Health Care Analysis最新文献_第8页

Engaging Tomorrow's Doctors in Clinical Ethics: Implications for Healthcare Organisations. 参与未来医生的临床伦理学:对医疗机构的影响。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 DOI: 10.1007/s10728-020-00403-z

Laura L Machin, Robin D Proctor

{"title":"Engaging Tomorrow's Doctors in Clinical Ethics: Implications for Healthcare Organisations.","authors":"Laura L Machin, Robin D Proctor","doi":"10.1007/s10728-020-00403-z","DOIUrl":"https://doi.org/10.1007/s10728-020-00403-z","url":null,"abstract":"Clinical ethics can be viewed as a practical discipline that provides a structured approach to assist healthcare practitioners in identifying, analysing and resolving ethical issues that arise in practice. Clinical ethics can therefore promote ethically sound clinical and organisational practices and decision-making, thereby contributing to health organisation and system quality improvement. In order to develop students' decision-making skills, as well as prepare them for practice, we decided to introduce a clinical ethics strand within an undergraduate medical curriculum. We designed a programme of clinical ethics activities for teaching and assessment purposes that involved using ethical frameworks to analyse hypothetical and real-life cases in uni- and inter- professional groups. In this paper, we draw on medical student feedback collected over 6 years to illustrate the appeal to students of learning clinical ethics. We also outline the range of benefits for students, healthcare organisations, and the field of clinical ethics arising from tomorrow's doctors experiencing clinical ethics early in their training. We conclude by briefly reflecting on how including clinical ethics within tomorrow's doctors curricular can secure and continue future engagement in clinical ethics support services in the UK, alongside the dangers of preparing students for organisational cultures that might not (yet) exist. We anticipate the findings presented in the paper will contribute to wider debates examining the impact of ethics teaching, and its ability to inform future doctors' practice.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"319-342"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00403-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38448215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Ethico-Political Aspects of Conceptualizing Screening: The Case of Dementia. 将筛查概念化的伦理-政治方面：痴呆症案例。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 Epub Date: 2021-03-16 DOI: 10.1007/s10728-021-00431-3

Martin Gunnarson, Alexandra Kapeller, Kristin Zeiler

{"title":"Ethico-Political Aspects of Conceptualizing Screening: The Case of Dementia.","authors":"Martin Gunnarson, Alexandra Kapeller, Kristin Zeiler","doi":"10.1007/s10728-021-00431-3","DOIUrl":"10.1007/s10728-021-00431-3","url":null,"abstract":"While the value of early detection of dementia is largely agreed upon, population-based screening as a means of early detection is controversial. This controversial status means that such screening is not recommended in most national dementia plans. Some current practices, however, resemble screening but are labelled \"case-finding\" or \"detection of cognitive impairment\". Labelled as such, they may avoid the ethical scrutiny that population-based screening may be subject to. This article examines conceptualizations of screening and case-finding. It shows how the definitions and delimitations of the concepts (the what of screening) are drawn into the ethical, political, and practical dimensions that screening assessment criteria or principles are intended to clarify and control (the how of screening, how it is and how it should be performed). As a result, different conceptualizations of screening provide the opportunity to rethink what ethical assessments should take place: the conceptualizations have different ethico-political implications. The article argues that population-based systematic screening, population-based opportunistic screening, and case-finding should be clearly distinguished.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"343-359"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25484357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gender Transition: Is There a Right to Be Forgotten? 性别转换:有被遗忘的权利吗?

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 Epub Date: 2021-05-02 DOI: 10.1007/s10728-021-00433-1

