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Ethics in Psychiatry

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214 papers 100 to 500 followers Articles highlighting ethical issues (and other interesting stuff). Worth reflecting on, discussing...
https://www.readbyqxmd.com/read/29871682/the-significance-of-ethics-reflection-groups-in-mental-health-care-a-focus-group-study-among-health-care-professionals
#1
Marit Helene Hem, Bert Molewijk, Elisabeth Gjerberg, Lillian Lillemoen, Reidar Pedersen
BACKGROUND: Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. METHODS: In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive...
June 5, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29760032/white-privilege-in-a-white-coat-how-racism-shaped-my-medical-education
#2
Max J Romano
In this essay, I reflect on some of the ways racial privilege influenced my experience as a white physician in training. While white Americans often think of "racism" as a social construct primarily affecting people of color, "racism" is a system of both racial disadvantage as well as reciprocal racial advantage. Medical professionals are increasingly aware of how social determinants of health lead to important health disparities, however white physicians seldom ask how their own racial privilege reinforces a white supremacist culture and what effects this may have on our patients' health...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29745363/application-of-n-of-1-treatment-trials-in-schizophrenia-systematic-review
#3
Katie F M Marwick, Anna J Stevenson, Caitlin Davies, Stephen M Lawrie
BACKGROUND: Single patient or 'n-of-1' trials are a pragmatic method to achieve optimal, evidence-based treatments for individual patients. Such trials could be particularly valuable in chronic, heterogeneous, difficult to treat illnesses such as schizophrenia.AimsTo identify how often, and in what way, n-of-1 trials have been used in schizophrenia. METHOD: We performed a systematic search in the major electronic databases for studies adopting n-of-1 methodology in schizophrenia, published in English from the start of records until the end of January 2017...
May 10, 2018: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/29614866/coercion-in-outpatients-under-community-treatment-orders-a-matched-comparison-study
#4
Arash Nakhost, Frank Sirotich, Katherine M Francombe Pridham, Vicky Stergiopoulos, Alexander I F Simpson
OBJECTIVE: Since the deinstitutionalization of psychiatric services around the world, the scope of outpatient psychiatric care has also increased to better support treatment access and adherence. For those with serious mental illness who may lack insight into their own illness, available interventions include coercive community practices such as mandated community treatment orders (CTOs). This paper examines the perceptions of coercion among service users treated with a CTO. METHOD: We used a cross-sectional comparative design where service users treated under a CTO were matched to a comparison group of voluntary psychiatric outpatients...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29635929/-for-their-own-good-a-response-to-popular-arguments-against-permitting-medical-assistance-in-dying-maid-where-mental-illness-is-the-sole-underlying-condition
#5
Justine Dembo, Udo Schuklenk, Jonathan Reggler
Canada is approaching its federal government's review of whether patients should be eligible for medical assistance in dying (MAID) where mental illness is the sole underlying medical condition, and when "natural death" is not "reasonably foreseeable". For those opposed, arguments involve the following themes: capacity, value of life, vulnerability, stigma, irremediability, and the role of physicians. It has also been suggested that those who are able-bodied should have to kill themselves, even though suicide may be painful, lonely, and violent...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29528031/how-do-doctors-deliver-a-diagnosis-of-dementia-in-memory-clinics
#6
Jemima Dooley, Nick Bass, Rose McCabe
BACKGROUND: Dementia diagnosis rates are increasing. Guidelines recommend that people with dementia should be told their diagnosis clearly and honestly to facilitate future planning. Aims To analyse how doctors deliver a dementia diagnosis in practice. METHOD: Conversation analysis was conducted on 81 video-recorded diagnosis feedback meetings with 20 doctors from nine UK memory clinics. RESULTS: All doctors named dementia; 59% (n = 48) approached the diagnosis indirectly but delicately ('this is dementia') and 41% (n = 33) approached this directly but bluntly ('you have Alzheimer's disease')...
April 2018: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/29513631/media-guidelines-for-reporting-on-suicide-2017-update-of-the-canadian-psychiatric-association-policy-paper
#7
Mark Sinyor, Ayal Schaffer, Marnin J Heisel, André Picard, Gavin Adamson, Christian P Cheung, Laurence Y Katz, Rakesh Jetly, Jitender Sareen
This paper has been substantially revised by the Canadian Psychiatric Association's Research Committee and approved for republication by the CPA's Board of Directors on May 3, 2017. The original policy paper1 was developed by the Scientific and Research Affairs Standing Committee and approved by the Board of Directors on November 10, 2008.
March 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/27254842/the-vulnerability-of-psychiatric-research-participants-why-this-research-ethics-concept-needs-to-be-revisited
#8
REVIEW
Dearbhail Bracken-Roche, Emily Bell, Eric Racine
No abstract text is available yet for this article.
