Rosalind Mcdougall
Biographic Data
| ID | 3601190 |
|---|---|
| NAME | Rosalind Mcdougall |
| GIVEN NAMES | Rosalind |
| FAMILY NAME | Mcdougall |
| SIGNATURE | MCDOUGALL R |
| AFFILIATIONS | The University of Melbourne |
| ORCID | 0000-0002-3809-2575 |
| VERIFIED | Yes |
| TOTAL WORKS | 18 |
| TOTAL CITATIONS | 1 |
| AUTHOR COUNT | 18 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2019 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 1 |
From corridor to boardroom
In this paper, we present a model of clinical ethics support that is focused on addressing clinicians’ ethical concerns in practical and meaningful ways, including at a systems level within the hospital by engaging institutional leadership. Our work highlights the importance of this approach as a focus in nascent service establishment. The ‘corridor-to-boardroom’ model that we put forward aims to amplify clinicians’ voices in order to motivate or…
Attending to the micro in resource prioritisation
Since the COVID-19 pandemic, attention to elective (or planned) surgery waiting lists has been increasingly urgent and sustained. While the ethical challenge of prioritising patients for planned surgeries is extensively discussed at a policy or system level, little attention has been paid to ethical practice at the individual clinician level. We argue that surgical resource allocation should be reconceptualised as an ethical issue that spans the …
Information, Access, and Stress
This study explores parents’ perspectives on expanded genomic testing in pregnancy and its implications for reproductive autonomy. We conducted four workshops using dialogue group methodology and involving thirty-three Australian parents with recent experience of pregnancy. Participants used a fictional scenario involving prenatal testing to reflect on their own experiences and views. Four interconnected themes were identified: barriers to autono…
Using an ethical lens in frontline alcohol and other drug services
There are significant clinician, policy and systemic barriers to accessing Alcohol and Other Drug (AOD) services. Although frontline clinicians have very limited impact on the systemic barriers, there is a zone of clinical discretion within policy interpretation and implementation. Work within this zone can enhance access to services. Although not consistently recognised as such, this is ethical work; and facilitating access to services within th…
How is clinical ethics reasoning done in practice? A review of the empirical literature
BACKGROUND: Clinical ethics reasoning is one of the unique contributions of clinical ethicists to healthcare, and is common to all models of clinical ethics support and methods of case analysis. Despite being a fundamental aspect of clinical ethics practice, the phenomenon of clinical ethics reasoning is not well understood. There are no formal definitions or models of clinical ethics reasoning, and it is unclear whether there is a shared underst…
Gut feelings and lived experiences
This paper examines whether the motivations and experiences of 'anti-diet' dietitians and psychologists represent a paradigm shift in healthcare. We conducted four 2-hour, discipline-specific focus groups with a total of 16 female participants residing in Australia. Our reflexive thematic analysis generated four themes that we consider to be stages of a weight-neutral paradigm shift: (1) a recognition of a mismatch between one's weight-centred tr…
The ethical dimensions of everyday alcohol and other drug work
Visitor restrictions in hospitals during infectious disease outbreaks
In this paper, we explore the ethics of restricting visitation to hospitals during an infectious disease outbreak. We aim to answer three questions: What are the features of an ethically justified hospital visitor restriction policy? Should policies include scope for case‐by‐case exemptions? How should decisions about exemptions be made? Based on a critical interpretive review of the existing ethical literature on visitor restrictions, we argue t…
Fertility preservation for transgender children and young people in paediatric healthcare
In the identified literature, there is consensus that transgender children and young people should not be refused access to fertility preservation services solely due to their gender identity, and that clinicians with conscientious objections to fertility preservation for this group have an obligation to refer on to willing providers. Factors that create ethical complexity in this area of paediatric care include the child's age, mental health, an…
Junior doctors and conscientious objection to voluntary assisted dying
In jurisdictions where voluntary assisted dying (VAD) is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously …
Exploring the Ethics of the Parental Role in Parent‐Clinician Conflict
In pediatric health care, parents and clinicians sometimes have competing ideas of what should be done for a child. In this article, we explore the idea that notions of what should be done for a child partly depend on one's perception of one's role in the child's life and care. Although role‐based appeals are common in health care, role‐differentiated approaches to understanding parent‐clinician conflicts are underexplored in the pediatric bioeth…
Eligibility and access to voluntary assisted dying
In their analysis of the eligibility criteria for assisted dying in Canada, Downie and Schuklenk put forward a strong argument for the ethical defensibility of including mental illnesses and disabilities as underlying conditions driving a person’s request for assisted dying.1 In this commentary, we add a view on these debates from our home state of Victoria, Australia, where voluntary assisted dying has been legal since June 2019. We highlight th…
