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https://www.readbyqxmd.com/read/28809614/confidentiality-and-fitness-to-drive-professional-ethical-and-legal-duties-in-the-case-of-the-diabetic-bus-driver
#1
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/28807682/evaluation-and-treatment-of-minors
#2
REVIEW
Lee Benjamin, Paul Ishimine, Madeline Joseph, Sanjay Mehta
Many patients under the age of majority present to emergency departments (EDs) without parents or guardians. This may create concern in regard to evaluation of these patients without formal consent to treat. The Emergency Medical Treatment and Labor Act mandates that all patients presenting to EDs receive a medical screening examination and does not exclude these minors. Standards for who can provide consent for a patient vary from state to state and address important issues such as consent by parent surrogates, as well as adolescent emancipation, reproductive health, mental health, and substance use...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28807551/the-optimal-cut-off-of-blood-pressure-related-to-left-ventricular-diastolic-dysfunction-and-remodeling-in-asian-diabetic-patients
#3
Ju Young Jung, Sung Keun Park, Jae-Hong Ryoo, Chang-Mo Oh, Jeong Gyu Kang, Kanghee Moon, Keum Ok Lee, Joong-Myung Choi
BACKGROUND: Although a recent randomized trial found no difference between intensive and standard blood pressure (BP) control in patients with diabetes mellitus (DM), the debate over the optimal BP target continues. Thus, the present study investigated the effect of BP on the subclinical left ventricular (LV) function and structural changes in diabetic patients. METHOD: A total of 2649 patients with DM who received echocardiography were enrolled in this study. Study population was stratified by three groups according to BP and presence of hypertension (normal, <130/80mmHg; prehypertension, ≥130/80mmHg without hypertension; hypertension, ≥140/90mmHg or history of hypertension)...
August 11, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28805115/hindrances-to-achieve-professional-confidence-the-nurse-s-participation-in-ethical-decision-making
#4
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
#5
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/28802671/the-internet-and-nurse-education
#6
EDITORIAL
Martin Aasbrenn, Anne Raustøl, Hanne Maria Bingen
Participation in a community of practice through asynchronous writing is useful for learning in higher education. We argue that such computer-mediated communication via the internet is valuable in nurse education, but that it often should take place at sites protected from search with access restricted to a limited group to make the students confident and enable learning. We further argue why we think discussion of patient stories in educational settings often should be done without computers. Reflection around patient stories is a fundamental part of the education of a clinician, but should be done either with fictional cases or as face-to-face activities to protect patient confidentiality...
August 8, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28800808/legal-and-ethical-challenges-part-1-general-population
#7
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
https://www.readbyqxmd.com/read/28799483/ethical-application-of-precision-medicine-to-schizophrenia-management
#8
Steven Daws
A recent effort has been made to better characterize the genetic architecture of schizophrenia, and apply a precision medicine model to its treatment. In pursuing this approach, it is likely that ethical concerns regarding cost-benefit uncertainties, the duty to inform and confidentiality will arise. Due to the complexity of schizophrenia's genetic profile, research efforts must be weighed against the risk to human subjects and the required consumption of valuable healthcare resources. Genetic risk profiles must be judged in conjunction with actionability and must be fully explained to patients and others potentially affected...
July 2017: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
https://www.readbyqxmd.com/read/28797919/the-efficacy-and-safety-of-using-a-bipolar-sealer-to-prevent-blood-loss-in-spine-surgery-a-meta-analysis
#9
REVIEW
Di Lu, Wei-Guo Ding, Hong-Feng Sheng, Xin-Wei Xu, Ying-Xiao Zhang, Weixing Xu
OBJECTIVE: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to evaluate the effect of using a bipolar sealer to prevent surgical bleeding in spine surgery. METHODS: In June 2017, the PubMed, Embase, Cochrane controlled trials register, Web of Science, Google, and Chinese Wanfang databases were used to identify RCTs and non-RCTs comparing the effects of intraoperative placement of a bipolar sealer versus standard electrocautery with regard to blood loss and blood transfusion...
August 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28794547/evolution-of-ethics-in-clinical-research-and-ethics-committee
#10
Nilay Kanti Das, Amrita Sil
Ethics are the moral values of human behavior and the principles which govern these values. The situation becomes challenging for a doctor when he assumes the role of researcher. The doctor-researcher has to serve both the roles and at times the zeal of an investigator has the potential to cloud the morality of the physician inside. It is very important to realize that exploiting the faith of patients is an offence that tantamount to a crime. Medical science is one discipline where the advancement of knowledge is hugely guided by research and mankind has benefitted from many experiments...
July 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28783394/communication-between-primary-and-secondary-care
#11
Laura Mk Pannell, Jonathan Tyrrell-Price
Background Up to date patient data is a cornerstone of optimal safety and care, so admission to hospital requires transfer of data held in the community to secondary care. Despite the advent of electronic medical record systems such as Connecting Care and EMIS, the telephone remains the mainstay of communication. Methods A prospective cross-sectional quality improvement project was conducted to assess the time taken in telephone communication between primary and secondary care doctors and determine if access to the electronic shared system, Connecting Care, would improve efficiency...
