Ethics in Child Health: Principles and Cases in Neurodisability Edited by Peter LRosenbaum, Gabriel MRosen, EricRacine, JenniferJohannesen and BernardDanLondon: Mac Keith Press, 2016 £39.95 (Paperback), pp 369 ISBN: 978‐1‐909962‐63‐7
Bibliographic record
Abstract
This is an outstanding book that should be in every department of paediatrics and child health for all staff to access, not only those working in neurodisability.It is outstanding because it addresses real 'lived experiences' of children and families alongside 'worked examples' of the practical challenges confronting the clinician.Fifty-nine authors write from Rwanda, Canada, the USA, Australia, and across Europe.It sets a logical approach across thirty-one chapters in six sections and an epilogue.Section A sets the scene, attuning moral and ethical thinking, before moving to Section B, 'Early days, the start of the different development journey'.Section C approaches ethical issues in addressing families' priorities, before Section D, 'Respecting social and cultural values'.The last three sections consider ethics in relation to therapies, rehabilitation, and interventions, then ethical issues in specific conditions and contexts, before concluding with considerations around emerging independence and preparing for adulthood.The book demands concentration.It is not one to read from cover to cover in one sitting.However, the comprehensive index facilitates exploring the contents.How ethics has changed since I graduated as a young doctor in 1967!I can't recall much teaching on the subject, but since then there has been an explosion of ethical committees of one kind or another, alongside strength in the discipline of medical ethics.So, what reflections on the book can I offer through what I have witnessed?The book says little on the management of ethical issues in organisations.As President of the British Medical Association I attended its national Ethics Committee, with its members comprising clinicians, lawyers, bioethicists, theologians from different faiths, patient representatives and officials producing impactful publications.1 The range of issues discussed is formidable, most recently on 'End of life care and physician-assisted dying' (https://www.bma.org. uk/collective-voice/policy-and-research/ethics/end-of-life- care).Issues now on the horizon include the ethics and legality of three parent embryos, and the implications of human-pig hybrids.At the institutional level, as Director of Clinical R&D at Great Ormond Street Hospital in London I was responsible for managing over 1500 research projects.This required a dedicated R&D Office with people and expertise, alongside computerised systems to register, track, and
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.009 |
| Scholarly communication | 0.007 | 0.004 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.013 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".