The rapid developments of science and technology in China over recent decades, particularly in biomedical research, have brought forward serious challenges regarding ethical governance. Recently, Jian-kui HE, a Chinese scientist, claimed to have "created" the first gene-edited babies, designed to be naturally immune to the human immunodeficiency virus (HIV). The news immediately triggered widespread criticism, denouncement, and debate over the scientific and ethical legitimacy of HE's genetic experiments. China's guidelines and regulations have banned germline genome editing on human embryos for clinical use because of scientific and ethical concerns, in accordance with the international consensus. HE's human experimentation has not only violated these Chinese regulations, but also breached other ethical and regulatory norms. These include questionable scientific value, unreasonable risk-benefit ratio, illegitimate ethics review, invalid informed consent, and regulatory misconduct. This series of ethical failings of HE and his team reveal the institutional failure of the current ethics governance system which largely depends on scientist's self-regulation. The incident highlights the need for urgent improvement of ethics governance at all levels, the enforcement of technical and ethical guidelines, and the establishment of laws relating to such bioethical issues.

New Zealand is considering a change in law to permit euthanasia and/or assisted dying (EAD). We reviewed 20 years of research to investigate New Zealanders' attitudes towards EAD, including those of health professionals. A systematic search was conducted using relevant databases. We identified 21 quantitative and 5 qualitative studies. For quantitative data, descriptive analyses were used to examine any demographic patterns that influenced attitudes. We reviewed the circumstances under which people think that EAD should be accessible, and which forms of EAD they support. All public attitude studies reported that the majority (68%) of respondents support EAD. There are few statistically significant demographic associations with attitudes toward EAD; exceptions include religiousity, educational attainment, and some ethnic groups. Health professionals' attitudes varied by speciality. Qualitative research was analysed for reoccurring themes; 'feeling like a burden' was evident across most studies. We conclude from the quantitative research that public attitudes are stable and a majority are open to legislative change. However, the qualitative research reveals the complexity of the issue and indicates a need for careful consideration of any proposed law changes. It is unclear what safeguards people expect if the law changes. We found little research involving vulnerable and marginalised populations.

We then propose a model for medical education based on patient contact, reflection, self-care, role model development, and feedback that will see students learn the art of human care as well as the science of disease management.

No abstract

In this paper, we outline a framework for understanding the different kinds of knowledge required for medical practice and use this framework to show how scientism undermines aspects of this knowledge. The framework is based on Michael Polanyi's claim that knowledge is primarily the product of the contemplations and convictions of persons and yet at the same time carries a sense of universality because it grasps at reality. Building on Polanyi's ideas, we propose that knowledge can be described along two intersecting "dimensions": the tacit-explicit and the particular-general. These dimensions supersede the familiar "objective-subjective" dichotomy, as they more accurately describe the relationship between medical science and medical practice. Scientism, we argue, excludes tacit and particular knowledge and thereby distorts "clinical reality" and impairs medical practice and medical ethics.