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https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#1
Ewan C Goligher, E Wesley Ely, Daniel P Sulmasy, Jan Bakker, John Raphael, Angelo E Volandes, Bhavesh M Patel, Kate Payne, Annmarie Hosie, Larry Churchill, Douglas B White, James Downar
OBJECTIVE: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. SYNTHESIS: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28078616/physician-power-to-declare-death-by-neurologic-criteria-threatened
#2
Ariane Lewis, Thaddeus Mason Pope
BACKGROUND: Three recent lawsuits that address declaration of brain death (BD) garnered significant media attention and threaten to limit physician power to declare BD. METHODS: We discuss these cases and their consequences including: the right to refuse an apnea test, accepted medical standards for declaration of BD, and the irreversibility of BD. RESULTS: These cases warrant discussion because they threaten to: limit physicians' power to determine death; incite families to seek injunctions to continue organ support after BD; and force hospitals to dispense valuable resources to dead patients in lieu of patients with reparable illnesses or injuries...
January 11, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28074587/after-the-dnr-surrogates-who-persist-in-requesting-cardiopulmonary-resuscitation
#3
Ellen M Robinson, Wendy Cadge, Angelika A Zollfrank, M Cornelia Cremens, Andrew M Courtwright
Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a set of clearly defined procedures for these decisions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28064252/philosophical-provocation-the-lifeblood-of-clinical-ethics
#4
Laurence B McCullough
The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation...
February 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28062651/an-activist-s-argument-that-participant-values-should-guide-risk-benefit-ratio-calculations-in-hiv-cure-research
#5
David Evans
The patient empowerment movement, spurred by AIDS activism in the 1980s, quickly evolved to encompass how study participants are considered and treated in clinical research. Initially, people fearing death of AIDS sought early access to experimental medications that had not undergone rigorous testing in hopes of extending their lives. Thirty years on, scientists are asking a different set of ethical questions about clinical research, this time in the pursuit of either a sterilising cure or long-term remission for HIV...
January 6, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28060431/the-social-value-of-knowledge-and-the-responsiveness-requirement-for-international-research
#6
Danielle M Wenner
Ethicists have long recognized that two necessary features of ethical research are scientific validity and social value. Yet despite a significant literature surrounding the validity component of this dictate, until recently there has been little attention paid to unpacking what the social value component might require. This article introduces a framework for assessing the social value of research, and in particular, for determining whether a given research program is likely to have significant social value of the kind necessary to fulfill the social value requirement...
February 2017: Bioethics
https://www.readbyqxmd.com/read/28043018/dynamic-axes-of-informed-consent-in-japan
#7
Laura Specker Sullivan
Scholarship in cross-cultural bioethics routinely frames Japanese informed consent in contrast to informed consent in North America. This contrastive analysis foregrounds cancer diagnosis disclosure and physician paternalism as unique aspects of Japanese informed consent that deviate from American practices. Drawing on in-depth interviews with 15 Japanese medical professionals obtained during fieldwork in Japan from 2013 to 15, this article complicates the informed consent discourse beyond East-West comparisons premised on Anglo-American ethical frameworks...
December 23, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/28042147/emergency-care-after-hours-comments-on-an-ethicist-s-remarks
#8
COMMENT
Bernard Vallée
No abstract text is available yet for this article.
January 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28007007/to-what-extent-do-risks-need-to-be-minimized
#9
Practical Ethicist
No abstract text is available yet for this article.
December 2016: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/28005252/the-biopolitics-of-lifestyle-foucault-ethics-and-healthy-choices-christopher-mayes-2016-routledge-oxford-and-new-york-978-1-138-93386-6-156-pp
#10
Andrew Cooper
Unlike many recent studies on the notion of lifestyle, Christopher Mayes' The Biopolitics of Lifestyle balances theoretical rigour with empirical investigation to problematize the use of lifestyle in public health strategies. Not only does Mayes' book expose the unjustified emphasis on individual autonomy undergirding neoliberal strategies of governance and contemporary ethical theory, it also marks a significant step forward in enhancing our understanding of one of Foucault's most underappreciated concepts, the dispositif...
December 22, 2016: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28001141/cases-from-the-cleveland-clinic-foundation-what-s-knowledge-got-to-do-with-it-ethics-epistemology-and-intractable-conflicts-in-the-medical-setting
#11
Bryan Kibbe, Paul J Ford
This article utilizes the case of Ms H. to examine the contrasting ways that surrogate decision makers move from simply hearing information about the patient to actually knowing and understanding the patient's medical condition. The focus of the case is on a family's request to actually see the patient's wounds instead of being told about the wounds, and the role of clinical ethicists in facilitating this request. We argue that clinical ethicists have an important role to play in the work of converting information into knowledge and that this can serve as a valuable way forward in the midst of seemingly intractable conflicts in the medical setting...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28001140/cultivating-administrative-support-for-a-clinical-ethics-consultation-service
#12
Courtney R Bruce, Mary A Majumder, Ashley Stephens, Janet Malek, Amy McGuire
Hospital administrators may lack familiarity with what clinical ethicists do (and do not do), and many clinical ethicists report receiving inadequate financial support for their clinical ethics consultation services (CECSs). Ethics consultation is distinct in that it is not reimbursable by third parties, and its financial benefit to the hospital may not be quantifiable. These peculiarities make it difficult for clinical ethicists to resort to tried-and-true outcome-centered evaluative strategies, like cost reduction or shortened length of stay for patients, to show a "need" for ethics consultation...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27999232/the-relationship-between-medical-ethics-and-the-legal-system-in-italy-food-for-thought
#13
Carlo Petrini, Walter Ricciardi
Relations between ethics in general - and medical ethics in particular - and legal systems are complex and have been extensively examined in the literature. The topic is important not only for ethicists and jurists, but also for members of the public, who benefit from the services offered by the professions. While the Italian Institute of Health does not claim to propose new avenues for exploration of the relations between ethics and legal systems, it offers some food for thought in the ongoing debate.
