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Law and ethics

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https://www.readbyqxmd.com/read/28647725/percutaneous-coronary-intervention-patients-and-cardiologists-experiences-of-the-informed-consent-process-in-northern-england-a-qualitative-study
#1
Joy Probyn, Joanne Greenhalgh, Janet Holt, Dwayne Conway, Felicity Astin
OBJECTIVE: Informed consent is central to ethical medical practice, but little is known about how the process takes place in clinical practice. Percutaneous coronary intervention (PCI) is a common revascularisation procedure. Studies report that patients overestimate benefits, forget the risks and are unaware of alternative treatments. The aim of this study was to describe PCI patients' and cardiologists' experiences of the informed consent process in acute care settings. DESIGN/SETTING/PARTICIPANTS: A qualitative study with a maximum variation sample of elective and acute PCI patients and cardiologists taking their consent, recruited from a district general hospital and tertiary centre...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28643812/-conscience-clause-in-end-of-life-care
#2
Ludovica De Panfilis, Daniela Cattaneo, Luisanna Cola, Maddalena Gasparini, Corinna Porteri, Daniela Tarquini, Alessandro Tiezzi, Simone Veronese, Silvia Zullo, Eugenio Pucci
The article proposes a critical reflection on issues that appeal to the conscience clause as part of end of life care can produce and what can guarantee freedom of conscience, self-determination of those involved and respect for the dignity of the sick person. After a philosophical and normative analysis, the article is organized on the basis of two important documents for discussion: a position paper of Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) signed by several scientific societies "Grandi insufficienze d'organo end stage: cure intensive o cure palliative?" and the Design of Law currently being debated "Norme in materia di consenso informato e di disposizioni anticipate di trattamento"...
May 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28642509/in-our-opinion
#3
G Roberts, V S Lucas, F McDonald, S Camilleri, J Jayaraman, D Davies, K Moze
The misleading statements made in the British Dental Journal in the December 2016 issue relating to dental age assessment are assessed for inaccuracies and negligent omission of the issue of Child Protection. It is emphasised that there is a need for the approach of objective knowledge viz. not influenced by personal feelings or opinions in considering and representing facts. The article by the Chair of the Education, Ethics, and Team Working Group implies that unsatisfactory consent procedures are followed...
June 23, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28638933/-implementation-status-of-regulation-eu-536-2014-in-the-member-states
#4
REVIEW
Elke Stahl
The upcoming Regulation EU 536/2014 for clinical trials of medicinal products for human use requires multinational cooperation in the assessment of clinical trial applications by the member states concerned as well as one single decision per member state concerned, supported by the new EU Portal and database system. The implementation makes national reorganisation of the processes necessary, especially coordination and cooperation between the national competent authorities and the ethics committees, necessary...
June 21, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28634769/decision-making-capacity-and-unusual-beliefs-two-contentious-cases-australasian-association-of-bioethics-and-health-law-john-mcphee-law-student-essay-prize-2016
#5
Brent Hyslop
Decision-making capacity is a vital concept in law, ethics, and clinical practice. Two legal cases where capacity literally had life and death significance are NHS Trust v Ms T [2004] and Kings College Hospital v C [2015]. These cases share another feature: unusual beliefs. This essay will critically assess the concept of capacity, particularly in relation to the unusual beliefs in these cases. Firstly, the interface between capacity and unusual beliefs will be examined. This will show that the "using and weighing of information" is the pivotal element in assessment...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28634767/including-people-with-dementia-in-research-an-analysis-of-australian-ethical-and-legal-rules-and-recommendations-for-reform
#6
Nola M Ries, Katie A Thompson, Michael Lowe
Research is crucial to advancing knowledge about dementia, yet the burden of the disease currently outpaces research activity. Research often excludes people with dementia and other cognitive impairments because researchers and ethics committees are concerned about issues related to capacity, consent, and substitute decision-making. In Australia, participation in research by people with cognitive impairment is governed by a national ethics statement and a patchwork of state and territorial laws that have widely varying rules...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28630539/theorizing-time-in-abortion-law-and-human-rights
#7
Joanna N Erdman
The legal regulation of abortion by gestational age, or length of pregnancy, is a relatively undertheorized dimension of abortion and human rights. Yet struggles over time in abortion law, and its competing representations and meanings, are ultimately struggles over ethical and political values, authority and power, the very stakes that human rights on abortion engage. This article focuses on three struggles over time in abortion and human rights law: those related to morality, health, and justice. With respect to morality, the article concludes that collective faith and trust should be placed in the moral judgment of those most affected by the passage of time in pregnancy and by later abortion-pregnant women...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28617097/involuntary-civil-commitment-for-substance-use-disorder-legal-precedents-and-ethical-considerations-for-social-workers
#8
Matthew T Walton, Martin T Hall
Although each state in the United States legally authorizes involuntary civil commitment on the grounds of severe mental illness, a considerable number do not have comparable laws to mandate drug addiction treatment. This discrepancy is due, in part, to differing ethical positions regarding whether a substance use disorder diagnosis provides sufficient justification to suspend individual liberty rights. This article chronicles some of the legal and ethical thinking on the subject and applies them to a social work-specific context...
