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Ethics of care

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https://www.readbyqxmd.com/read/28231356/using-ethical-frameworks-in-times-of-transition-and-uncertainty
#1
Eileen M Sullivan-Marx
Health care policy is never easy and always fraught with concerns about quality, access, and cost. Currently, uncertainty abounds regarding new federal and state policies on the horizon for older adult care and quality. Empirics undergird most policy-making decisions regarding risk/benefit, cost, and knowing the best action to put in place for the best results. However, in times of great change in policy direction and political viewpoints, empirical knowledge must be combined with ethical knowledge for planning and implementation...
March 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28228974/the-solidarity-and-health-neutrality-of-physicians-in-war-peace
#2
Frederick M Burkle, Timothy Erickson, Johan von Schreeb, Stephanie Kayden, Anthony Redmond, Emily Yy Chan, Francesco Della Corte, Hilarie Cranmer, Yasuhiro Otomo, Kirsten Johnson, Nobhojit Roy
The wars in the Middle East have led to unprecedented threats and attacks on patients, healthcare workers, and purposeful targeting of hospitals and medical facilities. It is crucial that every healthcare provider, both civilian and military, on either side of the conflict become aware of the unique and inherent protections afforded to them under International Humanitarian Law. However, these protections come with obligations. Whereas Governments must guarantee these protections, when violated, medical providers have equal duty and obligations under the Law to ensure that they will neither commit nor assist in these violations nor take part in any act of hostility...
January 20, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28226465/in-silico-pre-clinical-trials-for-implantable-cardioverter-defibrillators
#3
Zhihao Jiang, Houssam Abbas, Kuk Jin Jang, Marco Beccani, Jackson Liang, Sanjay Dixit, Rahul Mangharam, Zhihao Jiang, Houssam Abbas, Kuk Jin Jang, Marco Beccani, Jackson Liang, Sanjay Dixit, Rahul Mangharam, Jackson Liang, Marco Beccani, Sanjay Dixit, Rahul Mangharam, Houssam Abbas, Zhihao Jiang, Kuk Jin Jang
Regulatory authorities require that the safety and efficacy of a new high-risk medical device be proven in a Clinical Trial (CT), in which the effects of the device on a group of patients are compared to the effects of the current standard of care. Phase III trials can run for several years, cost millions of dollars, and expose patients to an unproven device. In this paper, we demonstrate how to use a large group of synthetic patients based on computer modeling to improve the planning of a CT so as to increase the chances of a successful trial for implantable cardioverter defibrillators (ICDs)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226049/predictors-for-the-functional-incapacity-of-the-elderly-in-primary-health-care
#4
Lívia Carvalho Pereira, Maria do Livramento Fortes Figueiredo, Cinara Maria Feitosa Beleza, Elaine Maria Leite Rangel Andrade, Maria Josefina da Silva, Antonio Francisco Machado Pereira
Objectives: to assess the predictors for the functional incapacity of the elderly in primary health care. Method: cross-sectional study, of which 388 older people participated, conducted in three Primary health care Units, using the Katz index and Lawton's scale. The research project was approved by the Research Ethics Committee. Results: regarding the degree of dependency for Basic Activities, 90.2% were less independent for dressing themselves; and for Instrumental Activities, 77...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28225694/polarities-in-clinical-thinking-and-practice
#5
John Z Sadler
This analysis of a case of a bereaved patient that poses two treatment options-watchful waiting or medication-focuses on five "polarities" in clinical practice: (1) the normal and the pathological, (2) the individual and the diagnostic collective, (3) the primary care physician and the consultant, (4) the expert and nonexpert, and (5) the moment and the process. These polarities can accentuate ethical problems posed by this case, for example, by creating stark contrasts that mask the complex contexts of care and characteristics of patients...
