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Oncology bioethic

Selene Beviláqua Chaves Afonso, Maria Cecília de Souza Minayo
We present a study about the relations between pediatric oncological haematologists, mothers, and children in sharing bad news (BN) in a public hospital in Rio de Janeiro. The text emphasizes the intertwining of technique and emotions for the treatment of children with diagnoses in which the fatal outcome is always a probability. We used a qualitative approach, privileging participant observation and open interviews with oncologists (at this service all professionals were female) and mothers. We sought to understand the importance of communication which includes expressions and control of emotions; bioethical issues that require sensitivity, serenity, and truth about approaching the end of life; and how the professionals balance proximity to children and families and objectivity in their activity...
January 2017: Ciência & Saúde Coletiva
P Voultsos, N Raikos, N Vasileiadis, Ch Spiliopoulou, B Tarlatzis
Ovarian tissue transplantation (OTT) is a promising experimental method which may soon become well-established. In cases of minor oncology, where patients' fertility is seriously threatened by treatment, it may be applied as a unique fertility preservation option. OTT has a dual nature ('organ' and 'gamete'). Many stakeholders are involved, including donor, recipient, child, health-care providers and society at large. There is considerable uncertainty about the long-term consequences of the application of OTT and OT cryopreservation (OTC)...
July 4, 2016: Medicine, Science, and the Law
Bartłomiej Noszczyk
Over the last decade autologous fat from subcutaneous tissue has been used by plastic surgeons for face volumization. It has also been used with growing frequency for aesthetic breast enhancement. Currently, experts in this field are becoming increasingly aware of the potential of fat for breast reconstruction. However, the safety of fat transfers to post-mastectomy defects has been called into question in recent debates due to the, albeit rare, observations of their possible influence on local cancer recurrence...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Rachel B Mejia, Laura A Shinkunas, Ginny L Ryan
OBJECTIVE: Obstetrics and gynecology (ob/gyn) is fraught with bioethical issues, the professional significance of which may vary based on clinical experience. Our objective was to utilize our novel ethics curriculum to identify ethics and professionalism issues highlighted by ob/gyn learners and to compare responses between learner levels to further inform curricular development. STUDY DESIGN: We introduced an integrated and dynamic ob/gyn ethics and professionalism curriculum and mixed methods analysis of 181 resulting written reflections (case observation and assessments) from third-year medical students and from first- to fourth-year ob/gyn residents...
December 2015: American Journal of Obstetrics and Gynecology
Uría Guevara-López, Myriam M Altamirano-Bustamante, Carlos Viesca-Treviño
BACKGROUND: In our time there is growing interest in developing a systematic approach to oncologic patients and end-of-life care. An important goal within this domain is to identify the values and ethical norms that guide physicians' decisions and their recourse to technological aids to preserve life. Though crucial, this objective is not easy to achieve. The purpose of this study is to evaluate empirically the real-life bioethical dilemmas with which palliative physicians are confronted when treating terminal cancer patients...
February 26, 2015: BMC Medical Ethics
Natalia Podkowa, Paulina Komasińska, Magdalena Roszak, Robert Gryczka, Sylwia Grodecka-Gazdecka, Katarzyna Łacka
UNLABELLED: Breast cancer (BC) is one of the most common neoplasms and the second biggest cause of death among women. The aim of the study was to investigate how separate risk factors influence the development of breast neoplasms. MATERIALS AND METHODS: The study included 200 women aged between 17 and 86 years diagnosed with breast neoplasm, who were treated at the Department of Oncological Surgery in Poznan. The study included patients who underwent an operation because of a benign or malignant breast tumor...
September 2014: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Dominique Lossignol
PURPOSE OF REVIEW: To evaluate the application of narrative within medical practice. Illness like cancer constitutes a biographical disruption that occurs several times during the disease, from diagnosis to complications and treatments. This review analyzes the interest of narrative ethics in medicine with a focus on cancer. RECENT FINDINGS: The field of narrative ethics in medicine has emerged from a confluence of humanities, contemporary narratology, literature and social sciences...