Should clinicians make chest surgery available to transgender male adolescents
Bioethicists are increasingly engaged in considering the ethical issues associated with the care of transgender people. One such issue facing paediatric clinicians is requests for chest surgery from transgender male adolescents. For transgender young people who identify as male but have already progressed through the mid to late stages of puberty, hormone treatment will not reverse breast development. Some of these young people are distressed by …
Navigating difficult decisions in medical care and research
The articles in this issue explore a number of difficult choices in medical care and research. They investigate ethical complexity in a range of decisions faced by policymakers and clinicians, and offer new evidence or normative approaches for navigating this complexity. In this issue’s feature article, Ford and colleagues engage with an ethical challenge faced by policymakers in relation to health research: should free text data contained in med…
Forever young? The ethics of ongoing puberty suppression for non-binary adults
In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression (OPS) to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that (1) the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; (2) there are additional equity-b…
Pandemic medical ethics
The COVID-19 pandemic will generate vexing ethical issues for the foreseeable future and many journals will be open to content that is relevant to our collective effort to meet this challenge. While the pandemic is clearly the critical issue of the moment, it’s important that other issues in medical ethics continue to be addressed as well. As can be seen in this issue, the Journal of Medical Ethics (JME) will uphold its commitment to publishing h…
Balancing health worker well-being and duty to care
The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment (PPE) in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-bei…
Computer knows best? The need for value-flexibility in medical AI
Artificial intelligence (AI) is increasingly being developed for use in medicine, including for diagnosis and in treatment decision making. The use of AI in medical treatment raises many ethical issues that are yet to be explored in depth by bioethicists. In this paper, I focus specifically on the relationship between the ethical ideal of shared decision making and AI systems that generate treatment recommendations, using the example of IBM’s Wat…
Gut feelings and lived experiences
This paper examines whether the motivations and experiences of 'anti-diet' dietitians and psychologists represent a paradigm shift in healthcare. We conducted four 2-hour, discipline-specific focus groups with a total of 16 female participants residing in Australia. Our reflexive thematic analysis generated four themes that we consider to be stages of a weight-neutral paradigm shift: (1) a recognition of a mismatch between one's weight-centred tr…
Computer knows best? The need for value-flexibility in medical AI
Artificial intelligence (AI) is increasingly being developed for use in medicine, including for diagnosis and in treatment decision making. The use of AI in medical treatment raises many ethical issues that are yet to be explored in depth by bioethicists. In this paper, I focus specifically on the relationship between the ethical ideal of shared decision making and AI systems that generate treatment recommendations, using the example of IBM’s Wat…
Navigating difficult decisions in medical care and research
The articles in this issue explore a number of difficult choices in medical care and research. They investigate ethical complexity in a range of decisions faced by policymakers and clinicians, and offer new evidence or normative approaches for navigating this complexity. In this issue’s feature article, Ford and colleagues engage with an ethical challenge faced by policymakers in relation to health research: should free text data contained in med…
Forever young? The ethics of ongoing puberty suppression for non-binary adults
In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression (OPS) to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that (1) the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; (2) there are additional equity-b…
Pandemic medical ethics
The COVID-19 pandemic will generate vexing ethical issues for the foreseeable future and many journals will be open to content that is relevant to our collective effort to meet this challenge. While the pandemic is clearly the critical issue of the moment, it’s important that other issues in medical ethics continue to be addressed as well. As can be seen in this issue, the Journal of Medical Ethics (JME) will uphold its commitment to publishing h…
Balancing health worker well-being and duty to care
The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment (PPE) in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-bei…
Eligibility and access to voluntary assisted dying
In their analysis of the eligibility criteria for assisted dying in Canada, Downie and Schuklenk put forward a strong argument for the ethical defensibility of including mental illnesses and disabilities as underlying conditions driving a person’s request for assisted dying.1 In this commentary, we add a view on these debates from our home state of Victoria, Australia, where voluntary assisted dying has been legal since June 2019. We highlight th…
Should clinicians make chest surgery available to transgender male adolescents
Bioethicists are increasingly engaged in considering the ethical issues associated with the care of transgender people. One such issue facing paediatric clinicians is requests for chest surgery from transgender male adolescents. For transgender young people who identify as male but have already progressed through the mid to late stages of puberty, hormone treatment will not reverse breast development. Some of these young people are distressed by …
Fertility preservation for transgender children and young people in paediatric healthcare
In the identified literature, there is consensus that transgender children and young people should not be refused access to fertility preservation services solely due to their gender identity, and that clinicians with conscientious objections to fertility preservation for this group have an obligation to refer on to willing providers. Factors that create ethical complexity in this area of paediatric care include the child's age, mental health, an…
Junior doctors and conscientious objection to voluntary assisted dying
In jurisdictions where voluntary assisted dying (VAD) is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously …
Exploring the Ethics of the Parental Role in Parent‐Clinician Conflict
In pediatric health care, parents and clinicians sometimes have competing ideas of what should be done for a child. In this article, we explore the idea that notions of what should be done for a child partly depend on one's perception of one's role in the child's life and care. Although role‐based appeals are common in health care, role‐differentiated approaches to understanding parent‐clinician conflicts are underexplored in the pediatric bioeth…
The ethical dimensions of everyday alcohol and other drug work
Visitor restrictions in hospitals during infectious disease outbreaks
In this paper, we explore the ethics of restricting visitation to hospitals during an infectious disease outbreak. We aim to answer three questions: What are the features of an ethically justified hospital visitor restriction policy? Should policies include scope for case‐by‐case exemptions? How should decisions about exemptions be made? Based on a critical interpretive review of the existing ethical literature on visitor restrictions, we argue t…
Gut feelings and lived experiences
This paper examines whether the motivations and experiences of 'anti-diet' dietitians and psychologists represent a paradigm shift in healthcare. We conducted four 2-hour, discipline-specific focus groups with a total of 16 female participants residing in Australia. Our reflexive thematic analysis generated four themes that we consider to be stages of a weight-neutral paradigm shift: (1) a recognition of a mismatch between one's weight-centred tr…
From corridor to boardroom
In this paper, we present a model of clinical ethics support that is focused on addressing clinicians’ ethical concerns in practical and meaningful ways, including at a systems level within the hospital by engaging institutional leadership. Our work highlights the importance of this approach as a focus in nascent service establishment. The ‘corridor-to-boardroom’ model that we put forward aims to amplify clinicians’ voices in order to motivate or…
Attending to the micro in resource prioritisation
Since the COVID-19 pandemic, attention to elective (or planned) surgery waiting lists has been increasingly urgent and sustained. While the ethical challenge of prioritising patients for planned surgeries is extensively discussed at a policy or system level, little attention has been paid to ethical practice at the individual clinician level. We argue that surgical resource allocation should be reconceptualised as an ethical issue that spans the …
Information, Access, and Stress
This study explores parents’ perspectives on expanded genomic testing in pregnancy and its implications for reproductive autonomy. We conducted four workshops using dialogue group methodology and involving thirty-three Australian parents with recent experience of pregnancy. Participants used a fictional scenario involving prenatal testing to reflect on their own experiences and views. Four interconnected themes were identified: barriers to autono…
Using an ethical lens in frontline alcohol and other drug services
There are significant clinician, policy and systemic barriers to accessing Alcohol and Other Drug (AOD) services. Although frontline clinicians have very limited impact on the systemic barriers, there is a zone of clinical discretion within policy interpretation and implementation. Work within this zone can enhance access to services. Although not consistently recognised as such, this is ethical work; and facilitating access to services within th…
How is clinical ethics reasoning done in practice? A review of the empirical literature
BACKGROUND: Clinical ethics reasoning is one of the unique contributions of clinical ethicists to healthcare, and is common to all models of clinical ethics support and methods of case analysis. Despite being a fundamental aspect of clinical ethics practice, the phenomenon of clinical ethics reasoning is not well understood. There are no formal definitions or models of clinical ethics reasoning, and it is unclear whether there is a shared underst…
Medicine (11 works) · Psychology (8 works) · Ethics in medical practice (7 works) · Political science (7 works) · Health care (6 works) · Law (6 works) · Engineering ethics (5 works) · Clinical Ethics (4 works) · Computer Science (4 works) · Ethics and Legal Issues in Pediatric Healthcare (4 works)