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|47||47||["Prescribing medical cannabis: ethical considerations for primary care providers"]||10.1136/medethics-2019-105759||http://dx.doi.org/10.1136/medethics-2019-105759||2019-12-18T22:15:30Z||["Health Policy", "Arts and Humanities (miscellaneous)", "Issues, ethics and legal aspects", "Health(social science)"]||27||1||["0306-6800", "1473-4257"]||Journal of Medical Ethics||<jats:p>Medical cannabis is widely available in the USA and legalisation is likely to expand. Despite the increased accessibility and use of medical cannabis, physicians have significant knowledge gaps regarding evidence of clinical benefits and potential harms. We argue that primary care providers have an ethical obligation to develop competency to provide cannabis to appropriate patients. Furthermore, specific ethical considerations should guide the recommendation of medical cannabis. In many cases, these ethical considerations are extensions of well-established principles of beneficence and nonmaleficence, which indicate that providers should recommend cannabis only for conditions that have the strongest evidence base. Additionally, the contested status of cannabis in American culture raises specific issues related to shared decision-making and patient education, as well as continuing clinical education.</jats:p>||2||["http://orcid.org/0000-0002-2282-9253"]||["Aaron Glickman", "Dominic Sisti"]||[""]||[""]||[""]|
|99||99||["Randomised evaluation of government health programmes does present a challenge to standard research ethics frameworks"]||10.1136/medethics-2019-106003||http://dx.doi.org/10.1136/medethics-2019-106003||2019-12-18T22:15:26Z||["Health Policy", "Arts and Humanities (miscellaneous)", "Issues, ethics and legal aspects", "Health(social science)"]||5||0||["0306-6800", "1473-4257"]||Journal of Medical Ethics||<jats:title>Abstract</jats:title><jats:p>In a recent issue of Journal of Medical Ethics (JME), we discussed the ethical review of evaluations of interventions that would occur whether or not the evaluation was taking place. We concluded that standard research ethics frameworks including the Ottawa Statement, which requires justification for all aspects of an intervention and its roll-out, were a poor guide in this area. We proposed that a consideration of researcher responsibility, based on the consequences of the research taking place, would be a more appropriate way delineate the scope of research ethics review. Weijer and Taljaard present a counterargument to our proposal, which we address in this reply. They claim that a focus on researcher responsibility will weaken the protection of research participants and link it to ‘unethical research’ and a ‘government experimenting on its own people’. However, the moral responsibility of researchers is defined in terms of the consequences of the research on human welfare and harm, not in opposition to it. Weijer and Taljaard argue that researchers must justify what they are studying whether or not they have any control over it and that governments must justify their programmes, including by demonstrating equipoise, to a research ethics committee if they implement them in a randomised way. We strongly disagree that this is a defensible way to define the scope of research ethics review and argue that this provides no further protections to research participants beyond what we propose, but places a potential barrier to learning from government programmes.</jats:p>||3||||["Samuel I Watson", "Mary Dixon-Woods", "Richard J Lilford"]||["WT09789"]||["Wellcome Trust", "National Institute for Health Research"]||["10.13039/100004440", "10.13039/501100000272"]|
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