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AMA journal of ethics最新文献

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How Should Focus Be Shifted From Individual Preference to Collective Wisdom for Patients at the End of Life With Antimicrobial-Resistant Infections? 对于抗菌药物耐药性感染的生命末期患者，应如何将关注点从个人偏好转移到集体智慧？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.486
Jeannie P Cimiotti, Kimberly Adams Tufts, Lucia D Wocial, Elizabeth Peter
{"title":"How Should Focus Be Shifted From Individual Preference to Collective Wisdom for Patients at the End of Life With Antimicrobial-Resistant Infections?","authors":"Jeannie P Cimiotti, Kimberly Adams Tufts, Lucia D Wocial, Elizabeth Peter","doi":"10.1001/amajethics.2024.486","DOIUrl":"https://doi.org/10.1001/amajethics.2024.486","url":null,"abstract":"<p><p>Despite growth in numbers of organizational antimicrobial stewardship programs, antimicrobial resistance continues to escalate. Interprofessional education and collaboration are needed to make these programs appropriately responsive to the ethically and clinically complex needs of patients at the end of life whose care plans still require antimicrobial management.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E486-493"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248591","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
How to Mitigate Community Harms of Antibacterial Resistance With Patient-Centered Care. 如何通过以患者为中心的护理减轻抗菌药耐药性对社区造成的危害？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.494
Chelsea Modlin
{"title":"How to Mitigate Community Harms of Antibacterial Resistance With Patient-Centered Care.","authors":"Chelsea Modlin","doi":"10.1001/amajethics.2024.494","DOIUrl":"https://doi.org/10.1001/amajethics.2024.494","url":null,"abstract":"<p><p>Overprescription of antibiotics in cases in which bacterial infection is clinically uncertain contributes to increased prevalence of multidrug-resistant bacteria. Ethically, merits and drawbacks of stricter prescription practice oversight should be weighed against risks of untreatable bacterial infections to patients and communities. This article considers how to balance this set of ideas and values.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E494-501"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248612","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
What Does Disability Justice Require of Antimicrobial Stewardship? 残疾公正对抗菌药物管理有何要求？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.448
Katie Savin, Laura Guidry-Grimes, Olivia S Kates
{"title":"What Does Disability Justice Require of Antimicrobial Stewardship?","authors":"Katie Savin, Laura Guidry-Grimes, Olivia S Kates","doi":"10.1001/amajethics.2024.448","DOIUrl":"https://doi.org/10.1001/amajethics.2024.448","url":null,"abstract":"<p><p>This commentary on a case argues that antimicrobial stewardship requires an intersectional disability justice approach if it is to be equitable, particularly for multiply marginalized patients with disabilities residing in nursing homes, who are more susceptible to antibiotic under- and overtreatment. Disability justice concepts emphasize resistance to structural and capitalist roots of ableism and prioritize leadership by disabled persons. A disability justice perspective on antimicrobial stewardship means prioritizing clarification of presumptive diagnoses of infection in vulnerable patients, clinician education led by disabled persons, and data collection.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E448-455"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248617","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
What Is Antimicrobial Stewardship? 什么是抗菌药物管理？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.437
Olivia S Kates
{"title":"What Is Antimicrobial Stewardship?","authors":"Olivia S Kates","doi":"10.1001/amajethics.2024.437","DOIUrl":"https://doi.org/10.1001/amajethics.2024.437","url":null,"abstract":"","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E437-440"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248624","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
Why Assuring the Quality of Antimicrobials Is a Global Imperative. 为什么保证抗菌药物的质量是全球的当务之急？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.472
Amy B Cadwallader, Kavitha Nallathambi, Carly Ching
{"title":"Why Assuring the Quality of Antimicrobials Is a Global Imperative.","authors":"Amy B Cadwallader, Kavitha Nallathambi, Carly Ching","doi":"10.1001/amajethics.2024.472","DOIUrl":"https://doi.org/10.1001/amajethics.2024.472","url":null,"abstract":"<p><p>Poor-quality antimicrobial medicines continue to proliferate across supply chains, threatening patients' health and safety, especially in low- and middle-income regions. This article discusses consequences and risks of antimicrobial resistance and other ways in which antimicrobial medicines can be of poor quality and recommends regulatory and policy reforms to help maintain supply chain resilience and quality of antimicrobial medicines.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E472-478"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248638","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
How Might Antibiotic Stewardship Programs Influence Clinicians' Autonomy and Organizations' Liability? 抗生素管理计划如何影响临床医生的自主权和组织的责任？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.463
George Maliha, Keith Robert Thomas, Mary Ellen Nepps, Keith W Hamilton