February 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28223855/perception-of-educational-value-in-clinical-rotations-by-medical-students
#6
David A Kandiah
AIM: Clinical teaching in Australian medical schools has changed to meet the needs of substantially increased medical student cohorts. As such, formal feedback from these student cohorts is needed about the value they place on the educational input from each clinical rotation. This study aims to determine which aspects of clinical placements are most educationally useful to medical students. METHODS: In this study, final year medical students from the University of Western Australia (UWA) were surveyed via an anonymous online questionnaire, identifying which clinical placements were found to be the most and the least useful to their learning and the positive aspects of these placements...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28222516/intelligent-assistive-technology-for-alzheimer-s-disease-and-other-dementias-a-systematic-review
#7
Marcello Ienca, Jotterand Fabrice, Bernice Elger, Maurizio Caon, Alessandro Scoccia Pappagallo, Reto W Kressig, Tenzin Wangmo
Intelligent assistive technologies (IATs) have the potential of offering innovative solutions to mitigate the global burden of dementia and provide new tools for dementia care. While technological opportunities multiply rapidly, clinical applications are rare as the technological potential of IATs remains inadequately translated into dementia care. In this article, the authors present the results of a systematic review and the resulting comprehensive technology index of IATs with application in dementia care...
February 7, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28222476/-positionpaper-on-telemonitoring-in-sleep-related-breathing-disorders
#8
W Randerath, M Bögel, C Franke, A Hellmann, B Jany, G Nilius, T Penzel, T Voshaar, A Wiater
The use of telemonitoring in the care of patients with Sleep-related Breathing Disorders (SBD) can enhance medical support significantly. Telemonitoring aims at helping physicians to detect therapy problems early and thus improve patients' therapy adherence. Diagnostics and therapy decisions in the telemonitoring process nevertheless remain the responsibility of sleep specialists. The selection of data monitored, their evaluation and resulting consequences fall to the physician, who makes decisions and prescribes therapy in consultation with the patient...
February 2017: Pneumologie
https://www.readbyqxmd.com/read/28222038/evidence-based-ethically-justified-counseling-for-fetal-bilateral-renal-agenesis
#9
Alana N Thomas, Laurence B McCullough, Frank A Chervenak, Frank X Placencia
BACKGROUND: Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. AIM: To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. STUDY DESIGN: A systematic literature search was performed using multiple databases...
February 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28220732/should-doctors-provide-futile-medical-treatment-if-patients-or-their-proxies-are-prepared-to-pay-for-it
#10
D J McQuoid-Mason
Ethically and legally doctors are not obliged to provide futile treatment to patients, even if the patient or their proxies are prepared to pay for it. However, it may be justified where such treatment is harmless and has a placebo effect. In deciding about a request for futile treatment, doctors should be guided by the ethical principles of patient autonomy, beneficence, non-maleficence and justice. Guidelines are provided to assist doctors in making such decisions. Where futile treatment is withdrawn or refused, palliative care must always be offered...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219959/randomised-prospective-medico-economic-nationwide-french-study-of-islet-transplantation-in-patients-with-severely-unstable-type-1-diabetes-the-stabilot-study-protocol
#11
Sandrine Lablanche, Sandra David-Tchouda, Jennifer Margier, Edith Schir, Anne Wojtusciszyn, Sophie Borot, Laurence Kessler, Emmanuel Morelon, Charles Thivolet, François Pattou, Marie Christine Vantyghem, Thierry Berney, Pierre-Yves Benhamou
INTRODUCTION: Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy...
February 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28219376/cooperate-a-paradigm-shift-for-health-equity
#12
REVIEW
Wei-Ching Chang, Joy H Fraser
The role of competition and cooperation in relation to the goal of health equity is examined in this paper. The authors explain why the win-lose mentality associated with avoidable competition is ethically questionable and less effective than cooperation in achieving positive outcomes, particularly as it relates to health and health equity. Competition, which differentiates winners from losers, often with the winner-takes-all reward system, inevitably leads to a few winners and many losers, resulting in social inequality, which, in turn, engenders and perpetuates health inequity...
February 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28219363/to-change-or-not-to-change-translating-and-culturally-adapting-the-paediatric-version-of-the-moral-distress-scale-revised-mds-r
#13
Margareta Af Sandeberg, Marika Wenemark, Cecilia Bartholdson, Kim Lützén, Pernilla Pergert
BACKGROUND: Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised (MDS-R) is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises...
