David M. Shaw

Emerging biotechnology may soon allow the creation of genetically human organs inside animals, with non-human primates and pigs being the best candidate species. This prospect raises the question of whether creating organs in primates in order to then transplant them into humans would be more acceptable than using them for research. In this paper, we examine the validity of the purported moral distinction between primates and other animals, and analyze the ethical acceptability of using primates to create organs for human use.

Over the last decade, several European countries and the Council of Europe itself have strongly supported the use of advance directives as a means of protecting patients’ autonomy, and adopted specific norms to regulate this matter. However, it remains unclear under which conditions those regulations should apply to people who are placed in correctional settings. The issue is becoming more significant due to the increasing numbers of inmates of old age or at risk of suffering from mental disorders, all of whom might benefit from using advance directives. At the same time, the closed nature of prisons and the disparate power relationships that characterise them mean that great caution must be exercised to prevent care being withdrawn or withheld from inmates who actually want to receive it. This paper explores the issue of prisoners’ advance directives in the European context, starting with the position enshrined in international and European law that prisoners retain all their human rights, except the right to liberty, and are therefore entitled to self-determination regarding health care decisions.

MacDougall has argued that Rawls’s liberal social theory suggests that parents who hold certain religious convictions can legitimately refuse blood transfusion on their children’s behalf. This paper argues that this is wrong for at least five reasons. First, MacDougall neglects the possibility that true freedom of conscience entails the right to choose one’s own religion rather than have it dictated by one’s parents. Second, he conveniently ignores the fact that children in such situations are much more likely to die than to survive without blood. Third, he relies on an ambiguous understanding of what is "rational" and treats children as mere extensions of their parents. Fourth, he neglects the fact that those in the original position would seek to protect themselves from persecution and enslavement and thus would not allow groups of children to be killed because of their parents’ beliefs. Finally, Rawls makes it clear that we should choose for children as we would choose for ourselves in the original position, with no particular conception of the good (such as that held by Jehovah’s Witnesses)

A new Swiss law requires that any research involving humans must aim to answer "a relevant research question". This paper explains the relevance of the relevance criterion in research, analyses the Swiss and British guidelines on relevance, and proposes a framework for researchers and REC members that enables a clearer conception of the role of relevance in research. We conclude that research must be either scientifically or societally beneficial in order to qualify as relevant, and RECs therefore cannot avoid reviewing the scientific aspects of proposed studies. Normally only scientifically relevant studies can be of benefit to society, but research of low scientific relevance can nonetheless be relevant to society if it forms part of the education of new doctors and scientists.

Doctors at four German hospitals have been suspended from their posts following internal investigations which alleged that they had been manipulating the organ transplant allocation system in order to help their patients get donor livers more quickly. It is alleged that doctors exaggerated the severity of their patients’ conditions so that they would be accorded higher priority for receiving organs, but there may also have been manipulation of medical records, deception of patients and potential harm to patients both within Germany and across the EU. There has been significant public reaction to these events. The reported events require analysis as there may be several lessons for the UK context; doing so requires analyzing the alleged events in terms of the issues raised in a hypothetical manner.

The Ebola epidemic in Western Africa has highlighted issues related to weak health systems, the politics of drug and vaccine development and the need for transparent and ethical criteria for use of scarce local and global resources during public health emergency. In this paper we explore two key themes. First, we argue that independent of any use of experimental drugs or vaccine interventions, simultaneous implementation of proven public health principles, community engagement and culturally sensitive communication are critical as these measures represent the most cost-effective and fair utilization of available resources. Second, we attempt to clarify the ethical issues related to use of scarce experimental drugs or vaccines and explore in detail the most critical ethical question related to Ebola drug or vaccine distribution in the current outbreak: who among those infected or at risk should be prioritized to receive any new experimental drugs or vaccines? We conclude that healthcare workers should be prioritised for these experimental interventions, for a variety of reasons

Cryoethics is a new theme within bioethics (see bioethics) concerned with the ethics of cryonic storage. Cryonics, which is also erroneously referred to as “cryogenic” technology, offers people the option of having their bodies or brain-stems preserved at very low temperatures after death in order to be revived at some point in the future when technology is sufficiently advanced to enable reanimation, and possibly immortality. The main issues in cryoethics center around whether it is ethical to use this technology, and whether it is prudent to do so. While there are several prudential and ethical arguments against cryonic storage, there is only one argument in favor, but it is quite powerful: the possibility of cheating death for a few years, or even forever if technology advances enough in the time before revival (Shaw 2009).

Many ethical issues are posed by public health interventions. Although abstract theorizing about these issues can be useful, it is the application of ethical theory to real cases which will ultimately be of benefit in decision-making. To this end, this paper will analyse the ethical issues involved in Childsmile, a national oral health demonstration programme in Scotland that aims to improve the oral health of the nation's children and reduce dental inequalities through a combination of targeted and universal interventions. With Scotland's level of dental caries among the worst in Europe, Childsmile represents one of the largest programmes of work aimed at combating oral health inequalities in the UK. The areas of ethical interest include several contrasting themes: reducing health inequalities and improving health; universal and targeted interventions; political values and evidence base; prevention and treatment; and underlying all of these, justice and utility.