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Law and ethics

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https://www.readbyqxmd.com/read/28918408/effectiveness-cost-utility-and-implementation-of-a-decision-aid-for-patients-with-localised-prostate-cancer-and-their-partners-study-protocol-of-a-stepped-wedge-cluster-randomised-controlled-trial
#1
Hoda H M Al-Itejawi, Cornelia F van Uden-Kraan, Peter M van de Ven, Veerle M H Coupé, André N Vis, Jakko A Nieuwenhuijzen, Jeroen A van Moorselaar, Irma M Verdonck-de Leeuw
INTRODUCTION: Patient decision aids (PDAs) have been developed to help patients make an informed choice for a treatment option. Despite proven benefits, structural implementation falls short of expectations. The present study aims to assess the effectiveness and cost-utility of the PDA among newly diagnosed patients with localised prostate cancer and their partners, alongside implementation of the PDA in routine care. METHODS/ANALYSIS: A stepped-wedge cluster randomised trial will be conducted...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28911349/tuberculosis-human-rights-and-ethics-considerations-along-the-route-of-a-highly-vulnerable-migrant-from-sub-saharan-africa-to-europe
#2
V Wild, D Jaff, N S Shah, M Frick
Migrant health is a critical public health issue, and in many countries attention to this topic has focused on the link between migration and communicable diseases, including tuberculosis (TB). When creating public health policies to address the complex challenges posed by TB and migration, countries should focus these policies on evidence, ethics, and human rights. This paper traces a commonly used migration route from sub-Saharan Africa to Europe, identifying situations at each stage in which human rights and ethical values might be affected in relation to TB care...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28899906/does-the-doctrine-of-double-effect-apply-to-the-prescription-of-barbiturates-syme-vs-the-medical-board-of-australia
#3
Xavier Symons
The doctrine of double effect (DDE) is a principle of crucial importance in law and medicine. In medicine, the principle is generally accepted to apply in cases where the treatment necessary to relieve pain and physical suffering runs the risk of hastening the patient's death. More controversially, it has also been used as a justification for withdrawal of treatment from living individuals and physician-assisted suicide. In this paper, I will critique the findings of the controversial Victorian Civil and Administrative Tribunal (VCAT) hearing Syme vs the Medical Board of Australia In that hearing, Dr Rodney Syme, a urologist and euthanasia advocate, was defending his practice of prescribing barbiturates to terminally ill patients...
September 12, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28893073/challenges-faced-by-caregivers-of-children-on-antiretroviral-therapy-at-mutale-municipality-selected-healthcare-facilities-vhembe-district-limpopo-province
#4
Rhudzani V Mafune, Rachel T Lebese, Livhuwani H Nemathaga
BACKGROUND: Children depend solely on caregivers who can be either parents or guardians for drug administration to enhance adherence to antiretroviral treatment (ART), which might pose any number of challenges. PURPOSE: The purpose of this study was to explore and describe the challenges faced by caregivers of children on ART at Mutale Municipality, Vhembe District, Limpopo Province. RESEARCH DESIGN AND METHOD: The research design was qualitative, explorative, descriptive and contextual in nature...
August 28, 2017: Curationis
https://www.readbyqxmd.com/read/28885218/off-label-use-of-medicines-the-need-for-good-practice-guidelines
#5
Marc Dooms, James Killick
BACKGROUND: 'Off-label use' is the term used for the prescription and dispensing of a medicinal product for any indication, patient group, route of administration, dosage or treatment regimen other than that listed in the Summary of Product Characteristics. OBJECTIVE: In this article the authors present a brief overview of current practices of off-label use in Europe and the applicable European law and jurisprudence. They then go on to present a set of guidelines for best practice in off-label use which underlines the need for guidance on prescription to be firmly rooted in the need to ensure patient safety above all other concerns...
2017: International Journal of Risk & Safety in Medicine
https://www.readbyqxmd.com/read/28884846/the-responsibility-of-gynecologists-and-obstetricians-in-providing-safe-abortion-services-within-the-limits-of-the-law
#6
Anibal Faúndes
Approximately 47 000 women die each year worldwide as a result of the complications of unsafe abortion, almost exclusively in low- and middle-income countries with restrictive abortion laws. In these countries, very few women who comply with the conditions imposed by the law can access safe abortion services in the public health system. The main obstacle is the unwillingness of gynecologists and obstetricians to provide abortion services by claiming conscientious objection, which is often used to hide their fear of the stigma associated with abortion...
