Canadian Journal of Bioethics最新文献

{"title":"Récits de professeurs d’université à mi-carrière","authors":"Marie-Josée Drolet","doi":"10.2307/j.ctv28m3h84","DOIUrl":"https://doi.org/10.2307/j.ctv28m3h84","url":null,"abstract":"Résumé Abstract Ce texte propose un court compte rendu d’un livre publié par les Presses de l’Université du Québec intitulé : Récits de professeurs d’université à mi-carrière. Si c’était à refaire… Il porte aussi un regard critique de nature éthique sur son contenu. This text offers a short review of a book published by the Presses de l’Université du Québec entitled Récits de professeurs d’université à mi-carrière. Si c’était à refaire ... It also takes a critical look at its content from an ethical perspective.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42375997","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}

{"title":"Evaluating Knowledge, Practice, and Barriers to Informed Consent Among Professional and Staff Nurses in South Africa: An Empirical Study","authors":"S. Chima","doi":"10.7202/1089785ar","DOIUrl":"https://doi.org/10.7202/1089785ar","url":null,"abstract":"and Study. abstract Background: Informed consent (IC) is an ethical and legal obligation protected by constitutional rights to bodily integrity, well-being, and privacy in South Africa. The National Health Act 2003 codified IC regulations, requiring that all healthcare professionals inform patients about diagnosis, risks, benefits, options, and refusal rights while factoring in patients’ language and literacy levels. Objectives: This study’s primary aim was to determine the extent of South African professional/staff nurses’ compliance with current IC regulations and ascertain socio-cultural impediments impacting proper IC practice. Methods: A cross-sectional survey using semi-structured questionnaires was used to evaluate knowledge and practice of IC among nurses in KwaZulu-Natal province. Data were analyzed using SPSS, v.21. Descriptive statistics, chi-squared tests, and content analysis were used to compare nursing domains. Results: Three hundred fifty-five (355) nurses, 92% females, with 1 to 41 years of professional experience, completed this study. Information disclosed by nurses to patients included diagnosis (77%), treatment benefits (71%), risks (69%), recommendations (65%), risks of refusal (80%), and right of refusal (67%). Nurses (80%) felt information disclosure was adequate, while 85% reported that patients understood disclosed information. Conclusions: Nurses practicing in local public hospitals had moderate knowledge of IC regulations. Practical implementation appeared deficient. Barriers to IC included language, workload, time constraints, lack of interpreters, and skewed gender norms in the nursing profession. Nurses require continuing professional education in healthcare law and ethics, a “corps of trained interpreters”, and gender transformation in the nursing profession to improve IC practice and overall quality of healthcare service delivery in South Africa. Résumé Abstract Contexte : Le consentement éclairé (CE) est une obligation éthique et juridique protégée par les droits constitutionnels à l’intégrité corporelle, au bien-être et à la vie privée en Afrique du Sud. La loi nationale sur la santé de 2003 a codifié les règlements en matière de CE, exigeant que tous les professionnels de la santé informent les patients sur le diagnostic, les risques, les avantages, les options et les droits de refus, tout en tenant compte de la langue et du niveau d’alphabétisation des patients. Objectifs : L’objectif principal de cette étude était de déterminer le degré de conformité des infirmières professionnelles/du personnel infirmier sud-africain avec les réglementations actuelles en matière de CI et de vérifier les obstacles socioculturels ayant un impact sur la pratique correcte de la CE. Méthodes : Une enquête transversale utilisant des questionnaires semi-structurés a été utilisée pour évaluer les connaissances et la pratique de la CE parmi les infirmières de la province de KwaZulu-Natal. Les données ont été analysées à l’aide de SPS","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248629","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}

{"title":"Éthique de la recherche en période de pandémie et d’urgence sanitaire","authors":"Mathieu Bourhis","doi":"10.7202/1089797ar","DOIUrl":"https://doi.org/10.7202/1089797ar","url":null,"abstract":"Numerous ethical questions have emerged since mid-March 2020 in France as a result of the Covid-19 crisis. The research issues are tested and questioned despite the indisputable results since the year 2021. During this pandemic, the boundaries of research methodology have been broken and many treatments and vaccines have been promoted to patients and authorities without maximum scientific integrity. Between a scientific race on the side of physician-researchers and the methodology of the urgency to provide care, it is interesting to take to stock of the respect of research methodology and its pretests, its limits with regard to the emergency and the autonomy of research ethics.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248878","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}

