Journal of Clinical Ethics最新文献_第6页

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

引用次数: 0

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}

引用次数: 0

Permanent Sterilization in Nulliparous Patients: Is Legislative Anxiety an Indication for Surgery? 未生育患者的永久绝育:立法焦虑是手术的指征吗?

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/727435

Catherine Hennessey, Camille Johnson, Hillary McLaren, Neha Bhardwaj, Katherine Rivlin, Julie Chor

{"title":"Permanent Sterilization in Nulliparous Patients: Is Legislative Anxiety an Indication for Surgery?","authors":"Catherine Hennessey, Camille Johnson, Hillary McLaren, Neha Bhardwaj, Katherine Rivlin, Julie Chor","doi":"10.1086/727435","DOIUrl":"10.1086/727435","url":null,"abstract":"AbstractThe Supreme Court's Dobbs v. Jackson Women's Health Organization decision, first leaked to the public on 2 May 2022 and officially released on 24 June 2022, overturned Roe v. Wade and thereby determined that abortion is no longer a federally protected right under the Constitution. Instead, the decision gives individual states the right to regulate abortion. Since the Dobbs decision first leaked, our institution has received numerous requests for permanent contraception from individuals stating that their motivation to pursue permanent contraception was influenced by the Dobbs decision and concerns about their reproductive autonomy. Discussions with patients seeking permanent contraception since the Supreme Court's leaked decision have led us to ask ourselves, is legislative anxiety an indication for surgery? This article presents a case series consisting of a convenience sample of 17 young, nulliparous individuals who sought out permanent contraception in the six months following the leak of the Dobbs decision. Healthcare professionals often feel discomfort in offering permanent contraception to young and nulliparous individuals. Accordingly, we discuss pertinent legal issues, review relevant ethical considerations, and offer a framework for these discussions intended to empower the consulting healthcare professional to center the bodily autonomy of every patient regardless of age, parity, or indication for permanent contraception.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"34 4","pages":"320-327"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291974","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

Capacity Assessment in Emergency Surgery. 急诊外科能力评估。

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/726817

Darren S Bryan, Selwyn O Rogers

引用次数: 0

When Guideline-Concordant Standardized Care Results in Healthcare Disparities. 当指南一致性标准化护理导致医疗保健差异时。

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/726815

Micah Prochaska, David Meltzer, Peter Angelos

引用次数: 0

Reducing Moral Distress by Teaching Healthcare Providers the Concepts of Values Pluralism and Values Imposition. 通过教导医疗保健提供者价值观多元化和价值观强加的概念来减少道德困扰。

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/727437

Autumn Fiester

{"title":"Reducing Moral Distress by Teaching Healthcare Providers the Concepts of Values Pluralism and Values Imposition.","authors":"Autumn Fiester","doi":"10.1086/727437","DOIUrl":"10.1086/727437","url":null,"abstract":"AbstractThere is a clear need for interventions that reduce moral distress among healthcare providers (HCPs), given the high prevalence of moral distress and the far-ranging negative consequences it has for them. Healthcare ethics consultants are frequently called upon to manage moral distress, especially among nursing staff. Recently, researchers have both broadened the definition of moral distress and demarcated subcategories of the phenomenon with the intent of creating more targeted and effective interventions. One of the most frequently occurring subcategories of moral distress in this new taxonomy has been labeled \"moral-constraint distress,\" though scholars have argued that not all constraints on HCPs' moral agency are inappropriate given the often-competing healthcare values of patients, families, and clinical staff. To attempt to reduce the instances of moral distress in cases in which the constraints on HCPs' moral agency are justified, we propose an intervention that focuses on shifting the HCPs' \"frame of reference\" on moral-constraint distress, teaching HCPs how to distinguish unjustified and justified constraints on their moral agency. The anchors of this blueprint for reducing moral-constraint distress are the philosophical concepts of \"values pluralism\" and \"values imposition.\" The rationale for this intervention is that, in situations where the constraint on moral agency is justified but the experience of moral distress could nevertheless be severe, the emphasis needs to be on helping the HCP to \"think differently\" rather than \"act differently.\"","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"34 4","pages":"296-306"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291975","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 Providers Defer versus Impose Their Views? 什么时候提供者应该推迟还是强加他们的观点?

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/727439

Edmund G Howe

引用次数: 0