This paper provides a legal and ethical analysis of some controversial aspects of a recent proposal for an independent audit of New Zealand's National Cervical Screening Programme. The analysis reveals the difficulties likely to arise between investigators and ethics committees when the interests served by important public health research compete with the rigorous protection of patients' privacy.
Numerous studies have shown that the use of marginal hearts for organ transplantation produces clinically favourable results, however the association of these marginal hearts with a separate list of potential recipients, often the elderly, is ethically disturbing for some transplant facilities. Examination of the outcome data alone is not enough to justify the use of an alternate recipient list (ARL) as an ethical practice. However, upon analysis and reflection on the allocation process and the goals of medicine, the operating principles of medical ethics clearly emerge. Based upon this ethical analysis, an ARL for heart transplantation is not a form of ageism but rather a method of technology stewardship that operates by way of facilitating transplant eligibility to those with the capacity to benefit.
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