Journal of Clinical Ethics最新文献_第10页

Depression and Capacity to Withdraw from Dialysis. 抑郁和退出透析的能力。

Journal of Clinical Ethics Pub Date : 2022-01-01

Olivia Silva, Diana Jaber, Anthony Chiu, Cyrus Adams-Mardi, Edward Wicht

引用次数: 0

Discharging to the Street: When Patients Refuse Medically Safer Options. 出院到街上:当病人拒绝更安全的医疗选择。

Journal of Clinical Ethics Pub Date : 2022-01-01

Georgina D Campelia, James N Kirkpatrick, Patsie D Treece, Jamie L Shirley, Denise M Dudzinski

{"title":"Discharging to the Street: When Patients Refuse Medically Safer Options.","authors":"Georgina D Campelia, James N Kirkpatrick, Patsie D Treece, Jamie L Shirley, Denise M Dudzinski","doi":"","DOIUrl":"","url":null,"abstract":"The ethical obligation to provide a reasonably safe discharge option from the inpatient setting is often confounded by the context of homelessness. Living without the security of stable housing is a known determinant of poor health, often complicating the safety of discharge and causing unnecessary readmission. But clinicians do not have significant control over unjust distributions of resources or inadequate societal investment in social services. While physicians may stretch inpatient stays beyond acute care need in the interest of their patients who are experiencing homelessness, they must also consider the implications of using an inpatient hospital bed for someone without the attendant level of medical need. Caring for patients in an inpatient setting when they no longer require acute care means fewer beds for acute care patients. And when a patient who is experiencing homelessness declines a medically safer option such as a skilled nursing facility, then clinicians may be faced with the sole option of discharge to the street, which raises troubling questions of nonmaleficence and social justice. Here we investigate the different forms of injustice that play out when patients are discharged to the street, and offer a map of the interwoven ethical responsibilities of clinicians, hospitals, and skilled nursing facilities.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":" ","pages":"92-100"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40193494","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

Medical Decision Making and the Previvor. 医疗决策和前人。

Journal of Clinical Ethics Pub Date : 2022-01-01

Valerie Gutmann Koch

引用次数: 0

Convergence and Divergence in Canadian Ethics Support Services. 加拿大伦理支持服务的趋同与分歧。

Journal of Clinical Ethics Pub Date : 2022-01-01

Marika Warren, Christy Simpson, Diane Godkin, Allen Alvarez, Amanda Porter

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Values Imposition and Ethical Pluralism: An Argument Against Standardized Ethical Directives for Healthcare Ethics Consultants. 价值观强加与伦理多元主义:反对医疗伦理咨询师标准化伦理指令的论证。

Journal of Clinical Ethics Pub Date : 2022-01-01

Autumn Fiester

{"title":"Values Imposition and Ethical Pluralism: An Argument Against Standardized Ethical Directives for Healthcare Ethics Consultants.","authors":"Autumn Fiester","doi":"","DOIUrl":"","url":null,"abstract":"In the article \"An Argument for Standardized Ethical Directives for Secular Healthcare Services,\" Abram L. Brummett and Jamie C. Watson argue that, parallel to the directives of the Roman Catholic Church, secular healthcare ethics consultants (HECs) need substantive standardized ethical guidelines (what they call SEGs) that would constitute a best practice across all HECs in the U.S. Brummett and Watson believe that the absence of such directives constitutes an important deficit in clinical ethics consultation (CEC) that needs to be rectified in order for consultation to achieve the professionalism and universality necessary for legitimacy. This is a bold argument worthy of consideration, perhaps most because it challenges the field to engage in a self-assessment about its current and future directions against the backdrop of both the concerning data on national CEC and the current intense values polarization in the U.S. As part of assessment, I will argue in this essay that such a consensus document is not only impossible in our current national climate, but undesirable given the way that it would impose liberal clinical ethics values on an extremely values-pluralistic populace and exacerbate the deep divisions that many of us fear could be our national undoing.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"33 3","pages":"189-197"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479052","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

Responding to Fiester's Critique of a Bioethical Consensus Project. 回应菲斯特对生物伦理共识计划的批评。

Journal of Clinical Ethics Pub Date : 2022-01-01

Abram L Brummett, Jamie C Watson

引用次数: 0

Clinical Medical Ethics: How Did We Start? Where Are We Heading? 临床医学伦理学:我们是如何开始的?我们要去哪里?

Journal of Clinical Ethics Pub Date : 2022-01-01

Bernard Lo

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The Ethics of Distrust: The Balancing of Perspectives Is Crucial in Surrogate Decision Making and Mediation. 不信任伦理:观点的平衡在替代决策和调解中是至关重要的。

Journal of Clinical Ethics Pub Date : 2022-01-01

Shahla Siddiqui

引用次数: 0

Effectiveness of Advance Care Planning: What Works, What Doesn't, and What Needs to Change? 提前护理计划的有效性:哪些有效，哪些无效，哪些需要改变?

Journal of Clinical Ethics Pub Date : 2022-01-01

Susan W Tolle, Katrina Hedberg

{"title":"Effectiveness of Advance Care Planning: What Works, What Doesn't, and What Needs to Change?","authors":"Susan W Tolle, Katrina Hedberg","doi":"","DOIUrl":"","url":null,"abstract":"An increasing recognition over the past five decades of the importance of patients' autonomy and the right to be able to choose to limit medical treatment at the end of life has led to the development of a number of documents related to advance care planning, including the advance directive, medical power of attorney, and portable orders for life-sustaining treatment (POLST). While these documents are important aspects of advance care planning, without having goals-of-care conversations, a specific plan, and necessary supports to achieve these goals, the documents alone offer a false promise. Healthcare professionals must be trained on how to have indepth goals-of-care conversations with patients and their families, and effectively document the decisions. Advance care planning needs to be viewed as a process that must continue as the patient's health status, social support system, and living environment change. Designating a healthcare representative who participates in goals-of-care conversations and can work with the healthcare team to make \"just in time\" decisions about care reduces the burden and stress on friends and family. In this article we discuss the strengths and limitations of advance directives, medical power of attorney forms, and POLST forms; propose concrete changes to optimize the effectiveness of each; and present a comprehensive approach to advance care planning that we hope will improve care for those nearing the end of life, and ensure that their wishes and goals to have or to limit treatment are more consistently honored.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"33 3","pages":"210-219"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479501","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

Seeing the Invisible. 看到看不见的东西。

Journal of Clinical Ethics Pub Date : 2022-01-01

Edmund G Howe

引用次数: 0