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Lynn Gillam [64]Lynn H. Gillam [1]
  1. The zone of parental discretion: An ethical tool for dealing with disagreement between parents and doctors about medical treatment for a child.Lynn Gillam - 2016 - Clinical Ethics 11 (1):1-8.
    Dealing with situations where parents’ views about treatment for their child are strongly opposed to doctors’ views is one major area of ethical challenge in paediatric health care. The traditional approach focuses on the child’s best interests, but this is problematic for a number of reasons. The Harm Principle test is regarded by many ethicists as more appropriate than the best interests test. Despite this, use of the best interests test for intervening in parental decisions is still very common in (...)
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  2.  9
    Critical dialogue method of ethics consultation: making clinical ethics facilitation visible and accessible.Clare Delany, Sharon Feldman, Barbara Kameniar & Lynn Gillam - forthcoming - Journal of Medical Ethics.
    In clinical ethics consultations, clinical ethicists bring moral reasoning to bear on concrete and complex clinical ethical problems by undertaking ethical deliberation in collaboration with others. The reasoning process involves identifying and clarifying ethical values which are at stake or contested, and guiding clinicians, and sometimes patients and families, to think through ethically justifiable and available courses of action in clinical situations. There is, however, ongoing discussion about the various methods ethicists use to do this ethical deliberation work. In this (...)
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  3.  44
    Forever young? The ethics of ongoing puberty suppression for non-binary adults.Lauren Notini, Brian D. Earp, Lynn Gillam, Rosalind J. McDougall, Julian Savulescu, Michelle Telfer & Ken C. Pang - 2020 - Journal of Medical Ethics 46 (11):743-752.
    In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical defensibility (...)
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  4.  40
    Can the Ethical Best Practice of Shared Decision-Making lead to Moral Distress?Trisha M. Prentice & Lynn Gillam - 2018 - Journal of Bioethical Inquiry 15 (2):259-268.
    When healthcare professionals feel constrained from acting in a patient’s best interests, moral distress ensues. The resulting negative sequelae of burnout, poor retention rates, and ultimately poor patient care are well recognized across healthcare providers. Yet an appreciation of how particular disciplines, including physicians, come to be “constrained” in their actions is still lacking. This paper will examine how the application of shared decision-making may contribute to the experience of moral distress for physicians and why such distress may go under-recognized. (...)
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  5.  62
    The role of emotions in health professional ethics teaching.Lynn Gillam, Clare Delany, Marilys Guillemin & Sally Warmington - 2014 - Journal of Medical Ethics 40 (5):331-335.
    In this paper, we put forward the view that emotions have a legitimate and important role in health professional ethics education. This paper draws upon our experience of running a narrative ethics education programme for ethics educators from a range of healthcare disciplines. It describes the way in which emotions may be elicited in narrative ethics teaching and considers the appropriate role of emotions in ethics education for health professionals. We argue there is a need for a pedagogical framework to (...)
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  6.  41
    Balancing health worker well-being and duty to care: an ethical approach to staff safety in COVID-19 and beyond.Rosalind J. McDougall, Lynn Gillam, Danielle Ko, Isabella Holmes & Clare Delany - 2021 - Journal of Medical Ethics 47 (5):318-323.
    The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-being. We describe each of these values, and present a decision-making framework (...)
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  7.  27
    Understanding the Reasons Behind Healthcare Providers’ Conscientious Objection to Voluntary Assisted Dying in Victoria, Australia.Casey M. Haining, Louise A. Keogh & Lynn H. Gillam - 2021 - Journal of Bioethical Inquiry 18 (2):277-289.
    During the debates about the legalization of Voluntary Assisted Dying in Victoria, Australia, the presence of anti-VAD health professionals in the medical community and reported high rates of conscientious objection to VAD suggested access may be limited. Most empirical research on CO has been conducted in the sexual and reproductive health context. However, given the fundamental differences in the nature of such procedures and the legislation governing it, these findings may not be directly transferable to VAD. Accordingly, we sought to (...)
