This article discusses the ethics of nuclear waste management in terms of the concept of responsibility for the harmful effects of modern technology. At present, the principle that every country and new generation should assume responsibility for the nuclear waste they produce is challenged by a globalised industry and the repositories of nuclear waste that have accumulated over the past fifty years and been left for future generations to manage. The basic premise of the article is that modern technology, particularly (...) nuclear power, calls for a new kind of responsibility that extends to future generations as well. This new concept of responsibility and the principles of long-term management of nuclear waste are set out and discussed in detail, with reference to Kant, Jaspers, Jonas, Peter Kemp and others. (shrink)

Patient autonomy is recognised within mental healthcare, although the capacity to participate in one’s own treatment planning is often reduced during a psychotic crisis. The patient may not be sufficiently competent to give consent or express preferences at the time treatment decisions are made. Nine participants were interviewed shortly after a crisis. We discussed participation in the treatment planning and recovery process with particular emphasis on interactions with professionals and understanding treatment. The participants recognised the need for drugs and mental (...) healthcare but emphasised the need for better cooperation and communication. To facilitate the development of patient autonomy, we recommend an increased emphasis on providing information and participating in a dialogue about drug treatment options. This could counteract many of the negative experiences reported. The use of debriefing during hospitalisation and following coercion can be a practical tool for clarifying patient preferences and mutual understanding. (shrink)

The practice of covertly administering medication is controversial. Although condemned by some as overly paternalistic, others have suggested that it may be acceptable if patients have permanent mental incapacity and refuse needed treatment. Ethical, legal, and clinical considerations become more complex when the mental incapacity is temporary and when the medication actually serves to restore autonomy. We discuss these issues in the context of a young man with schizophrenia. His mother had been giving him antipsychotic medication covertly in his soup. (...) Should the doctor continue to provide a prescription, thus allowing this to continue? We discuss this case based on the “four principles” ethical framework, addressing the conflict between autonomy and beneficence/non-maleficence, the role of antipsychotics as an autonomy restoring agent, truth telling and the balance between individual versus family autonomy. (shrink)