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Medical ethics

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https://www.readbyqxmd.com/read/28812979/truth-in-research-labelling
#1
John H Noble
This report describes the background and context of a currently circulating petition to the US Congress that seeks amendment of Section 801 of the Public Health Services Act (42 U.S.C. 282) to close a loophole in existing law which makes possible post hoc adjustment of randomised controlled trial (RCT) results reported to the Food and Drug Administration that differ from those reported to ClinicalTrials.gov and to medical journals. The report describes the petition's rationale, underlying assumptions, and support for its proposed remedy in deontological, consequentialist, and casuist philosophical ethics theories...
July 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28812253/the-land-of-no-milk-and-no-honey-force-feeding-in-israel
#2
Zohar Lederman, Shmuel Lederman
In 2015, the Israeli Knesset passed the force-feeding act that permits the director of the Israeli prison authority to appeal to the district court with a request to force-feed a prisoner against his expressed will. A recent position paper by top Israeli clinicians and bioethicists, published in Hebrew, advocates for force-feeding by medical professionals and presents several arguments that this would be appropriate. Here, we first posit three interrelated questions: 1. Do prisoners have a right to hunger-strike? 2...
August 15, 2017: Monash Bioethics Review
https://www.readbyqxmd.com/read/28810984/impact-of-a-7-day-field-training-on-oral-health-condition-in-japan-ground-self-defense-force-personnel
#3
Koji Yamashita, Takeshi Nishiyama, Emi Nagata, Atik Ramadhani, Miki Kawada-Matsuo, Hitoshi Komatsuzawa, Takahiko Oho
INTRODUCTION: In the Japan Ground Self-Defense Force (JGSDF), personnel periodically perform intensive training that mimics the conditions seen in battle and during natural disasters. Military training involves intensive, stressful conditions, and changes in immune responses have been found in personnel following training. Good oral condition is important for military personnel to fulfill their duties; however, they have difficulty performing daily oral care under training conditions...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28809614/confidentiality-and-fitness-to-drive-professional-ethical-and-legal-duties-in-the-case-of-the-diabetic-bus-driver
#4
Christopher Wareham
Patients who pose a risk of serious accidents present a difficult ethical problem for medical practitioners. The duty to maintain confidentiality is an ancient and weighty obligation and has many beneficial consequences for patients and society generally. Similarly, the duty of care towards a patient militates against disclosing details that could remove his or her source of income and imperil physical and mental wellbeing. However, in cases where maintaining confidentiality can result in severe harm to the patient and the public, the benefits of confidential practice may be outweighed...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28805115/hindrances-to-achieve-professional-confidence-the-nurse-s-participation-in-ethical-decision-making
#5
Anne Storaker, Dagfinn Nåden, Berit Sæteren
BACKGROUND: Research suggests that nurses generally do not participate in ethical decision-making in accordance with ethical guidelines for nurses. In addition to completing their training, nurses need to reflect on and use ethically grounded arguments and defined ethical values such as patient's dignity in their clinical work. OBJECTIVES: The purpose of this article is to gain a deeper understanding of how nurses deal with ethical decision-making in daily practice...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28805113/hospitalized-adolescents-perception-of-dignity-a-qualitative-study
#6
Neda Jamalimoghadam, Shahrzad Yektatalab, Marzieh Momennasab, Abbas Ebadi, Najaf Zare
BACKGROUND: Adolescents can be vulnerable to diminished dignity in the hospital because young people have significantly different healthcare needs than children and adults. They like to cooperate with caregivers only when they get respectful and dignified care. Care without considering dignity can adversely influence the adolescents' recovery. However, many studies have been conducted on exploring the concept of the patients' dignity from the adult patients and fewer studies still have explored the dignity of young people...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28804960/handle-with-care-rethinking-the-rights-versus-culture-dichotomy-in-cancer-disclosure-in-india
#7
Cecilia Coale Van Hollen
Medical practitioners, bioethicists, psychologists, and anthropologists have debated whether it is ethical to disclose or withhold information from patients about cancer diagnoses. This debate is framed as pitting universal individual human rights against cultural pluralism. The rights-based argument asserts that people have a right to information about their own health to make the best decisions about their treatment. The cultural variation argument suggests that in some cultural contexts there is a perception that information about one's cancer diagnosis may cause more harm than good due to the psychological trauma this may cause...
