Canadian Journal of Bioethics最新文献

The Hidden Realities of Discrimination from Patients: A Scoping Review of Healthcare Workers’ Experiences 患者歧视的隐藏现实：对医护人员经验的范围审查

Canadian Journal of Bioethics Pub Date : 2025-01-01 DOI: 10.7202/1117871ar

Claudia Barned, Akosua Nwafor, Melanie Anderson

{"title":"The Hidden Realities of Discrimination from Patients: A Scoping Review of Healthcare Workers’ Experiences","authors":"Claudia Barned, Akosua Nwafor, Melanie Anderson","doi":"10.7202/1117871ar","DOIUrl":"https://doi.org/10.7202/1117871ar","url":null,"abstract":"Discrimination in healthcare settings is a burgeoning area of applied inquiry and intervention. Existing research has focused on the experiences of patients as the targets of discrimination with less attention paid to patients as the source of discrimination. The main objective of this scoping review is to identify, explore and map the literature on the experiences of healthcare workers (HCWs) as targets of discrimination from patients and/or their family members. A scoping review of articles indexed in Ovid Medline, Ovid Embase, Ovid Emcare, and Web of Science Core Collection was conducted between March 2022 and June 2023. The results were summarized, coded and thematically categorized according to the aim. The review identified 173 articles that highlighted various forms of discrimination manifesting in a multitude of ways, including requests for, and refusals of specific HCWs based on social identity markers. The results suggest that there are significant barriers that prevent HCWs from reporting and responding to these incidents in efficient ways, resulting in an array of negative psychological ramifications. This review highlights core areas in need of greater attention in order to better support HCWs during challenging interactions with discriminatory patients. Institutional recommendations aimed at research and education efforts, learner experiences, policy writing, documenting and reporting, institutional culture, resources and support as well as the role of professional bodies, were identified. Evidence-informed work is needed in this area to ensure that policy-level changes are informed by the lived experiences of those enduring these incidents.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"8 1-2","pages":"74-106"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.erudit.org/fr/revues/bioethics/2025-v8-n1-2-bioethics010012/1117871ar.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147910766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Developing a New Clinical Ethics Framework for Rehab: A Pre-Implementation Evaluation from the Perspective of Future Users 构建康复临床伦理新框架:基于未来使用者视角的实施前评价

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1098555ar

L. Leblanc, S. Ménard, C. Maïano, Louis Perron, Catherine Baril, Nicole Ouellette-Hughes

引用次数: 0

Frameworks and Practices in Bioethics 生物伦理学的框架和实践

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1098562ar

J. Dwyer

引用次数: 0

Operationalizing Equity in Surgical Prioritization 手术优先顺序的操作公平性

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1101124ar

Kayla Wiebe, Simon Kelley, Annie Fecteau, Mark Levine, Iram Blajchman, Randi Zlotnik Shaul, Roxanne Kirsch

{"title":"Operationalizing Equity in Surgical Prioritization","authors":"Kayla Wiebe, Simon Kelley, Annie Fecteau, Mark Levine, Iram Blajchman, Randi Zlotnik Shaul, Roxanne Kirsch","doi":"10.7202/1101124ar","DOIUrl":"https://doi.org/10.7202/1101124ar","url":null,"abstract":"The allocation of critical care resources and triaging patients garnered a great deal of attention during the COVID-19 pandemic, but there is a paucity of guidance regarding the ethical aspects of resource allocation and patient prioritization in ‘normal’ circumstances for Canadian healthcare systems. One context where allocation and prioritization decisions are required are surgical waitlists, which have been globally exacerbated due to the COVID-19 pandemic. In this paper, we detail the process used to develop an ethics framework to support prioritization for elective surgery at The Hospital for Sick Children, Toronto, a tertiary pediatric hospital. Our goal was to provide guidance for the more value-laden aspects of prioritization, particularly when clinical urgency alone is insufficient to dictate priority. With this goal in mind, we worked to capture familial, relational, and equity considerations. As part of our institution’s concerted efforts to ethically and effectively address our surgical backlog, an ethics working group was formed comprising clinicians from surgery, anesthesiology, intensive care, a hospital bioethicist, a parent advisor, and an academic bioethics researcher. A reflective equilibrium process was used to develop an ethics framework. To this end, the same methodology was used to create a support for patient prioritization that identifies clinically and morally relevant factors for prioritization among medically similar surgical cases, with a substantive goal being to identify and redress health inequities in surgical prioritization, inasmuch as this is possible. While further steps are needed to validate several aspects of the framework, our research suggests that an ethics framework grounded in the practical realities of hospital operations provides consistency, transparency, and needed support for decisions that are often left to individual clinicians, as well as an opportunity to reflect upon the presence of health inequities in all domains of healthcare delivery.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135733897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

La collégialité dans la mise en place d’une sédation profonde et continue dans un centre de cancérologie en France 在法国的一个癌症中心实施深度和持续镇静的合作

