Linacre Quarterly最新文献

Incoherence in the Brain Death Guideline Regarding Brain Blood Flow Testing: Lessons from the Much-Publicized Case of Zack Dunlap.

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Linacre Quarterly Pub Date : 2025-02-04 DOI: 10.1177/00243639251317690

Doyen Nguyen, Christine M Zainer

{"title":"Incoherence in the Brain Death Guideline Regarding Brain Blood Flow Testing: Lessons from the Much-Publicized Case of Zack Dunlap.","authors":"Doyen Nguyen, Christine M Zainer","doi":"10.1177/00243639251317690","DOIUrl":"10.1177/00243639251317690","url":null,"abstract":"At age 21, following a severe traumatic brain injury, Zack Dunlap was declared brain-dead according to the American Academy of Neurology guideline (Guideline) when he met the clinical criteria of brain death (minus apnea testing because of bradycardia) with technetium-99m diethylene-triamine-pentaacetate scintigraphy reported as showing no intracranial blood flow. His parents agreed to organ donation. During preparations for organ donation, Zack manifested a purposeful movement in response to a noxious stimulus made by his cousin. Following subsequent neurological recovery, he has returned to a normal life, holding steady employment and raising a family. During an interview, he reported that while in coma, he heard a doctor say that he was brain-dead and felt angry about it. His experience fits the phenomenon of cognitive-motor dissociation. Recently, Zack's medical records were made available to the first author. A critical review of the records uncovered a problem inherent in the logic of the Guideline algorithm regarding brain blood flow scintigraphy. This article discusses the lessons drawn from Zack's case, namely, that both the aforementioned problem and the occurrence of cognitive-motor dissociation in patients deemed to be brain-dead can pose a significant risk of a false-positive declaration of death.","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639251317690"},"PeriodicalIF":0.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366140","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

The Imitation of Christ as a Model for Physician Wellness. 仿效基督作为医生健康的典范。

IF 0.4

Linacre Quarterly Pub Date : 2025-02-02 DOI: 10.1177/00243639241311314

Jeremy Jones, Nicholas Nguyen, MaryClaire Cooke

引用次数: 0

Cultivating Attention as a Surgical Resident: Sabbath as Resistance. 作为外科住院医师培养注意力:安息日作为抵抗

IF 0.4

Linacre Quarterly Pub Date : 2025-02-01 Epub Date: 2023-08-08 DOI: 10.1177/00243639231189333

Thomas Clark Howell

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The Power Broker Conveys the Risks of Rejecting Reality.

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Linacre Quarterly Pub Date : 2025-01-29 DOI: 10.1177/00243639241309930

Barbara Golder

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Winners of the 2024 Poster Contest.

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Linacre Quarterly Pub Date : 2025-01-29 DOI: 10.1177/00243639241296575

引用次数: 0

Avoiding the Subjunctive.

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Linacre Quarterly Pub Date : 2025-01-29 DOI: 10.1177/00243639241304807

Barbara Golder

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The Loss of a Physician's Freedom of Conscience Will Result in the Breakdown of Patient Autonomy Within the Doctor-Patient Relationship.

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Linacre Quarterly Pub Date : 2025-01-29 DOI: 10.1177/00243639241296576

Brian J Burke

{"title":"The Loss of a Physician's Freedom of Conscience Will Result in the Breakdown of Patient Autonomy Within the Doctor-Patient Relationship.","authors":"Brian J Burke","doi":"10.1177/00243639241296576","DOIUrl":"10.1177/00243639241296576","url":null,"abstract":"Editor's Note: Issues of conscience are of increasing importance in medicine, especially when it comes to the Catholic physician. Nearly fifteen years ago, this alarm was sounded regarding the connection between physician conscience and patient autonomy. First published Vol 76, No 4, November 1, 2009. The development of patient autonomy within healthcare has created new challenges in the physician-patient relationship. When a patient demands a service that violates the conscience of a physician, it creates conflict within that relationship. This has become particularly problematic when a patient demands abortion or artificial contraception and the physician is morally bound to refuse. This article argues that the integrity of the physician's conscience must be maintained in order to uphold the integrity of the patient's autonomy. If the physician is forced to violate his conscience, then the guarantee that a patient's desires and wishes will be respected will be lost because a great moral inequality will be created between the physician and the patient. To safeguard both the physician-patient relationship and the patient's autonomy, it is vital that the physician's conscience be protected.","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639241296576"},"PeriodicalIF":0.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081520","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

First, Do No Harm (to the One You Train).

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Linacre Quarterly Pub Date : 2025-01-23 DOI: 10.1177/00243639241311315

J Brewer Eberly, Benjamin W Frush

{"title":"First, Do No Harm (to the One You Train).","authors":"J Brewer Eberly, Benjamin W Frush","doi":"10.1177/00243639241311315","DOIUrl":"10.1177/00243639241311315","url":null,"abstract":"Primum non nocere or \"first, do no harm\" is perhaps the most well-known aphorism in the culture of medical education. While its application to patients is well known, the injunction can also be read with medical trainees in mind. Teaching physicians have an obligation to recognize their role as moral teachers and coaches, who must consider \"first, do no harm\" not only when considering their patients but also when weighing the moral formation of their trainees, especially in a season in which medical educators are attempting to clarify the \"harms\" of medical training. This multi-valent vision of \"first, do no harm\" offers an alternative way to frame the contemporary difficulties of medical education while inviting a more candid, nuanced discourse between teachers and learners about the experiences of medical training, in which it can be difficult to discern between that which is truly harm and that which is merely \"hard.\" For those situations in which it is unclear-or indeed when harm is unavoidable-it may be through communal practices of reharmonization, reincorporation, and \"reharm\" that master educators might learn to tell the story of good medicine with their trainees anew, fostering moral articulacy for the trainees to whom they must also \"first, do no harm.\"Summary: Primum non nocere or \"first, do no harm\" is among the most well-known proverbs in medical education. While its application to patients is well known, the injunction can also be read with medical trainees in mind. Teaching physicians might consider \"first, do no harm\" not only when considering their patients but also when considering the moral formation of their trainees. In a season when medical educators are attempting to clarify the \"harms\" of medical training, this reading can invite a more candid, nuanced discourse between teachers and learners about the experiences of medical training.","PeriodicalId":44238,"journal":{"name":"Linacre Quarterly","volume":" ","pages":"00243639241311315"},"PeriodicalIF":0.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047923","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

Cognitive Motor Dissociation and Spiritual Physical Association. 认知运动分离和精神物理关联。

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Linacre Quarterly Pub Date : 2024-12-10 DOI: 10.1177/00243639241296783

Lealani Mae Y Acosta

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Challenges, Conflicts, and Opportunities. 挑战、冲突和机遇。

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Linacre Quarterly Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI: 10.1177/00243639241285509

Barbara Golder

引用次数: 0