August 13, 2017: Medical Anthropology Quarterly
https://www.readbyqxmd.com/read/28804867/sources-of-distress-for-physicians-and-nurses-working-in-swiss-neonatal-intensive-care-units
#8
Sabine D Klein, Hans Ulrich Bucher, Manya J Hendriks, Ruth Baumann-Hölzle, Jürg C Streuli, Thomas M Berger, Jean-Claude Fauchère, On Behalf Of The Swiss Neonatal End-Of-Life Study Group
BACKGROUND: Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. AIMS OF THE STUDY: The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). METHODS: In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28804393/ageism-among-physicians-nurses-and-social-workers-findings-from-a-qualitative-study
#9
Aya Ben-Harush, Sharon Shiovitz-Ezra, Israel Doron, Sara Alon, Arthur Leibovitz, Hava Golander, Yafa Haron, Liat Ayalon
This study investigated ageism among healthcare professionals in various therapeutic settings in Israel. Using a qualitative approach, the current study aimed to examine similarities and differences across healthcare disciplines. Three focus groups were conducted with physicians, nurses, and social workers. Data from each focus group were analyzed separately, and then commonalities and differences across the groups were evaluated. Three main themes relating to older adults emerged from the data. The first theme pertains to perceived difficulties that healthcare professionals experience in working with older adults and their family members; the second focuses on invisibility and discriminatory communication patterns; and the third theme relates to provision of inappropriate care to older adults...
March 2017: European Journal of Ageing
https://www.readbyqxmd.com/read/28803665/-teledermatology-between-two-french-hospitals-two-years-of-experience
#10
C Bertin, A Diakite, B Carton, C Wozniak, S Nathanson, S Monnier, C Sin, M-A Dommergues, J Parigot, F Moreau, M-L Sigal, P Foucaud, A Greder, E Mahé
BACKGROUND: Teledermatology is currently booming. Due to the shortage of dermatologists in hospitals access to dermatological consultations is very limited in some hospitals. We present our experience of collaboration between an expert center, the dermatology department of the Victor-Dupouy Hospital Centre in Argenteuil, and all medical structures under the André-Mignot Hospital in Versailles (CHV), including 2 prison medical centers (UCSA), traditional departments and emergency department...
August 10, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/28803223/social-responsibilities-of-a-physician-reflections-of-major-general-s-l-bhatia-1891-1981
#11
Radhika Hegde, Mario Vaz
This paper examines various documents written by Major General SL Bhatia CIE, MC, IMS from the 1920s to the1960s on the "Social Responsibilities of a Physician". His reflections are of historical significance, since they provide us with an insight into the challenges confronting the people who attempted to rebuild a nation plagued by poverty resulting from fractured agricultural growth, a feudalistic social structure and the regional inequalities that accompany it, and prolonged imperial rule, among other things...
July 25, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28803221/reflective-student-narratives-honing-professionalism-and-empathy
#12
Upreet Dhaliwal, Satendra Singh, Navjeevan Singh
The affective domain is not explicitly targeted during medical studies and poor skills in this domain may lead to conflict when dealing with patients. Reflective narratives are said to promote humanitarianism and professional development. We aimed to examine reflective narratives written by medical students in our institution for content relating to ethical and professional Attitude and Behaviour, Communication, respect for Diversity and Disability, and Empathy (the ABCDE paradigm). We were also interested in understanding how far the students enjoyed learning through the writing of narratives and in determining their perceived learning from the exercise...
July 18, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28801944/the-emergence-of-second-generation-lethal-injection-protocols-a-brief-history-and-review
#13
Daniel R Malcom, Frank Romanelli
The history of capital punishment in the United States is long and controversial. In many cases, lethal injection has brought medical personnel, ethically and professionally charged with preserving life, into the arena of assisting the state in taking life. Recent US Supreme Court decisions, including Baze v. Rees and Glossip v. Gross, have evaluated and condoned lethal injection protocols. Despite the judicial validation of some midazolam-containing protocols, controversy exists as to the level of unconsciousness provided due to the ceiling effects of the drug...
August 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28801760/the-need-for-authenticity-based-autonomy-in-medical-ethics
#14
Lucie White
The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of "authenticity", the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical ethics, and too stringent for use in practical contexts...