{"title":"How Might Antibiotic Stewardship Programs Influence Clinicians' Autonomy and Organizations' Liability?","authors":"George Maliha, Keith Robert Thomas, Mary Ellen Nepps, Keith W Hamilton","doi":"10.1001/amajethics.2024.463","DOIUrl":"https://doi.org/10.1001/amajethics.2024.463","url":null,"abstract":"<p><p>Federal and state governments mandate some health care organizations to implement antibiotic stewardship programs (ASPs). Some early adopters developed model ASPs that have helped set industry standards; other benchmarks will likely be forged in subsequent regulation, legislation, and jurisprudence. This article considers how ASP designs can affect professional autonomy, especially of frontline antibiotic stewards who are usually physicians and pharmacists. This article also considers how ASP development and implementation might influence standards of care and malpractice liability.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E463-471"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247547","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
How Should Clinicians Navigate Interprofessional Tension in Their Roles as Antimicrobial Stewards? 作为抗菌药物管理者，临床医生应如何处理专业间的紧张关系？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.441
James B Cutrell, James M Sanders
{"title":"How Should Clinicians Navigate Interprofessional Tension in Their Roles as Antimicrobial Stewards?","authors":"James B Cutrell, James M Sanders","doi":"10.1001/amajethics.2024.441","DOIUrl":"https://doi.org/10.1001/amajethics.2024.441","url":null,"abstract":"<p><p>Pharmacists and physicians play key roles in antimicrobial stewardship. This commentary on a case describes these health professionals' need to collaborate to optimize therapeutic use of antimicrobials in clinical settings. Prescription preauthorization is one antimicrobial stewardship strategy that can meet with some physicians' frustration and generate conflict between pharmacists and prescribing physicians, particularly when pharmacists make alternative treatment recommendations. This commentary considers interprofessional tension concerning prescription preauthorization and suggests strategies for navigating such conflict.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E441-447"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247864","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
When Should Patients at the End of Life Get Antimicrobials? 生命末期患者何时应该使用抗菌药物？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.456
Noah Boton, Jeffrey Larnard
{"title":"When Should Patients at the End of Life Get Antimicrobials?","authors":"Noah Boton, Jeffrey Larnard","doi":"10.1001/amajethics.2024.456","DOIUrl":"10.1001/amajethics.2024.456","url":null,"abstract":"<p><p>Although antimicrobial medications are commonly prescribed to patients at the end of life (EOL), clinicians might not discuss the benefits and harms of antimicrobials with their patients in the advance care planning process. This commentary on a case discusses challenges and strategies in antimicrobial decision making for patients at the EOL. As antimicrobial use can harm some patients, and as antimicrobial resistance remains an urgent public health issue, this article advocates for ethical reasoning to guide antimicrobial decision making for patients at the EOL.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E456-462"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248629","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
How Should We Think About Clinicians' Individual Antibiotic Stewardship Duties? 我们应该如何看待临床医生的个人抗生素管理职责？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.479
Travis N Rieder, Chelsea Modlin
{"title":"How Should We Think About Clinicians' Individual Antibiotic Stewardship Duties?","authors":"Travis N Rieder, Chelsea Modlin","doi":"10.1001/amajethics.2024.479","DOIUrl":"https://doi.org/10.1001/amajethics.2024.479","url":null,"abstract":"<p><p>The language of antibiotic stewardship is often used to capture the moral importance of individual prescribers doing their part to combat antibiotic resistance. \"Stewardship\" as an ethics concept borrows from collective action problems-those that cannot be solved by individuals only-like those discussed in the environmental ethics literature. This article suggests that hyper focus on stewardship, however, risks misunderstanding individual prescribers' reasons to limit antibiotic use.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E479-485"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248596","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
Should We Think of Early Career Cheaters as Capable of Stewardship? 我们是否应该把职业生涯初期的作弊者视为有管理能力的人？
AMA journal of ethics Pub Date : 2024-06-01 DOI: 10.1001/amajethics.2024.502
Christy A Rentmeester
{"title":"Should We Think of Early Career Cheaters as Capable of Stewardship?","authors":"Christy A Rentmeester","doi":"10.1001/amajethics.2024.502","DOIUrl":"https://doi.org/10.1001/amajethics.2024.502","url":null,"abstract":"<p><p>Resistance to acknowledging and curbing cheating should be seen as expressing academic organizations' dereliction of their tacit early career health professional self-regulatory duties. Cheating among students and trainees deserves ethical attention, scrutiny, and self-regulatory responses because cheating behaviors express characterological vices that undermine trust and trustworthiness, which, among other virtues, are key to good stewardship and other duties of health professionals.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"26 6","pages":"E502-505"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248614","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
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