Journal of Medical Ethics
April 2016, Volume 42, Issue 4
http://jme.bmj.com/content/current

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Current controversy
The Ebola outbreak in Western Africa: ethical obligations for care
Aminu Yakubu, Morenike Oluwatoyin Folayan, Nasir Sani-Gwarzo, Patrick Nguku, Kristin Peterson, Brandon Brown
J Med Ethics 2016;42:209-210 Published Online First: 9 September 2014 doi:10.1136/medethics-2014-102434
Abstract
The recent wave of the Ebola Virus Disease (EVD) in Western Africa and efforts to control the disease where the health system requires strengthening raises a number of ethical challenges for healthcare workers practicing in these countries. We discuss the implications of weak health systems for controlling EVD and limitations of the ethical obligation to provide care for patients with EVD using Nigeria as a case study. We highlight the right of healthcare workers to protection that should be obligatorily provided by the government. Where the national government cannot meet this obligation, healthcare workers only have a moral and not a professional obligation to provide care to patients with EVD. The national government also has an obligation to adequately compensate healthcare workers that become infected in the course of duty. Institutionalisation of policies that protect healthcare workers are required for effective control of the spread of highly contagious diseases like EVD in a timely manner.

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Research led by participants: a new social contract for a new kind of research
Effy Vayena, Roger Brownsword, Sarah Jane Edwards, Bastian Greshake, Jeffrey P Kahn, Navjoyt Ladher, Jonathan Montgomery, Daniel O’Connor, Onora O’Neill, Martin P Richards, Annette Rid, Mark Sheehan, Paul Wicks, John Tasioulas
J Med Ethics 2016;42:216-219 Published Online First: 30 March 2015 doi:10.1136/medethics-2015-102663

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Paper: Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees
Rebecca H Li, Mary C Wacholtz, Mark Barnes, Liam Boggs, Susan Callery-D’Amico, Amy Davis,
Alla Digilova, David Forster, Kate Heffernan, Maeve Luthin, Holly Fernandez Lynch, Lindsay McNair, Jennifer E Miller, Jacquelyn Murphy, Luann Van Campen, Mark Wilenzick, Delia Wolf,
Cris Woolston, Carmen Aldinger, Barbara E Bierer
J Med Ethics 2016;42:229-234 Published Online First: 25 January 2016 doi:10.1136/medethics-2014-102540
Abstract
A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval

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Ethics briefing
The Mediterranean refugee crisis: ethics, international law and migrant health
Sophie Brannan, Ruth Campbell, Martin Davies, Veronica English, Rebecca Mussell, Julian C Sheather
J Med Ethics 2016;42:269-270 doi:10.1136/medethics-2016-103444
Extract
Europe is experiencing levels of forced migration not seen since the Second World War. Its sources lie in the fragile, strife-torn states of the Middle East and Africa: four million people have fled Syria since the conflict began; 12 million of those remaining require humanitarian assistance. Large numbers of people are fleeing violence in Iraq, Afghanistan and Eritrea. Although millions have been displaced by violence, others are seeking relief from endemic poverty and brutally restricted life-choices. Overwhelmingly their chosen routes into Europe are perilous—according to the UN High Commissioner for Refugees (UNHCR) over 590 000 people have arrived in Europe by sea this year.1 Nor do their difficulties end once they reach Europe. The asylum systems of the frontline countries, overwhelmingly Greece and Italy, never designed for such high levels of migration, are inadequate. In this thematic ethics brief we provide some background information to the crisis and raise a number of ethical issues it gives rise to…