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Ethics in Psychiatry

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199 papers 100 to 500 followers Articles highlighting ethical issues (and other interesting stuff). Worth reflecting on, discussing...
The Lancet
No abstract text is available yet for this article.
January 27, 2018: Lancet
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...
January 29, 2018: Social Science & Medicine
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
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
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
Theodore T Lee, Gregory D Curfman
To provide the highest-quality medical care, physicians must be able to communicate openly with their patients and provide advice in conformance with professional standards of care. Although states have the power to regulate many aspects of medical practice, laws that interfere with speech by preventing physicians from discussing specific subjects with patients are constitutionally suspect. In 2017, the US Court of Appeals for the Eleventh Circuit struck down key provisions of a Florida law that prohibited physicians from speaking with their patients about firearm safety as a violation of the First Amendment...
August 1, 2017: JAMA Internal Medicine
Timothy E Quill, Linda Ganzini, Robert D Truog, Thaddeus Mason Pope
Patients with advanced illnesses sometimes request that physicians help hasten their death. Increasingly in North America and Europe, legal options allow physicians to perform this role. Among death-hastening options, the spotlight has been on physician-assisted death. However, voluntarily stopping eating and drinking (VSED) is also a course that patients may choose. Although VSED theoretically does not require physician involvement, clinician participation is critical in terms of initial assessment and ongoing management...
November 6, 2017: JAMA Internal Medicine
Maria Chiu
There is strong evidence of ethnic disparities in chronic medical conditions, such as diabetes and cardiovascular diseases; however, less is known about ethnic differences in mental illness and health service utilization. Previous studies have shown that Asians are more likely to avoid or delay seeking help for their mental illness. We conducted a population-based study using Ontario health administrative data to examine ethnic differences in mental illness severity at hospital presentation. We found that Chinese and South Asian psychiatric patients were significantly more likely to be involuntarily admitted and exhibited more aggressive behaviours and psychotic symptoms compared to the general population...
2017: Healthcare Quarterly
Dennis McCarty
No abstract text is available yet for this article.
January 1, 2018: American Journal of Psychiatry
Aaron J Kivisto
OBJECTIVE: This study presents data on the relative contribution to gun violence by people with a history of inpatient psychiatric treatment and on federal efforts to deter presumptively dangerous persons from obtaining firearms, information useful for analyzing the potential public health benefits of gun policies targeting people with serious mental illness. The study also estimates the reduction in gun violence victims that would be expected if individuals with a previous psychiatric hospitalization were prohibited from purchasing firearms...
October 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
Paul S Appelbaum
Physicians increasingly have recognized the importance of asking patients whether they own firearms and suggesting safe means of storage. Florida's legislature perceived these questions as threats to patients' rights to keep guns and passed a law restricting physicians from making such inquiries. When a number of physicians and their organizations challenged the law in 2011, a six-year odyssey through the courts ensued. In the end, the U.S. 11th Circuit Court of Appeals struck down the statute, recognizing that physicians' free speech rights extend to communications with patients, a decision that may influence other attempts to restrict clinicians' speech...
July 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
Deanna L Kelly, Oliver Freudenreich, MacKenzie A Sayer, Raymond C Love
Although clozapine has demonstrated unique efficacy for the treatment of seriously ill patients with refractory psychosis, its real-world use presents challenges to clinicians in a variety of settings, leading to its underutilization in the United States. The barriers include a lack of prescriber knowledge and confidence, negative prescriber attitudes, special monitoring requirements, administrative burden, unprepared health systems, and inadequate appreciation of clozapine's unique nature by policy makers and payers...
October 16, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
Reidun Norvoll, Marit Helene Hem, Hilde Lindemann
Coercion in mental healthcare does not only affect the patient, but also the patient's families. Using data from interviews with 36 family members of adult and adolescent people with mental health problems and coercion experiences, the present narrative study explores family members' existential and moral dilemmas regarding coercion and the factors influencing these dilemmas. Four major themes are identified: the ambiguity of coercion; struggling to stay connected and establishing collaboration; worries and distress regarding compulsory care; and dilemmas regarding initiating coercion...
January 1, 2018: Qualitative Health Research
Paula Rowland, Arno K Kumagai
The role of the patient in bedside teaching has long been a matter of consideration in health professions education. Recent iterations of patient engagement include patients as storytellers, members of curriculum planning committees, guest lecturers, and health mentors. While these forms of patient engagement are reported to have many benefits for learners, educators, and the patients themselves, there is concern that such programs may not be representative of the diversity of patients that health care professionals will encounter throughout their careers...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Martin P Paulus
No abstract text is available yet for this article.
December 1, 2017: JAMA Psychiatry
Rebecca L Haffajee, Michelle M Mello
The opioid epidemic has claimed more than 300,000 lives in the United States since 2000 and could claim another half million over the next decade. Although heroin and illicitly manufactured fentanyl account for an increasing proportion of opioid-involved overdoses, the majority of persons with..
December 14, 2017: New England Journal of Medicine
Rinad S Beidas, Emily M Becker-Haimes, Danielle R Adams, Laura Skriner, Rebecca E Stewart, Courtney Benjamin Wolk, Alison M Buttenheim, Nathaniel J Williams, Patricia Inacker, Elizabeth Richey, Steven C Marcus
BACKGROUND: Informed by our prior work indicating that therapists do not feel recognized or rewarded for implementation of evidence-based practices, we tested the feasibility and acceptability of two incentive-based implementation strategies that seek to improve therapist adherence to cognitive-behavioral therapy for youth, an evidence-based practice. METHODS: This study was conducted over 6 weeks in two community mental health agencies with therapists (n = 11) and leaders (n = 4)...
December 15, 2017: Implementation Science: IS
Jeffrey A Lieberman, Anke A Ehrhardt, H Blair Simpson, Melissa R Arbuckle, Abby J Fyer, Susan M Essock
No abstract text is available yet for this article.
November 6, 2017: Academic Psychiatry
Jan-Willem Weenink, Rudolf B Kool, Ronald H Bartels, Gert P Westert
OBJECTIVE: To provide an overview of the evidence regarding outcomes of remediation and rehabilitation programmes for healthcare professionals with performance concerns, and to explore if outcomes differ for specific concerns and professions. METHODS: A search in four databases (Medline, Embase, PsycINFO and CINAHL) was conducted from 1 January 1990 to 7 May 2017. Studies reporting on outcomes of nationwide and state-wide programmes aimed at remediation and rehabilitating healthcare professionals with performance concerns (ie, dentists, midwives, nurses, pharmacists, physicians, physiotherapists, psychologists and psychotherapists) were included...
December 2017: BMJ Quality & Safety
Carlos Aguilera-Serrano, Jose Guzman-Parra, Juan A Garcia-Sanchez, Berta Moreno-Küstner, Fermin Mayoral-Cleries
OBJECTIVE: This systematic review presents evidence regarding factors that may influence the patient's subjective experience of an episode of mechanical restraint, seclusion, or forced administration of medication. METHOD: Two authors searched CINAHL, PubMed, SCOPUS, Web of Science, and Psych-Info, considering published studies between 1 January 1992 and 1 February 2016. Based on the inclusion criteria and methodological quality, 34 studies were selected, reporting a total sample of 1,869 participants...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
2017-10-29 12:48:48
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