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Locating lawful abortion on the spectrum of ‘proper medical treatment'
Published in Sara Fovargue, Alexandra Mullock, The Legitimacy of Medical Treatment, 2015
The essence of my argument so far has been threefold. First, proper medical treatment is wider than the medical exception. Second, as Sara Fovargue and I have argued elsewhere, within the category of proper medical treatment we can distinguish between clear and liminal cases of proper treatment. Finally, developing the second point, I want to understand proper medical treatment as a spectrum. At one end of this spectrum are paradigm cases of proper treatment, treatment (i) where consent is both possible and clearly present, and (ii) which has clear therapeutic benefit for the patient being intervened upon. Further along the spectrum there are other cases where interventions ‘clearly’ constitute proper treatment because two criteria are satisfied: (i) they are justified not by consent, because consent is impossible, but by some other patient-centred test such as necessity or best interests, and (ii) there is clear therapeutic benefit to the patients concerned. Further along still, interventions which are consensual may be proper notwithstanding that their potential for therapeutic benefit is either contested or non-existent, providing either that the intervention is not a clear harm which is not outweighed by (potential for) benefit (risky/experimental cancer treatment, for example), or that there are public interest considerations which weigh in favour of allowing the intervention to take place (if we construe live organ donation as a net harm to the donor, we may decide, nonetheless, as UK law has done, that it ought to be permitted as a public good). This is the liminal zone of proper medical treatment; still proper but less clearly proper than the first two categories of treatment. If therapeutic potential is absent or contested, a treatment is either liminally proper or even improper, depending on the circumstances; but it is liminally proper at best.
Views of IRB members regarding phase 1 pediatric oncology trials
Published in Pediatric Hematology and Oncology, 2023
David Wendler, Will Schupmann, Xiaobai Li
The IRB survey asked respondents to imagine their IRB is reviewing a phase 1 study testing the safety of an experimental cancer treatment which has the aforementioned risks and potential medical benefits (see supplemental information for verbatim wording of the scenario). The study proposes to enroll children with advanced cancer whose only alternative is to be kept as comfortable as possible until they die, which is likely to occur in a few months. Following this description, respondents were asked three test questions to ensure they understood the risks and potential medical benefits. They were then asked how the risks and potential medical benefits compare.