June 15, 2017: Social Work in Public Health
https://www.readbyqxmd.com/read/28614074/a-patient-not-alone
#9
Lauren Sydney Flicker
This case analysis examines questions that arise when an ethically appropriate recommendation initially appears to be in conflict with the legally appropriate recommendation. The case involves a dying, incapacitated octogenarian who had friends who were willing to share her values, but not to make decisions on her behalf. These circumstances put the patient in the unique position of being legally considered a "patient alone," but who was ethically like a patient with surrogates-distinctions that are crucial when making end-of-life decisions under the New York Family Health Care Decisions Act...
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
#10
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/28611089/protocol-for-a-randomised-controlled-trial-evaluating-the-effects-of-providing-essential-medicines-at-no-charge-the-carefully-selected-and-easily-accessible-at-no-charge-medicines-clean-meds-trial
#11
Nav Persaud, Taehoon Lee, Haroon Ahmad, Winny Li, Michael Sergio Taglione, Yathavan Rajakulasingam, Norman Umali, Andrew Boozary, Richard H Glazier, Tara Gomes, Stephen W Hwang, Peter Jüni, Michael Law, Muhammad M Mamdani, Braden Manns, Danielle Martin, Steve Morgan, Paul Oh, Andrew David Pinto, Baiju R Shah, Frank M Sullivan, Kevin E Thorpe, Karen Tu, Andreas Laupacis
INTRODUCTION: Cost-related non-adherence to medicines is common in low-income, middle-income and high-income countries such as Canada. Medicine non-adherence is associated with poor health outcomes and increased mortality. This randomised trial will test the impact of a carefully selected list of essential medicines at no charge (compared with usual medicine access) in primary care patients reporting cost-related non-adherence. METHODS AND ANALYSIS: This is an open-label, parallel two-arm, superiority, individually randomised controlled trial conducted in three primary care sites (one urban, two rural) in Ontario, Canada, that was codesigned by a community guidance panel...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28608034/abortion-of-fetus-with-down-s-syndrome-india-joins-the-worldwide-controversy-surrounding-abortion-laws
#12
Alankrita Taneja, Sharath Burugina Nagaraja, Jagadish Rao Padubidri, Mohammed Madadin, Ritesh G Menezes
Abortion continues to be a moral and ethical dilemma in medicine. While abortions in general have always faced social stigmas, the abortion of fetuses with Down's syndrome in particular remains the subject of debate across the globe. In India, under the Medical Termination of Pregnancy Act, abortion is legal under prescribed circumstances only till 20 weeks of gestation. Laws for abortion after 20 week of gestation are ill defined. In a recent ruling of the Supreme Court in India, a woman was denied the right to abortion of her 26 week old fetus...
June 12, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/28607229/recognition-and-treatment-of-law-enforcement-violence-against-detainees-and-prisoners-a-survey-among-israeli-physicians-and-medical-students
#13
Zvi Benninga, Bettina Steiner-Birmanns, Revital Arbel, Firas Abu Akar, Mushira Aboo Dia
INTRODUCTION: Physicians regularly encounter victims of violence. Although some at-risk groups are increasingly recognized as such, the risks faced by prisoners and detainees are often overlooked. The scope of violence against them is unknown and their treatment is often hampered by unique social and institutional impediments. This article reviews the need for improved recognition and protection of such patients and the associated obstacles, while presenting information on the experience, knowledge and attitudes of physicians in Israel regarding the maltreatment of prisoners and detainees...
2017: Torture: Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture
https://www.readbyqxmd.com/read/28601821/study-protocol-comparison-of-the-effect-of-treatment-with-nonsteroidal-anti-inflammatory-drugs-added-to-anti-tumour-necrosis-factor-a-therapy-versus-anti-tumour-necrosis-factor-a-therapy-alone-on-progression-of-structural-damage-in-the-spine-over-two-years
#14
Fabian Proft, Burkhard Muche, Joachim Listing, Valeria Rios-Rodriguez, Joachim Sieper, Denis Poddubnyy
INTRODUCTION: There is some evidence that non-steroidal anti-inflammatory drugs (NSAIDs), in particular celecoxib, might possess not only a symptomatic efficacy but also disease-modifying properties in ankylosing spondylitis (AS), retarding the progression of structural damage in the spine if taken continuously. In contrast, this remains controversial for tumour necrosis factor alpha (TNF-α) inhibitors, despite their good clinical efficacy. The impact of a combined therapy (a TNF inhibitor plus an NSAID) on radiographic spinal progression in AS is unclear...
