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Biomedical subjects

G R Gillett

Publications and source records attributed to G R Gillett.

11 recordsLinked to original sources
PubMed1994

Ethics and dental research.

Dentistry is a Hippocratic profession and is therefore committed to ongoing research into the causes and treatments of disease. This research embodies ethical standards which place a high value on a respect for persons. Those standards emphasize that we obtain informed consent from individuals selected to participate in research. The relevant information required for informed consent varies from situation to situation but should take into account the need for participants to make a reasoned decision about their involvement. Where community research is involved, there should be consultation with appropriate representatives. In all contemporary medical research, there is an inherent conflict between the ethical requirement that we share information which will help those who are suffering and the need to preserve rights to competitively sensitive information related to product development and academic funding. These various pressures on research emphasize the need for an active and lively appreciation of ethical issues in contemporary biomedical sciences.

Clinical Trials as Topic↗
PubMed1993

Learning to do no harm.

The legalization of euthanasia creates a certain tension when it is compared with those traditional medical principles that seem to embody respect for the sanctity of life. It also creates a real need for us to explore what we mean by harm in relation to dying patients. When we consider that we must train physicians so that they not only understand ethical issues but also show the virtues in their clinical practice, it becomes important for us to strive to train them in virtue rather than mere knowledge. We can only do this by conveying a real sense of the needs of the patient and an ability to relate to patients as people not problems. Such attitudes take shape in a training programme in which practical situations are explored and discussed and the limits of scientific medical responses to those challenges are exposed.

Codes of Ethics↗
PubMed1990

Neuropsychology and meaning in psychiatry.

The relationship between "causal" and "meaningful" (Jaspers) influences on behavior is explored. The nature of meaning essentially involves rules and the human practices in which they are imparted to a person and have a formative influence on that person's thinking. The meanings that come to be discerned in life experience are then important in influencing the shape of that person's conduct. The reasoning and motivational structures that develop on this basis are realized by the shape of the neural processing networks that constitute the mature human brain. This implies that meaning is not only realized by brain micro-structure but, in part, explains its workings. This in turn entails that in psychiatry we must continue to avail ourselves both of neuropsychology/neurobiology and of dynamic/meaningful explanation.

Brain↗
PubMed1989

Informed consent and moral integrity.

Informed consent is required for any medical procedure although the situations in which it is given are beset by uncertainties and indeterminacies. These make medicolegal scrutiny of such situations very difficult. Although some people find the decision in the Sidaway case incomprehensible because of its continuing regard for a 'professional practice standard' in informed consent, I will argue that an important fact in many cases is the moral integrity of the doctor concerned and the pattern of his practice. This may provide the only morally principled and legally accessible evidence enabling a correct decision to be made in a difficult case. Although the epistemological significance of a professional practice standard is thereby defended the 'prudent patient standard' for what counts as consent is left intact.

Communication↗
PubMed1987

Hypothalamic glioma.

Seven patients from a series of 400 parasellar lesions presenting with visual failure treated in the Gough-Cooper Department of Neurological Surgery, The National Hospital for Nervous Diseases, Queen Square, were found to have low-grade gliomas of the hypothalamus. All were retrochiasmatic in site. The median age was 18 years. All showed low-grade astrocytoma, grade 2 and, in 6 of the 7 cases, presentation was with a variety of visual problems including homonymous hemianopia, bitemporal hemianopia, and unilateral scotomata. The other case presented with papilledema. Skull x-rays were, by and large, normal. Computed tomography scanning showed low- or mixed-density midline lesions and angiography showed mass effect and occasionally a capsular blush. All were operated on directly through a variety of approaches, and in each case, a radical subtotal removal was carried out. Postoperatively there were no major complications and no major worsening of symptoms in any patient. Radiotherapy was applied in 6 of the 7 cases. Follow-up periods range from 6 months to 6 years and 5 of the 7 patients remain well. The other 2, who are surviving, have advancing neurological disturbance.

Adolescent↗
PubMed1986

Why let people die?

This paper concerns those patients whose brain is irreversibly damaged to the point where they will never recover significant mental life. I examine the reasons which justify the decision to withhold or discontinue active medical intervention in these patients. They involve the identity, quality of life and agency of those beings whom we value as persons.

Brain Death↗
PubMed1975

Mediodorsal nucleus and behavior regulation in the rat.

Twelve electrodes aimed at the mediodorsal thalamic nucleus were implanted in 6 rats. In 5 of these animals intracranial stimulation was effective in punishing a bar press response on a baseline schedule of water reinforcement. The sixth animal was not tested. In all 6 animals lesions produced through these electrodes disrupted response suppression to punishing electric shock superimposed on the same baseline. Those animals in which both parts of the mediodorsal thalamic nucleus were damaged showed a more marked and graded punishment effect of intracranial stimulation and a more profound disruption of the quantitative shock intensity-response relationship than those in which only the rostromedial part of the nucleus was damaged. Three other animals had electrodes implanted in the rostromedial hypothalamus or the midline thalamus. They showed neither the punishing effect of intracranial stimulation nor the dusruptive effect on response suppression of electrocoagulative lesions.

Animals↗