transfer into embryonic cells\, for their therapeutic advantage\, does not imply acceptance where the procedures are aimed at so-called “improvement” of future generations. \nThus\, while there may well be differences of opinion between religious communities about their approach to some of these issues\, on one particular issue there is consensus. That is that there is an essential role for “faith ethics” in the debate\, and for these communities to be given ample opportunity to contribute\, not only in deciding policy but also working at the individual case level\, even if they have not been universally successful in the past. Regulatory controls are important\, acting as a stabilising influence. Formulation of such controls with support from faith communities would seem to be one useful way forward for the future. \nDiscussion\nChaired by Dr Greg Gardner.\nGeneral Practitioner\, Birmingham \nIn Islam children need to honour their parents. A cloned child would not be considered as having proper parents. On so called “therapeutic cloning” there is no consensus. There is a strong tradition of respecting life from fertilisation\, even before ensoulment.* \nMonitoring of public meetings of the Select Committee on Stem Cell Research\, reveals that a preponderance of the members are supporters of the Government position. The committees report is likely to have far reaching consequences of which they themselves are unaware. \nThe global nature of pharmaceutical industries is a major factor. Some decisions seem to be made on the basis of science\, commerce and politics. \nThere is a need for believers to make a strong input. This is best achieved by dialogue rather than token representation on committees. \nNew treatments dependent on human cloning would not be universally accepted\, as has been seen when sections of the community rejected vaccines grown on human cell lines obtained from abortuses. New treatments should be based on non-controversial research to be generally accepted. \nFaith inspired persons should engage in the debates generated by such new technologies as cloning. \n*In Christian dialogue\, whether human life exists prior to ‘ensoulment is controversial. Ed. \nGoto to CMQ August 2001
URL:https://medethicsalliance.org.uk/event/human-cloning-scientific-aspects-and-a-world-faiths-perspective/
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