Journal of Clinical Ethics最新文献_第9页

The Ethics of Refusing Lifesaving Treatment Following a Failed Suicide Attempt. 自杀未遂后拒绝救生治疗的伦理学。

Journal of Clinical Ethics Pub Date : 2023-01-01 DOI: 10.1086/726974

Megan K Applewhite, Jacob Mago, Wayne Shelton

引用次数: 0

Addressing Racism in the Healthcare Encounter: The Role of Clinical Ethics Consultants. 解决种族主义在医疗保健遭遇:临床伦理顾问的作用。

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

Vanessa Madrigal, Kate MacDuffie, Erin Talati Paquette

引用次数: 0

Infertility Counseling and Misattributed Paternity: When Should Physicians Become Involved in Family Affairs? 不孕症咨询和错误的父亲鉴定:医生何时应该参与家庭事务?

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

Stephen P Pittman, Syed M Alam, Tarris Rosell, Ajay K Nangia

引用次数: 0

Knowing Together: The Physician-Patient Encounter and Encountering Others: Imagining Relationships and Vulnerable Possibilities. 共同了解:医患相遇和遇到他人:想象关系和脆弱的可能性。

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

Norman Quist

{"title":"Knowing Together: The Physician-Patient Encounter and Encountering Others: Imagining Relationships and Vulnerable Possibilities.","authors":"Norman Quist","doi":"","DOIUrl":"","url":null,"abstract":"In this essay, by example of the physician-patient relationship and drawing on the work of D.W. Winnicott, I explore what may be possible together in relationships, and in the pursuit of health and flourishing, at understanding what we need, and getting ourselves and the other \"right\"-what we are afraid of and how we get each other wrong, and the distance or gap between \"what has been\" and \"what might be.\" In pursuit of these questions, I consider what both physicians and patients might endeavor to do together to address this distance: to recognize and respond to each other, and to identify and address common needs and felt distances. And, how, along the way, we may be able to better identify and understand fundamental challenges to all relationships. Finally, I ask the reader to imagine a physician-patient encounter (and all relationships) as vulnerable possibilities. And I suggest a method for a way forward. While we may not always get what we want in a relationship, perhaps our earnest effort at knowing together will open a potential space for us to get what we need. This is where I imagine that the physician-patient relationship begins: where all relationships begin.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"33 3","pages":"249-256"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33470066","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

An Argument for Standardized Ethical Directives for Secular Healthcare Services. 世俗医疗服务的标准化伦理指令的争论。

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

Abram L Brummett, Jamie C Watson

{"title":"An Argument for Standardized Ethical Directives for Secular Healthcare Services.","authors":"Abram L Brummett, Jamie C Watson","doi":"","DOIUrl":"","url":null,"abstract":"We argue that the American Society for Bioethics and Humanities has endorsed a facilitation approach to clinical ethics consultation that asserts that bioethicists can offer moral recommendations that are well-grounded in bioethical consensus. We claim that the closest thing the field currently has to a citable, nationally endorsed bioethical consensus are the 22 Core References used to construct the questions for the Healthcare Ethics Consultant-Certified (HEC-C) exam. We acknowledge that the Core References reflect some important points of bioethical consensus, but note they are unwieldy, repetitive, and sometimes inconsistent on important issues faced by clinical ethicists. In this article, we draw carefully qualified inspiration from the Ethical and Religious Directives for Catholic Health Care Services (ERDs) to argue for the creation of a concise, nationally endorsed bioethical consensus document on moral issues commonly faced in clinical ethics, what we call the Standardized Ethical Guidelines for Secular Health Care Services (SEGs). We observe that such a document would better meet the expectations of stakeholders, clinical ethicists, and their trainees who desire moral recommendations grounded in a clearly articulated bioethical consensus, and we defend the SEGs from some common objections.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"33 3","pages":"175-188"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479051","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