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  8.  22
    Telling the truth to seriously ill children: Considering children's interests when parents veto telling the truth.Lynn Gillam, Merle Spriggs, Maria McCarthy & Clare Delany - 2022 - Bioethics 36 (7):765-773.
    Bioethics, Volume 36, Issue 7, Page 765-773, September 2022.
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  9.  28
    The practice of balancing in clinical ethics case consultation.Rosalind McDougall, Cade Shadbolt & Lynn Gillam - 2020 - Clinical Ethics 15 (1):49-55.
    Models for clinical ethics case consultation often make reference to ‘balancing’ or ‘weighing’ moral considerations, without further detail. In this paper, we investigate balancing in clinical ethics case consultation. We suggest that, while clinical ethics services cannot resolve ongoing deep philosophical debates about the nature of ethical reasoning, clinical ethicists can and should be more systematic and transparent when balancing considerations in case consultations. We conceptualise balancing on a spectrum from intuitive to deliberative, and argue that good balancing in case (...)
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  10. Predictive genetic testing in minors for late-onset conditions: a chronological and analytical review of the ethical arguments: Figure 1.Cara Mand, Lynn Gillam, Martin B. Delatycki & Rony E. Duncan - 2012 - Journal of Medical Ethics 38 (9):519-524.
    Predictive genetic testing is now routinely offered to asymptomatic adults at risk for genetic disease. However, testing of minors at risk for adult-onset conditions, where no treatment or preventive intervention exists, has evoked greater controversy and inspired a debate spanning two decades. This review aims to provide a detailed longitudinal analysis and concludes by examining the debate's current status and prospects for the future. Fifty-three relevant theoretical papers published between 1990 and December 2010 were identified, and interpretative content analysis was (...)
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  11.  21
    Identity, well-being and autonomy in ongoing puberty suppression for non-binary adults: a response to the commentaries.Lauren Notini, Brian D. Earp, Lynn Gillam, Julian Savulescu, Michelle Telfer & Ken C. Pang - 2020 - Journal of Medical Ethics 46 (11):761-762.
    We thank the commentators for their thoughtful responses to our article.1 Due to space constraints, we will confine our discussion to just three key issues. The first issue relates to the central ethical conundrum for clinicians working with young people like Phoenix: namely, how to respect, value and defer to a person’s own account of their identity and what is needed for their well-being, while staying open to the possibility that such an account may reflect a work in progress. This (...)
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  12.  35
    Collaboration in Clinical Ethics Consultation: A Method for Achieving “Balanced Accountability”.Rosalind McDougall, Clare Delany, Merle Spriggs & Lynn Gillam - 2014 - American Journal of Bioethics 14 (6):47-48.
  13.  23
    Managing aggression in hospitals: A role for clinical ethicists.Clare Delany, Anusha Hingalagoda, Lynn Gillam & Neil Wimalasundera - 2021 - Clinical Ethics 16 (3):252-258.
    Hospitals are places where patients are unwell, where patients and their families may be upset, confused, frustrated, in pain, and vulnerable. The likelihood of these experiences and emotions manifesting in anger and aggressive behaviour is high. In this paper, we describe the involvement of a clinical ethics service responding to a request to discuss family aggression within a rehabilitation department in a large paediatric hospital in Australia. We suggest two key advantages of involving a clinical ethics service in discussions about (...)
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  14.  23
    The Value of Open Deliberation in Clinical Ethics, and the Role of Parents’ Reasons in the Zone of Parental Discretion.Rosalind McDougall, Clare Delany & Lynn Gillam - 2018 - American Journal of Bioethics 18 (8):47-49.
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  15.  19
    What Is the Ethical Goal of Empowering Parents in Emergent Decision-making about Their Premature Newborn?Lynn Gillam & Trisha M. Prentice - 2022 - American Journal of Bioethics 22 (11):38-40.
