All Canadian bioethicists need to reflect on the meaning and value of their work, to see more clearly how the ethics of bioethics is being undermined from within. In the case involving Dr Olivieri, the Hospital for Sick Children, the University of Toronto, and Apotex Inc, there were countless opportunities for bioethical heroism. And yet, no bioethics heroes emerged from this case. Much has been written about the hospital’s and the university’s failures in this case. But what about the deafening (...) silence from the Canadian bioethics community? Given the duty of bioethicists to “speak truth to power”, this silence is troubling. To date, nothing has been written about the silence. This article is intended as a partial remedy. As well, the article pays tribute to heretofore unsung heroes among Dr Olivieri’s research colleagues. (shrink)

International medical travel occurs when patients cross national borders to purchase medical goods and services. On occasion, physicians in home countries will be the last point of domestic contact for patients seeking healthcare information before they travel abroad for care. When this is the case, physicians have a unique opportunity to inform patients about their options and help guide them towards ethical practices. This opportunity brings to the fore an important question: What role should physicians in more-developed home countries play (...) in promoting or constraining international medical travel towards less-developed destination countries? In our view, critical attention to the decision spaces of patients—defined by the personal circumstances, socio-cultural cues, and legal constraints that inform decision-making—is a useful starting point for evaluating the proper response of physicians to various forms of international medical travel. (shrink)

In the summer of 1997 one could scarcely enter a bookstore in Beijing without encountering Wang Xiaobo's pensive and defiant look on the cover of dozens of books displayed at the entrance. Wang had suddenly died in the spring of that year at the age of forty-five. Born in Beijing in 1952 to a family of intellectuals, he remained attached to China's capital despite periods of separation, such as during the Cultural Revolution, when he was sent to Yunnan to "learn (...) from the peasants" and taught in a "people-run-school" in Shandong, and also during the 1980s, when he studied in the United States . Wang always returned to Beijing, in the late 1970s to study economy and business at the People's University and in the late 1980s to teach there. After retiring in 1993, he devoted his time to writing: poetry, novels, essays, non-fiction, and a movie script. (shrink)

It is not unusual for patients and their families, when confronted with difficult medical choices, to ask their physicians for advice. This paper outlines the shades of meaning of two questions frequently put to physicians: “What should I do?” and “What would you do?” It is argued that these are not questions about objective matters of fact. Hence, any response to such questions requires an understanding, appreciation, and disclosure of the personal context and values that inform the recommendation. A framework (...) for considering and articulating a response to these questions is suggested, using as a heuristic the phrasing “If I were you…/If it were me…” Journal of Medical Ethics. (shrink)

In responding to Ms Rowell’s commentary on her original paper the author points out that the job of all bioethicists, namely, speaking truth to power, is a daunting task which is unlikely to succeed “if we do not learn to ask for and to accept, to offer and to provide, moral support and meaningful help.”In my article “The Olivieri debacle: where were the heroes of bioethics?”1 I make four comments about Ms Rowell’s involvement in the case. In my first comment (...) relating to Ms Rowell, I suggest that a careful reader of the Naimark report could reasonably conclude “that the role of bioethics in helping to resolve the controversy was, at best, very limited”. In reaching this conclusion, I relied on the findings of the two official reports/inquiries about this case. Though the two reports reach different conclusions about the case, there appears to be agreement on the very limited role of bioethics. As noted in my original article, in the 160 page Naimark report there are but a few paragraphs about bioethics and Ms Rowell’s role in the Olivieri case. This is surprising, and I say as much in my article. In the 540 page report of the Committee of Inquiry, which Ms Rowell describes as “a review that I believe to provide a public report of integrity”, little more detail is provided regarding Ms Rowell’s role. I included all references to Ms Rowell from the first report in the original article. I did not do so with the second report. This was not done to diminish any contribution Ms Rowell might have made. In my view, no new evidence germane to the points I wanted to make was provided in the text that I did not include in my article.In …. (shrink)