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https://www.readbyqxmd.com/read/28614078/-development-of-a-clinical-ethics-committee-de-novo-at-a-small-community-hospital-by-addressing-needs-and-potential-barriers
#1
Bonnie H Arzuaga
Hospital ethics committees are common, but not universal, in small hospitals. A needs assessment was completed at a 155-bed community hospital in order to adapt an academic tertiary center model for a clinical ethics committee to fit the needs of the small hospital community. Of 678 questionnaires distributed, 209 were completed. Data suggested that clinical staff frequently experienced ethical dilemmas. Significantly more nonphysicians indicated that they would utilize a consultation service, if available, compared to physicians (p = 0...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28614077/structure-operation-and-experience-of-clinical-ethics-consultation-2007-2013-a-report-from-the-massachusetts-general-hospital-optimum-care-committee
#2
Ellen M Robinson, Wendy Cage, Kimberly Erler, Sharon Brackett, Julia Bandini, Alexandra Cist, M Cornelia Cremens, Eric L Krakauer, Andrew Courtwright
We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation's first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was consulted, and salient features of the consults themselves...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28614071/going-from-what-is-to-what-should-be-to-care-better-for-our-patients-and-families
#3
Edmund G Howe
This piece discusses ways in which clinicians may go beyond their usual practices. These include exploring the limits of old laws, consulting with colleagues and ethics committees earlier and more often, and giving patients' family members new choices they didn't have previously. This could include asking patients and family members whether clinicians should prioritize staying in the single, unconflicted role of serving patients and families, even when this might preclude simultaneously serving another interest, for example, that of a hospital...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28611111/the-impact-of-interventions-to-improve-the-quality-of-prescribing-and-use-of-antibiotics-in-primary-care-patients-with-respiratory-tract-infections-a-systematic-review-protocol
#4
Nahara Anani Martínez-González, Samuel Coenen, Andreas Plate, Annelies Colliers, Thomas Rosemann, Oliver Senn, Stefan Neuner-Jehle
INTRODUCTION: Respiratory tract infections (RTIs) are the most common reason for primary care (PC) consultations and for antibiotic prescribing and use. The majority of RTIs have a viral aetiology however, and antibiotic consumption is ineffective and unnecessary. Inappropriate antibiotic use contributes greatly to antibiotic resistance (ABR) leading to complications, increased adverse events, reconsultations and costs. Improving antibiotic consumption is thus crucial to containing ABR, which has become an urgent priority worldwide...
June 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28603156/conflicts-of-interest-and-distribution-of-resources-to-community-partners-an-organizational-ethics-dilemma
#5
Allison M Cole, Laura-Mae Baldwin, Gina A Keppel, Ellen Kuwana, Brenda L Mollis, Benjamin S Wilfond
BACKGROUND: Conflicts of interest can arise when faculty and staff administer programs that distribute research funds, training opportunities, and other resources across academic and community partners. We describe the ethical concerns encountered by a Clinical Translational Science Award (CTSA) program in administering its community-focused pilot grant program and how its Research Bioethics Consultation service helped to address them.Ethical Concerns: CTSA program faculty and staff identified ethical concerns in several areas, including appropriateness of including Regional Research Collaborations (RRC) faculty as principal or co-investigators on applications, determining how much help RRC faculty and staff should provide to prospective applicants, and creating a fair and effective application review process...
2017: Progress in Community Health Partnerships: Research, Education, and Action
https://www.readbyqxmd.com/read/28600658/clinical-ethics-support-for-healthcare-personnel-an-integrative-literature-review
#6
Dara Rasoal, Kirsti Skovdahl, Mervyn Gifford, Annica Kihlgren
This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice...
June 9, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28596046/capacity-evaluation-requests-in-the-medical-setting-a-retrospective-analysis-of-underlying-psychosocial-and-ethical-factors
#7
Stephen Pesanti, Brandon Hamm, Bryn Esplin, Matt Karafa, Xavier F Jimenez
BACKGROUND: Psychosocial and ethical variables influence physicians in requesting decision-making capacity (DMC) evaluations. Previous authors have classified certain DMC evaluation requests as "unwarranted" when there is no explicit suspicion or evidence that the patient might lack DMC. OBJECTIVE: To explore psychosocial and ethical reasons motivating both "warranted" and "unwarranted" DMC evaluation requests by physicians in the medical setting. METHODS: A retrospective electronic health record review was approved by the institutional review board...
March 28, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28587503/sense-of-responsibility-in-icu-end-of-life-decision-making-relatives-experiences
#8
Ranveig Lind
BACKGROUND: Relatives of intensive care unit patients who lack or have reduced capacity to consent are entitled to information and participation in decision-making together with the patient. Practice varies with legislation in different countries. In Norway, crucial decisions such as withdrawing treatment are made by clinicians, usually morally justified to relatives with reference to the principle of non-maleficence. The relatives should, however, be consulted about whether they know what the patient would have wished in the situation...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28584495/prevalence-pattern-and-correlates-of-alcohol-misuse-among-male-patients-attending-rural-primary-care-in-india
#9
Sanghamitra Pati, Subhashisa Swain, Sandeep Mahapatra, Mohammad Akhtar Hussain, Sandipana Pati
BACKGROUND: There are limited data available on how the problem of alcohol use is detected in primary care setting in India. Particularly in Odisha, it has not been investigated yet. This study was conducted to determine the prevalence of drinking, drinking patterns, and quitting behavior among the male patients visiting a primary health-care facility in a district of Odisha. METHODOLOGY: A cross-sectional study was conducted among patients attending community health center (CHC), Buguda in the state of Odisha, India, from December 1, 2014, to February 31, 2015...
