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Clinical ethics

Commentary

When they believe in miracles

 1. Steve Clarke

 1. Correspondence to Dr Steve Clarke, Institute for Science and Ethics, Oxford
    Martin School and Faculty of Philosophy, University of Oxford, Suite 8,
    Littlegate House, 16-17 St Ebbes Street, Oxford OX1 1PT, UK;
    stephen.clarke@philosophy.ox.ac.uk




ABSTRACT

Brierley et al argue that in cases where it is medically futile to continue
providing life-sustaining therapies to children in intensive care, medical
professionals should be allowed to withdraw such therapies, even when the
parents of these children believe that there is a chance of a miracle cure
taking place. In reasoning this way, Brierley et al appear to implicitly assume
that miracle cures will never take place, but they do not justify this
assumption and it would be very difficult for them to do so. Instead of seeking
to override the wishes of parents, who are waiting for a miracle, it is
suggested that a better response may be to seek to engage devout parents on
their own terms, and encourage them to think about whether or not continuing
life-sustaining therapies will make it more likely that a miracle cure will
occur.

 * Care of dying minors
 * religious ethics
 * informed consent
 * moral psychology
 * philosophical ethics





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 * Care of dying minors
 * religious ethics
 * informed consent
 * moral psychology
 * philosophical ethics

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FOOTNOTES

 * Competing interests None.

 * Provenance and peer review Commissioned; internally peer reviewed.




LINKED ARTICLES

 * Clinical ethics
   Should religious beliefs be allowed to stonewall a secular approach to
   withdrawing and withholding treatment in children?
   Joe Brierley Jim Linthicum Andy Petros
   Journal of Medical Ethics 2012; 39 573-577 Published Online First: 30 Mar
   2012. doi: 10.1136/medethics-2011-100104
 * Clinical ethics
   If you ask the wrong question, you'll get the wrong answer
   Charles Foster
   Journal of Medical Ethics 2012; 39 578-578 Published Online First: 13 Aug
   2012. doi: 10.1136/medethics-2012-100682
 * Clinical ethics
   Cultural sensitivity in paediatrics
   Gregory L Bock
   Journal of Medical Ethics 2013; 39 579-581 Published Online First: 26 Apr
   2013. doi: 10.1136/medethics-2012-100716
 * Clinical ethics
   Rationality, religion and refusal of treatment in an ambulance revisited
   Kate McMahon-Parkes
   Journal of Medical Ethics 2012; 39 587-590 Published Online First: 16 May
   2012. doi: 10.1136/medethics-2011-100079
 * Clinical ethics
   Religious red herrings
   Mark Sheehan
   Journal of Medical Ethics 2012; 39 585-586 Published Online First: 13 Aug
   2012. doi: 10.1136/medethics-2012-100676
 * Clinical ethics
   Just dying: the futility of futility
   Julian Savulescu
   Journal of Medical Ethics 2012; 39 583-584 Published Online First: 13 Aug
   2012. doi: 10.1136/medethics-2012-100683
 * The concise argument
   Withholding artificial nutrition and hydration
   Imogen Goold
   Journal of Medical Ethics 2013; 39 541-542 Published Online First: 19 Aug
   2013. doi: 10.1136/medethics-2013-101745




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These cookies are necessary for the website to function and cannot be switched
off in our systems. They are usually only set in response to actions made by you
which amount to a request for services, such as setting your privacy
preferences, logging in or filling in forms.    You can set your browser to
block or alert you about these cookies, but some parts of the site will not then
work. These cookies do not store any personally identifiable information.

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PERFORMANCE COOKIES

Performance Cookies


These cookies allow us to count visits and traffic sources so we can measure and
improve the performance of our site. They help us to know which pages are the
most and least popular and see how visitors move around the site.    All
information these cookies collect is aggregated and therefore anonymous. If you
do not allow these cookies we will not know when you have visited our site, and
will not be able to monitor its performance.