October 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28884750/brain-imaging-tests-for-chronic-pain-medical-legal-and-ethical-issues-and-recommendations
#7
REVIEW
Karen D Davis, Herta Flor, Henry T Greely, Gian Domenico Iannetti, Sean Mackey, Markus Ploner, Amanda Pustilnik, Irene Tracey, Rolf-Detlef Treede, Tor D Wager
Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. Brain imaging (for example, functional MRI, PET, EEG and magnetoencephalography) is widely considered to have potential for diagnosis, prognostication, and prediction of treatment outcome in patients with chronic pain. In this Consensus Statement, a presidential task force of the International Association for the Study of Pain examines the capabilities of brain imaging in the diagnosis of chronic pain, and the ethical and legal implications of its use in this way...
September 8, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28876358/animal-models-in-biological-and-biomedical-research-experimental-and-ethical-concerns
#8
Monica L Andersen, Lucile M F Winter
Animal models have been used in experimental research to increase human knowledge and contribute to finding solutions to biological and biomedical questions. However, increased concern for the welfare of the animals used, and a growing awareness of the concept of animal rights, has brought a greater focus on the related ethical issues. In this review, we intend to give examples on how animals are used in the health research related to some major health problems in Brazil, as well as to stimulate discussion about the application of ethics in the use of animals in research and education, highlighting the role of National Council for the Control of Animal Experimentation (Conselho Nacional de Controle de Experimentação Animal - CONCEA) in these areas...
September 4, 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28868846/personhood-and-moral-status-of-the-embryo-it-s-effect-on-validity-of-surrogacy-contract-revocation-according-to-shia-jurisprudence-perspective
#9
Saeid Nazari Tavakkoli
Background: One of the most controversial issues related to the human embryo is the determination of the moment when an embryo is considered a human being and acquires a moral status. Although personhood and moral status are frequently mentioned in medical ethics, they are considered interdisciplinary as concepts that shape the debate in medical law (fiqh) since their consequences are influential in the way which the parents and other individuals behave towards the embryo. MATERIALS AND METHODS: This analytical-descriptive research gathered relevant data in a literature search...
October 2017: International Journal of Fertility & Sterility
https://www.readbyqxmd.com/read/28861904/equity-trade-offs-in-conservation-decision-making
#10
Elizabeth A Law, Nathan J Bennett, Christopher D Ives, Rachel Friedman, Katrina J Davis, Carla Archibald, Kerrie A Wilson
Conservation decisions increasingly involve multiple environmental and social objectives, which result in complex decision contexts with high potential for trade-offs. Improving social equity is one such objective that is often considered an enabler of successful outcomes and a virtuous ideal in itself. Despite its idealized importance in conservation policy, social equity is often highly simplified or ill-defined and is applied uncritically. What constitutes equitable outcomes and processes is highly normative and subject to ethical deliberation...
September 1, 2017: Conservation Biology: the Journal of the Society for Conservation Biology
https://www.readbyqxmd.com/read/28854718/single-fathers-by-choice-using-surrogacy-why-men-decide-to-have-a-child-as-a-single-parent
#11
Nicola Carone, Roberto Baiocco, Vittorio Lingiardi
STUDY QUESTION: Why do men decide to have a child by surrogacy as a single parent? SUMMARY ANSWER: Reasons included feeling that it was the right time (i.e. having 'worked through' concerns about single parenthood; career and financial stability; a fear of getting older; no longer wanting to wait for the 'right' relationship), external encouragement, a desire to reproduce and a fear of separation/divorce. WHAT IS KNOWN ALREADY: Because no research has been conducted on single fathers who used surrogacy, their characteristics, motivations and experiences are unknown...
September 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28853142/blowing-the-whistle-the-ethical-professional-and-legal-implications-of-raising-concerns-and-self-regulation-within-dentistry
#12
REVIEW
Alexander C L Holden
Whistle-blowers are a necessary part of any system; dentistry is no different. The role of whistle-blowers in dentistry has been enshrined in Australian law since 2010. Raising concerns has become a legal duty as well as an ethical and professional obligation. It is important that these different aspects of raising concerns are explored as each adds another layer of consideration to the issue. The health professional's duty to whistle-blow could be viewed as problematic; the observance of this duty is associated with being trapped between a rock and a hard place where any decision to engage or not may have negative consequences...
