Un projet de recherche exempté d’évaluation éthique : Réflexions et questionnements sur l’article 2.1 de l’Énoncé de politique des trois Conseils

Étude de cas / Case studyCette étude de cas présente l’article 2.1 de l’Énoncé de politique des trois Conseils, permettant désormais à certains projets de recherche qualitative à risque minimal d’être exempté d’évaluation éthique. Cependant, son application soulève des questionnements.This case study presents the Article 2.1 of the Tri-council Policy Statement, which now allows some qualitative research with minimal risk to be exempt from ethics review. However, its application raises questions

Légaliser la vente de reins : à quel prix… Compte-rendu de The Kidney Sellers: A Journey of Discovery in Iran par Sigrid Fry-Revere

Compte-rendu / ReviewThe Kidney Sellers: A Journey of Discovery in Iran est un ouvrage qui présente la mise en place d’un marché légal de reins comme la solution au problème du manque d’organes. L’auteure, Sigrid Fry-Revere, s’est rendue en Iran pour y étudier les effets de ce marché balisé. Le livre est clairement en faveur d’un marché. Les conséquences néfastes encourues à long terme par les vendeurs sont très peu décrites et les autres moyens visant à augmenter les dons d’organes ne sont pas abordés.The Kidney Sellers: A Journey of Discovery in Iran is a book that describes the implementation of a regulated kidney market as a means to solve the organ shortage. The author, Sigrid Fry-Revere, travelled to Iran to study the effects of the regulated market in that country. The book is clearly in favour of a market. The long-term adverse consequences to those selling their organs are very poorly described, nor are other means to increase organ donations rates addressed

Un projet de recherche exempté d’évaluation éthique : quelques précisions

Lettre à l'éditeur / Letter to the EditorEn réponse aux commentaires de Caillé et Beauregard, ce texte apporte quelques précisions au sujet de l’exemption d’évaluation éthique d’un projet de recherche.This piece responds to the comments made by Caillé and Beauregard by offering clarifications regarding the exemption from ethics review of a research project

Les représentations de transplanteurs autour de la question du don altruiste dans deux contextes culturels : entretiens avec des médecins transplanteurs français et québécois

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

The use of personalized medicine for patient selection for renal transplantation: Physicians' views on the clinical and ethical implications

<p>Abstract</p> <p>Background</p> <p>The overwhelming scarcity of organs within renal transplantation forces researchers and transplantation teams to seek new ways to increase efficacy. One of the possibilities is the use of personalized medicine, an approach based on quantifiable and scientific factors that determine the global immunological risk of rejection for each patient. Although this approach can improve the efficacy of transplantations, it also poses a number of ethical questions.</p> <p>Methods</p> <p>The qualitative research involved 22 semi-structured interviews with nephrologists involved in renal transplantation, with the goal of determining the professionals' views about calculating the global immunological risk and the attendant ethical issues.</p> <p>Results</p> <p>The results demonstrate a general acceptance of this approach amongst the participants in the study. Knowledge of each patient's immunological risk could improve treatment and the post-graft follow-up. On the other hand, the possibility that patients might be excluded from transplantation poses a significant ethical issue. This approach is not seen as something entirely new, given the fact that medicine is increasingly scientific and evidence-based. Although renal transplantation incorporates scientific data, these physicians believe that there should always be a place for clinical judgment and the physician-patient relationship.</p> <p>Conclusions</p> <p>The participants see the benefits of including the calculation of the global immunological risk within transplantation. Such data, being more precise and rigorous, could be of help in their clinical work. However, in spite of the use of such scientific data, a place must be retained for the clinical judgment that allows a physician to make decisions based on medical data, professional expertise and knowledge of the patient. To act in the best interests of the patient is key to whether the calculation of the global immunological risk is employed.</p

Living ethics: a stance and its implications in health ethics

Moral or ethical questions are vital because they affect our daily lives: what is the best choice we can make, the best action to take in a given situation, and ultimately, the best way to live our lives? Health ethics has contributed to moving ethics toward a more experience-based and user-oriented theoretical and methodological stance but remains in our practice an incomplete lever for human development and flourishing. This context led us to envision and develop the stance of a “living ethics”, described in this inaugural collective and programmatic paper as an effort to consolidate creative collaboration between a wide array of stakeholders. We engaged in a participatory discussion and collective writing process known as instrumentalist concept analysis. This process included initial local consultations, an exploratory literature review, the constitution of a working group of 21 co-authors, and 8 workshops supporting a collaborative thinking and writing process. First, a living ethics designates a stance attentive to human experience and the role played by morality in human existence. Second, a living ethics represents an ongoing effort to interrogate and scrutinize our moral experiences to facilitate adaptation of people and contexts. It promotes the active and inclusive engagement of both individuals and communities in envisioning and enacting scenarios which correspond to their flourishing as authentic ethical agents. Living ethics encourages meaningful participation of stakeholders because moral questions touch deeply upon who we are and who we want to be. We explain various aspects of a living ethics stance, including its theoretical, methodological, and practical implications as well as some barriers to its enactment based on the reflections resulting from the collaborative thinking and writing process

2. Perspectives d’une jeune chercheure

Une des branches de la bioéthique, l’éthique de la recherche, s’intéresse aux problèmes posés par la recherche avec des sujets humains. Les expérimentations nazies ainsi que les dérives en recherche telles que décrites par Beecher ont mis à jour l’importance cruciale de réglementer, normaliser et baliser la recherche avec des sujets humains. Plusieurs textes fondateurs ont établi des principes de base devant guider la conception, la réalisation et l’évaluation de projets de recherche avec des..