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Medical ethics

Nancy D Campbell
Using the ethical and legal concept of shared responsibility for healthy births, this article considers social, cultural, and historical contexts in which medicalization and criminalization have worked in tandem to widen surveillance in ways that intensify scrutiny of women's lives under the guise of child protection, bringing women who are pregnant, postpartum, or parenting under criminal justice control. Although pregnant and postpartum women are prime candidates for medication-assisted treatment (MAT), the expanding carceral system has not prioritized drug treatment or reproductive justice...
March 1, 2018: AMA Journal of Ethics
Amy G Bryant, Jonas J Swartz
Crisis pregnancy centers are organizations that seek to intercept women with unintended pregnancies who might be considering abortion. Their mission is to prevent abortions by persuading women that adoption or parenting is a better option. They strive to give the impression that they are clinical centers, offering legitimate medical services and advice, yet they are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities. Because the religious ideology of these centers' owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options...
March 1, 2018: AMA Journal of Ethics
Christina Krudy, Kavita Shah Arora
The United States, along with other resource-rich countries, leads global health care by advancing medical care through randomized controlled trials (RCTs). While most medical research is conducted in these resource-rich areas, RCTs, including replications of previous trials, are additionally carried out in low- and middle-income countries. On the basis of positive findings from several RCTs conducted in high-income countries, the Antenatal Corticosteroids Trial (ACT) evaluated the effectiveness of antenatal corticosteroids in reducing neonatal mortality in low- and middle-income countries...
March 1, 2018: AMA Journal of Ethics
Samuel Kimani, Bettina Shell-Duncan
Purpose of Review: Female genital cutting/mutilation (FGM/C) performed by health care professionals (medicalization) and reduced severity of cutting have been advanced as strategies for minimizing health risks, sparking acrimonious ongoing debates. This study summarizes key debates and critically assesses supporting evidence. Recent Findings: While medicalization is concentrated in Africa, health professionals worldwide have faced requests to perform FGM/C. Whether medicalization is hindering the decline of FGM/C is unclear...
2018: Current Sexual Health Reports
Nausheen Bakht
The social contract between medicine and society is being renegotiated and demands the reorientation of healthcare. Neither society nor doctors are happy with the way modern medicine is being practised. An obtuse focus on medical sciences and a myopic view of medical humanities (MH) has been incriminated. MH reflects on healthcare-related topics in the light of shared human experiences. It addresses the genuine concerns of patients and their attendants. It also helps inculcate humanistic values in doctors by enhancing ethical understanding, cultural sensitivity, mutual respect, empathy, communication skills and decision-making...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Muhammad Shahid Shamim, Lubna Baig, Adrienne Torda, Chinthaka Balasooriya
The world is geographically divided into hemispheres, continents and countries, with varying cultures in different regions. Asia, the largest of continents, has a variety of philosophically distinctive cultures and lifestyles, informing the norms of societies that are much different from cultures in other continents. These complexities in the societal norms in Asian cultures have created unique issues in development of ethics education in the region. This paper looks in to the distinctions in what is generally referred to as the "non-western" Asian culture, the importance of cultural context and how it influences the ethics curriculum in the region...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Beatriz Paulina Ayala Quintanilla, Wendy E Pollock, Susan J McDonald, Angela J Taft
INTRODUCTION: Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality...
March 14, 2018: BMJ Open
Regina Wing Shan Sit, Keith Kwok Wai Chan, Benjamin Hon Kei Yip, Daisy Dexing Zhang, Kenneth Dean Reeves, Ying Ho Chan, Vincent Chi Ho Chung, Samuel Yeung Shan Wong
INTRODUCTION: Knee osteoarthritis (KOA) is a common, disabling and costly medical condition. The patellofemoral joint is a critical source of pain in individuals with KOA, and coexistence of patellofemoral osteoarthritis (PFOA) and tibiofemoral osteoarthritis (TFOA) is sometimes observed. The identification of subgroups with PFOA and customised interventions to correct underlying pathomechanics is beneficial for individuals with KOA. This study aims to evaluate whether a clinic-based patella mobilisation therapy (PMT) leads to significant improvement in pain, physical function and quality of life of individuals with KOA...
March 14, 2018: BMJ Open
Mohammad Nauzef Mahmood, Laura H C Peeters, Micha Paalman, Gijsbertus J Verkerke, Idsart Kingma, Jaap H van Dieën
BACKGROUND: Patients with Duchenne muscular dystrophy gradually lose the ability to use different muscles of their body. Consequently, they lose the ability to stabilize their trunk against gravity. This hinders them to effectively perform different daily activities. In this paper, we describe the design, realization and evaluation of a trunk orthosis for these patients that should allow them to move their trunk and maintain stability. METHOD: This study aimed to primarily assess the effectiveness of the trunk support system in terms of unloading of trunk muscles, so only healthy participants were recruited for this phase of the study...