    The idea of “postponed withholding,” proposed by Syltern et al. (2022), is a provocative one, and like all good provocative ideas, provokes deeper thinking from fresh perspectives. Our attention wa...
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  16.  16
    Expertise and Knowledge Required to Support Health Staff to Manage Stressful Events.Clare Delany, Sarah Jones, Jenni Sokol, Lynn Gillam & Trisha Prentice - 2022 - Journal of Bioethical Inquiry 19 (4):535-536.
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  17.  13
    Decision-making approaches for children with life-limiting conditions: results from a qualitative phenomenological study.Lynn Gillam, Katrina Williams, Jenny Hynson & Sidharth Vemuri - 2022 - BMC Medical Ethics 23 (1):1-11.
    BackgroundFor children with life-limiting conditions who are unable to participate in decision-making, decisions are made for them by their parents and paediatricians. Shared decision-making is widely recommended in paediatric clinical care, with parents preferring a collaborative approach in the care of their child. Despite the increasing emphasis to adopt this approach, little is known about the roles and responsibilities taken by parents and paediatricians in this process. In this study, we describe how paediatricians approach decision-making for a child with a (...)
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  18.  45
    The zone of parental discretion and the complexity of paediatrics: A response to Alderson.Rosalind McDougall, Lynn Gillam, Merle Spriggs & Clare Delany - 2018 - Clinical Ethics 13 (4):172-174.
    Alderson critiques our recent book on the basis that it overlooks children’s own views about their medical treatment. In this response, we discuss the complexity of the paediatric clinical context and the value of diverse approaches to investigating paediatric ethics. Our book focuses on a specific problem: entrenched disagreements between doctors and parents about a child’s medical treatment in the context of a paediatric hospital. As clinical ethicists, our research question arose from clinicians’ concerns in practice: What should a clinician (...)
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  19.  46
    Human Research Ethics in Practice: Deliberative Strategies, Processes and Perceptions.Lynn Gillam, Marilys Guillemin, Annie Bolitho & Doreen Rosenthal - 2009 - Monash Bioethics Review 28 (1):34-50.
    In theory, HREC members should use the ethical guidelines in the National Statement on the Ethical Conduct of Research Involving Humans as the basis for their decisions, and researchers should design their research in accordance with these guidelines However, very little is known about what researchers and HREC members actually do in practice. In this paper, we report some of the key findings of the study “Human Research Ethics in Practice”, a qualitative interview-based study of health researchers and HREC members (...)
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  20.  52
    Arguing by Analogy in the Fetal Tissue Debate.Lynn Gillam - 1997 - Bioethics 11 (5):397-412.
    In the debate over fetal tissue use, an analogy is often drawn between removing organs from the body of a person who has been murdered to use for transplantation, and collecting tissue from an aborted fetus to use for the same purpose. The murder victim analogy is taken by its proponents to show that even if abortion is the moral equivalent of murder, there is still no good reason to refrain from using the fetal tissue, since as a society we (...)
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  21.  26
    Therapeutic appropriation: a new concept in the ethics of clinical research.Rosalind McDougall, Dominique Martin, Lynn Gillam, Nina Hallowell, Alison Brookes & Marilys Guillemin - 2016 - Journal of Medical Ethics 42 (12):805-808.
    Ethical concerns about therapeutic misconception have been raised since the early 1980s. This concept was originally described as research participants' assumptions that decisions relating to research interventions are made on the basis of their individual therapeutic needs. The term has since been used to refer to a range of ‘misunderstandings’ that research participants may have. In this paper, we describe a new concept—therapeutic appropriation. Therapeutic appropriation occurs when patients, or clinicians, actively reframe research participation as an opportunity to enhance patients' (...)
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  22.  53
    Body Dysmorphic Disorder: Contraindication or Ethical Justification for Female Genital Cosmetic Surgery in Adolescents.Merle Spriggs & Lynn Gillam - 2016 - Bioethics 30 (9):706-713.
    Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has; and even if there is valid parental consent, the presence of Body Dysmorphic Disorder means that cosmetic surgery will (...)
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  23. (1 other version)When Medicine Went Mad: Bioethics and the Holocaust.Arthur L. Caplan & Lynn Gillam - 1996 - Bioethics 10 (2):180-181.
     
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  24.  71
    Developing “Ethical Mindfulness” in Continuing Professional Development in Healthcare: Use of a Personal Narrative Approach.Marilys Guillemin, Rosalind Mcdougall & Lynn Gillam - 2009 - Cambridge Quarterly of Healthcare Ethics 18 (2):197.
  25.  34
    Making Meaning From Experience: A Working Typology for Pediatrics Ethics Consultations.Lynn Gillam, Rosalind McDougall & Clare Delany - 2015 - American Journal of Bioethics 15 (5):24-26.
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  26.  27
    (1 other version)Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?Rosalind J. McDougall, Lynn Gillam, Clare Delany & Yasmin Jayasinghe - 2017 - Journal of Medical Ethics Recent Issues 44 (1):27-31.
    Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion (...)
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  27.  32
    Ethical complexities in child co-research.Merle Spriggs & Lynn Gillam - 2017 - Research Ethics 15 (1):1-16.
    Child co-research has become popular in social research involving children. This is attributed to the emphasis on children’s rights and is seen as a way to promote children’s agency and voice. It is a way of putting into practice the philosophy, common amongst childhood researchers, that children are experts on childhood. In this article, we discuss ethical complexities of involving children as co-researchers, beginning with an analysis of the literature, then drawing on data from interviews with researchers who conduct child (...)
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  28.  18
    A commentary on the NH&MRC Draft Values and Ethics in Aboriginal and Torres Strait Islander Health Research.Lynn Gillam & Priscilla Pyett - 2003 - Monash Bioethics Review 22 (4):8-19.
    In this paper, we discuss and critically evaluate the National Health and Medical Research Council’s recently released document entitled ‘Draft Values and Ethics in Aboriginal and Torres Strait Islander Health Research’. We provide a brief account of its development, philosophy and contents, and then consider how the document could be used by HRECs. We recommend that three specially targeted documents be developed from this one document, to meet the particular needs of HRECs, Indigenous people and researchers. We propose a system (...)
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  29.  52
    Balancing obligations: should written information about life-sustaining treatment be neutral?Vicki Xafis, Dominic Wilkinson, Lynn Gillam & Jane Sullivan - 2015 - Journal of Medical Ethics 41 (3):234-239.
    Parents who are facing decisions about life-sustaining treatment for their seriously ill or dying child are supported by their child's doctors and nurses. They also frequently seek other information sources to help them deal with the medical and ethical questions that arise. This might include written or web-based information. As part of a project involving the development of such a resource to support parents facing difficult decisions, some ethical questions emerged. Should this information be presented in a strictly neutral fashion? (...)
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  30.  10
    Doctor–Parent Disagreement for Preterm Infants Born in the Grey Zone: Do Ethical Frameworks Help?Alice Cavolo, Danya F. Vears, Gunnar Naulaers, Bernadette Dierckx de Casterlé, Lynn Gillam & Chris Gastmans - forthcoming - Journal of Bioethical Inquiry:1-12.
    Objective: To examine i) how ethical frameworks can be used in concrete cases of parent–doctors’ disagreements for extremely preterm infants born in the grey zone to guide such difficult decision-making; and ii) what challenges stakeholders may encounter in using these frameworks. Design: We did a case analysis of a concrete case of parent–doctor disagreement in the grey zone using two ethical frameworks: the best interest standard and the zone of parental discretion. Results: Both ethical frameworks entailed similar advantages and challenges. (...)