Ethics of Extracorporeal Membrane Oxygenation under Conventional and Crisis Standards of Care. 常规和危机护理标准下体外膜氧合的伦理学。

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

Gina M Piscitello, Mark Siegler, William F Parker

{"title":"Ethics of Extracorporeal Membrane Oxygenation under Conventional and Crisis Standards of Care.","authors":"Gina M Piscitello, Mark Siegler, William F Parker","doi":"","DOIUrl":"","url":null,"abstract":"Extracorporeal membrane oxygenation (ECMO) is a form of life support for cardiac and/or pulmonary failure with unique ethical challenges compared to other forms of life support. Ethical challenges with ECMO exist when conventional standards of care apply, and are exacerbated during periods of absolute ECMO scarcity when \"crisis standards of care\" are instituted. When conventional standards of care apply, we propose that it is ethically permissible to withhold placing patients on ECMO for reasons of technical futility or when patients have terminal, short-term prognoses that are untreatable by ECMO. Under crisis standards of care, it is ethically permissible to broaden exclusionary criteria to also withhold ECMO from patients who have a low likelihood of recovery, to maximize the overall number of lives saved. Unilateral withdrawal of ECMO against a patient's preferences is unethical under conventional standards of care, but is ethical under crisis standards of care to increase access to ECMO to others in society. ECMO should only be rationed when true scarcity exists, and allocation protocols should be transparent to the public. When rationing must occur under crisis standards of care, it is imperative that oversight bodies assess for inequities in the allocation of ECMO and make frequent changes to improve any inequities.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"33 1","pages":"13-22"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648099/pdf/nihms-1840946.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39874995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Interdisciplinary Ethics Panel Approach to End-of-Life Decision Making for Unbefriended Nursing Home Residents. 一个跨学科的伦理小组的方法，临终决策的护理之家不友好的居民。

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

Howard J Finger, Cheryl A Dury, Giorgio R Sansone, Rani N Rao, Nancy Neveloff Dubler

{"title":"An Interdisciplinary Ethics Panel Approach to End-of-Life Decision Making for Unbefriended Nursing Home Residents.","authors":"Howard J Finger, Cheryl A Dury, Giorgio R Sansone, Rani N Rao, Nancy Neveloff Dubler","doi":"","DOIUrl":"","url":null,"abstract":"For those with advanced life-limiting illness, the optimization of quality of life and avoidance of nonbeneficial treatments at the end of life are key ethical concerns. This article evaluates the efficacy of an Interdisciplinary Ethics Panel (IEP) approach to decision making at the end of life for unbefriended nursing home residents who lack decisional capacity and have advanced life-limiting illness, through the use of a nine-step algorithm developed for this purpose. We reviewed the outcomes of three quality-of-care phased initiatives conducted in our facility, a large public nursing home in New York City, between June 2016 and February 2020, which indicated that this IEP approach promoted advance-care planning, as palliative measures were endorsed to optimize quality of life for this vulnerable population at the end of life. We also examined another quality-of-care initiative when this IEP approach was applied to end-of-life decision making for nursing home residents who had a surrogate during the COVID-19 pandemic. This application appeared to be beneficial in adding more residents to our Palliative Care Program while it improved rates of advance-care planning. When all of the above findings are considered, we believe this novel IEP approach and algorithm have the potential to be applied elsewhere after appropriate assessment.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":" ","pages":"101-111"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40193495","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

Moral Distress and Involuntary COVID-19 Vaccination of a Mature Minor Receiving Inpatient Psychiatric Treatment. 一名住院精神病治疗的成年未成年人的道德困境与非自愿接种COVID-19

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

Brent M Kious, Toni Hesse, Philip L Baese

引用次数: 0

Defining Death Behind the Veil of Ignorance. 在无知的面纱背后定义死亡。

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

Christos Lazaridis

引用次数: 0

When Should Careproviders Deviate from Consensus? 什么时候护理人员应该偏离共识?

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

Edmund G Howe

引用次数: 0