June 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29504203/the-effect-of-medicaid-on-management-of-depression-evidence-from-the-oregon-health-insurance-experiment
#9
Katherine Baicker, Heidi L Allen, Bill J Wright, Sarah L Taubman, Amy N Finkelstein
Policy Points: We take advantage of Oregon's Medicaid lottery to gauge the causal effects of Medicaid coverage on mental health care, how effectively it addresses unmet needs, and how those effects differ for those with and without a history of depression. Medicaid coverage reduced the prevalence of undiagnosed depression by almost 50% and untreated depression by more than 60%. It increased use of medications and reduced the share of respondents reporting unmet mental health care needs by almost 40%. There are likely to be substantial mental health consequences of policy decisions about Medicaid coverage for vulnerable populations...
March 2018: Milbank Quarterly
https://www.readbyqxmd.com/read/29486013/gabapentin-approvals-off-label-use-and-lessons-for-postmarketing-evaluation-efforts
#10
EDITORIAL
Joshua D Wallach, Joseph S Ross
No abstract text is available yet for this article.
February 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29493411/implicit-bias-and-mental-health-professionals-priorities-and-directions-for-research
#11
Yesenia Merino, Leslie Adams, William J Hall
This Open Forum explores the role of implicit bias along the mental health care continuum, which may contribute to mental health disparities among vulnerable populations. Emerging research shows that implicit bias is prevalent among service providers. These negative or stigmatizing attitudes toward population groups are held at a subconscious level and are automatically activated during practitioner-client encounters. The authors provide examples of how implicit bias may impede access to care, clinical screening and diagnosis, treatment processes, and crisis response...
March 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29285536/language-science-and-politics-the-politicization-of-public-health
#12
Lawrence O Gostin
No abstract text is available yet for this article.
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28249596/implicit-bias-in-healthcare-professionals-a-systematic-review
#13
REVIEW
Chloë FitzGerald, Samia Hurst
BACKGROUND: Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. METHODS: PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria...
March 1, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/23576243/physicians-and-implicit-bias-how-doctors-may-unwittingly-perpetuate-health-care-disparities
#14
REVIEW
Elizabeth N Chapman, Anna Kaatz, Molly Carnes
Although the medical profession strives for equal treatment of all patients, disparities in health care are prevalent. Cultural stereotypes may not be consciously endorsed, but their mere existence influences how information about an individual is processed and leads to unintended biases in decision-making, so called "implicit bias". All of society is susceptible to these biases, including physicians. Research suggests that implicit bias may contribute to health care disparities by shaping physician behavior and producing differences in medical treatment along the lines of race, ethnicity, gender or other characteristics...
November 2013: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29444880/cdc-tightens-controls-on-scientists-communication-with-news-media
#15
Peter Doshi
No abstract text is available yet for this article.
February 14, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29413032/institutional-and-coercive-mental-health-treatment-in-europe
#16
EDITORIAL
The Lancet
No abstract text is available yet for this article.
January 27, 2018: Lancet
https://www.readbyqxmd.com/read/29421458/a-systematic-review-of-the-methodological-and-practical-challenges-of-undertaking-randomised-controlled-trials-with-cognitive-disability-populations
#17
REVIEW
Peter Mulhall, Laurence Taggart, Vivien Coates, Toni McAloon, Angela Hassiotis
Approximately 10% of the world's population have a cognitive disability. Cognitive disabilities can have a profound impact on a person's social, cognitive or mental functioning, requiring high levels of costly health and social support. Therefore, it is imperative that interventions and services received are based upon a sound evidence-base. For many interventions for this population, this evidence-base does not yet exist and there is a need for more Randomised Controlled Trials (RCTs). The process of conducting RCTs with disabled populations is fraught with methodological challenges...
March 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/28784729/small-cash-incentives-can-encourage-primary-care-visits-by-low-income-people-with-new-health-care-coverage
#18
Cathy J Bradley, David Neumark
In a randomized controlled trial, we studied low-income adults newly covered by a primary care program to determine whether a cash incentive could encourage them to make an initial visit to a primary care provider. Subjects were randomly assigned to one of four groups: three groups whose members received $10 to complete a baseline survey during an interview and who were randomized to incentives of $50, $25, or $0 to visit their assigned primary care provider within six months after enrolling in the study; and a nonincentivized control group not contacted by the research team...
August 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/29385960/understanding-mental-illness-stigma-toward-persons-with-multiple-stigmatized-conditions-implications-of-intersectionality-theory
#19
Nathalie Oexle, Patrick W Corrigan
People with mental illness are often members of multiple stigmatized social groups. Therefore, experienced disadvantage might not be determined solely by mental illness stigma. Nevertheless, most available research does not consider the effects and implications of membership in multiple stigmatized social groups among people with mental illness. Reflecting on intersectionality theory, the authors discuss two intersectional effects determining disadvantage among people with mental illness who are members of multiple stigmatized social groups, namely double disadvantage and prominence...
February 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29371211/research-ethics-for-emerging-trial-designs-does-equipoise-need-to-adapt
#20
Spencer Phillips Hey, Charles Weijer, Monica Taljaard, Aaron S Kesselheim
No abstract text is available yet for this article.
January 25, 2018: BMJ: British Medical Journal
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