Journal of Medical Ethics – July 2014

Journal of Medical Ethics
July 2014, Volume 40, Issue 7
http://jme.bmj.com/content/current

The concise argument
Why is informed consent important?
Rebecca Roache, Associate Editor
Decision-making is a prominent theme in this edition of the Journal of Medical Ethics. Our feature article examines the relationship between trust and informed consent. Informed consent is, of course, central to the decision-making process in medicine. In addition, several articles consider decision-making in medicine from a variety of angles.

Clinical ethics
Paper
Overriding parents’ medical decisions for their children: a systematic review of normative literature
Rosalind J McDougall, Lauren Notini
Author Affiliations
Centre for Health and Society, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
Abstract
This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question ‘when health professionals and parents disagree about the appropriate course of medical treatment for a child, under what circumstances is the health professional ethically justified in overriding the parents’ wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. Each of these frameworks centred on a different key moral concept including harm, constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality.

Theoretical ethics
Paper
Islam and the four principles of medical ethics
Yassar Mustafa
Author Affiliations
Queen Elizabeth Hospital, Birmingham, West Midlands, UK
Abstract
The principles underpinning Islam’s ethical framework applied to routine clinical scenarios remain insufficiently understood by many clinicians, thereby unfortunately permitting the delivery of culturally insensitive healthcare. This paper summarises the foundations of the Islamic ethical theory, elucidating the principles and methodology employed by the Muslim jurist in deriving rulings in the field of medical ethics. The four-principles approach, as espoused by Beauchamp and Childress, is also interpreted through the prism of Islamic ethical theory. Each of the four principles (beneficence, non-maleficence, justice and autonomy) is investigated in turn, looking in particular at the extent to which each is rooted in the Islamic paradigm. This will provide an important insight into Islamic medical ethics, enabling the clinician to have a better informed discussion with the Muslim patient. It will also allow for a higher degree of concordance in consultations and consequently optimise culturally sensitive healthcare delivery.