{"title":"Repérer et combattre le capacitisme, le sanisme et le suicidisme en santé","authors":"Marie-Josée Drolet","doi":"10.7202/1094701ar","DOIUrl":"https://doi.org/10.7202/1094701ar","url":null,"abstract":"The purpose of this critical commentary is to define, explain and illustrate three systems of belief and oppression that are generally not well known in the health field, but that are likely to have a negative influence on the practices of health and social service professionals as well as those of public or private health organizations, namely: ableism, sanism and suicidism. It also aims to identify certain courses of action that could help combat these systems, which are widespread in the institutions and organizations of our contemporary Western societies.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71255721","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}

{"title":"Ethical Aspects of the Guidelines for Medical Education for Students in their Clerkship Year at the Schulich School of Medicine and Dentistry During the COVID-19 Pandemic","authors":"Christine M. Gignac, Hazel J. Markwell","doi":"10.7202/1094694ar","DOIUrl":"https://doi.org/10.7202/1094694ar","url":null,"abstract":"Guidelines for clerkship training at one Canadian medical school - Western University's Schulich School of Medicine and Dentistry - did not state the ethical principles associated with the decision to suspend and eventually resume clinical training during the COVID-19 pandemic. The absence of stated ethical principles was notable considering the impact these decisions had on various stakeholders, and since ethics plays a large role in the practice of medicine. This study assessed these guidelines using an ethical lens approach to identify ethical principles and tensions implicit in the guidelines. Clerkship is defined as the third year of training at this medical school, which consists of clinical rotations. While ethical principles were not documented, it was hypothesized that these could be identified within the guidelines. A literature search was conducted, which yielded a gap in knowledge concerning ethical considerations of clerkship clinical training. The guidelines were analyzed and ethical principles and tensions between conflicting principles were identified. The most prevalent principles were beneficence and non-maleficence. It is recommended that in the future, the ethical principles associated with guidelines responding to significant issues affecting undergraduate medical education be stated, in order to increase transparency to all parties involved, enhance communication with students, and to serve as an example of how ethics is applied in a medical education setting. One limitation of this study was the use of internal guideline documents, which were circulated internally but are not published.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71255887","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}

{"title":"L’accès aux soins palliatifs, équitable pour tous ? Le cas des personnes en fin de vie vivant l’itinérance","authors":"Marie-Hélène Marchand","doi":"10.7202/1094695ar","DOIUrl":"https://doi.org/10.7202/1094695ar","url":null,"abstract":"Résumé Abstract Tout être humain sera exposé un jour à un certain degré de souffrance. Une tranche de la population, les personnes vivant l’itinérance, sera cependant beaucoup plus susceptible de côtoyer la mort, la maladie et les deuils. En effet, au Québec, elles sont quatre fois plus à risque de développer un cancer et leur espérance de vie se situe entre 42 et 52 ans. Devant la mortalité et la morbidité élevées rencontrées dans la population itinérante est soulevée cette question : est-ce que ces individus ont un accès équitable aux ressources en soins palliatifs? L’arrivée de la Loi 2 en 2015 a permis d’encadrer les soins de fin de vie au Québec. Au cœur de cette loi se trouve le droit des malades en fin de vie d’avoir accès à des soins palliatifs pour prévenir et apaiser leurs souffrances. Or, plusieurs enjeux viennent influencer l’accessibilité aux soins palliatifs pour la population itinérante, notamment des facteurs individuels tels que la maladie mentale et la dépendance aux substances, compliquant la recherche de soins. La méfiance des individus ayant vécu de multiples expériences traumatiques ajoute une barrière supplémentaire. De plus, trop occupées à survivre, ces personnes naviguent difficilement dans le système de santé. Des facteurs structuraux, tels l’absence de logements abordables ou les répercussions d’un système en silos moins adapté aux situations sociales complexes contribuent au manque d’accessibilité. Les préjugés sont très répandus, participant à l’exclusion symbolique et institutionnelle de cette population. L’objectif de cet article sera donc d’approfondir notre compréhension des enjeux d’accès aux soins palliatifs pour la population en situation d’itinérance au Québec. Every human being will at some point be exposed to some degree of suffering. One segment of the population, people experiencing homelessness, will be much more likely to experience death, illness and bereavement. In Quebec, they are four times more likely to develop cancer and their life expectancy is between 42 and 52 years. The high mortality and morbidity of the homeless population raises the following question: do these individuals have equitable access to palliative care resources? The arrival of Bill 2 in 2015, allowed for the regulation of end-of- life care in Quebec. At the heart of this law is the right of patients at the end of life to have access to palliative care to prevent and ease their suffering. Several issues influence the accessibility of palliative care for the homeless population. Individual factors such as mental illness and substance abuse complicate access to care. The distrust of individuals with multiple traumatic experiences adds another barrier. In addition, these individuals are too busy surviving to navigate the health care system. Structural factors, such as the lack of affordable housing or the impact of a siloed system less suited to complex social situations, contribute to a lack of accessibility. Prejudice is widespre","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71256026","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}