July 2014: Current Opinion in Oncology
Jia An Chong, Yan Ling Quah, Grace Meijuan Yang, Sumytra Menon, Lalit Kumar Radha Krishna
BACKGROUND: The practice of patient autonomy within the prevailing bioethical framework in the West appears increasingly at odds with the prominent influence of the family in medical decision making in the Asian culture. The actual extent of involvement of patient versus the family in the decision making process for cancer management in clinical practice is largely unknown in Asia. AIMS: (1) To describe patient and family involvement in healthcare decision making in actual practice, and to determine whether those practices are consistent with Singapore law; and (2) to act as a pilot for a larger prospective study examining the preferences of cancer patients on the decision making process, and the reasons for excluding patients from that process...
December 2015: BMJ Supportive & Palliative Care
Ruth Powazki, Declan Walsh, Brenda Cothren, Lisa Rybicki, Shirley Thomas, Gloria Morgan, Diana Karius, Mellar P Davis, Shiva Shrotriya
BACKGROUND: Care of the dying is a significant component of nursing practice particularly in hospitals. Nurses who work in certain areas like oncology, intensive care unit (ICU) face the care of the dying, more so than other units. OBJECTIVES: The survey was conducted to assess nurses' self-perception of their professional capability and comfort in the care of the actively dying. Determine if professional capability and comfort was associated with any of the six demographics characteristics (age, gender, clinical experience, education level, nursing unit, continuing education)...
September 2014: American Journal of Hospice & Palliative Care
Selene Beviláqua Chaves Afonso, Maria Cecília de Souza Minayo
In order to discuss and understand the experiences of oncologists faced with the task of communicating difficult news to children and their close family members, a bibliographical review was conducted in the Virtual Health Library databases containing the literature published by PubMed, Lilacs, Scielo, Scopus and SciVerse with input on the theme. The articles available evaluated by thematic analysis reveal the following aspects: the lack of studies focusing on the perception of professionals about imparting difficult news; communication as a strategy by which psychosocial, cultural, bioethical, legal and emotional aspects are handled; that more is expected from physicians than they were trained for...
September 2013: Ciência & Saúde Coletiva
Federico Bozzetti
This review focuses on the nutritional support of the non-surgical cancer patient. The following topics are reviewed: cancer cachexia (definition and staging, prevalence and impact on clinical outcome); nutritional screening to identify potential candidates for nutritional support; nutritional requirements in terms of macro-and micro-nutrients of the advanced cancer patient. Finally, the indications and results of nutritional support are presented with a special focus on the following issues: routes of delivering nutritional support, the use of standard or n-3 fatty acids-enriched oral nutritional supplements during radiation therapy and/or chemotherapy, tube feeding during RT (with/without chemotherapy), parenteral nutrition during chemotherapy, nutritional support during hematopoietic stem cell transplantation, (home) enteral or total and supplemental parenteral nutrition in the incurable patient...
August 2013: Critical Reviews in Oncology/hematology
Thomas W LeBlanc, Lawrence N Shulman, Peter P Yu, Bradford R Hirsch, Amy P Abernethy
Health information technology (HIT) is ever-increasing in complexity and has incrementally become a fundamental part of our everyday clinical lives. As HIT becomes more complex and commonplace, so do the questions it raises about stewardship and usage of data, along with the ethics of these applications. With the development of rapid-learning systems, such as ASCO's CancerLinQ, careful thought about the ethics and applications of these technologies is necessary. This article uses the principles-based framework of modern bioethics to examine evolving ethical issues that arise in the context of HIT and also discusses HIT's application in reducing cancer care disparities in the developing world...
2013: American Society of Clinical Oncology Educational Book
Joshua D Schiffman, James I Geller, Erin Mundt, Anthony Means, Lindsey Means, Von Means
Hereditary cancer syndromes in children and adolescents are becoming more recognized in the field of pediatric hematology/oncology. A recent workshop held at the American Society of Pediatric Hematology/Oncology (ASPHO) 2012 Annual Meeting included several interactive sessions related to specific familial cancer syndromes, genetic testing and screening, and ethical issues in caring for families with inherited cancer risk. This review highlights the workshop presentations, including a brief background about pediatric cancer predisposition syndromes and the importance of learning about them for the practicing pediatric hematologists/oncologists...
August 2013: Pediatric Blood & Cancer
Graziano Martignoni, Nicola Grignoli, Valentina Di Bernardo, Martina Malacrida, Guenda Bernegger, Fabrizio Barazzoni, Roberto Malacrida
The Medical Humanities go beyond bioethics, cross over multiple disciplines and represent a new way of perceiving, seeing and thinking about illness. They represent a different view that gives value to the human side of treatment, that recognizes in self-narration an authentic and living foundation. Today, the technical aspects of medicine need more than ever to be accompanied by content derived from the arts and social or human sciences that focus on other, but not less important, aspects of being sick or in health...
