Journal of Clinical Ethics最新文献_第4页

When Patients and Providers Feel Helpless: A Commentary on "Palliative Care for Refractory Depressive Symptoms in a Female Veteran Geriatric Patient". 当病人和医护人员感到无助时：女性退伍老年患者难治性抑郁症的姑息治疗 "评论。

Journal of Clinical Ethics Pub Date : 2024-01-01 DOI: 10.1086/730894

Edmund G Howe

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When Parents Request Nondisclosure: Rights of Adolescents to Access Their Health Information and Implications of the 21st Century Cures Act Final Rule. 当父母要求保密时：青少年获取其健康信息的权利及 21 世纪治愈法案最终规则的影响》。

Journal of Clinical Ethics Pub Date : 2024-01-01 DOI: 10.1086/729413

Edward McArdle, Karen L Teelin, Adrienne Borschuk, Amy E Caruso Brown

{"title":"When Parents Request Nondisclosure: Rights of Adolescents to Access Their Health Information and Implications of the 21st Century Cures Act Final Rule.","authors":"Edward McArdle, Karen L Teelin, Adrienne Borschuk, Amy E Caruso Brown","doi":"10.1086/729413","DOIUrl":"10.1086/729413","url":null,"abstract":"AbstractDespite broad ethical consensus supporting developmentally appropriate disclosure of health information to older children and adolescents, cases in which parents and caregivers request nondisclosure continue to pose moral dilemmas for clinicians. State laws vary considerably regarding adolescents' rights to autonomy, privacy, and confidentiality, with many states not specifically addressing adolescents' right to their own healthcare information. The requirements of the 21st Century Cures Act have raised important ethical concerns for pediatricians and adolescent healthcare professionals regarding the protection of adolescent privacy and confidentiality, given requirements that chart notes and results be made readily available to patients via electronic portals. Less addressed have been the implications of the act for adolescents' access to their health information, since many healthcare systems' electronic portals are available to patients beginning at age 12, sometimes requiring that the patients themselves authorize their parents' access to the same information. In this article, we present a challenging case of protracted disagreement about an adolescent's right to honest information regarding his devastating prognosis. We then review the legal framework governing adolescents' rights to their own healthcare information, the limitations of ethics consultation to resolve such disputes, and the potential for the Cures Act's impact on electronic medical record systems to provide one form of resolution. We conclude that although parents in cases like the one presented here have the legal right to consent to medical treatment on their children's behalf, they do not have a corresponding right to direct the withholding of medical information from the patient.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"35 2","pages":"85-92"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904930","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

Analysis of 20 Years of Ethics Consultations at a U.S. Children's Hospital. 美国儿童医院 20 年伦理咨询分析。

Journal of Clinical Ethics Pub Date : 2024-01-01 DOI: 10.1086/729417

Richard James, Ricki S Carroll, Jonathan M Miller

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Journal of Clinical Ethics Pub Date : 2023-09-01 DOI: 10.1086/728208

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Journal of Clinical Ethics Pub Date : 2023-06-01 DOI: 10.1086/726057

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Journal of Clinical Ethics Pub Date : 2023-03-01 DOI: 10.1086/725078

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Navigating Informed Consent and Patient Safety in Surgery: Lessons for Medical Students and Junior Trainees. 外科手术中的知情同意与患者安全：医学生和初级实习生的课程。

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/726816

August A Culbert, Alejandro Bribriesco, Michael S O'Connor, Eric Kodish

引用次数: 1

Patient Autonomy: How a Student's Surgical Experience Highlights the Need for a New Standard Operating Procedure. 患者自主性：学生的手术经验如何凸显对新标准操作程序的需求。

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/726814

Theresa McAlister Mairson

引用次数: 1

Patients with Invisible Pain: How Might We See This Pain and Help These Patients More? 隐形疼痛患者：我们如何看待这种疼痛并更多地帮助这些患者？

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/726812

Edmund G Howe

引用次数: 0

Default Positions in Clinical Ethics. 临床伦理学中的默认立场。

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/726809

Parker Crutchfield, Tyler S Gibb, Michael J Redinger

{"title":"Default Positions in Clinical Ethics.","authors":"Parker Crutchfield, Tyler S Gibb, Michael J Redinger","doi":"10.1086/726809","DOIUrl":"10.1086/726809","url":null,"abstract":"AbstractDefault positions, predetermined starting points that aid in complex decision-making, are common in clinical medicine. In this article, we identify and critically examine common default positions in clinical ethics practice. Whether default positions ought to be held is an important normative question, but here we are primarily interested in the descriptive, rather than normative, properties of default positions. We argue that default positions in clinical ethics function to protect and promote important values in medicine-respect for persons, utility, and justice. Further, default positions in clinical ethics may also guard against harm. Where default positions exist, there are epistemic burdens to overturn them. The person wishing to reject the default position, rather than the person endorsing it, bears this burden. The person who bears the burden of meeting the epistemic requirements must provide evidence proportional to the degree of harm the default position protects against. Default positions that protect against significant harm impose significant epistemic requirements to overturn. This asymmetry not only makes medical decision-making more economical but also serves to promote and protect certain values. The identification and analysis of common and recognizable default positions can help to identify other default positions and the conditions under which their associated epistemic requirements are met. The article concludes with considerations of potential problems with the use of default positions in clinical ethics.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"34 3","pages":"258-269"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215386","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}

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