January 2017: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28581878/what-happens-when-the-doctor-denies-a-patient-s-request-a-qualitative-interview-study-among-general-practitioners-in-norway
#10
Stein Nilsen, Kirsti Malterud
OBJECTIVE: To explore general practitioners (GPs') experiences from consultations when a patient's request is denied, and outcomes of such incidents. DESIGN AND PARTICIPANTS: We conducted a qualitative study with semi-structured individual interviews with six GPs in Norway. We asked them to tell about experiences from specific encounters where they had refused a patient's request. The texts were analysed with Systematic Text Condensation, a method for thematic cross-case analysis...
June 5, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28554932/the-role-of-academic-health-centres-in-building-equitable-health-systems-a-systematic-review-protocol
#11
Alexandra Edelman, Judy Taylor, Pavel V Ovseiko, Stephanie M Topp
INTRODUCTION: Academic health centres (AHCs) are complex organisations often defined by their 'tripartite' mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28553902/how-situational-diagnosis-helps-disentangle-ethical-and-psychological-features-of-complex-cases
#12
Jerry Joseph Ignatius, Walter Baile
We review Marguerite S. Lederberg's 1999 Acta Oncologica article entitled "Disentangling Ethical and Psychological Issues: A Guide for Oncologists," in which she introduces a method of analysis that facilitates clarification of ethical and psychological aspects of complex cases. Based on her understanding of the dynamics at play in patients', family members', and physicians' experiences, Lederberg formulated what she calls "situational diagnosis," a guide on how to distinguish ethical from psychological issues at the bedside or when an ethics consultation is requested...
May 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28552193/the-trio-framework-conceptual-insights-into-family-caregiver-involvement-and-influence-throughout-cancer-treatment-decision-making
#13
REVIEW
Rebekah Laidsaar-Powell, Phyllis Butow, Cathy Charles, Amiram Gafni, Vikki Entwistle, Ronald Epstein, Ilona Juraskova
OBJECTIVE: Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed. METHODS: Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group...
May 5, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28543660/challenges-working-with-presidential-bioethics-commissions
#14
Ruth Macklin
Presidential commissions come and go by design, and it is reasonable to wonder about the impact of their recommendations. I have been involved in the work of two presidential commissions: as a member of the Advisory Committee on Human Radiation Experiments (from 1994 to 1995) and as senior consultant to the National Bioethics Advisory Commission (from 1999 to 2000) for its report on multinational research. I continue to reflect on and look for the impact of both these commissions. ACHRE's charter included the review of experiments with ionizing radiation sponsored or conducted by the United States government since the 1940s...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28535143/intercultural-communication-through-the-eyes-of-patients-experiences-and-preferences
#15
Emma Paternotte, Sandra van Dulmen, Lindsay Bank, Conny Seeleman, Albert Scherpbier, Fedde Scheele
Objectives: To explore patients' preferences and experiences regarding intercultural communication which could influence the development of intercultural patient-centred communication training. Methods: This qualitative study is based on interviews with non-native patients. Thirty non-native patients were interviewed between September and December 2015 about their preferences and experiences regarding communication with a native Dutch doctor. Fourteen interviews were established with an interpreter...
May 16, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#16
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28525312/evaluation-of-the-introduction-of-an-e-health-skills-component-for-dietetics-students
#17
Megan E Rollo, Clare E Collins, Lesley MacDonald-Wicks
BACKGROUND: Appropriate and effective use of technology within practice is a key competency outlined in Australian dietetics training standards. An e-health skills component (lecture and workshop) was introduced to undergraduate students enrolled in an Australian nutrition and dietetics program. METHODS: The lecture orientated students to key e-health terms and concepts relating to telehealth and m-health technologies, while the workshop provided an opportunity to apply knowledge...
May 19, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28507452/consulted-ethical-problems-of-clinical-nursing-practice-perspective-of-faculty-members-in-japan
#18
Mari Tsuruwaka
BACKGROUND: There are several studies that have targeted student nurses, but few have clarified the details pertaining to the specific ethical problems in clinical practice with the viewpoint of the nursing faculty. This study was to investigate the ethical problems in clinical practice reported by student nurses to Japanese nursing faculty members for the purpose of improving ethics education in clinical practice. METHOD: The subjects comprised 705 nursing faculty members (we sent three questionnaires to one university) who managed clinical practice education at 235 Japanese nursing universities...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28495644/improving-core-outcome-set-development-qualitative-interviews-with-developers-provided-pointers-to-inform-guidance
#19
E Gargon, P R Williamson, B Young
OBJECTIVES: To explore core outcome set (COS) developers' experiences of their work in order to inform methodological guidance on COS development and identify areas for future methodological research. STUDY DESIGN AND SETTING: Semi-structured, audio-recorded interviews with a purposive sample of 32 COS developers. Analysis of transcribed interviews was informed by the constant comparative method and framework analysis. RESULTS: Developers found COS development to be challenging, particularly in relation to patient participation and accessing funding...
May 8, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28473036/ethical-analysis-of-withdrawing-total-artificial-heart-support
#20
Erin S DeMartino, Sara E Wordingham, John M Stulak, Barry A Boilson, Kayla R Fuechtmann, Nausheen Singh, Daniel P Sulmasy, Octavio E Pajaro, Paul S Mueller
OBJECTIVES: To describe the characteristics of patients who undergo withdrawal of total artificial heart support and to explore the ethical aspects of withdrawing this life-sustaining treatment. PATIENTS AND METHODS: We retrospectively reviewed the medical records of all adult recipients of a total artificial heart at Mayo Clinic from the program's inception in 2007 through June 30, 2015. Management of other life-sustaining therapies, approach to end-of-life decision making, engagement of ethics and palliative care consultation, and causes of death were analyzed...
May 2017: Mayo Clinic Proceedings
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