15 found
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  1.  98
    Should religious beliefs be allowed to stonewall a secular approach to withdrawing and withholding treatment in children?Joe Brierley, Jim Linthicum & Andy Petros - 2013 - Journal of Medical Ethics 39 (9):573-577.
    Religion is an important element of end-of-life care on the paediatric intensive care unit with religious belief providing support for many families and for some staff. However, religious claims used by families to challenge cessation of aggressive therapies considered futile and burdensome by a wide range of medical and lay people can cause considerable problems and be very difficult to resolve. While it is vital to support families in such difficult times, we are increasingly concerned that deeply held belief in (...)
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  2.  42
    Living bioethics, clinical ethics committees and children's consent to heart surgery.Priscilla Alderson, Deborah Bowman, Joe Brierley, Martin J. Elliott, Romana Kazmi, Rosa Mendizabal-Espinosa, Jonathan Montgomery, Katy Sutcliffe & Hugo Wellesley - 2022 - Clinical Ethics 17 (3):272-281.
    This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. Different approaches (...)
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  3.  17
    Challenging misconceptions about clinical ethics support during COVID-19 and beyond: a legal update and future considerations.Joe Brierley, David Archard & Emma Cave - 2021 - Journal of Medical Ethics 47 (8):549-552.
    The pace of change and, indeed, the sheer number of clinical ethics committees has accelerated during the COVID-19 pandemic. Committees were formed to support healthcare professionals and to operationalise, interpret and compensate for gaps in national and professional guidance. But as the role of clinical ethics support becomes more prominent and visible, it becomes ever more important to address gaps in the support structure and misconceptions as to role and remit. The recent case of Great Ormond Street Hospital for Children (...)
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  4.  9
    Children of COVID-19: pawns, pathfinders or partners?Victor Larcher & Joe Brierley - 2020 - Journal of Medical Ethics 46 (8):508-509.
    Countries throughout the world are counting the health and socioeconomic costs of the COVID-19 pandemic, including the strategies necessary to contain it. Profound consequences from social isolation are beginning to emerge, and there is an urgency about charting a path to recovery, albeit to a ‘new normal’ that mitigates them. Children have not suffered as much from the direct effects of COVID-19 infection as older adults. Still, there is mounting evidence that their health and welfare are being adversely affected. Closure (...)
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  5.  30
    Children’s informed signified and voluntary consent to heart surgery: Professionals’ practical perspectives.Priscilla Alderson, Hannah Bellsham-Revell, Joe Brierley, Nathalie Dedieu, Joanna Heath, Mae Johnson, Samantha Johnson, Alexia Katsatis, Romana Kazmi, Liz King, Rosa Mendizabal, Katy Sutcliffe, Judith Trowell, Trisha Vigneswaren, Hugo Wellesley & Jo Wray - 2022 - Nursing Ethics 29 (4):1078-1090.
    Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...)
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  6.  15
    Adolescent autonomy revisited: clinicians need clearer guidance.Joe Brierley & Victor Larcher - 2016 - Journal of Medical Ethics 42 (8):482-485.
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  7.  10
    Consent in children’s intensive care: the voices of the parents of critically ill children and those caring for them.Phoebe Aubugeau-Williams & Joe Brierley - 2020 - Journal of Medical Ethics 46 (7):482-487.
    Despite its invasive nature, specific consent for general anaesthesia is rarely sought—rather consent processes for associated procedures include explanation of risk/benefits. In adult intensive care, because no one can consent to treatments provided to incapacitated adults, standardised consent processes have not developed. In paediatric intensive care, despite the ready availability of those who can provide consent, no tradition of seeking it exists, arguably due to the specialty’s evolution from anaesthesia and adult intensive care. With the current Montgomery-related focus on consent, (...)
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  8.  21
    Medical Innovation in a Children's Hospital: ‘Diseases desperate grown by desperate appliance are relieved, or not at all’.Vic Larcher, Helen Turnham & Joe Brierley - 2017 - Bioethics 32 (1):36-42.
    A balance needs to be struck between facilitating compassionate access to innovative treatments for those in desperate need, and the duty to protect such vulnerable individuals from the harms of untested/unlicensed treatments. We introduced a principle-based framework to evaluate such requests and describe its application in the context of recently evolved UK, US and European regulatory processes. 24 referrals were received by our quaternary children's hospital Clinical Ethics Committee over the 5-year period. The CEC-rapid response group evaluated individual cases within (...)
