Australasian Science: Australia's authority on science since 1938

Quandary

Quandary column

Can We (Ethically) Disinvest from Healthcare Interventions?

By Jessica Pace and Wendy Lipworth, Sydney Health Ethics

The withdrawal or reduction of a medication or surgical technique can make healthcare safer, cheaper and more effective. However, practical and ethical challenges mean that we can't solely rely on this to ensure a fair distribution of healthcare.

Systems that fund healthcare, such as Australia’s Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS), face two key challenges. First, health technologies are expensive, and are getting more so. Second, people often want fast access to new technologies, sometimes even when evidence of safety, effectiveness and value for money is lacking.

Values in Science Affect What Your Doctor Recommends

Credit: RFBSIP/Adobe

Credit: RFBSIP/Adobe

By Claire Hooker

Should a GP recommend exercise to chronic pain patients when the evidence doesn't match patient experience?

A GP is facing a common quandary: whether or not to recommend exercise to a patient suffering from chronic pain. The GP knows that many experimental studies have found that exercise temporarily reduces pain, a phenomenon called

The Wild West of Biotech Innovation

By Ainsley Newson & Wendy Lipworth

The failure of a US$9 billion health technology start-up provides a stark example of how venture capitalists can let market potential overrule evidence of efficacy.

Recently, we avidly listened to a podcast from ABC Radio America called The Dropout. This five-part series followed the rise and fall of Theranos, a Silicon Valley health start-up that folded in 2018.

Theranos (a combination of “therapy” and “diagnosis”) was founded in 2003 by Stanford University drop-out Elizabeth Holmes. She had been inspired by the possibility that micro­fluidics technology could lead to “near-patient” blood testing conducted in pharmacies, supermarkets or even a patient’s home.

Antibiotics: Which Lives Matter?

By Angus Dawson

Resistance to antibiotics is growing. Are you prepared to go without them to save the lives of future generations?

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Should Scientists Declare Non-Financial Conflicts of Interest?

By Miriam Wiersma and Wendy Lipworth

Conflicts of interest are rife in scientific research, but non-financial conflicts of interest are often overlooked.

When the term “conflict of interest” arises in scientific research, often the first thing that springs to mind is the use of financial incentives by industry to unduly influence researchers.

Molecular Life Extension

By Cynthia Forlini and Ainsley Newson

Alongside the question of whether we can treat ageing is the question of whether we should.

It is a universal certainty that we will all die one day. And we have a near-universal goal for our deaths to come painlessly after a long and full life.

Of course illness, disease and accident can cut life short. For many of us, however, our deaths will come as a result of growing old and our bodies gradually failing us.

But should we accept this biological status quo as the basis of our lives? Or is ageing something to rail against and try to defeat?

Is Cognitive Enhancement a Problem in Australia?

Sangoiri/Adobe

Credit: Sangoiri/Adobe

By Cynthia Forlini

Just because the non-medical use of cognitive stimulants isn’t common, it doesn’t mean it isn’t a problem.

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The Unspoken Limits of Liquid Biopsies

By Ainsley Newson

Liquid biopsies promise early detection of cancer, but some of their current limitations risk being overlooked.

Credit: Connect World/Adobe

Ethical Challenges About Voluntary Assisted Dying

By Ian Haines

Much of the focus on new voluntary assisted dying laws is centred on patient autonomy, but it is only one of the four pillars. Does the legislation also satisfy the other three tenets of beneficence, non-maleficence and justice?

Will voluntary assisted dying (VAD) legislation provide compassionate physician-assisted dying, as hoped, or are we providing state-sanctioned euthanasia and assisted suicide? It certainly raises some important ethical questions.

Many of the submissions in Victoria were about tragic cases of desperate and suffering people with incurable illness who had taken or attempted to take their lives in sometimes very horrific circumstances. There was also a focus on high-profile celebrities and politicians who had watched on feeling helpless as a loved one suffered and died.

The Man with the DNR Tattoo

By Michael Cook

Should doctors follow the instructions of a tattoo when facing end-of-life decisions?

Doctors at a Florida hospital’s emergency department were startled to discover the words “DO NOT RESUSCITATE” tattooed on an unconscious man’s chest. The word “not” was underlined. Beneath this imperative was his signature, also tattooed.

“We’ve always joked about this, but holy crap, this man actually did it,” one of the doctors who treated him said. “You look at it, laugh a little, and then go: Oh no, I actually have to deal with this.”