Textual practices in crafting bioethics cases

What is it to do good medical ethics? Minding the gap(s)

This paper discusses the character of medical ethics and suggests that there are significant gaps that warrant greater attention. It describes ways in which the content and form of medical ethics may exclude or marginalise perspectives and contributions, thereby reducing its influence and its potential impact on, and value to, patients, students, carers and society. To consider what it is 'to do good medical ethics' suggests an active approach that seeks out, and learns from, contributions beyond the traditional boundaries of scholarship.

Medical humanities: lineage, excursionary sketch and rationale

Medical Humanities the journal started life in 2000 as a special edition of the JME. However, the intellectual taproots of the medical humanities as a field of enquiry can be traced to two developments: calls made in the 1920s for the development of multidisciplinary perspectives on the sciences that shed historical light on their assumptions, methods and practices; refusals to assimilate all medical phenomena to a biomedical worldview. Medical humanities the term stems from a desire to situate the significance of medicine as a product of culture. But despite growing usage over half a century the term defies a unifying encapsulation and continues to conjure up a multitude of discourse communities, including scholars working at the interfaces of health and humanities, arts and health, and medical education and bioethics. The field is intellectually capacious and polymorphous, forming and reforming around critical new research questions and teaching tasks spanning disciplines.

Attempting to standardise ethical review within the complexity of health-related research

Researchers in medicine, allied disciplines and elsewhere submit research proposals to an ethical review board before research commences. This paper argues that the effectiveness of review relies on reviewers using discernment and judgement when applying standardised review criteria so that they accommodate the full range of research projects. With reference to ethics literature, the paper identifies five imperatives in the development of review guidelines and processes. It examines case composition and analysis, and explores interactions between professional developers, researchers and reviewers to illustrate problems in the review process. It refers to the ethical review system in New Zealand and the report to parliament: Inquiry into Improving New Zealand's Environment to Support Innovation through Clinical Trials (Health Committee 2011). Seeking to gain for New Zealand a competitive edge in clinical research, this report made 19 recommendations to improve the climate for clinical trials, ethical review included, in this country. The connection between these two case studies is the common endeavour to standardise the ethical review exercise, review systems and review processes. Cases with commentary are a recommended addition to guidelines documents to present research within its context and to demonstrate the complexity that a standardised ethical review does not always address.