October 2016: Annali Dell'Istituto Superiore di Sanità
https://www.readbyqxmd.com/read/27965065/recurrent-themes-in-the-history-of-the-home-use-of-electrical-stimulation-transcranial-direct-current-stimulation-tdcs-and-the-medical-battery-1870-1920
#14
REVIEW
Anna Wexler
BACKGROUND: In recent years, neuroscientists and ethicists have warned of the dangers of the unsupervised home use of transcranial direct current stimulation (tDCS), in which individuals stimulate their own brains with low levels of electricity for self-improvement purposes. Although the home use of tDCS is often referred to as a novel phenomenon, in reality the late nineteenth and early twentieth century saw a proliferation of electrical stimulation devices for home use. In particular, the use of an object known as the medical battery bears a number of striking similarities to the modern-day use of tDCS...
November 29, 2016: Brain Stimulation
https://www.readbyqxmd.com/read/27934772/the-ethics-liaison-program-building-a-moral-community
#15
Sarah R Bates, Wendy J McHugh, Alexander R Carbo, Stephen F O'Neill, Lachlan Forrow
Ethicists often struggle to maintain institution-wide awareness of and commitment to medical ethics. At Beth Israel Deaconess Medical Center (BIDMC), we created the Ethics Liaison Program to address that challenge by making ethics part of the moral culture of the institution. Liaisons represent clinical and non-clinical areas throughout the medical centre. The liaison has a four-part role: to spread awareness and understanding of Ethics Programs among their coworkers; share information regarding ethical dilemmas in their work area with the members of the Ethics Support Service; review ethics activities and needs within their area; and undertake ethics-related projects...
December 1, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27924420/-austrian-guideline-for-palliative-sedation-therapy-long-version-results-of-a%C3%A2-delphi-process-of-the-austrian-palliative-society-opg
#16
Dietmar Weixler, Sophie Roider-Schur, Rudolf Likar, Claudia Bozzaro, Thomas Daniczek, Angelika Feichtner, Christoph Gabl, Bernhard Hammerl-Ferrari, Maria Kletecka-Pulker, Ulrich H J Körtner, Hilde Kössler, Johannes G Meran, Aurelia Miksovsky, Bettina Pusswald, Thomas Wienerroither, Herbert Watzke
BACKGROUND: Palliative sedation therapy (PST) is an important and ethically accepted therapy in the care of selected palliative care patients with otherwise unbearable suffering from refractory distress. PST is increasingly used in end-of-life care. Austria does not have a standardized ethical guideline for this exceptional practice near end of life, but there is evidence that practice varies throughout the country. OBJECTIVE: The Austrian Palliative Society (OPG) nominated a multidisciplinary working group of 16 palliative care experts and ethicists who established the national guideline on the basis of recent review work with the aim to adhere to the Europeans Association of Palliative Care's (EAPC) framework on palliative sedation therapy respecting Austrians legal, structural and cultural background...
December 6, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27884969/ethics-knowledge-of-recent-paediatric-residency-graduates-the-role-of-residency-ethics-curricula
#17
Jennifer C Kesselheim, Julie Najita, Debra Morley, Elizabeth Bair, Steven Joffe
OBJECTIVE: To evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency. METHODS: We conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006-2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010-2011...
December 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27815753/pediatric-ethics-and-communication-excellence-peace-rounds-decreasing-moral-distress-and-patient-length-of-stay-in-the-picu
#18
Lucia Wocial, Veda Ackerman, Brian Leland, Brian Benneyworth, Vinit Patel, Yan Tong, Mara Nitu
This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers' moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation...
November 4, 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/27801360/key-ethical-issues-discussed-at-cdc-sponsored-international-regional-meetings-to-explore-cultural-perspectives-and-contexts-on-pandemic-influenza-preparedness-and-response
#19
Aun Lor, James C Thomas, Drue H Barrett, Leonard W Ortmann, Dionisio J Herrera Guibert
BACKGROUND: Recognizing the importance of having a broad exploration of how cultural perspectives may shape thinking about ethical considerations, the Centers for Disease Control and Prevention (CDC) funded four regional meetings in Africa, Asia, Latin America, and the Eastern Mediterranean to explore these perspectives relevant to pandemic influenza preparedness and response. The meetings were attended by 168 health professionals, scientists, academics, ethicists, religious leaders, and other community members representing 40 countries in these regions...
May 17, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/27753056/prevention-and-screening-in-hereditary-breast-and-ovarian-cancer
#20
Simon B Zeichner, Christine Stanislaw, Jane L Meisel
In recent years, we have learned a great deal about pathogenic mutations that increase the risk of breast and ovarian cancer, particularly mutations in the BRCA1 and BRCA2 genes. Here we review current guidelines on breast and ovarian cancer screening, prophylactic surgery, and other risk-reduction strategies in patients with these mutations, and we detail the data that drive these recommendations. We also discuss guidelines on screening and management for other cancers associated with BRCA1 and BRCA2, such as male breast cancer, pancreatic cancer, and prostate cancer...
October 15, 2016: Oncology (Williston Park, NY)
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