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  31.  76
    The Unique Nature of Clinical Ethics in Allied Health Pediatrics: Implications for Ethics Education.Clare Delany, Merle Spriggs, Craig L. Fry & Lynn Gillam - 2010 - Cambridge Quarterly of Healthcare Ethics 19 (4):471-480.
    Ethics education is recognized as an integral component of health professionals’ education and has been occurring in various guises in the curricula of health professional training in many countries since at least the 1970s. However, there are a number of different aims and approaches adopted by individual educators, programs, and, importantly, different health professions that may be characterized according to strands or trends in ethics education.
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  32.  23
    “I Don’t See That as a Medical Problem”: Clinicians’ Attitudes and Responses to Requests for Cosmetic Genital Surgery by Adolescents.Merle Spriggs & Lynn Gillam - 2018 - Journal of Bioethical Inquiry 15 (4):535-548.
    Labiaplasty is a form of genital surgery to reduce large or protruding labia minora. Internationally, the rates of this surgery among women and girls is increasing and is viewed as a worrying trend. Currently, the main clinical strategy is to reassure adolescents that they are normal by talking about the variation of labia size and appearance and showing pictures demonstrating the wide range of normal female genital appearance. For the most part, policy documents recommend against labiaplasty in adolescents, claiming that (...)
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  33.  54
    Gillick competence: an inadequate guide to the ethics of involving adolescents in decision-making.Avraham Bart, Georgina Antonia Hall & Lynn Gillam - 2024 - Journal of Medical Ethics 50 (3):157-162.
    Developmentally, adolescence sits in transition between childhood and adulthood. Involving adolescents in their medical decision-making prompts important and complex ethical questions. Originating in the UK, the concept of Gillick competence is a dominant framework for navigating adolescent medical decision-making from legal, ethical and clinical perspectives and is commonly treated as comprehensive. In this paper, we argue that its utility is far more limited, and hence over-reliance on Gillick risks undermining rather than promoting ethically appropriate adolescent involvement. We demonstrate that Gillick (...)
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  34.  37
    The Concept of “Continuing Creation” Will Not Save Us From Difficult Decisions.Trisha Prentice, Peter G. Davis & Lynn Gillam - 2017 - American Journal of Bioethics 17 (8):23-25.
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  35.  11
    ‘Obstructive and power hungry’?: the Australian human research ethics process.Doreen Rosenthal, Marilys Guillemin & Lynn Gillam - 2006 - Monash Bioethics Review 25 (2):S30-S38.
    ObjectivesTo investigate the views of Human Research Ethics Committee (HREC) members and of researchers concerning the human research ethics review process in Australia.To examine whether there are differences between views of researchers and HREC members.Design and settingRegistrants at the NHMRC Ethics in Human Research Conference held in Canberra in May 2005 were surveyed by anonymous questionnaire comprising 14 questionnaire items and background demographic questions.ResultsOf the 407 registrants, 252 completed the questionnaire (62% response rate). Respondents comprised 219 (87%) HREC members or (...)
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  36.  40
    Deception of children in research.Merle Spriggs & Lynn Gillam - 2015 - Journal of Medical Ethics 41 (2):179-182.
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  37.  20
    Ethical Issues in Transplantation.Lynn Gillam - 1992 - Monash Bioethics Review 11 (2):28-39.
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  38.  21
    Secret ethics business?Lynn Gillam - 2003 - Monash Bioethics Review 22 (1):S52-S62.
    In this paper, I question the common assumption that the workings of Human Research Ethics Committees should be treated as confidential This is actually quite a complex issue, since there are many stages in the ethics approval process, and a number of different stakeholders who might wish to claim access, or restrict access, to different sorts of information. Here I consider just one aspect — whether ethics committee members should be free to reveal in public the details of what occurs (...)
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  39.  17
    The scope of ethical dilemmas in paediatric nursing: a survey of nurses from a tertiary paediatric centre in Australia.Ingrid Schulz, Jenny O’Neill, Peter Gillam & Lynn Gillam - 2023 - Nursing Ethics 30 (4):526-541.
