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The potential role of self-experimentation in the search for a vaccine is in urgent need of further clarification.
COVID-19 pandemic: triage for intensive-care treatment under resource scarcity (3rd, updated version)
Given the development of the pandemic in October, the guidelines issued by the Swiss Academy of Medical Sciences (SAMS) and the Swiss Society of Intensive Care Medicine (SSICM) needed to be revised and updated in the light of the experience accumulated since March. There has been no change in the guiding principle that uniform criteria for intensive-care unit (ICU) admission and continued occupancy should be applied throughout Switzerland. The present guidelines provide the necessary basis.
The revised Swiss guidelines bring not only a useful framework for delicate discussions and decisions at the bedside, but hopefully also progress in public awareness of some limits of the best health systems in the world, appearing much faster in a time of scarcity of resources. Based on what we learned from the crisis of this year, several aspects of our and other health systems could benefit from a revision or an update, in line with a recognised truism.
With the progress in healthcare over recent decades and a growing life expectancy, discussions and decisions regarding end-of-life issues have become increasingly important. Especially in intensive care and emergency medicine there is a growing need of decision making for optimised end-of-life care. Prolonging life and preventing death is considered to be the highest principle of healthcare professionals; however, in some cases alleviation of suffering is a more appropriate goal. This article discusses communication challenges in end-of-life decision making and outlines strategies from an area of growing interest and research.
Jurisdictional inquiries are an important means for researchers to clarify whether their project requires ethical oversight. However, this mixed-methods study has identified some difficulties in the interpretation of legal terms, which often reflect persistent structural issues that many other countries also face. More detailed guidance may be helpful to reduce the researchers’ uncertainties and ethics committees’ workloads in relation to jurisdictional inquiries.
Shared decision making: patients have a right to be informed about possible treatment options and their risks and benefits
Shared decision making is a key concept in the process of working towards high-quality, patient-centred care for all patient populations. It is relevant not only for current care decisions, but also for advance care planning, and it is needed particularly during times of crisis such as we are seeing currently with COVID-19.
Social, cultural and experiential patterning of attitudes and behaviour towards assisted suicide in Switzerland: evidence from a national population-based study
Switzerland has the longest history of the legal practice of non-physician assisted suicide of any country. Assisted suicide is not very tightly regulated in Switzerland, and almost all assisted suicides are supported by a right-to-die organisation.
Careful preparation of submission documents by the investigators and close adherence to formal and legal requirements have the potential to considerably optimise and expedite the ethics committee review process, and thus the commencement of the clinical research.
The recommendations of the Swiss Academy of Medical Sciences (SAMS) are designed to draw attention, from an ethical perspective, to important aspects of the PGT counselling and decision-making situation, and to promote ethical awareness in the performance of PGT. In addition, they discuss how, for example, surplus information should be managed.
We need to mature along with our scientific discoveries, defining in what way we wish to use them. Only then can we claim to master technologies rather than being overwhelmed by them. In order to support this process, bioethics should not get out of the way − on the contrary, it should get viral.