August 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28766529/-the-coroner-s-autopsies-in-the-great-britain-the-problems-related-to-the-quality-of-the-studies-standardization-auditing-financial-support-and-the-approaches-to-their-solution-part-2
#12
I Ju Makarov, T A Kuprina, A A Gusarov, V A Fetisov
This article extends the previous publication of the authors based on the analysis of the detailed report of the experts of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD) issued in the Great Britain in 2006. The analysis has demonstrated that all autopsy studies should invariably involve measurement of the corpse length and weight (including body mass index) as well as the detailed description of all injuries to the body (or references to their absence). All autopsy studies should be carried out only by a medical professional (e...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28766395/dual-loyalties-everyday-ethical-problems-of-registered-nurses-and-physicians-in-combat-zones
#13
Kristina Lundberg, Sofia Kjellström, Lars Sandman
BACKGROUND: When healthcare personnel take part in military operations in combat zones, they experience ethical problems related to dual loyalties, that is, when they find themselves torn between expectations of doing caring and military tasks, respectively. AIM: This article aims to describe how Swedish healthcare personnel reason concerning everyday ethical problems related to dual loyalties between care and military tasks when undertaking healthcare in combat zones...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28761333/patient-satisfaction-with-clinical-laboratory-services-at-tikur-anbessa-specialized-hospital-addis-ababa-ethiopia
#14
Rodas Getachew Abera, Boaz Arka Abota, Melese Hailu Legese, Abebe Edao Negesso
BACKGROUND: Monitoring patient satisfaction is an important and useful quality improvement tool for clinical laboratories in particular and health care organizations in general. Thus, this study aimed to assess patient satisfaction toward clinical laboratory services at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. METHODS: A hospital-based cross-sectional study was conducted and a convenient sampling technique was applied to recruit study participants...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28751628/aliskiren-therapy-in-hypertension-and-cardiovascular-disease-a-systematic-review-and-a-meta-analysis
#15
REVIEW
Shufang Fu, Xin Wen, Fei Han, Yin Long, Gaosi Xu
The efficacy and safety of aliskiren combination therapy with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in patients with hypertension and cardiovascular disease remains attractive attention. We searched the Cochrane Central Register, the Clinical Trials Registry, EMBASE, MEDLINE and PubMed for relevant literatures up to January 2017. A total of 13 randomized controlled trials (RCTs) with 12222 patients were included in this study, and the combined results indicated that aliskiren in combination therapy with ACEIs or ARBs had remarkable effects in reducing systolic blood pressure (SBP) [weighted mean differences (WMD), -4...
July 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28750617/health-system-preparedness-for-integration-of-mental-health-services-in-rural-liberia
#16
Wilfred S Gwaikolo, Brandon A Kohrt, Janice L Cooper
BACKGROUND: There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history...
July 27, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28745941/veterans-preferences-for-remote-management-of-chronic-conditions
#17
Erica Sedlander, Katherine C Barboza, Ashley Jensen, Nicole Skursky, Katelyn Bennett, Scott Sherman, Mark Schwartz
BACKGROUND: The Veterans Health Administration (VA) is investing considerable resources into providing remote management care to patients for disease prevention and management. Remote management includes online patient portals, e-mails between patients and providers, follow-up phone calls, and home health devices to monitor health status. However, little is known about patients' attitudes and preferences for this type of care. This qualitative study was conducted to better understand patient preferences for receiving remote care...
July 26, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28744966/social-media-and-organ-donation-ethically-navigating-the-next-frontier
#18
Macey L Henderson, Kristel A Clayville, Jonathan S Fisher, Kristin K Kuntz, Harvey Mysel, Tanjala S Purnell, Randolph L Schaffer, Laurence A Sherman, Elizabeth P Willock, Elisa J Gordon
As the organ shortage continues to grow, the creation of social media communities by transplant centers and the public is rapidly expanding to increase the number of living donors. Social media communities are arranged in myriad ways, and without standardization, raising concerns about potential recipients' and potential donors' autonomy and quality of care. Social media communities magnify and modify extant ethical issues in deceased and living donation related to privacy, confidentiality, professionalism, and informed consent, and increase the potential for undue influence and coercion for potential living donors and transplant candidates...
July 25, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28743204/the-use-of-clinical-databases-in-disease-outcomes-research-is-the-ethics-of-irb-review-keeping-up
#19
Eugene Bereza
There is a perceived tension in research ethics between protecting the interests of participants and promoting good research as a societal good. The challenge of balancing the potential benefits of large clinical databases for disease outcomes research while protecting patients' privacy and confidentiality is an example of this dynamic. What is new about this tension in the context of "data warehousing" is the conflation of many differing interpretations of relevant ethics terminology, the proliferation of different kinds of databases, as well as the growth of research on a global level without the requisite harmonization of regulatory frameworks...
July 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28736389/hiv-testing-experiences-and-their-implications-for-patient-engagement-with-hiv-care-and-treatment-on-the-eve-of-test-and-treat-findings-from-a-multicountry-qualitative-study
#20
Alison Wringe, Mosa Moshabela, Constance Nyamukapa, Dominic Bukenya, Ken Ondenge, William Ddaaki, Joyce Wamoyi, Janet Seeley, Kathryn Church, Basia Zaba, Victoria Hosegood, Oliver Bonnington, Morten Skovdal, Jenny Renju
OBJECTIVE: In view of expanding 'test and treat' initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV. METHODS: As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South Africa, Tanzania, Kenya, Malawi and Zimbabwe with 5-10 health workers and 28-59 people living with HIV, per country. Topic guides covered patient and provider experiences of HIV testing and treatment services...
July 2017: Sexually Transmitted Infections
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