March 14, 2018: Journal of Neuroengineering and Rehabilitation
Jihye Seo, Cheol Hyun Kim, Hongmin Chu, Yeonju Moon, Sangkwan Lee
BACKGROUND: Migraine is a common disease of primary headache, which it causes many kinds of secondary diseases or symptoms. The treatment drugs have sometimes shown side effects such as overuse headache, stroke, and cardiovascular disease. Therefore, the demand for complementary and alternative interventions for migraine has increased. Herbal medicines are a representative intervention to treat migraine traditionally. Among these herbal medicines, Banhabaekchulchunma-tang (BBT) and Chongsanggeontong-tang (CGT) have been most commonly used for migraine treatment in traditional clinical practice...
March 2018: Medicine (Baltimore)
Jong-In Kim, Hee-Jung Kim, Jung Ju Lee, Ji Hee Jun, Tae-Young Choi, Myeong Soo Lee
BACKGROUND: The ability of acupuncture to successfully control pain has been reported in the past. However, currently no systematic reviews exist regarding the effect of acupuncture on trigeminal neuralgia (TN). This proposed review aims to evaluate the current evidence on the efficacy of acupuncture for the management of pain in TN. METHODS: A total of 11 databases were searched from their inception. These include MEDLINE, AMED, EMBASE, the Cochrane Library, 6 Korean medical databases, and 1 Chinese Medical Database...
March 2018: Medicine (Baltimore)
Natalie Colaneri, Mark Sheldon, Andrew Adesman
PURPOSE OF REVIEW: Given the pervasiveness of psychotropic medication in the youth population and an increasingly competitive culture regarding educational performance, children, teenagers, and/or their parents may increasingly seek psychotropic substances in an effort to enhance a student's cognitive abilities and/or academic performance. Physicians must become aware of this very important and clinically relevant issue and work to ensure that medications remain in the hands of patients seeking wellness and not enhancement...
March 13, 2018: Current Opinion in Pediatrics
James M West
Anesthesiologists have clearly established their place in the history of medical ethics. Our involvement goes back to 1966 when Henri Beecher published his landmark paper on research and informed consent. Participation in the ethics of transplantation is no less important than our previous work. Organ transplant has been life saving for many but also has given rise to many misunderstandings not just from the public but also among our own colleagues. These include methods of allocation and donation, the role that affluence may play in receiving an organ, the definition of death and donation after circulatory death...
March 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Jasper Littmann, Alena Buyx
Antibiotics resistance presents one of the major challenges for health care in the twenty-first century. This paper examines the ethical problems that arise as a result of antibiotic resistance. Two main categories of ethical problems in infectious disease control are distinguished: those that are exacerbated by antibiotics resistance, and those that are a direct result of antibiotics resistance. The second category, which is considered in greater detail in this paper, includes, among others, issues of fair distribution of effective antibiotics, if they are considered a scarce resource...
March 13, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Caroline Fertleman, Phoebe Aubugeau-Williams, Carmel Sher, Ai-Nee Lim, Sophie Lumley, Sylvie Delacroix, Xueni Pan
Background: Virtual reality technology is an exciting and emerging field with vast applications. Our study sets out the viewpoint that virtual reality software could be a new focus of direction in the development of training tools in medical education. We carried out a panel discussion at the Center for Behavior Change 3rd Annual Conference, prompted by the study, "The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality" (1)...
2018: Frontiers in Public Health
Farrukh Aslam Khalid, Usman Khalid Farooq, Muhammad Saleem, Jibran Rabbani, Muhammad Amin, Kamal Uddin Khan, Younas Mehrose, Moazzam N Tarar
BACKGROUND: The ear is the common site for keloid formation especially in women after ear piercing. Surgery is the main stay of treatment in these lesions but there are large numbers of treatment failures in surgery alone. OBJECTIVE: The objective of this study was to compare the efficacy of post-excision intralesional 5-fluorouracil/triamcinolone acetonide (5-FU/TAC) and post-excision radiotherapy in the treatment of ear keloids. STUDY DESIGN: A randomized controlled trial...
March 10, 2018: Burns: Journal of the International Society for Burn Injuries
Margaret Sleeboom-Faulkner
Genetic epidemiology examines the role of genetic factors in determining health and disease in families and in populations to help addressing health problems in a responsible manner. This paper uses a case study of genetic epidemiology in Taizhou, China, to explore ways in which anthropology can contribute to the validation of studies in genetic epidemiology. It does so, first, by identifying potential overgeneralizations of data, often due to mismatching scale and, second, by examining it's embedding in political, historical and local contexts...
April 2018: Anthropology & Medicine
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
Rebekah E McWhirter, Lisa Eckstein
Allowing persons to make an informed choice about their participation in research is a pre-eminent ethical and legal requirement. Almost universally, this requirement has been addressed through the provision of written patient information sheets and consent forms. Researchers and others have raised concerns about the extent to which such forms-particularly given their frequent lengthiness and complexity-provide participants with the tools and knowledge necessary for autonomous decision-making. Concerns are especially pronounced for certain participant groups, such as persons with low literacy and Indigenous persons...
March 12, 2018: Journal of Bioethical Inquiry
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