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FUNCTIONAL COOKIES

Functional Cookies


These cookies enable the website to provide enhanced functionality and
personalisation. They may be set by us or by third party providers whose
services we have added to our pages.    If you do not allow these cookies then
some or all of these services may not function properly.

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TARGETING COOKIES

Targeting Cookies


These cookies may be set through our site by our advertising partners. They may
be used by those companies to build a profile of your interests and show you
relevant adverts on other sites.    They do not store directly personal
information, but are based on uniquely identifying your browser and internet
device. If you do not allow these cookies, you will experience less targeted
advertising.

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GOOGLE & IAB TCF 2 PURPOSES OF PROCESSING

Google & IAB TCF 2 Purposes of Processing


Allowing third-party ad tracking and third-party ad serving through Google and
other vendors to occur. Please see more information on Google Ads
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STORE AND/OR ACCESS INFORMATION ON A DEVICE 50 PARTNERS CAN USE THIS PURPOSE

Store and/or access information on a device


Cookies, device or similar online identifiers (e.g. login-based identifiers,
randomly assigned identifiers, network based identifiers) together with other
information (e.g. browser type and information, language, screen size, supported
technologies etc.) can be stored or read on your device to recognise it each
time it connects to an app or to a website, for one or several of the purposes
presented here.

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PERSONALISED ADVERTISING AND CONTENT, ADVERTISING AND CONTENT MEASUREMENT,
AUDIENCE RESEARCH AND SERVICES DEVELOPMENT 65 PARTNERS CAN USE THIS PURPOSE

Personalised advertising and content, advertising and content measurement,
audience research and services development


 * USE LIMITED DATA TO SELECT ADVERTISING 45 PARTNERS CAN USE THIS PURPOSE
   
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   Advertising presented to you on this service can be based on limited data,
   such as the website or app you are using, your non-precise location, your
   device type or which content you are (or have been) interacting with (for
   example, to limit the number of times an ad is presented to you).
   
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 * CREATE PROFILES FOR PERSONALISED ADVERTISING 35 PARTNERS CAN USE THIS PURPOSE
   
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   Information about your activity on this service (such as forms you submit,
   content you look at) can be stored and combined with other information about
   you (for example, information from your previous activity on this service and
   other websites or apps) or similar users. This is then used to build or
   improve a profile about you (that might include possible interests and
   personal aspects). Your profile can be used (also later) to present
   advertising that appears more relevant based on your possible interests by
   this and other entities.
   
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 * USE PROFILES TO SELECT PERSONALISED ADVERTISING 33 PARTNERS CAN USE THIS
   PURPOSE
   
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   Advertising presented to you on this service can be based on your advertising
   profiles, which can reflect your activity on this service or other websites
   or apps (like the forms you submit, content you look at), possible interests
   and personal aspects.
   
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 * CREATE PROFILES TO PERSONALISE CONTENT 15 PARTNERS CAN USE THIS PURPOSE
   
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   Information about your activity on this service (for instance, forms you
   submit, non-advertising content you look at) can be stored and combined with
   other information about you (such as your previous activity on this service
   or other websites or apps) or similar users. This is then used to build or
   improve a profile about you (which might for example include possible
   interests and personal aspects). Your profile can be used (also later) to
   present content that appears more relevant based on your possible interests,
   such as by adapting the order in which content is shown to you, so that it is
   even easier for you to find content that matches your interests.
   
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 * USE PROFILES TO SELECT PERSONALISED CONTENT 12 PARTNERS CAN USE THIS PURPOSE
   
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   Content presented to you on this service can be based on your content
   personalisation profiles, which can reflect your activity on this or other
   services (for instance, the forms you submit, content you look at), possible
   interests and personal aspects, such as by adapting the order in which
   content is shown to you, so that it is even easier for you to find
   (non-advertising) content that matches your interests.
   
