Synaptic plasticity in neurological deficit as a form of indemnification: The utility of analogical reasoning.

Analogical reasoning is a useful analytical tool for formulating a hypothesis from which to springboard rigorous methodological analysis. Paradoxically, the tool's utility lies in its capacity to conceptualize a viable avenue for further inquiry as much as in its capacity to expose flaws in the analogical concept hypothesized. While it should not be the exclusive means upon which to rely absent evidence-based data or other valid corroboration, analogies provide an important means of stimulating creative thought. An illustration is offered: analogizing synaptic plasticity in neurological deficits to the invocation of a contractual indemnification.

Ethical aspects of collateral clinical services by non-credentialled personnel in international medical crises.

The study of global responses to medical crises in developing and under-developed countries demands reflection about the ethical engagement of non-credentialled medical personnel in the context of clinical care. The need for, and the desire to contribute by, people and organisations that lack demonstrable or readily transferable credentialed skills must be reconciled with the ethical administration of collateral clinical services. The urgent need for the provision of such services must neither preclude their use nor permit their use irrespective of salient ethical considerations. One way to explore these issues is to examine a recent exemplar of a non-governmental organisation's utilisation of non-credentialled medical personnel during the Ebola outbreak in Sierra Leone. Although the group lacked clinical proficiency (apart from community health workers), it collaborated with experts in interment to train staff to bury those who had succumbed to the disease in respectful and hygienic individually marked graves. The group leveraged its cultural competency and in-country presence to deploy staff judiciously, support the workers to combat social ostracism and offer vocational and other education to help them assimilate back into the workforce once the outbreak subsided. The non-governmental organisation stepped up to do the work that others shunned, and to do it ethically and proficiently. I offer the work to show a compelling and innovative blueprint for ethical mobilisation of non-credentialed healthcare personnel in a global medical crisis.

Journeys.

This abstract painting represents how patients' experiences of darkness and doubt can be replaced by a sense of buoyancy and lightness. Color and movement convey a patient's sense of striving, aspiration, and optimism.

Informed consent revisited: a doctrine in the service of cancer care.

Informed consent traditionally has been viewed as a safeguard for the protection of patients' decisional autonomy. While informed consent is a critical means for the protection of the patient's dominion over the integrity of his body, exclusive consideration of the doctrine as a safeguard for patients eclipses the doctrine's significant benefits for the therapeutic endeavor. Undertaking a thorough informed consent process helps the physician avoid the unilateral burdens of paternalism; furthers compliance with the doctor's legal obligations, ethical duties, and clinical responsibilities; and, as importantly, enhances the collaborative treatment enterprise. When informed consent is viewed narrowly and solely as a protective device for patients' rights, the physician may be less likely to engage the patient in ongoing discussions. Important opportunities may be missed to elicit additional clinical information, assess psychosocial concerns, and reiterate the commitment to collaboration and patient autonomy.

Patently controversial: markets, morals, and the President's proposal for embryonic stem cell research.

This essay considers the implications of President George W. Bush's proposal for human embryonic stem cell research. Through the perspective of patent law, privacy, and informed consent, we elucidate the ongoing controversy about the moral standing of human embryonic stem cells and their derivatives and consider how the inconsistencies in the president's proposal will affect clinical practice and research.