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ethics consultation

Emily F M Fitzpatrick, Alexandra L C Martiniuk, Heather D'Antoine, June Oscar, Maureen Carter, Elizabeth J Elliott
BACKGROUND: When conducting research with Indigenous populations consent should be sought from both individual participants and the local community. We aimed to search and summarise the literature about methods for seeking consent for research with Indigenous populations. METHODS: A systematic literature search was conducted for articles that describe or evaluate the process of seeking informed consent for research with Indigenous participants. Guidelines for ethical research and for seeking consent with Indigenous people are also included in our review...
October 22, 2016: BMC Medical Ethics
Fabrice Kwiatkowski, Pascal Dessenne, Claire Laquet, Jean-Pierre Daures, Mathilde Gay-Bellile, Yves-Jean Bignon
BACKGROUND: Young women exposed to a high hereditary breast and ovarian cancer (HBOC) risk are particularly vulnerable. They are ignored by health prevention measures but exposed to a stream of contradictory information (medicine, media, Internet). They may feel concerned about surgical prevention issues at a key moment of their identity construction (self, relationship, sexuality). We designed a special psychoeducational intervention to help these women cope better with these difficulties...
October 21, 2016: Trials
Cristina Longo, Vasiliki Rahimzadeh, Kieran O'Doherty, Gillian Bartlett
AIM: Primary care physicians will play a central role in the successful implementation of pharmacogenomics (PGx); however, important challenges remain. We explored the perspectives of stakeholders on key challenges of the PGx translation process in primary care using deliberative consultations. METHODS: Primary care physicians, patients and policy-makers attended deliberations, where they discussed four ethical questions raised by PGx research and implementation in the primary care context...
October 21, 2016: Pharmacogenomics
Paul L Schneider, Zhaoping Li
OBJECTIVE: To provide a thorough analysis of the range of ethical concerns that may present in relation to the care of the morbidly obese inpatient over the course of several years of care. METHODS: A narrative of the patient's complex medical care is given, with particular attention to the recommendations of three separate ethics committee consultations that were sought by his health care providers. An ethical analysis of the relevant issues is given within the Principles of Biomedical Ethics framework, highlighting the principles of autonomy, beneficence, non-maleficence, and justice...
2016: Narrative Inquiry in Bioethics
Yutaka Imai
It has been confirmed that clinical significance of home blood pressure measurements (HBPM) is higher than clinic BP measurements and ambulatory BP monitoring. However, several drawbacks of HBPM have also been mentioned, e.g. selection and reporting biases, difficulties of calculation of multiple measurements, difficulties of onsite judgement of numerous recordings, etc. Recent devices for HBPM incorporate memory function. This function can overcome such drawbacks of HBPM. These memorized data can transmit, storage, retrieve, be arithmetic and control, be judged based on algorithm and be got feedback...
September 2016: Journal of Hypertension
Kyriakos Souliotis, Eirini Agapidaki, Lily Evangelia Peppou, Chara Tzavara, George Samoutis, Mamas Theodorou
Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study...
June 20, 2016: International Journal of Health Policy and Management
M Gruß, F Salomon
In intensive care units far-reaching decisions are often made at short notice that require the consent of the informed patient. If this is not possible due to the patient's condition, physicians and legal representatives must ascertain the previously expressed or presumed will of the patient and act accordingly. The legal principles are specified in the Patient Advance Directives Act and the Patient Rights Act. Any indications for medical treatment need a clearly defined aim of the therapy, which can be questioned during the progress of the disease...
September 29, 2016: Der Anaesthesist
D Carrieri, C Bewshea, G Walker, T Ahmad, W Bowen, A Hall, S Kelly
Current guidelines on consenting individuals to participate in genomic research are diverse. This creates problems for participants and also for researchers, particularly for clinicians who provide both clinical care and research to their patients. A group of 14 stakeholders met on 7 October 2015 in Exeter to discuss the ethical issues and the best practice arising in clinically based genomic research, with particular emphasis on the issue of returning results to study participants/patients in light of research findings affecting research and clinical practices...
September 27, 2016: Journal of Medical Ethics
Nathaly Quintero-Prigent, Naima Brennetot, Coline Martinot-Lagarde, Malak Fanhy, Frédéric Clavier, Frank Fitoussi, Marion Fiat
Our unit has been providing antenatal consultations for 30 years following the discovery of limb malformation with the fetus. Each of these consultations is specific and carried out by a multi-professional team. It requires a physical and rehabilitation doctor, an orthopedic surgeon, an occupational therapist for upper limb malformation, a physiotherapist for lower malformation and a psychologist. This multidisciplinary consultation is unique because of each pregnancy story, because of each patient life story but also because of the words used by the sonologist when announcing the diagnosis...
September 2016: Annals of Physical and Rehabilitation Medicine
Marshall B Kapp
The Physician Orders for Life-Sustaining Treatment (POLST), otherwise known as the POLST paradigm, represents the next generation in end-of-life (EOL) planning for certain patients who wish to exercise prospective control over their own medical treatment in their final days. As is true for any physician treatment orders, a POLST is written in consultation with the patient or patient's surrogate. There are a number of practical impediments to widespread adoption and implementation of the POLST paradigm in medical practice...
2016: AMA Journal of Ethics
Connie M Ulrich
Few bioethicists are educated with a view into nursing. Thus, much of the conceptual and empirical research on ethical issues in nursing practice has been conducted by nurse ethicists themselves and, to a lesser degree, by individuals with a strong interest in nursing ethics. Although this work has internally shaped nursing practice, education, and policy, the broader field of bioethics has seldom examined and acknowledged the everyday ethical concerns of practicing nurses and their important contributions to bioethics discourse...
