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https://www.readbyqxmd.com/read/29304784/ethical-aspects-of-diagnosis-and-interventions-for-children-with-fetal-alcohol-spectrum-disorder-fasd-and-their-families
#1
Gert Helgesson, Göran Bertilsson, Helena Domeij, Gunilla Fahlström, Emelie Heintz, Anders Hjern, Christina Nehlin Gordh, Viviann Nordin, Jenny Rangmar, Ann-Margret Rydell, Viveka Sundelin Wahlsten, Monica Hultcrantz
BACKGROUND: Fetal alcohol spectrum disorders (FASD) is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. METHODS: Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a series of discussions with experts in the field, published literature, and medical ethicists...
January 5, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29288287/a-contemporary-paradigm-integrating-spirituality-in-advance-care-planning
#2
Katie Lutz, Stefan R Rowniak, Prabjot Sandhu
In the 25 years since advance care planning first drew the attention of the national healthcare and legal systems, gains in the rate of advance care directive completion have been negligible despite the effort of researchers, ethicists, and lawmakers. With the benefit of sophisticated healthcare technology, patients are living longer. Despite the benefits of increased longevity, it is widely acknowledged that enough has not been done to adequately address end-of-life care decisions at the crossroads between medical futility and quality of life...
December 29, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29280164/the-epistemic-costs-of-compromise-in-bioethics
#3
Katrien Devolder, Thomas Douglas
Bioethicists sometimes defend compromise positions, particularly when they enter debates on applied topics that have traditionally been highly polarised, such as those regarding abortion, euthanasia and embryonic stem cell research. However, defending compromise positions is often regarded with a degree of disdain. Many are intuitively attracted to the view that it is almost always problematic to defend compromise positions, in the sense that we have a significant moral reason not to do so. In this paper, we consider whether this common sense view can be given a principled basis...
December 27, 2017: Bioethics
https://www.readbyqxmd.com/read/29247306/identifying-criteria-for-the-evaluation-of-the-implications-of-brain-reading-for-mental-privacy
#4
Giulio Mecacci, Pim Haselager
Contemporary brain reading technologies promise to provide the possibility to decode and interpret mental states and processes. Brain reading could have numerous societally relevant implications. In particular, the private character of mind might be affected, generating ethical and legal concerns. This paper aims at equipping ethicists and policy makers with conceptual tools to support an evaluation of the potential applicability and the implications of current and near future brain reading technology. We start with clarifying the concepts of mind reading and brain reading, and the different kinds of mental states that could in principle be read...
December 15, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/29246088/a-spoonful-of-care-ethics-the-challenges-of-enriching-medical-education
#5
Eva van Reenen, Inge van Nistelrooij
BACKGROUND: Nursing Ethics has featured several discussions on what good care comprises and how to achieve good care practices. We should "nurse" ethics by continuously reflecting on the way we "do" ethics, which is what care ethicists have been doing over the past few decades and continue to do so. Ethics is not limited to nursing but extends to all caring professions. In 2011, Elin Martinsen argued in this journal that care should be included as a core concept in medical ethical terminology because of "the harm to which patients may be exposed owing to a lack of care in the clinical encounter," specifically between doctors and patients...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/29236658/how-using-generative-learning-strategies-improved-medical-student-self-competency-in-end-of-life-care
#6
Sandra Marquez Hall, Janet Lieto, Roy Martin
During a mandatory fourth-year core geriatric medicine rotation at our medical school, we discovered that our medical students were struggling with end-of-life (EOL) issues both personally and professionally. We implemented curriculum changes to assist them in developing emotional awareness about death and dying, and to help develop their ability to respond personally and professionally to patients and their families during EOL experiences.In our new curriculum, a seasoned ethicist at our university conducts 2 educational sessions addressing EOL issues...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29201387/a-half-century-of-electronic-fetal-monitoring-and-bioethics-silence-speaks-louder-than-words
#7
REVIEW
Thomas P Sartwelle, James C Johnston, Berna Arda
Bioethics abolished the prevailing Hippocratic tenet instructing physicians to make treatment decisions, replacing it with autonomy through informed consent. Informed consent allows the patient to choose treatment after options are explained by the physician. The appearance of bioethics in 1970 coincided with the introduction of electronic fetal monitoring (EFM), which evolved to become the fetal surveillance modality of choice for virtually all women in labor. Autonomy rapidly pervaded all medical procedures, but there was a clear exemption for EFM...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29151056/between-professional-values-social-regulations-and-patient-preferences-medical-doctors-perceptions-of-ethical-dilemmas
#8
Berit Bringedal, Karin Isaksson Rø, Morten Magelssen, Reidun Førde, Olaf Gjerløv Aasland
BACKGROUND: We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice. METHODS: The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded (78%). We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so...
