A5054984207- Traumatic Brain Injury Research
- Ethics in Clinical Research
- Psychosomatic Disorders and Their Treatments
- Cardiac Arrest and Resuscitation
- Biomedical Ethics and Regulation
- Artificial Intelligence in Healthcare and Education
- Healthcare Decision-Making and Restraints
- Ethics in medical practice
- Palliative Care and End-of-Life Issues
- Traumatic Brain Injury and Neurovascular Disturbances
- Free Will and Agency
- Pain Management and Placebo Effect
- Epistemology, Ethics, and Metaphysics
- Neuroethics, Human Enhancement, Biomedical Innovations
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare cost, quality, practices
- Health Services Management and Policy
- Patient Dignity and Privacy
- Lysosomal Storage Disorders Research
- Mental Health and Patient Involvement
- Complement system in diseases
- Birth, Development, and Health
- Adenosine and Purinergic Signaling
- Qualitative Research Methods and Ethics
- Mental Health and Psychiatry
Wellcome Centre for Ethics and Humanities
2018-2025
University of Oxford
2018-2025
The University of Melbourne
2021
University of Edinburgh
2021
Western University
2013-2017
Recent neuroscientific findings suggest that functional magnetic resonance imaging (fMRI)-based brain–computer interfaces may be a viable strategy for detecting covert awareness in patients clinically diagnosed as being vegetative state. This research open promising new avenue developing neuroimaging techniques provide prognostic and diagnostic information complements current behavioral tests assessing disorders of consciousness, thereby increasing the effectiveness screening. These also...
Clinical genome and exome sequencing is currently used in only a small fraction of patients, yet large scale genomic initiatives are becoming more embedded clinical services. This paper examines the ethical principles that should guide regulatory processes regarding consent data sharing this context. We argue dataset administered by health system carries substantial societal benefits, collective nature initiative means at least those patients who benefit from have an obligation to share...
ABSTRACT Many are calling for concrete mechanisms of oversight health research involving artificial intelligence (AI). In response, institutional review boards (IRBs) being turned to as a familiar model governance. Here, we examine the IRB form ethics that uses AI. We consider model's origins, analyze challenges IRBs facing in contexts both industry and academia, offer recommendations how these committees might be adapted order provide an effective mechanism health‐related AI research.
Abstract Disorders of consciousness (DOC) continue to profoundly challenge both families and medical professionals. Once a brain-injured patient has been stabilized, questions turn the prospect recovery. However, what “recovery” means in context patients with prolonged DOC is not always clear. Failure recognize potential differences interpretation—and assumptions about relationship between health well-being that underlie these differences—can inhibit communication surrogate decisionmakers...
Powered by 'big health data' and enormous gains in computing power, artificial intelligence related technologies are already changing the healthcare landscape. Harnessing potential of these will necessitate partnerships between institutions commercial companies, particularly as it relates to sharing data. The need for companies be trustworthy users data has been argued critical success this endeavour. I argue that approach is mistaken. Our interactions with not, should based on trust....
Patients in the vegetative state are wholly unaware of themselves, or their surroundings. However, a minority patients diagnosed as actually aware. What is well-being these patients? How lives going, for them? It has been argued that on reasonable conception well-being, faring so poorly it may be best interests not to continue existing. I argue against this claim. Standard conceptions do clearly support conclusion would better off having life-sustaining treatment withdrawn, and fact,...
Patients with severe disorders of consciousness are thought to be unaware themselves or their environment. However, research suggests that a minority patients diagnosed as having disorder remain aware. These patients, designated "cognitive motor dissociation" (CMD), can demonstrate awareness by imagining specific tasks, which generates brain activity detectable via functional neuroimaging. The discovery in these raises difficult questions about well-being, and it has been argued would better...
Recent research suggests that a minority of patients diagnosed as vegetative using traditional behavioral assessments may be covertly aware. One the most pressing concerns with respect to these is their welfare. This article examines foundational issues concerning application theory welfare patients, and develops agenda patient central focus. We argue covert awareness likely have sentient interests, because interests are sufficient for moral status, others an obligation take seriously....
Despite the apparent absence of external signs consciousness, a significant proportion behaviorally nonresponsive patients can respond to commands by willfully modulating their brain activity. However, little is known about mental life these patients. We discuss recent innovative approach, which sheds light on preserved cognitive capacities patients, including executive function, theory mind, and experience affective states. This research represents fundamental shift in our understanding has...
Abstract Prognosis after severe brain injury is highly uncertain, and decisions to withhold or withdraw life‐sustaining treatment are often made prematurely. These driven by a desire avoid situation where the patient becomes ‘trapped’ in condition they would find unacceptable. However, this means that proportion of patients who have gone on make good recovery, allowed die. I propose shift practice towards routine provision aggressive care, even cases probability survival acceptable recovery...
<h3>Purpose/Objective</h3> The optimal adjuvant treatment of type II endometrial carcinoma after hysterectomy remains controversial. objective this study was to determine the effect radiation therapy (RT) on recurrence-free survival (RFS), disease-specific (DSS), and overall in patients with early-stage carcinoma. <h3>Materials Methods</h3> In institutional review board–approved study, our database 1450 cancer reviewed. Seventy-nine surgically staged 2009 International Federation Gynecology...
The UK government has recently committed to adopting a new policy—dubbed ‘Martha’s Rule’—which been characterised as providing patients the right rapidly access second clinical opinion in urgent or contested cases. Support for rule emerged following death of Martha Mills 2021, after doctors failed admit her intensive care despite concerns raised by parents. We argue that framing this issue terms patient rights is not productive, and should be avoided. Insofar ultimate goal Martha’s Rule...
Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment difficult and misdiagnosis may be as high 43%. Recent advances in neuroimaging suggest solution. Both functional magnetic resonance imaging electroencephalography have been used to detect residual cognitive function patients. Neuroimaging improve...
Unresponsive wakefulness syndrome is a disorder of consciousness wherein patient awake, but completely non-responsive at the bedside. However, research has shown that minority these patients remain aware, and can demonstrate their awareness via functional neuroimaging; are referred to as having 'cognitive motor dissociation' (CMD). Unfortunately, we have little insight into subjective experiences patients, making it difficult determine how best promote well-being. In this paper, I argue...
Neuroimaging research regularly yields "incidental findings": observations of potential clinical significance in healthy volunteers or patients, but which are unrelated to the purpose variables study.
A general obligation to make aggregate research results available participants has been widely supported in the bioethics literature. However, dementia presents several challenges this perspective, particularly because of fear associated with developing dementia. The authors argue that considerations respect for persons, beneficence, and justice fail justify an research. Nevertheless, there are positive reasons favor making available; when decision is made do so, it critical a clear strategy...
Functional neuroimaging may provide a viable means of assessment and communication in patients with Guillain-Barré Syndrome (GBS) mimicking the complete locked-in state. has been used to assess residual cognitive function allowed for binary other behaviourally non-responsive patients, such as those diagnosed unresponsive wakefulness syndrome. We evaluated potential application functional using clinical-grade scanner determine if individuals severe GBS retained auditory function, command...
Abstract Patients with disorders of consciousness after severe brain injury need surrogate decision makers to guide treatment decisions on their behalf. Formal guidelines for decisionmaking generally instruct first appeal a patient’s written advance directive, followed by making substituted judgment what the patient would have chosen, and lastly, make according seems be in best medical interests. Substituted is preferable because it taken preserve autonomy, using past wishes values...