February 20, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28219284/conscientious-objection-understanding-the-right-of-conscience-in-health-and-healthcare-practice
#14
Christina Lamb
In situations of moral gravitas, healthcare professionals are largely protected in the Western world to invoke their right to conscientiously object to providing care that conflicts with their personal, moral, and religious beliefs. However, making a conscientious objection needs to be predicated by an understanding of conscience, and knowledge of conscience is largely absent in definition as well as discourse surrounding conscientious objection in healthcare practice. Moreover, current definitions of health do not place emphasis on the ethical well-being of patients as well as care providers...
April 2016: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
https://www.readbyqxmd.com/read/28218157/depression-in-cancer-patients-undergoing-chemotherapy-in-a-tertiary-care-hospital-of-north-bengal-india
#15
Sutanay Bhattacharyya, Sharmistha Bhattacherjee, Tanuka Mandal, Dilip Kumar Das
BACKGROUND: Detection of cancer and subsequent chemotherapy can lead to clinical depression in many cancer patients. OBJECTIVES: The study was conducted to find out the extent of depression in cancer patients undergoing chemotherapy and determine the factors associated with depression. METHODS: A cross-sectional descriptive study was conducted at the Chemotherapy Day Care Centre of North Bengal Medical College and Hospital from May to June 2013...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28217728/association-between-socioeconomic-and-psychological-experiences-of-parents-with-children-on-leukemia-treatment-in-kenyatta-national-hospital-kenya
#16
Roselyne Anyango Okumu, Margret Muiva, Miriam Wagoro, Fatmah Abdallah, Erick Oweya
OBJECTIVE: The survival rate for children with leukemia has increased dramatically since the late 1990s; treatment effects of the disease can be extremely stressful for families. Research on psychological and socioeconomic effects of leukemia treatment had been conducted in Western countries, but little is known within Africa including Kenya. METHODS: This was a cross-sectional study with a sample of 62 out of 72 parents of children undergoing leukemia treatment at Kenyatta National Hospital...
January 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28216956/assessment-of-cost-of-illness-for-diabetic-patients-in-south-indian-tertiary-care-hospital
#17
Leelavathi D Acharya, N R Rau, N Udupa, M Surulivel Rajan, K Vijayanarayana
BACKGROUND: The impact of diabetes on health-care expenditures has been increasingly recognized. To formulate an effective health planning and resource allocation, it is important to determine economic burden. OBJECTIVE: The objective of this study is to assess the cost of illness (COI) for diabetic inpatients with or without complications. METHODOLOGY: The study was conducted in the medicine wards of tertiary care hospital after ethical approval by the Institutional Ethical Committee...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28216079/2016-caps-ethics-session-ein-debate-1-regionalization-of-pediatric-surgical-care-2-ethical-introduction-of-surgical-innovation-3-addressing-stress-in-a-surgical-practice-resiliency-well-being-and-burnout
#18
REVIEW
Charles E Bagwell, Priscilla Chiu, Annie Fecteau, Kenneth W Gow, Claudia M Mueller, David Price, Andrew F Zigman
The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2. Innovation in clinical care: ethical considerations, and 3. Surgeon well-being: caring for the caregiver. The authors of this paper, as participants in the debate, were assigned their positions at random...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28215925/-elderly-patients-and-intensive-care-systematic-review-and-geriatrician-s-point-of-view
#19
H Vallet, B Riou, J Boddaert
The global population is aging and intensive care unit admission rate of elderly patients is dramatically increasing. The objective of this review is to provide an overview of the literature about the management of elderly patients in intensive care unit and more specifically about epidemiology, admission criteria, mortality, functional prognosis and ethical aspects. We also discuss the data on cardiorespiratory arrest, shock, acute respiratory failure and delirium. The mortality rate of patients over 80 years old in intensive care unit can reach up to 70% at 1year, but is dependent on many factors, such as comorbidities or frailty...
February 16, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28215187/experiences-of-ebola-survivors-causes-of-distress-and-sources-of-resilience
#20
Patricia M Schwerdtle, Veronique De Clerck, Virginia Plummer
: Introduction An appreciation of the experience of Ebola survivors is critical for community engagement and an effective outbreak response. Few qualitative, descriptive studies have been conducted to date that concentrate on the voices of Ebola survivors. Problem This study aimed to explore the experiences of Ebola survivors following the West African epidemic of 2014. METHOD: An interpretive, qualitative design was selected using semi-structured interviews as the method of data collection...
February 20, 2017: Prehospital and Disaster Medicine
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