August 11, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28801439/validation-of-asthma-recording-in-the-clinical-practice-research-datalink-cprd
#15
Francis Nissen, Daniel R Morales, Hana Mullerova, Liam Smeeth, Ian J Douglas, Jennifer K Quint
OBJECTIVES: The optimal method of identifying people with asthma from electronic health records in primary care is not known. The aim of this study is to determine the positive predictive value (PPV) of different algorithms using clinical codes and prescription data to identify people with asthma in the United Kingdom Clinical Practice Research Datalink (CPRD). METHODS: 684 participants registered with a general practitioner (GP) practice contributing to CPRD between 1 December 2013 and 30 November 2015 were selected according to one of eight predefined potential asthma identification algorithms...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801429/multicentric-randomised-study-of-helicobacter-pylori-eradication-and-pepsinogen-testing-for-prevention-of-gastric-cancer-mortality-the-gistar-study
#16
Marcis Leja, Jin Young Park, Raul Murillo, Inta Liepniece-Karele, Sergejs Isajevs, Ilze Kikuste, Dace Rudzite, Petra Krike, Sergei Parshutin, Inese Polaka, Arnis Kirsners, Daiga Santare, Valdis Folkmanis, Ilva Daugule, Martyn Plummer, Rolando Herrero
INTRODUCTION: Population-based eradication of Helicobacter pylori has been suggested to be cost-effective and is recommended by international guidelines. However, the potential adverse effects of widespread antibiotic use that this would entail have not been sufficiently studied. An alternative way to decrease gastric cancer mortality is by non-invasive search for precancerous lesions, in particular gastric atrophy; pepsinogen tests are the best currently available alternative. The primary objective of GISTAR is to determine whether H pylori eradication combined with pepsinogen testing reduces mortality from gastric cancer among 40-64-year-old individuals...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801407/the-boundaries-of-mild-chronic-obstructive-pulmonary-disease-copd-design-of-the-searching-clinical-copd-onset-soon-study
#17
Gonzalo Labarca, Andrea Bustamante, Gonzalo Valdivia, Rodrigo Díaz, Álvaro Huete, Paul Mac Nab, Laura Mendoza, Jaime Leppe, Carmen Lisboa, Fernando Saldías, Orlando Díaz
INTRODUCTION: Clinical onset of chronic obstructive pulmonary disease (COPD) is the point at which the disease is first identifiable by physicians. It is a poorly defined stage which seems to include both mild spirometric and non-spirometric disease, and could be described as early grade COPD, for practical purposes. While dyspnoea; chronic bronchitis and CT imaging evidence of emphysema and airway disease may be present very early, the lone significance of dyspnoea, the most relevant symptom in COPD in identifying these individuals, has been scarcely assessed...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801393/protocol-for-the-mwellcare-trial-a-multicentre-cluster-randomised-12-month-controlled-trial-to-compare-the-effectiveness-of-mwellcare-an-mhealth-system-for-an-integrated-management-of-patients-with-hypertension-and-diabetes-versus-enhanced-usual-care-in-india
#18
Dilip Jha, Priti Gupta, Vamadevan S Ajay, Devraj Jindal, Pablo Perel, David Prieto-Merino, Pramod Jacob, Jonathan Nyong, Vidya Venugopal, Kavita Singh, Shifalika Goenka, Ambuj Roy, Nikhil Tandon, Vikram Patel, Dorairaj Prabhakaran
INTRODUCTION: Rising burden of cardiovascular disease (CVD) and diabetes is a major challenge to the health system in India. Innovative approaches such as mobile phone technology (mHealth) for electronic decision support in delivering evidence-based and integrated care for hypertension, diabetes and comorbid depression have potential to transform the primary healthcare system. METHODS AND ANALYSIS: mWellcare trial is a multicentre, cluster randomised controlled trial evaluating the clinical and cost-effectiveness of a mHealth system and nurse managed care for people with hypertension and diabetes in rural India...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801389/the-role-of-rehabilitation-measures-in-reintegration-of-children-with-brain-tumours-or-leukaemia-and-their-families-after-completion-of-cancer-treatment-a-study-protocol
#19
Mona Leandra Peikert, Laura Inhestern, Corinna Bergelt
INTRODUCTION: For ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment. METHODS AND ANALYSIS: This prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3)...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801387/microbubbles-and-ultrasound-accelerated-thrombolysis-must-for-peripheral-arterial-occlusions-protocol-for-a-phase-ii-single-arm-trial
#20
Harm P Ebben, Johanna H Nederhoed, Rutger J Lely, Willem Wisselink, Kakkhee Yeung
INTRODUCTION: Acute peripheral arterial occlusions can be treated with intra-arterial catheter-directed thrombolysis as an alternative to surgical thromboembolectomy. Although less invasive, this treatment is time-consuming and carries a significant risk of haemorrhagic complications. Contrast-enhanced ultrasound using microbubbles could accelerate dissolution of thrombi by thrombolytic medications due to mechanical effects caused by oscillation; this could allow for lower dosages of thrombolytics and faster thrombolysis, thereby reducing the risk of haemorrhagic complications...
August 11, 2017: BMJ Open
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