August 29, 2017: Australian Dental Journal
https://www.readbyqxmd.com/read/28852560/substitute-consent-to-data-sharing-a-way-forward-for-international-dementia-research
#13
Adrian Thorogood, Constance Deschênes St-Pierre, Bartha Maria Knoppers
A deluge of genetic and health-related data is being generated about patients with dementia. International sharing of these data accelerates dementia research. Seeking consent to data sharing is a challenge for dementia research where patients have lost or risk losing legal capacity. The laws of most countries enable substitute decision makers (SDMs) to consent on behalf of incapable adults to research participation. We compare regulatory frameworks governing capacity, research, and personal data protection across eight countries to determine when SDMs can consent to data sharing...
April 2017: Journal of Law and the Biosciences
https://www.readbyqxmd.com/read/28852558/reflecting-the-human-nature-of-ivf-embryos-disappearing-women-in-ethics-law-and-fertility-practice
#14
Jenni Millbank
Many laws and ethical documents instruct us that disembodied embryos created through IVF processes are not mere tissue; they are 'widely regarded' as unique objects of serious moral consideration. Even in jurisdictions which disavow any overt characterization of embryonic personhood, the embryo, by virtue of its uniqueness and orientation toward future development, is said to have a 'special status' or command 'respect'. The woman whose desire for a child or children created this embryo, and who inhabits the body to whom it may one day be returned, is an omission or at best an afterthought in such frameworks...
April 2017: Journal of Law and the Biosciences
https://www.readbyqxmd.com/read/28846520/should-euthanasia-be-considered-iatrogenic
#15
Silvana Barone, Yoram Unguru
As more countries adopt laws and regulations concerning euthanasia, pediatric euthanasia has become an important topic of discussion. Conceptions of what constitutes harm to patients are fluid and highly dependent on a myriad of factors including, but not limited to, health care ethics, family values, and cultural context. Euthanasia could be viewed as iatrogenic insofar as it results in an outcome (death) that some might consider inherently negative. However, this perspective fails to acknowledge that death, the outcome of euthanasia, is not an inadvertent or preventable complication but rather the goal of the medical intervention...
August 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28829007/how-do-doctors-and-nurses-in-emergency-departments-in-hong-kong-view-their-disaster-preparedness-a-cross-sectional-territory-wide-online-survey
#16
Rex P K Lam, Satchit Balsari, Kevin K C Hung, Kai-Hsun Hsiao, L P Leung, Jennifer Leaning
OBJECTIVES: To assess the level of all-hazards disaster preparedness and training needs of emergency department (ED) doctors and nurses in Hong Kong from their perspective, and identify factors associated with high perceived personal preparedness. DESIGN: This study was a cross-sectional territory-wide online survey conducted from 9 September to 26 October, 2015. Participants The participants were doctors from the Hong Kong College of Emergency Medicine and nurses from the Hong Kong College of Emergency Nursing...
August 22, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28814138/finnish-nurses-attitudes-towards-their-role-in-the-euthanasia-process
#17
Anja Terkamo-Moisio, Chris Gastmans, Olli-Pekka Ryynänen, Anna-Maija Pietilä
BACKGROUND: Nurses' voices remain unheard in most debates about euthanasia, although their crucial role in the euthanasia process is widely acknowledged. Moreover, in Canadian euthanasia law, nurses have a more active role, which further highlights the need for knowledge about nurses' attitudes towards their role in the euthanasia process. RESEARCH QUESTIONS: What are Finnish nurses' attitudes towards their potential role in the euthanasia process? Which characteristics are associated with those attitudes? RESEARCH DESIGN: Cross-sectional web-based survey...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28812979/truth-in-research-labelling
#18
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/28801944/the-emergence-of-second-generation-lethal-injection-protocols-a-brief-history-and-review
#19
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/28800808/legal-and-ethical-challenges-part-1-general-population
#20
REVIEW
Britta Ostermeyer, Anim N Shoaib, Swapna Deshpande
Several federal and state laws and regulations, as well as ethical medical principles, govern the emergency clinician's practice of care. Although some common legal-medical and ethical principles are shared with other medical specialties, emergency medicine and emergency psychiatry have unique legal and ethical challenges. This article presents and discusses these challenges, including the physician-patient relationship, malpractice, confidentiality and privilege, duty to report, decision-making capacity and vicarious decision-making, the Emergency Medical Treatment and Labor Act, right to treatment, hospital admissions, involuntary commitment, forced medication administration, and child and elder abuse...
September 2017: Psychiatric Clinics of North America
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