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 * MEASURE ADVERTISING PERFORMANCE 59 PARTNERS CAN USE THIS PURPOSE
   
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   Information regarding which advertising is presented to you and how you
   interact with it can be used to determine how well an advert has worked for
   you or other users and whether the goals of the advertising were reached. For
   instance, whether you saw an ad, whether you clicked on it, whether it led
   you to buy a product or visit a website, etc. This is very helpful to
   understand the relevance of advertising campaigns.
   
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 * MEASURE CONTENT PERFORMANCE 29 PARTNERS CAN USE THIS PURPOSE
   
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   Information regarding which content is presented to you and how you interact
   with it can be used to determine whether the (non-advertising) content e.g.
   reached its intended audience and matched your interests. For instance,
   whether you read an article, watch a video, listen to a podcast or look at a
   product description, how long you spent on this service and the web pages you
   visit etc. This is very helpful to understand the relevance of
   (non-advertising) content that is shown to you.
   
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 * UNDERSTAND AUDIENCES THROUGH STATISTICS OR COMBINATIONS OF DATA FROM
   DIFFERENT SOURCES 40 PARTNERS CAN USE THIS PURPOSE
   
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   Reports can be generated based on the combination of data sets (like user
   profiles, statistics, market research, analytics data) regarding your
   interactions and those of other users with advertising or (non-advertising)
   content to identify common characteristics (for instance, to determine which
   target audiences are more receptive to an ad campaign or to certain
   contents).
   
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 * DEVELOP AND IMPROVE SERVICES 39 PARTNERS CAN USE THIS PURPOSE
   
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   Information about your activity on this service, such as your interaction
   with ads or content, can be very helpful to improve products and services and
   to build new products and services based on user interactions, the type of
   audience, etc. This specific purpose does not include the development or
   improvement of user profiles and identifiers.
   
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USE PRECISE GEOLOCATION DATA 25 PARTNERS CAN USE THIS PURPOSE

Use precise geolocation data


With your acceptance, your precise location (within a radius of less than 500
metres) may be used in support of the purposes explained in this notice.

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ENSURE SECURITY, PREVENT AND DETECT FRAUD, AND FIX ERRORS 42 PARTNERS CAN USE
THIS PURPOSE

Always Active

Your data can be used to monitor for and prevent unusual and possibly fraudulent
activity (for example, regarding advertising, ad clicks by bots), and ensure
systems and processes work properly and securely. It can also be used to correct
any problems you, the publisher or the advertiser may encounter in the delivery
of content and ads and in your interaction with them.

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DELIVER AND PRESENT ADVERTISING AND CONTENT 47 PARTNERS CAN USE THIS PURPOSE

Always Active

Certain information (like an IP address or device capabilities) is used to
ensure the technical compatibility of the content or advertising, and to
facilitate the transmission of the content or ad to your device.

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MATCH AND COMBINE DATA FROM OTHER DATA SOURCES 36 PARTNERS CAN USE THIS PURPOSE

Always Active

Information about your activity on this service may be matched and combined with
other information relating to you and originating from various sources (for
instance your activity on a separate online service, your use of a loyalty card
in-store, or your answers to a survey), in support of the purposes explained in
this notice.

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LINK DIFFERENT DEVICES 25 PARTNERS CAN USE THIS PURPOSE

Always Active

In support of the purposes explained in this notice, your device might be
considered as likely linked to other devices that belong to you or your
household (for instance because you are logged in to the same service on both
your phone and your computer, or because you may use the same Internet
connection on both devices).

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IDENTIFY DEVICES BASED ON INFORMATION TRANSMITTED AUTOMATICALLY 40 PARTNERS CAN
USE THIS PURPOSE

Always Active

Your device might be distinguished from other devices based on information it
automatically sends when accessing the Internet (for instance, the IP address of
your Internet connection or the type of browser you are using) in support of the
purposes exposed in this notice.

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