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  9.  13
    Premortem interventions in dying children to optimise organ donation: an ethical analysis.Joe Brierley & David Shaw - 2016 - Journal of Medical Ethics 42 (7):424-428.
  10.  32
    Living bioethics, theories and children’s consent to heart surgery.Priscilla Alderson, Deborah Bowman, Joe Brierley, Nathalie Dedieu, Martin J. Elliott, Jonathan Montgomery & Hugo Wellesley - forthcoming - Clinical Ethics:147775092210910.
    Background This analysis is about practical living bioethics and how law, ethics and sociology understand and respect children’s consent to, or refusal of, elective heart surgery. Analysis of underlying theories and influences will contrast legalistic bioethics with living bioethics. In-depth philosophical analysis compares social science traditions of positivism, interpretivism, critical theory and functionalism and applies them to bioethics and childhood, to examine how living bioethics may be encouraged or discouraged. Illustrative examples are drawn from research interviews and observations in two (...)
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  11.  12
    Involving parents in paediatric clinical ethics committee deliberations: a current controversy.David Archard, Emma Cave & Joe Brierley - 2023 - Journal of Medical Ethics 49 (11):733-736.
    In cases where the best interests of the child are disputed or finely balanced, Clinical Ethics Committees (CECs) can provide a valuable source of advice to clinicians and trusts on the pertinent ethical dimensions. Recent judicial cases have criticised the lack of formalised guidance and inconsistency in the involvement of parents in CEC deliberations. In Manchester University NHS FT v Verden [2022], Arbuthnot J set out important procedural guidance as to how parental involvement in CEC deliberations might be managed. She (...)
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  12.  5
    ‘Who Ya Gonna Call …?’ Ethical and legal dilemmas in specialist children centres and district general hospitals.Harika Avula, Mariana Dittborn & Joe Brierley - 2022 - Clinical Ethics 17 (4):415-424.
    The field of Paediatric Bioethics, or ethical issues applied to children's healthcare, is relatively new but has recently gained an increased professional and public profile. Clinical ethics support to health professionals and patients who face ethical challenges in clinical practice varies between and within institutions. Literature regarding services available to paediatricians is sparse in specialist tertiary centres and almost absent in general paediatrics. We performed a mixed-methods study using online surveys and focus groups to explore the experiences of ethical and (...)
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  13.  45
    Cui bono? Can feminist ethics show a path in complex decision-making where 'classical' theories cannot?Joe Brierley & Vic Larcher - 2011 - Clinical Ethics 6 (2):86-90.
    We present the case of a six-year-old child with a fatal brainstem tumour, who was left in a ‘locked-in state’ post-decompressive biopsy. A discussion of the ethical dilemma this situation presents, together with the deliberations of the ethics service when consulted about the optimal course of action, follow. The issues raised highlight an important conflict between the parental view of what is in the child's best interests and what may appear, prima facie, to clinical staff, to be in that child's (...)
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  14.  23
    Preventing arrests in the intensive care unit.Joe Brierley - 2013 - Journal of Medical Ethics 39 (12):776-777.
    You have not opened the wrong journal!The police have a duty to protect the public and to investigate any, and all, serious crimes. The article by Lynøe and Leijonhufvud raises important issues about the interaction between hospital staff and police in cases in which suggested medical negligence crosses into the arena of serious legal offences, which range from murder and homicide to serious assault.1Although arising in Sweden, the issues raised in this case are generalisable. While our understanding is limited to (...)
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  15.  23
    Quantitative valuation placed by children and teenagers on participation in two hypothetical research scenarios.Dan Funnell, Caroline Fertleman, Liz Carrey & Joe Brierley - 2012 - Journal of Medical Ethics 38 (11):686-691.
    For paediatric medicine to advance, research must be conducted specifically with children. Concern about poor recruitment has led to debate about payments to child research participants. Although concerns about undue influence by such ‘compensation’ have been expressed, it is useful to determine whether children can relate the time and inconvenience associated with participation to the value of payment offered. This study explores children's ability to determine fair remuneration for research participation, and reviews payments to children participating in research. Forty children (...)
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