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1101131ar

Bettina Couderc, Alfonsina Faya Robles, Nathalie Caunes-Hilary, Laurie Galiby, Emmanuelle Rial Sebbag

{"title":"La collégialité dans la mise en place d’une sédation profonde et continue dans un centre de cancérologie en France","authors":"Bettina Couderc, Alfonsina Faya Robles, Nathalie Caunes-Hilary, Laurie Galiby, Emmanuelle Rial Sebbag","doi":"10.7202/1101131ar","DOIUrl":"https://doi.org/10.7202/1101131ar","url":null,"abstract":"Une procédure collégiale désigne le fait de recueillir, avant de prendre une décision médicale délicate, l’avis de l’ensemble de l’équipe de soins responsable du patient, incluant le personnel infirmier et aide-soignant, entre autres. La loi Claeys-Leonetti relative à la fin de vie (2016) l’inscrit dans le droit français comme étant obligatoire lors de la mise en place d’une sédation profonde et continue maintenue jusqu’au décès (SPCMD). L’objectif de l’étude est de faire un état des lieux de la connaissance de cet aspect de loi par le personnel soignant d’un institut de cancérologie et d’identifier comment la collégialité se met en place pour une décision de SPCMD selon les services. Nous avons proposé un questionnaire en ligne et anonyme à l’ensemble des acteurs du soin (connaissance de la loi Claeys-Leonetti) puis nous avons rencontré les soignants des différents services en groupes de discussion (cadres, personnel infirmier et aides-soignants) ou en entretiens individuels (médecins). Les résultats montrent que la loi est mieux connue, toutes professions confondues, des jeunes soignants (moins de 5 ans d’expérience) et surtout mieux revendiquée par les infirmières et aides-soignantes que par les médecins. Nous rapportons la diversité de la mise en oeuvre de la collégialité pour une décision de sédation, en termes de formalisation, de standardisation et d’inter professionnalisation. Nous concluons que la mise en place de la collégialité de façon anticipée pour une décision élargit les modes de communication pluri/inter professionnelle et permet d’apaiser la souffrance des patients, des médecins et des soignants.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135733899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Where Do I Go to Wait? Ethical Considerations During the 90 Day Reflection Period for MAiD 我该去哪里等?女佣90天反思期的道德考量

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1098559ar

Kesi Disha, Andria Bianchi, R. Shanker, Nikolija Lukich

引用次数: 0

An Ethics Journey: From Kant to Assisted Suicide 伦理之旅:从康德到协助自杀

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1098567ar

Michael S. Gordon

引用次数: 0

Respect for Patient Confidentiality Must Not Be Dependent Upon a Fee: The Case of Adolescents’ Access to Contraceptives in Ontario 对病人保密的尊重不能依赖于费用:青少年在安大略省获得避孕药具的情况

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1098569ar

J. Brisson

引用次数: 0

Collecting Race-Based Data in Health Research: A Critical Analysis of the Ongoing Challenges and Next Steps for Canada 在卫生研究中收集基于种族的数据:对加拿大目前面临的挑战和今后步骤的批判性分析

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1098560ar

F. Sheikh, A. Fox-Robichaud, Lisa Schwartz

{"title":"Collecting Race-Based Data in Health Research: A Critical Analysis of the Ongoing Challenges and Next Steps for Canada","authors":"F. Sheikh, A. Fox-Robichaud, Lisa Schwartz","doi":"10.7202/1098560ar","DOIUrl":"https://doi.org/10.7202/1098560ar","url":null,"abstract":"The COVID-19 pandemic has had a global effect. The disproportionate impact on Indigenous peoples and racialized groups has brought ethical challenges to the forefront in research and clinical practice. In Canada, the Tri-Council Policy Statement (TCPS2), and specifically the principle of justice, emphasizes additional care for individuals \"whose circumstances make them vulnerable\", including Indigenous and racialized communities. In the absence of race-based data to measure and inform health research and clinical practice, we run the risk of causing more harm and contributing to ongoing injustices. However, without an accepted framework for collecting, maintaining, and reporting race-based data in Canada, more guidance is needed on how to do this well. Importantly, a framework for collecting race-based data should build on existing guidance from Indigenous and other structurally marginalized communities, the TCPS2, recommendations from the World Health Organization, and involve relevant stakeholders. In this paper, we describe historical examples of unethical studies on Indigenous and racialized groups, discuss the challenges and potential benefits of collecting race-based data, and conclude with objectives for a pan-Canadian framework to inform how race-based data is collected, stored, and accessed in health research.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71265660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Invisibility of the Asian American Identity in North American Bioethics 北美生命伦理学中亚裔美国人身份的隐蔽性

Canadian Journal of Bioethics Pub Date : 2023-01-01 DOI: 10.7202/1098568ar

Katherine Huerne

引用次数: 0