Mónica Correia, Guilhermina Rêgo, Rui Nunes

{"title":"Gender Transition: Is There a Right to Be Forgotten?","authors":"Mónica Correia, Guilhermina Rêgo, Rui Nunes","doi":"10.1007/s10728-021-00433-1","DOIUrl":"https://doi.org/10.1007/s10728-021-00433-1","url":null,"abstract":"The European Union (EU) faced high risks from personal data proliferation to individuals' privacy. Legislation has emerged that seeks to articulate all interests at stake, balancing the need for data flow from EU countries with protecting personal data: the General Data Protection Regulation. One of the mechanisms established by this new law to strengthen the individual's control over their data is the so-called \"right to be forgotten\", the right to obtain from the controller the erasure of records. In gender transition, this right represents a powerful form of control over personal data, especially health data that may reveal a gender with which they do not identify and reject. Therefore, it is pertinent to discern whether the right to have personal data deleted-in particular, health data-is ethically acceptable in gender transition. Towards addressing the ethical dimensions of the right to be forgotten in this case, this study presents relevant concepts, briefly outlines history, ethics and law of records considering the evolution from paper to electronic format, the main aspects of identity construction and gender identity, and explores the relationship between privacy, data protection/information control and identity projection. Also, it discusses in gender transition the relation between \"the right to self-determination\", \"the right to delete\", and \"the right to identity and individuality\". Conclusions on the ethical admissibility of the 'right to be forgotten' to control gender-affirming information are presented.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"283-300"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-021-00433-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38941775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Beyond Individual Triage: Regional Allocation of Life-Saving Resources such as Ventilators in Public Health Emergencies. 超越个人分类:突发公共卫生事件中呼吸机等救生资源的区域分配。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-12-01 Epub Date: 2021-02-06 DOI: 10.1007/s10728-020-00427-5

Jonathan Pugh, Dominic Wilkinson, Cesar Palacios-Gonzalez, Julian Savulescu

{"title":"Beyond Individual Triage: Regional Allocation of Life-Saving Resources such as Ventilators in Public Health Emergencies.","authors":"Jonathan Pugh, Dominic Wilkinson, Cesar Palacios-Gonzalez, Julian Savulescu","doi":"10.1007/s10728-020-00427-5","DOIUrl":"https://doi.org/10.1007/s10728-020-00427-5","url":null,"abstract":"In the first wave of the COVID-19 pandemic, healthcare workers in some countries were forced to make distressing triaging decisions about which individual patients should receive potentially life-saving treatment. Much of the ethical discussion prompted by the pandemic has concerned which moral principles should ground our response to these individual triage questions. In this paper we aim to broaden the scope of this discussion by considering the ethics of broader structural allocation decisions raised by the COVID-19 pandemic. More specifically, we consider how nations ought to distribute a scarce life-saving resource across healthcare regions in a public health emergency, particularly in view of regional differences in projected need and existing capacity. We call this the regional triage question. Using the case study of ventilators in the COVID-19 pandemic, we show how the moral frameworks that we might adopt in response to individual triage decisions do not translate straightforwardly to this regional-level triage question. Having outlined what we take to be a plausible egalitarian approach to the regional triage question, we go on to propose a novel way of operationalising the 'save the most lives' principle in this context. We claim that the latter principle ought to take some precedence in the regional triage question, but also note important limitations to the extent of the influence that it should have in regional allocation decisions.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 4","pages":"263-282"},"PeriodicalIF":1.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00427-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25339780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

From 'Consent or Anonymise' to 'Share and Protect': Facilitating Access to Surplus Tissue for Research Whilst Safeguarding Donor Interests. 从“同意或匿名”到“分享和保护”:促进获取多余组织用于研究，同时维护捐赠者的利益。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-07-14 DOI: 10.1007/s10728-021-00435-z

Catherine Blewett

{"title":"From 'Consent or Anonymise' to 'Share and Protect': Facilitating Access to Surplus Tissue for Research Whilst Safeguarding Donor Interests.","authors":"Catherine Blewett","doi":"10.1007/s10728-021-00435-z","DOIUrl":"https://doi.org/10.1007/s10728-021-00435-z","url":null,"abstract":"There is significant research value in the secondary use of surplus human tissue which has been removed during clinical care and is stored in diagnostic archives. However, this value is limited without access to information about the person from whom the tissue was removed. As the research value of surplus tissue is often not realised until after the patient's episode of care, it is often the case that no consent has been given for any surplus tissue to be used for research purposes. The Human Tissue Act 2004 does permit research use of surplus tissue without consent, but the researcher must not be in possession of information which could identify the person from whom the tissue was removed. Due to the commonly applied 'consent or anonymise' approach, linking tissue and data is challenging and full anonymisation would likely render much research on surplus tissue ineffectual. This article suggests that in recognising the value in surplus tissue linked with information about the person, a 'share and protect' approach which considers safeguards other than anonymisation, where obtaining consent for research use would not be feasible, would better balance the public benefit of health research with the protection of individual rights and interests than a requirement for either consent or anonymisation.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"213-230"},"PeriodicalIF":1.9,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