    Background No previous study has provided evidence for the scope and frequency of ethical dilemmas for paediatric nurses. It is essential to understand this to optimise patient care and tailor ethics support for nurses. Research aim The aim of this study was to explore the scope of nurses’ ethical dilemmas in a paediatric hospital and their engagement with the hospital clinical ethics service. Research design This study used a cross-sectional survey design. Participants and research context Paediatric nursing staff in a (...)
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  40.  13
    Teaching Ethics in the Health Professions.Lynn Gillam - 1998 - In Helga Kuhse & Peter Singer (eds.), A Companion to Bioethics. Malden, Mass., USA: Wiley-Blackwell. pp. 584–593.
    This chapter contains sections titled: Trends in Ethics Teaching in the Health Professions Theoretical Questions Underlying Curriculum Content Ethical Knowledge or Ethical Behavior? The Hidden Curriculum Conclusion References.
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  41. Truth-telling to the seriously ill child – Nurses’ experiences, attitudes, and beliefs.Mandy El Ali, Sharon Licqurish, Jenny O'Neill & Lynn Gillam - 2024 - Nursing Ethics 31 (5):930-950.
    Background Nurses play an integral role in the care of children hospitalised with a serious illness. Although information about diagnostics, treatments, and prognosis are generally conveyed to parents and caregivers of seriously ill children by physicians, nurses spend a significant amount of time at the child’s bedside and have an acknowledged role in helping patients and families understand the information that they have been given by a doctor. Hence, the ethical role of the nurse in truth disclosure to children is (...)
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  42.  21
    Democratizing “Psychotropic Neuroenhancement”.Jared Cooze & Lynn Gillam - 2010 - American Journal of Bioethics Neuroscience 1 (1):19-20.
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  43.  38
    Predictive testing in minors: the need for empirical evidence.Martin B. Delatycki, Cara Mand, Lynn Gillam & Rony Duncan - 2012 - Journal of Medical Ethics 38 (9):533-534.
  44.  12
    But is this really a matter for the ethics committee?Lynn Gillam - 1993 - Monash Bioethics Review 12 (5):15-19.
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  45.  13
    Expertise in research ethics: Is there any such thing?Lynn Gillam - 2004 - Monash Bioethics Review 23 (3):S58-S64.
    In this paper, I consider the question of whether there is such a thing as ‘expertise in research ethics’. I discuss first the issue of expertise in ethics more generally. There is quite a lot of resistance to the idea that there are ethics experts, for reasons which I will raise and respond to. I outline two different views of what might be counted as expertise in ethics, and argue that only one of these is defensible. But the defensible view (...)
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  46.  12
    Experimenting on human subjects: the ethical issues.Lynn Gillam - 1993 - Monash Bioethics Review 12 (5):30-47.
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  47.  16
    Human embryo experimentation: The ethical debate.Lynn Gillam - 1993 - Monash Bioethics Review 12 (4):33-42.
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  48.  9
    (1 other version)Pure Selection: The Ethics Of Pre-Implantation Genetic Diagnosis And Choosing Children Without Abortion.Lynn Gillam - 2001 - Journal of Medical Ethics 27 (6):415-2.
    This book investigates the issue of “pure selection”–that is, choosing the genetic characteristics of one's children, without using abortion as the method to achieve this. Pure selection is made possible by the relatively new technology of preimplantation genetic diagnosis (PGD), in conjunction with now-routine IVF procedures for creating embryos. In PGD, a cell or cells can be extracted from an early embryo, and be subjected to genetic diagnosis of whatever kind, without damaging the embryo. So embryos with the genetic make (...)
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  49.  33
    Response.Lynn Gillam - 2007 - Journal of Bioethical Inquiry 4 (2):153-153.
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  50.  15
    (1 other version)Resource allocation: The unavoidable debate.Lynn Gillam - 1992 - Monash Bioethics Review 12 (1):43-53.
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