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- W4206804096 abstract "In October 2016, Medicine for the first time published an issue dedicated to ‘Ethics and Communication Skills’. In doing so, it was recognizing the increasing importance of ethics and communication in the daily practice of medicine. Something more was required beyond a belief that doctors could get by on ‘common sense’ or copying the beliefs or decision-making processes of others – if it was even possible to discern those in the first place. Looking back on that issue, it represented a selection of subjects some of which were part of the staple fare of medical ethics (e.g. consent, confidentiality) and others that did not always feature (e.g. religion, compassion). Inevitably, there were gaps, but the issue was well received and achieved the highest position among downloads in the series. As the cycle of Medicine moved on, decisions had to be made on the structure of a new issue. On the one hand, ethics and communication do not update in the way that science and scientific practice do; on the other hand, contexts change and some subjects not covered in 2016 now deserve a place. As a result, some subjects have been revised by their original contributors (e.g. Hordern, Hain, Harpwood) or written by a new contributor (e.g. Davies, Gordon), while others cover new subjects (e.g. Courtwright-Lim, Mallia, George, Saunders). ‘Consent’ is the major subject to be dropped for reasons of space, but this was well covered in 2016. This new issue does not outdate that of 2016, which remains a useful resource, but the hope is that the current issue will stimulate thinking and guide practice. Contributors have been drawn from an international selection of experts from Austria, Malta, Finland, Australia and the USA as well as the UK. The core aim of ethics is, however, simple enough: it is a subject concerned with good and bad, right and wrong. It aims to evaluate what we do: what Kant called ‘practical reason’ as contrasted with the ‘theoretical reason’ of science. This distinction between value and fact is fundamental. Events in the public realm as well as scientific advances highlight particular areas of ethical concern. At the time of writing, the impact of a coronavirus pandemic occupies public discourse, both professional and lay. In the UK, there has been an awareness of the importance of ethics in addressing this problem. To its credit, the UK government established a Committee for Ethical Aspects of Pandemic Influenza in 2006, which developed an ‘ethical framework for policy and planning’,1Cabinet Office and Department of HealthResponding to pandemic influenza: the ethical framework for policy and planning.November 2007https://webarchive.nationalarchives.gov.uk/20130105020420/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_080729.pdfDate accessed: May 13, 2020Google Scholar in advance of the pandemic that eventually occurred in 2009 and the Ebola outbreak in 2014. This committee was effectively re-established in October 2019 as a Moral and Ethical Advisory Group before (by chance, of course) the coronavirus outbreak.2Moral and Ethical Advisory Group. https://www.gov.uk/government/groups/moral-and-ethical-advisory-group (accessed 14 April 2020).Google Scholar The ethical framework aimed to help people think about their decisions in their individual contexts and recognized that a pandemic is a global event: UK actions could have international implications. Underpinning the framework is the fundamental principle of equal concern and respect: that everyone matters, and matters equally, and that the interests of each person are the concern of all of us. The harm that might be suffered by every person matters. Individual principles can conflict, but eight were set out and defined: (1) respect; (2) minimizing the harm that a pandemic could cause; (3) fairness; (4) working together; (5) reciprocity; (6) keeping things in proportion; (7) flexibility; and (8) good decision-making – involving (i) openness and transparency; (ii) inclusiveness; (iii) accountability, and (iv) reasonableness. In stating what each means, this consensus group produced something practical – a set of principles that could interrogate proposed policy, from individual or group perspectives. Sets of individual principles are a familiar interpretation of putting ethics into practice: a justification that lies in the philosophical grounding of meta-ethics in the same way as metaphysics identifies the underlying justification of scientific knowledge. The four principles expounded by Beauchamp and Childress, discussed in this issue, are just one example of an attempt to set out some foundational principles. They are a popular approach whose justification is discussed in Jones's article, with further expositions by Hain, Frischhut and Werner-Felmayer. But remember that they are not the only approach and certainly not the answer to the question, ‘What is medical ethics about?’ Readers might like to assess their utility in the current pandemic in terms of the eight principles of the ethical framework outlined above. For doctors practising in the UK, detailed familiarity with ethical guidance from the General Medical Council, including its legal summary, is essential and could legitimately be the subject of questions in postgraduate examinations. Studying this issue will provide you with a sound basis, but I hope it will encourage you to explore further. Reading in the humanities is different from that in the sciences and it may take time for some to appreciate this, but ongoing reading of this sort is part of the fulfilment of a humane approach to practice and medical culture." @default.
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- W4206804096 date "2020-10-01" @default.
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- W4206804096 title "Introduction" @default.
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- W4206804096 doi "https://doi.org/10.1016/j.mpmed.2020.07.006" @default.
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