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Ashby MA, Morrell B. The Pensive Gaze. J Bioeth Inq 2021; 18:365-370. [PMID: 34669092 PMCID: PMC8526987 DOI: 10.1007/s11673-021-10129-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Michael A. Ashby
- Cancer, Chronic Disease and Sub-Acute Stream, Royal Hobart Hospital, Tasmanian Health Service, School of Medicine, University of Tasmania, Royal Hobart Hospital, Hobart, TAS 7000 Australia
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Ghinea N, Critchley C, Morrell B, Kerridge I, Campbell T, Day R, Gazarian M, Isaacs D, Liauw W, Olver I, Pace J, Pearson S, Salkeld G, Lipworth W. A survey of Australian public attitudes towards funding of high cost cancer medicines. Health Policy 2020; 125:327-334. [PMID: 33402264 DOI: 10.1016/j.healthpol.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND In the past decade many novel, and in some cases transformative, cancer medicines have entered the market. Their prices and the amount spent on them by governments have increased rapidly, bringing to the forefront trade-offs that must be made. In this paper we explore the Australian public's attitude towards the funding of high cost cancer medicines (HCCM) to inform reimbursement and health technology assessment (HTA) policy. METHODS A survey consisting of 49 questions about the funding of HCCMs was developed by the investigators. Recruitment was conducted via Qualtrics. 1039 Australian adults completed the survey. RESULTS The Australian public overwhelmingly supports funding of HCCMs (95.5 %) to enhance equity of access (97.8 %), and to respond to patients' needs (98 %). When respondents were challenged to balance equity versus access in different contexts inconsistencies emerged. Different demographic factors were important in predicting support for various strategies. CONCLUSION Our results suggest that the Australian public strongly supports government funding of HCCMs and values both equity and access. Equally, however, the public is uncertain about how equity and access are to be balanced and achieved, and such ambivalence needs to be both further explored and accommodated in policy processes. Our results may be used by policymakers in Australia, and countries with similar systems and values, to further develop policies and processes for funding HCCMs.
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Affiliation(s)
- Narcyz Ghinea
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia.
| | - Christine Critchley
- Swinburne University of Technology, School of Health Sciences, Department of Psychology, VIC 3122, Australia
| | - Bronwen Morrell
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia
| | - Ian Kerridge
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia; Haematology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Terry Campbell
- UNSW Sydney, Faculty of Medicine, NSW 2052, Australia; St Vincent's Hospital Sydney, NSW 2010, Australia
| | - Richard Day
- UNSW Sydney, St Vincent's Clinical School, NSW 2010, Australia
| | | | - David Isaacs
- The University of Sydney, Faculty of Medicine and Health, NSW 2050, Australia; The Children's Hospital at Westmead, NSW 2145, Australia
| | - Winston Liauw
- UNSW Sydney, St George and Sutherland Clinical School, NSW 2217, Australia
| | - Ian Olver
- The University of Adelaide, Faculty of Health and Medical Sciences, School of Psychology, Australia
| | - Jessica Pace
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia
| | - Sallie Pearson
- UNSW Sydney, Centre for Big Data Research in Health, NSW 2052, Australia; The University of Sydney, Faculty of Medicine and Health, Menzies Centre for Health Policy, NSW 2006, Australia
| | - Glenn Salkeld
- The University of Wollongong, Faculty of Social Sciences, NSW 2522, Australia
| | - Wendy Lipworth
- The University of Sydney, School of Public Health, Sydney Health Ethics, NSW 2006, Australia
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Affiliation(s)
- Michael Ashby
- Cancer, Chronic Disease and Sub-Acute Stream, Royal Hobart Hospital, Tasmanian Health Service, Medical Ethics and Death Studies, School of Medicine, College of Health and Medicine, University of Tasmania, Repatriation Centre, 90 Davey Street, TAS, Hobart, 7000, Australia.
| | - Bronwen Morrell
- Sydney Health Ethics, Level 1, Medical Foundation Building, K25, University of Sydney, Sydney, NSW, 2006, Australia
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Ashby MA, Morrell B. To Your Good Health! Going to the Pub With Friends, Nursing Dying Patients, And 'ER' Receptionists: the Ubiquitous Rise of Risk Management and Maybe A 'Prudential' Bioethics? J Bioeth Inq 2019; 16:1-5. [PMID: 30968315 DOI: 10.1007/s11673-019-09912-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Michael A Ashby
- Cancer, Chronic Disease and Sub-Acute Stream, Royal Hobart Hospital, Tasmanian Health Service, University of Tasmania, Repatriation Centre, 90 Davey Street, Hobart, TAS, 7000, Australia.
- Medical Ethics and Death Studies, School of Medicine, College of Health and Medicine, University of Tasmania, Repatriation Centre, 90 Davey Street, Hobart, TAS, 7000, Australia.
| | - Bronwen Morrell
- Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney, Level 1, Medical Foundation Building, K25, Sydney, NSW, 2006, Australia
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Ashby MA, Morrell B. To the Barricades or the Blackboard: Bioethical Activism and the "Stance of Neutrality". J Bioeth Inq 2018; 15:479-482. [PMID: 30560401 DOI: 10.1007/s11673-018-9887-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Michael A Ashby
- Cancer, Chronic Disease and Sub-Acute Stream, Royal Hobart Hospital, Tasmanian Health Service, and Medical Ethics and Death Studies, School of Medicine, College of Health and Medicine, University of Tasmania, Repatriation Centre, 90 Davey Street, Hobart, TAS, 7000, Australia.
| | - Bronwen Morrell
- Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney, Level 1, Medical Foundation Building, K25, Sydney, NSW, 2006, Australia
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Ashby MA, Morrell B. Embedded Journalists or Empirical Critics? The Nature of The "Gaze" in Bioethics. J Bioeth Inq 2018; 15:305-307. [PMID: 30341675 DOI: 10.1007/s11673-018-9879-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Michael A Ashby
- Palliative Care Service, Royal Hobart Hospital, Tasmanian Health Service, and School of Medicine, Faculty of Health Sciences, University of Tasmania, 1st Floor, Peacock Building, Repatriation Centre, 90 Davey Street, Hobart, TAS, 7000, Australia.
| | - Bronwen Morrell
- Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney, Level 1, Medical Foundation Building, K25, Sydney, NSW, 2006, Australia
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Ashby MA, Morrell B. Bioethics and the Freedom Road. The JBI Community and the Change We Want To See. J Bioeth Inq 2018; 15:175-179. [PMID: 29968016 DOI: 10.1007/s11673-018-9867-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Michael A Ashby
- Palliative Care Service, Royal Hobart Hospital, Tasmanian Health Service, and School of Medicine, Faculty of Health Sciences, University of Tasmania, 1st Floor, Peacock Building, Repatriation Centre, 90 Davey Street, Hobart, TAS, 7000, Australia.
| | - Bronwen Morrell
- Faculty of Medicine and Health, The University of Sydney, Sydney Health Ethics, Level 1, Medical Foundation Building, K25, University of Sydney, NSW, 2006, Australia
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Affiliation(s)
- Michael A Ashby
- Royal Hobart Hospital, Tasmanian Health Service, and School of Medicine, Faculty of Health Sciences, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Bronwen Morrell
- Sydney Health Ethics, Sydney School of Public Health, University of Sydney, Sydney, Australia
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Ashby MA, Morrell B. Power to the People? J Bioeth Inq 2017; 14:457-459. [PMID: 29143188 DOI: 10.1007/s11673-017-9819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Michael A Ashby
- Palliative Care Service, Royal Hobart Hospital, Tasmanian Health Service, and School of Medicine, Faculty of Health Sciences, University of Tasmania, 1st Floor, Peacock Building, Repatriation Centre, 90 Davey Street, Hobart, TAS, 7000, Australia.
| | - Bronwen Morrell
- Sydney Health Ethics, The University of Sydney, Level 1, Medical Foundation Building, K25, Camperdown, NSW, 2006, Australia
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Gustot T, Fernandez J, Garcia E, Morando F, Caraceni P, Alessandria C, Laleman W, Trebicka J, Elkrief L, Hopf C, Solís-Munoz P, Saliba F, Zeuzem S, Albillos A, Benten D, Montero-Alvarez JL, Chivas MT, Concepción M, Córdoba J, McCormick A, Stauber R, Vogel W, de Gottardi A, Welzel TM, Domenicali M, Risso A, Wendon J, Deulofeu C, Angeli P, Durand F, Pavesi M, Gerbes A, Jalan R, Moreau R, Ginés P, Bernardi M, Arroyo V, Bañares R, Bocci M, Catalina MV, Chin JL, Coenraad MJ, Coilly A, Dorn L, Gatta A, Gerber L, Grøenbæk H, Graupera I, Guevara M, Hausen A, Karlsen S, Lohse AW, Maggioli C, Markwardt D, Martinez J, Marzano A, de la Mata García M, Mesonero F, Mookerjee RP, Moreno C, Morrell B, Mortensen C, Nevens F, Peck‐Radosavljevic M, Rizzetto M, Romano A, Samuel D, Sauerbruch T, Simon‐Talero M, Solà E, Soriano G, Sperl J, Spindelboeck W, Steib C, Valla D, Verbeke L, Van Vlierberghe H, Wege H, Willars C, Baenas MY, Zaccherini G. Clinical Course of acute-on-chronic liver failure syndrome and effects on prognosis. Hepatology 2015; 62:243-52. [PMID: 25877702 DOI: 10.1002/hep.27849] [Citation(s) in RCA: 407] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 04/07/2015] [Indexed: 12/20/2022]
Abstract
UNLABELLED Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation (AD) of cirrhosis, organ failure(s), and high 28-day mortality. We investigated whether assessments of patients at specific time points predicted their need for liver transplantation (LT) or the potential futility of their care. We assessed clinical courses of 388 patients who had ACLF at enrollment, from February through September 2011, or during early (28-day) follow-up of the prospective multicenter European Chronic Liver Failure (CLIF) ACLF in Cirrhosis study. We assessed ACLF grades at different time points to define disease resolution, improvement, worsening, or steady or fluctuating course. ACLF resolved or improved in 49.2%, had a steady or fluctuating course in 30.4%, and worsened in 20.4%. The 28-day transplant-free mortality was low-to-moderate (6%-18%) in patients with nonsevere early course (final no ACLF or ACLF-1) and high-to-very high (42%-92%) in those with severe early course (final ACLF-2 or -3) independently of initial grades. Independent predictors of course severity were CLIF Consortium ACLF score (CLIF-C ACLFs) and presence of liver failure (total bilirubin ≥12 mg/dL) at ACLF diagnosis. Eighty-one percent had their final ACLF grade at 1 week, resulting in accurate prediction of short- (28-day) and mid-term (90-day) mortality by ACLF grade at 3-7 days. Among patients that underwent early LT, 75% survived for at least 1 year. Among patients with ≥4 organ failures, or CLIF-C ACLFs >64 at days 3-7 days, and did not undergo LT, mortality was 100% by 28 days. CONCLUSIONS Assessment of ACLF patients at 3-7 days of the syndrome provides a tool to define the emergency of LT and a rational basis for intensive care discontinuation owing to futility.
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Affiliation(s)
- Thierry Gustot
- Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Elisabet Garcia
- Data Management Center of the EASL-CLIF Consortium, CIBEReHD, Barcelona, Spain
| | | | | | | | - Wim Laleman
- University Hospital Gasthuisberg, Leuven, Belgium
| | | | | | - Corinna Hopf
- University of Munich, Klinikum der LMU, Munich, Germany
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- Data Management Center of the EASL-CLIF Consortium, CIBEReHD, Barcelona, Spain
| | | | | | - Marco Pavesi
- Data Management Center of the EASL-CLIF Consortium, CIBEReHD, Barcelona, Spain
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Lipworth W, Kerridge I, Morrell B, Forsyth R, Jordens CFC. Views of health journalists, industry employees and news consumers about disclosure and regulation of industry-journalist relationships: an empirical ethical study. J Med Ethics 2015; 41:252-257. [PMID: 24603036 DOI: 10.1136/medethics-2013-101790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Bioethicists and policymakers are increasingly concerned about the effects on health journalism of relationships between journalists and private corporations. The concern is that relationships between journalists and manufacturers of medicines, medical devices, complementary medicines and food can and do distort health reporting. This is a problem because health news is known to have a major impact on the public's health-related expectations and behaviour. Commentators have proposed two related approaches to protecting the public from potential harms arising from industry-journalist interactions: greater transparency and external regulation. To date, few empirical studies have examined stakeholders' views of industry-journalist relationships and how these should be managed. We conducted interviews with 13 journalists and 12 industry employees, and 2 focus groups with consumers. Our findings, which are synthesised here, provide empirical support for the need for greater transparency and regulation of industry-journalist relationships. Our findings also highlight several likely barriers to instituting such measures, which will need to be overcome if transparency and regulation are to be accepted by stakeholders and have their intended effect on the quality of journalism and the actions of news consumers.
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Affiliation(s)
- Wendy Lipworth
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia Australian Institute of Health Innovation, University of New South Wales, Sydney, New South Wales, Australia
| | - Ian Kerridge
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Bronwen Morrell
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Rowena Forsyth
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher F C Jordens
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
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Morrell B, Lipworth WL, Forsyth R, Jordens CFC, Kerridge I. Power and control in interactions between journalists and health-related industries: the view from industry. J Bioeth Inq 2014; 11:233-244. [PMID: 24796423 DOI: 10.1007/s11673-014-9518-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 12/22/2013] [Indexed: 06/03/2023]
Abstract
The mass media is a major source of health information for the public, and as such the quality and independence of health news reporting is an important concern. Concerns have been expressed that journalists reporting on health are increasingly dependent on their sources--including representatives of industries responsible for manufacturing health-related products--for story ideas and content. Many critics perceive an imbalance of power between journalists and industry sources, with industry being in a position of relative power, however the empirical evidence to support this view is limited. The analysis presented here--which is part of a larger study of industry-journalist relationships--draws on in-depth, semi-structured interviews with representatives of health-related industries in Australia to inductively examine their perceptions of power relations between industry and journalists. Participants painted a picture in which journalists, rather than themselves, were in a position to control the nature, extent, and outcome of their interactions with industry sources. Our results resonate with the concept of "mediatisation" as it has been applied in the domain of political reporting. It appears that, from the perspective of industry representatives, the imposition of media logic on health-related industries may inappropriately influence the information that the public receives about health-related products.
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Affiliation(s)
- Bronwen Morrell
- Sydney School of Public Health c/o Centre for Values, Ethics and the Law in Medicine Level 1, Medical Foundation Building, K25, University of Sydney, Sydney, NSW, 2006, Australia,
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Abstract
The news media is frequently criticised for failing to support the goals of government health campaigns. But is this necessarily the purpose of the media? We suggest that while the media has an important role in disseminating health messages, it is a mistake to assume that the media should serve the interests of government as it has its own professional ethics, norms, values, structures and roles that extend well beyond the interests of the health sector, and certainly beyond those of the government. While considerable attention has been given to the ways in which uncritical publication of industry perspectives by news media can negatively impact on public understandings of health and health behaviours, we would argue that it is equally important that journalists not become the 'lapdogs' of government interests. Further, we suggest that the interests of public health may be served more by supporting the ongoing existence of an independent media than by seeking to overdetermine its purpose or scope.
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Affiliation(s)
- Wendy Lipworth
- University of New South Wales, Sydney, New South Wales 2052, Australia.
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Chapman S, Morrell B, Forsyth R, Kerridge I, Stewart C. Policies and practices on competing interests of academic staff in Australian universities. Med J Aust 2012; 196:452-6. [PMID: 22509876 DOI: 10.5694/mja11.11224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To document the existence and provisions of Australian universities' policies on the competing interests of academic staff and university practices in recording, updating and making these declarations publicly accessible. DESIGN AND SETTING A 14-item survey was sent to the vice-chancellors of 39 Australian universities and university websites were searched for relevant policies. RESULTS Twelve universities declined to provide any information. Of the 27 that did, all had policies on staff competing interests. Fifteen did not require regular declarations from staff and only four required annual declarations. Eight universities maintained a centralised register of COIs of all staff and six had a mechanism in place that allowed members of the public to access information on COIs. None reported that they required that staff place their COI declarations on their website profiles and none had policies that indicated that staff should declare COIs when making a public comment. CONCLUSIONS Australian universities vary significantly in their approaches to the declaration and management of competing interests. While two-thirds of Australian universities require staff to declare competing interests, this information is mostly inaccessible to the public. Australian universities should adopt a standard approach to the declaration and management of competing interests and commit to meaningful transparency and public accountability. This could include frequently updated declarations on website profiles of all staff. In addition, dialogue about what is needed to effectively deal with competing interests should be encouraged.
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Affiliation(s)
- Simon Chapman
- School of Public Health, University of Sydney, Sydney, NSW.
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Morrell B, Jordens CFC, Kerridge IH, Harnett P, Hobbs K, Mason C. The perils of a vanishing cohort: a study of social comparisons by women with advanced ovarian cancer. Psychooncology 2012; 21:382-91. [DOI: 10.1002/pon.1909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2010] [Revised: 12/08/2010] [Accepted: 12/09/2010] [Indexed: 11/10/2022]
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Abstract
Tissue banking (or biobanking), thought by many to be an essential form of medical research, has raised a number of ethical issues that highlight a need to understand the beliefs and values of tissue donors, including the motivations underlying consent or refusal to donate. Data from our qualitative study of the legal, social, and ethical issues surrounding tumor banking in New South Wales, Australia, show that participants' attitudes to donation of tumor tissue for research are partially captured by theories of weak altruism and social exchange. However, we argue that the psychological rewards of value transformation described by Thompson's rubbish theory provide additional insights into participants' attitudes to tumor donation. We believe our data provides sufficient justification for an approach to regulation of tumor banking that is aimed at fostering a relationship based on the notions of virtuous reassignment and social exchange.
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Affiliation(s)
- Bronwen Morrell
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia.
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Jordens CFC, Morrell B, Harnett P, Hobbs K, Mason C, Kerridge IH. Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer. Soc Sci Med 2010; 71:1548-56. [PMID: 20832155 DOI: 10.1016/j.socscimed.2010.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 04/14/2010] [Accepted: 07/14/2010] [Indexed: 10/19/2022]
Abstract
Post-treatment surveillance of advanced ovarian cancer involves regular testing of asymptomatic patients using the CA125 test. This practice is based on a rationale that is not supported by evidence from clinical trials. This paper aims to stimulate critical reflection concerning the effect of investigative tests on clinical decisions and interactions, and the experience of illness, particularly in the context of advanced malignant disease. Drawing on the idea of the "medical gaze", and building on previous health communication research, we present an analysis of in-depth interviews and psychometric tests collected in a prospective study of 20 Australian women with advanced ovarian cancer conducted between 2006 and 2009. We describe the demands placed on patients by the use of the CA125 test, some hazards it creates for decision-making, and some of the test's subjective benefits. It is widely believed that the CA125 test generates anxiety among patients, and the proposed solution is to educate women more about the test. We found no evidence that anxiety was a problem requiring a response over and above existing services. We conclude that the current debate is simplistic and limited. Focussing on patient anxiety does not account for other important effects of post-treatment surveillance, and educating patients about the test is unlikely to mitigate anxiety because testing is part of a wider process by which patients become aware of a disease that--once it has relapsed--will certainly kill them in the near future.
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Affiliation(s)
- Christopher F C Jordens
- Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Sydney, NSW, Australia.
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Lipworth W, Morrell B, Irvine R, Kerridge I. An empirical reappraisal of public trust in biobanking research: rethinking restrictive consent requirements. J Law Med 2009; 17:119-132. [PMID: 19771992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Collections of human tissue removed from patients in the course of medical diagnosis or therapy are believed to be an increasingly important resource for medical research (biobank research). As a result of a number of tissue-related "scandals" and increasing concern about ownership and privacy, the requirements to obtain consent from tissue donors are becoming increasingly stringent. The authors' data show that members of the general public perceive academic biobank researchers and their institutions to be highly trustworthy and do not see the need for recurrent, project-specific consent. They argue, on the basis of their empirical findings, that we should question the trend, at least in some settings, toward ever more stringent consent requirements for the use of tissue in research. They argue that this approach, while perhaps counterintuitive in the current regulatory environment, can be both ethically and legally sound so long as channels of communication are maintained and third-party relationships are tightly controlled.
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Affiliation(s)
- Wendy Lipworth
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Australia.
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Axler RE, Irvine R, Lipworth W, Morrell B, Kerridge IH. Why might people donate tissue for cancer research? Insights from organ/tissue/blood donation and clinical research. Pathobiology 2008; 75:323-9. [PMID: 19096227 DOI: 10.1159/000164216] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2008] [Accepted: 06/10/2008] [Indexed: 11/19/2022] Open
Abstract
Little is known about why patients with cancer do or do not donate their biopsied/cancerous tissue to research. A review of the literature on motivations to participate in clinical research and to donate tissues/organs for therapeutic use may provide some insights relevant to tumour banking research. While more research is necessary, a better understanding of the factors that motivate patients to give or refuse consent to tumour banking may ultimately improve consent practices, public trust and donation rates.
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Affiliation(s)
- Renata E Axler
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, Australia.
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Lipworth W, Morrell B, Kerridge I. Ethics as an act of listening. Am J Bioeth 2008; 8:80-81. [PMID: 19003720 DOI: 10.1080/15265160802521013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Wendy Lipworth
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, NSW 2006, Australia.
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