November 18, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29111936/empowerment-failure-how-shortcomings-in-physician-communication-unwittingly-undermine-patient-autonomy
#9
Peter A Ubel, Karen A Scherr, Angela Fagerlin
Many health care decisions depend not only upon medical facts, but also on value judgments-patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of medical decision making effectively promotes patients' health care goals...
November 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29070707/adverse-consequences-of-article-12-of-the-un-convention-on-the-rights-of-persons-with-disabilities-for-persons-with-mental-disabilities-and-an-alternative-way-forward
#10
Matthé Scholten, Jakov Gather
It is widely accepted among medical ethicists that competence is a necessary condition for informed consent. In this view, if a patient is incompetent to make a particular treatment decision, the decision must be based on an advance directive or made by a substitute decision-maker on behalf of the patient. We call this the competence model. According to a recent report of the United Nations (UN) High Commissioner for Human Rights, article 12 of the UN Convention on the Rights of Persons with Disabilities (CRPD) presents a wholesale rejection of the competence model...
October 25, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29058535/transplanting-the-body-preliminary-ethical-considerations
#11
Lantz Fleming Miller
A dissociated area of medical research warrants bioethical consideration: a proposed transplantation of a donor's entire body, except head, to a patient with a fatal degenerative disease. The seeming improbability of such an operation can only underscore the need for thorough bioethical assessment: Not assessing a case of such potential ethical import, by showing neglect instead of facing the issue, can only compound the ethical predicament, perhaps eroding public trust in ethical medicine. This article discusses the historical background of full-body transplantation, documents the seriousness of its current pursuit, and builds an argument for why prima facie this type of transplant is bioethically distinct...
October 23, 2017: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
https://www.readbyqxmd.com/read/29056630/cancer-and-fertility
#12
Ana S Iltis
This symposium includes 12 personal narratives from individuals who have faced a cancer diagnosis-either their own or their child's-where the disease itself, or their treatment, threatened future fertility. Three additional stories are available in the online supplement. Three commentaries on these narratives are written by an expert in oncofertility, a healthcare ethicist, and a pediatrician completing a fellowship in hematology/oncology. The observations and insights these authors share underscore the importance of addressing fertility loss and preservation early in the cancer journey...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/29017958/higher-priced-older-pharmaceuticals-how-should-we-respond
#13
Richard S Irwin, Scott Manaker, Mark L Metersky, Robert P Baughman, Tunde Otulana, Steven E Weinberger, Andrew J Sussman, Norine A McGrath
We and the patients have been aware of the high cost of medications in the United States for decades; however, we are now witnessing a relatively new phenomenon: exponential price increases for some older pharmaceuticals that have been available for years. To assist practitioners in how to respond to the issue of higher priced pharmaceuticals, an interprofessional session was developed and held at CHEST 2016 in Los Angeles. The session proceedings and a few updates are presented here to summarize what pulmonologists; a sarcoidosis expert; a retired executive of a medical society, of a pharmaceutical company, and of a pharmacy; and an ethicist advise that we do about the problem...