'We Should View Him as an Individual': The Role of the Child's Future Autonomy in Shared Decision-Making About Unsolicited Findings in Pediatric Exome Sequencing. “我们应该把他视为一个个体”:儿童未来自主决策在儿童外显子组测序中主动发现的作用。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-01-02 DOI: 10.1007/s10728-020-00425-7

W Dondorp, I Bolt, A Tibben, G De Wert, M Van Summeren

{"title":"'We Should View Him as an Individual': The Role of the Child's Future Autonomy in Shared Decision-Making About Unsolicited Findings in Pediatric Exome Sequencing.","authors":"W Dondorp, I Bolt, A Tibben, G De Wert, M Van Summeren","doi":"10.1007/s10728-020-00425-7","DOIUrl":"https://doi.org/10.1007/s10728-020-00425-7","url":null,"abstract":"In debates about genetic testing of children, as well as about disclosing unsolicited findings (UFs) of pediatric exome sequencing, respect for future autonomy should be regarded as a prima facie consideration for not taking steps that would entail denying the future adult the opportunity to decide for herself about what to know about her own genome. While the argument can be overridden when other, morally more weighty considerations are at stake, whether this is the case can only be determined in concrete cases. Importantly, when children grow into adolescents, respect for future autonomy will have to give way to respecting their emerging autonomy. When pediatric exome sequencing is done for complex conditions not involving developmental delay, respect for the child's future or emerging autonomy should be a primary consideration for those charged with deciding on behalf of the child. Building on what Emanuel and Emanuel have termed the 'deliberative model' of shared decision making, we argue that if parents fail to give these considerations their due, professionals should actively invite them to do so. Taking a directive stance may be needed in order to make sure that the future or emerging autonomy of the child are duly considered in the decision-making process, but also to help the parents and themselves to shape their respective roles as responsible care-givers.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"249-261"},"PeriodicalIF":1.9,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-020-00425-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38773275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A New Argument for No-Fault Compensation in Health Care: The Introduction of Artificial Intelligence Systems. 医疗保健无过错赔偿的新论点:人工智能系统的引入。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-03-21 DOI: 10.1007/s10728-021-00430-4

Søren Holm, Catherine Stanton, Benjamin Bartlett

引用次数: 10

The Doctor as Parent, Partner, Provider… or Comrade? Distribution of Power in Past and Present Models of the Doctor-Patient Relationship. 医生是父母、伙伴、提供者还是同志?过去和现在的医患关系模型中的权力分配。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-04-27 DOI: 10.1007/s10728-021-00432-2

Mani Shutzberg

{"title":"The Doctor as Parent, Partner, Provider… or Comrade? Distribution of Power in Past and Present Models of the Doctor-Patient Relationship.","authors":"Mani Shutzberg","doi":"10.1007/s10728-021-00432-2","DOIUrl":"https://doi.org/10.1007/s10728-021-00432-2","url":null,"abstract":"The commonly occurring metaphors and models of the doctor-patient relationship can be divided into three clusters, depending on what distribution of power they represent: in the paternalist cluster, power resides with the physician; in the consumer model, power resides with the patient; in the partnership model, power is distributed equally between doctor and patient. Often, this tripartite division is accepted as an exhaustive typology of doctor-patient relationships. The main objective of this paper is to challenge this idea by introducing a fourth possibility and distribution of power, namely, the distribution in which power resides with neither doctor nor patient. This equality in powerlessness-the hallmark of \"the age of bureaucratic parsimony\"-is the point of departure for a qualitatively new doctor-patient relationship, which is best described in terms of solidarity between comrades. This paper specifies the characteristics of this specific type of solidarity and illustrates it with a case study of how Swedish doctors and patients interrelate in the sickness certification practice.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"231-248"},"PeriodicalIF":1.9,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10728-021-00432-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38913002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Prospective Intention-Based Lifestyle Contracts: mHealth Technology and Responsibility in Healthcare. 基于意向的前瞻性生活方式契约：移动医疗技术与医疗保健中的责任。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2021-09-01 Epub Date: 2021-01-11 DOI: 10.1007/s10728-020-00424-8

Emily Feng-Gu, Jim Everett, Rebecca C H Brown, Hannah Maslen, Justin Oakley, Julian Savulescu

{"title":"Prospective Intention-Based Lifestyle Contracts: mHealth Technology and Responsibility in Healthcare.","authors":"Emily Feng-Gu, Jim Everett, Rebecca C H Brown, Hannah Maslen, