Phillipa Malpas

• University of Auckland

There is strong evidence that dishonesty occurs amongst medical students, and other allied health students and growing evidence that it occurs amongst medical academics. We believe that accidental dishonesty (or not knowing about the rules of regulations governing academic integrity) is a common attribution describing engagement in dishonesty; howe...

The monarch butterflies so abundant around the small pond are slowly disappearing. Tomatoes from the vine that curled its way up the drainage spout are now lined up on the kitchen windowsill to capture the sun’s rays. Summer draws to an end as my father’s life also draws to a close. As part of my narrative, I have included, in italics, entries from...

During an initial palliative care assessment, a dying man discloses that he had killed several people whilst a young man. The junior doctor, to whom he revealed his story, consulted with senior palliative care colleagues. It was agreed that legal advice would be sought on the issue of breaching the man's confidentiality. Two legal opinions conflict...

Aim: We set out to explore the question, what ethical challenges do medical students identify when asked to perform or observe a sensitive examination, given a historical background relevant to this context. Method: Thematic analysis of 21 Ethics Reports from 9 female and 12 male students. Results: Overall 14 students undertook a sensitive exa...

This article was migrated. The article was marked as recommended. Over the past 50 years, advances in medical technology have revolutionised the medical landscape. The ways in which patients, their families, and health professionals connect and interact together in the medical endeavour have also changed. At the same time as advances in medical tec...

In this viewpoint article we consider the situation of organ procurement from China, and address some of the ethical aspects arising for health professionals when New Zealand transplant patients contemplate traveling to China for an organ. We also consider some of the challenges facing health professionals involved in providing care to such patient...

This article describes the well-developed and long-standing medical ethics teaching programs in both of New Zealand’s medical schools at the University of Otago and the University of Auckland. The programs reflect the awareness that has been increasing as to the important role that ethics education plays in contributing to the “professionalism” and...

Aims: This study investigated New Zealand nurses' views on legalising assisted dying across a range of clinical conditions, nurses' willingness to engage in legal assisted dying, potential deterrents and enablers to such engagement, and nurses' perceptions of the proper role of their professional bodies in relation to legalising assisted dying. B...

Background: Compassion is a core virtue in medicine and lies at the heart of good medical care. It connects us to each other and reflects our need for relationships with others. Aim: Our aim is to explore how palliative care patients perceive, understand and experience compassion from health professionals, and to inform clinical practice. Metho...

Background People with dementia receive worse end of life care compared to those with cancer. Barriers to undertaking advanced care planning (ACP) in people with dementia include the uncertainty about their capacity to engage in such discussions. The primary aim of this study was to compare the Advance Care Planning–Capacity Assessment Vignette too...

Objective: The objective of this study was to explore whether older people want their doctors to make treatment decisions on their behalf when they no longer have capacity to do so, and their reasons for these preferences. Method: A convenience sample of older people from two retirement villages were interviewed and asked to respond to a hypothe...

Background: Assisted dying (AD) has been legalised by statute or court decisions in at least 15 jurisdictions internationally. Nonetheless, only three medical professional bodies (and none in nursing) across those jurisdictions have proactively developed authorised policy, practice standards, guidelines or protocols, or other professional supports...

Aim: This paper critically explores the research approach undertaken by Māori and tauiwi researchers working alongside kaumātua within the context of physician-assisted dying. We critically explore the collaborative process we undertook in framing the research context and discuss the rewards and challenges that emerged. Method: The research this...

Aims: To develop a policy governing the taking and sharing of photographic and radiological images by medical students. Methods: The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers' Rights were applied to the taking, storing and sharing of photographic and radiological images by medical...

Aim To explore kaumātua attitudes towards physician aid-in dying, to gain a clear understanding of how such attitudes may influence and shape their expectations of medical care at the end of life and to assist health professionals in Aotearoa/New Zealand to address the healthcare needs of older Māori near the end of life. Design A kaupapa Māori co...

Many students study overseas which has educational, cultural/social, and economic implications for host countries and those international students. It has been reported that medical and health sciences educational experiences are beginning to develop at a transnational level whereby curricula are shared among educational centres across different co...

Mr X was a 56 year old Chinese man (non-English speaking), who presented to the emergency department with a range of non-specific symptoms. On full workup, he was diagnosed with an advanced cancer of the pancreas. It was an aggressive, highly treatment resistant cancer, with an alarmingly poor prognosis. Before the diagnosis had been made, the fami...

One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemm...

Much has been written about the ethical issues involved in euthanasia, assisted suicide and other forms of assisted dying. Such discussions have often raised legitimate concerns and challenges to those arguing the case for some form of assisted dying to be legalised. A further concern, though, which relates only tangentially if at all to the ethica...

Rapidly aging populations and increased prevalence of chronic rather than acute illnesses have seen growing public and professional interest in medical decision making at the end of life and greater attention being paid to the factors that influence how individuals make such decisions. This study comprised 2 components: The first, a postal survey,...

Commentary on: Pestinger M, Stiel S, Elsner F, et al. The desire to hasten death: using Grounded Theory for a better understanding “When perception of time tends to be a slippery slope”. Palliat Med 2015;29:711–19.[OpenUrl][1][Abstract/FREE Full Text][2] Despite tremendous advancements in palliative and hospice care over the past several decades,...

Aims: The aim of this study was to explore medical decision-making practices at the end-of-life made by GPs (MDEL) in New Zealand and to identify changes in practice with a previous study published in 2004. Methods: A postal questionnaire was sent to 3,420 GPs in New Zealand in May 2013. Anonymous phone interviews were also undertaken. Analysis...

Background People with dementia receive worse end of life care compared to those with cancer. The main barrier to undertaking advanced care planning (ACP) in people with dementia has been uncertainty about their capacity to engage in such discussions. Although a capacity screening tool specific to advance care planning could improve its uptake with...

To develop a national consensus statement to promote a pragmatic, appropriate and unified approach to seeking consent for medical student involvement in patient care. A modified Delphi technique was used to develop the consensus statement involving stakeholders. Feedback from consultation and each stakeholder helped to shape the final consensus sta...

In higher education in New Zealand, there is a burgeoning interest in, and concern with, the way students conduct themselves in their learning practices. Engagement in academically honest and dishonest behaviours is a crucial area of study within higher education. To operationalize effective teaching and assessment, it is critically important to co...

Objectives: Physician-assisted dying (PAD) is legal in several countries in Europe and some states of the United States. Despite regular societal debate in New Zealand about assisted dying, little is known about what the New Zealand public think about this issue. The present study was the first to examine New Zealanders' attitudes toward assisted...

Background Physician-assisted dying at the end of life has become a significant issue of public discussion. While legally available in a number of countries and jurisdictions, it remains controversial and illegal in New Zealand. Aim The study aimed to explore the reasons some healthy older New Zealanders oppose physician-assisted dying in order to...

This paper presents students' views about honest and dishonest actions within the pharmacy and medical learning environments. Students also offered their views on solutions to ameliorating dishonest action. Three research questions were posed in this paper: (1) what reasons would students articulate in reference to engaging in dishonest behaviours?...

Background: There is ample evidence to suggest that academic dishonesty remains an area of concern and interest for academic and professional bodies. There is also burgeoning research in the area of moral reasoning and its relevance to the teaching of pharmacy and medicine. Aims: To explore the associations between self-reported incidence of aca...

To explore the reasons some healthy older New Zealanders support medical practices that hasten death. Recruitment was from the Voluntary Euthanasia Society of New Zealand (VESNZ), an organisation that supports legal medical assistance in dying. All participants were members of VESNZ. 106 individuals returned signed consent forms. All interviews too...

Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in many countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for legalisation of euthanasia or assisted suicide has never been stronger. While many studies...

Medical and nursing student numbers are expected to increase significantly in NZ over the next few years. The ethical, and professional and clinical skills' training of trainee health practitioners is a central and crucial component in medical and nursing education and is underpinned by a strong commitment to improve patient health and well being....

The decision to deactivate a pacemaker in a pacing-dependent patient is troubling for some health professionals who may regard such interventions as hastening death and therefore ethically impermissible. This may be especially concerning in situations where a patient is unable to clearly state what their preferences may be and the decision-were it...

This case concerns aspects of the treatment of a post-surgical patient in a major public hospital in New Zealand during the author's experiences as a fourth year medical student. This case is used to consider the interlinked ethical issues of sympathy, moral virtue, dignity and how the medical environment can realign these values.

In January 2010, fifth year medical students in the medical programme at the University of Auckland were asked to write a 1200-word report as part of their ethics assessment. The purpose of the report was to get students to reflect critically on the ethical dimension of a clinical case or situation they had been involved in during the past 2 years....

In New Zealand an advance directive can be either an oral statement or a written document. Such directives give individuals the opportunity to make choices about future medical treatment in the event they are cognitively impaired or otherwise unable to make their preferences known. All consumers of health care have the right to make an advance dire...

Background: Students' engagement in dishonest behaviours is problematic and may influence future professional practice. Aims: To consider the antecedents predicting engagement in academic dishonesty. Methods: A total of 433 pharmacy and medical students participated in a survey measuring engagement in academic dishonesty, self deception, justificat...

In October 2008 Baroness Warnock, medical ethicist and veteran British governmental advisor, claimed that an individual afflicted with dementia may have a moral duty to die when their continued living "wastes" the lives of others and the resources of the National Health Service. Her comments were widely publicised and largely condemned by those who...

Within the medical, legal and bioethical literature, there has been an increasing concern that the information derived from genetic tests may be used to unfairly discriminate against individuals seeking various kinds of insurance; particularly health and life insurance. Consumer groups, the general public and those with genetic conditions have also...

One of the central arguments given to resist testing currently healthy, asymptomatic children for adult-onset diseases is that they may be psychologically harmed by the knowledge gained from such tests. In this discussion I examine two of the most serious arguments: children who are tested may face limited futures, and that testing may result in da...

This paper first considers why it is important to give children genetic information about hereditary conditions in the family, which will go on to affect their lives in a salient way. If it is important to inform children that they are at risk for an adult-onset disease that exists in the family, why should they not also grow up knowing whether the...

Within the field of medicine, it has become widely accepted that respecting the autonomy of individuals justifies their right to know. More recently, commentators have asked whether such respect also justifies an individual's right not to know; that is, their right to remain in ignorance. In this paper, I examine what the concept of autonomy entail...

Thesis (MA--Philosophy)--University of Auckland, 2002.

Where are children situated in the moral community? Are children special from a moral point of view? Does children’s youth and vulnerability say anything significant about how we ought to treat them? These questions seek to articulate and clarify the moral status of children by considering what is required to be the beneficiary of moral standing, a...