October 7, 2017: Chest
https://www.readbyqxmd.com/read/28975705/potential-yield-of-imminent-death-kidney-donation
#14
Ryan A Denu, Eneida A Mendonca, Norman Fost
About 99 000 people are waiting for a kidney in the United States, and many will die waiting. The concept of "imminent death" donation, a type of living donation, has been gaining attention among physicians, patients, and ethicists. We estimated the number of potential imminent death kidney donors at the University of Wisconsin Hospital and Clinics by assessing the number of annual deaths in individuals with normal kidney function. Based on a previous survey suggesting that one-third of patients might be willing to donate at imminent death, we estimate that between 76 and 396 people in the state of Wisconsin would be medically eligible and willing to donate each year at the time of imminent death...
October 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28975473/why-are-there-so-few-ethics-consults-in-children-s-hospitals
#15
Brian Carter, Manuel Brockman, Jeremy Garrett, Angie Knackstedt, John Lantos
In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas...
October 3, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28932930/understanding-and-resolving-conflicting-traditions-a-macintyrean-approach-to-shared-deliberation-in-medical-ethics
#16
Jessica Adkins
The position of clinical ethicist exists to help resolve conflicts in the hospital. Sometimes these conflicts arise because of fundamental cultural differences between the patient and the medical team, and such cases present special challenges. Should the ideology of modern medicine reject the wishes of those who hold ideologies from differing cultures? How can the medical ethicist help resolve such conflicts? To answer these questions, I rely on the works of Alasdair MacIntyre. Using MacIntyre's philosophy, we can better understand why traditions exist, how conflicts arise, and how opposing traditions can collaborate in shared decision making...
September 20, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28912618/moral-theological-analysis-of-direct-versus-indirect-abortion
#17
John M Haas
Cases of a vital conflict, where the lives of both the mother and child are at risk during pregnancy, have been the subject of recent vigorous debate. The basic principles put forth in the Ethical and Religious Directives are reviewed, as is the principle of double effect. An illustrative case of severe cardiomyopathy in a pregnant woman is described and it is noted that the principle of double effect would not apply. Counter arguments are noted, focusing on Martin Rhonheimer who posits that in the case of vital conflicts, such as performing a craniotomy on a baby stuck in the birth canal, taking the baby's life does not constitute a direct abortion because moral norms do not apply in the extreme conflict situation where both mother and child will die...
August 2017: Linacre Quarterly
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
#18
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/28879860/ethical-issues-regarding-crispr-mediated-genome-editing
#19
Zabta Khan Shinwari, Faouzia Tanveer, Ali Talha Khalil
CRISPR-Cas9 has emerged as a simple, precise and most rapid genome editing technology. With a number of promising applications ranging from agriculture and environment to clinical therapeutics, it is greatly transforming the field of molecular biology. However, there are certain ethical, moral and safety concerns related to the attractive applications of this technique. The most contentious issues concerning human germline modifications are the challenges to human safety and morality such as risk of unforeseen, undesirable effects in clinical applications particularly to correct or prevent genetic diseases, matter of informed consent and the risk of exploitation for eugenics...
September 7, 2017: Current Issues in Molecular Biology
https://www.readbyqxmd.com/read/28859007/developing-professional-practice-and-ethics-engagement-a-leadership-model
#20
Karen M Reilly, Martha Jurchak
Nurse leaders are responsible for a practice environment that fosters safe, quality patient outcomes through excellence in nursing practice. This article describes a reflective practice intervention in the Cardiac Intensive Care Unit of an urban academic medical center led by the unit nursing director and the hospital's nurse ethicist. The twice monthly case-based discussions, called "Nursing Practice and Ethics Rounds," were attended by staff and unit managers (nurse director, assistant nurse director, and clinical educator) and were facilitated by the nurse ethicist...
October 2017: Nursing Administration Quarterly
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