{"title":"Licit Substance Use in Physical Rehabilitation Settings","authors":"Brynne McArthur, A. Campbell, A. Bianchi","doi":"10.7202/1089791ar","DOIUrl":"https://doi.org/10.7202/1089791ar","url":null,"abstract":"The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces. Résumé Abstract L’objectif de ce commentaire est d’examiner les circonstances dans lesquelles il peut être éthique de permettre aux patients de consommer des substances licites dans des contextes de réadaptation. Bien que le contenu de ce commentaire puisse être transposé à d’autres espaces de soins de santé, l’accent mis sur la réadaptation est fondé sur certaines distinctions importantes qui existent entre la réadaptation et les espaces de soins aigus. The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces. to an inpatient unit at a physical rehabilitation centre. As part of Courtney ’ s rehabilitation, her clinical team recommends a number of therapies, and she consents to all recommendations. Courtney has a good support network of friends who visit frequently and take her outside for fresh air. On one occasion, a clinician sees Courtney with her friends. The group appears to be drinking alcohol and smoking cannabis. Although both alcohol and cannabis are legal substances in this rehabilitation centre ’ s jurisdiction, the centre does not permit patients to use substances during their inpatient journey regardless of whether they are legal or consumed off-property. The clinical team approaches Courtney after being informed of the staff member’s observations, and in response to the team ’ s queries, Courtney states that alcohol and cannabis are a regular part of social activities with friends. She communicates good knowledge of the risks and knows where to seek support if ever needed. Courtney also expresses frustration upon learning of the rehabilitation centre ’ s position/prohibition of patients consuming these legal substances, especially since she will consume them post-discharge.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248725","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}

{"title":"Comment répartir les ressources en période de pandémie ? Quelle justice ?","authors":"Eloïse Ledolledec, Raphaël Kermaïdic","doi":"10.7202/1089794ar","DOIUrl":"https://doi.org/10.7202/1089794ar","url":null,"abstract":"If the question of the fair distribution of resources has been faced by societies since antiquity, the question of the fair distribution of medical resources takes on a whole new dimension in the context of the current global pandemic. This round table attempts to analyze and understand how to reconcile the principles of distributive justice in conditions of limited resources. It opens up a broader reflection on the fundamental difference between ethical or political decision making at the patient level and at the macroscopic level. Finally, a discussion guides us to reflect on the autonomy of patients and the legitimacy of resuscitation ??? for those who do not wish to continue living ??? on the value of ???saving at all costs??? and the place of triage in the practice of medicine.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248794","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}

{"title":"Learning Logs: Reflective Writing and Metacognition in Bioethics Courses","authors":"Marila Lázaro, Camila López-Echagüe, Fiorella Gago","doi":"10.7202/1094699ar","DOIUrl":"https://doi.org/10.7202/1094699ar","url":null,"abstract":"Résumé Abstract La valeur que la bioéthique a ajoutée au discours entre la science et les sciences humaines est indispensable","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71255648","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}

{"title":"The Benefits of Informed Non-Dissent when Families have Difficulty Making a Decision","authors":"Mila Nortje, Sajid Haque, N. Nortjé","doi":"10.7202/1094702ar","DOIUrl":"https://doi.org/10.7202/1094702ar","url":null,"abstract":"The","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71255772","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}