September 2016: Hastings Center Report
Kathryn Goldrath, Lauren B Smith
When a gynecologist asks a twenty-one-year-old patient about her use of contraception, he is surprised that she would like to have a tubal ligation. The patient says that she would "never want to bring a child into this screwed up world." She has discussed tubal ligation with her boyfriend of one year, and he has told her that he accepts her decision. She asks her doctor if she can schedule the procedure as soon as possible. Her gynecologist mentions that he is concerned that she is very young and may eventually change her mind about having children...
September 2016: Hastings Center Report
Richard L Frierson, Kaustubh G Joshi
The clinical case conference has been a hallmark of undergraduate and graduate medical education for decades and affords attendees the opportunity to hear about interesting and difficult cases and to learn from a discussion of the complexities of diagnosis and treatment. In forensic psychiatry, the complexities in a case conference also extend to the formation of a forensic opinion. The application of the clinical case conference to forensic psychiatry has not been described in the literature, although many fellowship programs engage in this activity...
September 2016: Journal of the American Academy of Psychiatry and the Law
Yutaka Imai
It has been confirmed that clinical significance of home blood pressure measurements (HBPM) is higher than clinic BP measurements and ambulatory BP monitoring. However, several drawbacks of HBPM have also been mentioned, e.g. selection and reporting biases, difficulties of calculation of multiple measurements, difficulties of onsite judgement of numerous recordings, etc. Recent devices for HBPM incorporate memory function. This function can overcome such drawbacks of HBPM. These memorized data can transmit, storage, retrieve, be arithmetic and control, be judged based on algorithm and be got feedback...
September 2016: Journal of Hypertension
Karen Hansen Kallesøe, Andreas Schröder, Rikard K Wicksell, Per Fink, Eva Ørnbøl, Charlotte Ulrikka Rask
INTRODUCTION: Functional somatic syndromes (FSS) are common in adolescents, characterised by severe disability and reduced quality of life. Behavioural treatments such as acceptance and commitment therapy (ACT) has shown promising results in children and adolescents with FSS, but has focused on specific syndromes such as functional pain. The current study will compare the efficacy of group-based ACT with that of enhanced usual care (EUC) in adolescents with a range of FSS operationalised by the unifying construct of multiorgan bodily distress syndrome (BDS)...
September 15, 2016: BMJ Open
Angela Beaton, Maui Hudson, Moe Milne, Ramari Viola Port, Khyla Russell, Barry Smith, Valmaine Toki, Lynley Uerata, Phillip Wilcox, Karen Bartholomew, Helen Wihongi
PURPOSE: He Tangata Kei Tua, a relationship model for biobanks, was developed to facilitate best practice in addressing Māori ethical concerns by guiding culturally informed policy and practice for biobanks in relation to governance, operational, and community engagement activities. METHODS: The model is based on key issues of relevance to Māori that were identified as part of the Health Research Council of New Zealand-funded research project, Te Mata Ira (2012-2015)...
September 15, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Sarah A Warby, Jon J Ford, Andrew J Hahne, Lyn Watson, Simon Balster, Ross Lenssen, Tania Pizzari
INTRODUCTION: The most commonly recommended treatment for multidirectional instability (MDI) of the shoulder is exercise. Despite this recommendation, there is limited evidence to support the effectiveness of exercise. The aim of this paper is to describe a pilot randomised controlled trial comparing the effectiveness of 2 exercise programmes on outcomes of participants with MDI. METHODS AND ANALYSIS: Consenting participants between 12 and 35 years, with non-traumatic MDI will be randomly allocated to participate in either the Rockwood Instability programme or the Watson MDI programme...
September 12, 2016: BMJ Open
Gunilla Skoog, Charlotta Edlund, Christian G Giske, Sigvard Mölstad, Christer Norman, Pär-Daniel Sundvall, Katarina Hedin
BACKGROUND: In 2014 the Swedish government assigned to The Public Health Agency of Sweden to conduct studies to evaluate optimal use of existing antibiotic agents. The aim is to optimize drug use and dosing regimens to improve the clinical efficacy. The present study was selected following a structured prioritizing process by independent experts. METHODS: This phase IV study is a randomized, open-label, multicenter study with non-inferiority design regarding the therapeutic use of penicillin V with two parallel groups...
2016: BMC Infectious Diseases
K Martakis, K Czabanowska, P Schröder-Bäck
BACKGROUND: Ethics education rarely exists in pediatric resident curricula, although ethical conflicts are common in the clinical practice. Ethics education can prepare residents to successfully handle these conflicts. AIM: We searched for methods in teaching ethics to clinical and especially pediatric residents, and identified recurring barriers to ethics teaching and solutions to overcome them. DESIGN: Literature from 4 electronic databases with peer-reviewed articles was screened in 3 phases and analyzed...
September 2016: Klinische Pädiatrie
Ivan Gentile, Alberto E Maraolo, Massimo Niola, Vincenzo Graziano, Guglielmo Borgia, Mariano Paternoster
INTRODUCTION: Hepatitis C virus (HCV) infection affects about 200 million people worldwide and represents a leading cause of liver-related mortality. Eradication of HCV infection, achieved mainly through direct-acting antivirals (DAA), results in a decrease of mortality and an improvement of quality of life. These drugs have a maximal efficacy and an optimal tolerability. However, their high cost precludes a universal access even in wealthy countries. AREAS COVERED: This article deals with the policies adopted for the use of the new anti-HCV drugs, especially in Europe and most of all in Italy, supposedly the developed country with the highest HCV prevalence...
September 8, 2016: Expert Review of Gastroenterology & Hepatology
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