June 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28600450/establishing-a-legal-service-for-major-trauma-patients-at-a-major-trauma-centre-in-the-uk
#15
William H Seligman, Julian Thompson, Hannah E Thould, Charlotte Tan, Andrew Dinsmore, David J Lockey
BACKGROUND: Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK. METHODS: In 2013, a legal service was established at North Bristol NHS Trust...
June 9, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28600377/serious-gaming-during-multidisciplinary-rehabilitation-for-patients-with-complex-chronic-pain-or-fatigue-complaints-study-protocol-for-a-controlled-trial-and-process-evaluation
#16
Miel A P Vugts, Margot C W Joosen, Agali Mert, Aglaia Zedlitz, Hubertus J M Vrijhoef
INTRODUCTION: Many individuals suffer from chronic pain or functional somatic syndromes and face boundaries for diminishing functional limitations by means of biopsychosocial interventions. Serious gaming could complement multidisciplinary interventions through enjoyment and independent accessibility. A study protocol is presented for studying whether, how, for which patients and under what circumstances, serious gaming improves patient health outcomes during regular multidisciplinary rehabilitation...
June 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28585456/potential-conflicts-in-midwifery-practice-regarding-conscientious-objection-to-abortions-in-scotland
#17
Valerie Fleming, Yvonne Robb
BACKGROUND: This study was developed as a result of a court case involving conflicts between midwives' professional practice and their faith when caring for women undergoing abortions in Scotland. RESEARCH QUESTIONS: What are practising Roman Catholics' perspectives of potential conflicts between midwives' professional practice in Scotland with regard to involvement in abortions and their faith? How relevant is the 'conscience clause' to midwifery practice today? and What are participants' understandings of Canon 1398 in relation to midwifery practice? RESEARCH DESIGN: The theoretical underpinning of this study was Gadamer's hermeneutic out of which the method developed by Fleming et al...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28581631/public-participation-moving-beyond-the-four-walls-of-therapy
#18
Lorien S Jordan, Desiree M Seponski
Family therapists have an ethical responsibility for public participation, to work toward creating a better society. Serving the public interest and developing laws to promote the profession and the public good can be achieved through policy advocacy and political participation. Political and policy work are important but overlooked aspects of family therapy, which is significant given the consequences differing policies have for clients and the profession. This paper reports on results from a random, national survey of licensed family therapists' (N = 174) advocacy actions...
June 5, 2017: Journal of Marital and Family Therapy
https://www.readbyqxmd.com/read/28578097/the-concept-of-a-waiting-period-for-preoperative-patient-consent-prospective-study-of-51-shoulder-arthroscopy-cases
#19
Henry Coudane, Michaël Mangin, Yasser Karam, Vincent Seivert, Didier Mainard, Jane Laure Danan, Bruno Py, Joëlle Alnot Lighelzzollo
INTRODUCTION: The French Code of Public Health (CSP) does not explicitly require that patients be given a certain amount of time to think about a procedure, except for cosmetic surgery, where 15 days is required (Art. L 6322-2 CSP). We hypothesized that patients require a waiting period during their decision-making process for scheduled shoulder arthroscopy procedure. MATERIALS AND METHODS: This prospective observational study of 51 patients analysed the concept of a waiting period based on a 10-item questionnaire...
May 31, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28576580/quassia-biopiracy-case-and-the-nagoya-protocol-a-researcher-s-perspective
#20
Geneviève Bourdy, Catherine Aubertin, Valérie Jullian, Eric Deharo
Biopiracy accusations are common in the world of biodiversity research. At the end of 2015, a French NGO accused researchers from the Institut de Recherche pour le Développement (IRD) of biopiracy. These researchers had applied for a patent for a natural bioactive molecule against malaria and cancer, the Simalikalactone E, isolated from Quassia amara L. (Simaroubaceae) leaves. This biopiracy allegation triggered a huge wave of attacks from the media and social networks, and vehement recrimination from political officials in French Guiana against researchers who have been accused of ethical misconduct, by stealing the traditional knowledge of indigenous people...
May 31, 2017: Journal of Ethnopharmacology
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