December 31, 2012: Critical Reviews in Oncology/hematology
Galen Joseph, Daniel Dohan
Since the U.S. National Institutes of Health (NIH) Revitalization Act of 1993, researchers with federal funding have been required to include "minorities and women" in their clinical trials, and inclusion in research has come to be seen as an important strategy for reducing health disparities. On the basis of ethnographic research in oncology clinics in an academic medical center and a public hospital over a period of two years, this article examines how the NIH inclusion mandate is playing out in the context of oncology clinical trials...
September 2012: Medical Anthropology Quarterly
Elise J Taylor, Liliya Golas, Joseph R Martel, James B Martel
The approach used by the authors for managing a patient with a schizoaffective disorder and advanced basal cell carcinoma involving the eyelids, orbit, and face is presented. Complexities included the advanced nature of the disease, neglect of the patient's condition due to schizoaffective disorder, the difficulty of obtaining informed consent, the required aggressive surgical intervention, reconstruction, and the necessary management during the postsurgical period. A multidisciplinary team approach with psychiatry, ophthalmology, ear, nose, and throat, plastic surgery, radiation oncology, oncology, legal, and bioethics specialties is required in patients with cognitive disabilities...
March 2013: Ophthalmic Plastic and Reconstructive Surgery
Isabelle Baszanger
During the past few years, debates have frequently erupted in oncology journals regarding the question of whether to prolong or end treatment. These debates have been informed by developments from both within and outside the field. Within Bioethics, some writers have put forward a number of principles for judging the legitimacy of medical interventions, notably that of patient autonomy. Broad social and political developments have also profoundly affected medical practices at the end of life. Though therapeutic options have evolved, whether to stop or to pursue treatment in the face of certain death has been a central issue in medical oncology since the early 1950s...
September 2012: Social Science & Medicine
Jennia Michaeli, Michael Weintraub, Eitan Gross, Yehuda Ginosar, Vardit Ravitsky, Einat Eizenman, Eduardo Mitrani, Meital Lebovich, Neri Laufer, Stephen Kennedy, Ariel Revel
Children that undergo treatment for cancer are at risk of suffering from subfertility or hormonal dysfunction due to the detrimental effects of radiotherapy and chemotherapeutic agents on the gonads. Cryopreservation of ovarian tissue prior to treatment offers the possibility of restoring gonadal function after resumption of therapy. Effective counseling and management of pediatric patients is crucial for preserving their future reproductive potential. The purpose of this article is to review recent literature and to revise recommendations we made in a 2007 article...
2012: Obstetrics and Gynecology International
C Segré
The 4th International PhD Student Cancer Conference was held at the IFOM-IEO-Campus in Milan from 19-21 May 2010 Conference covered many topics related to cancer, from basic biology to clinical aspects of the disease. All attendees presented their research, by either giving a talk or presenting a poster. This conference is an opportunity to introduce PhD students to top cancer research institutes across Europe.THE CORE PARTICIPANTING INSTITUTES INCLUDED: European School of Molecular Medicine (SEMM)-IFOM-IEO Campus, MilanBeatson Institute for Cancer Research (BICR), GlasgowCambridge Research Institute (CRI), Cambridge, UKMRC Gray Institute of Radiation Biology (GIROB), OxfordLondon Research Institute (LRI), LondonPaterson Institute for Cancer Research (PICR), ManchesterThe Netherlands Cancer Institute (NKI), Amsterdam'You organizers have crushed all my prejudices towards Italians...
2010: Ecancermedicalscience
Avram E Denburg, Steven Joffe, Sumit Gupta, Scott C Howard, Raul C Ribeiro, Federico A Antillon, Roberto Vasquez, Lillian Sung
Uneven strides in research and care have led to discrepancies in childhood cancer outcomes between high and low income countries (LICs). Collaborative research may help improve outcomes in LICs by generating knowledge for local scientific communities, augmenting knowledge translation, and fostering context-specific evaluation of treatment protocols. However, the risks of such research have received little attention. This paper investigates the relationship between pediatric oncology research in LICs and four core issues in the ethics literature: standard of care, trial benefits, ethics review, and informed consent...
April 2012: Pediatric Blood & Cancer
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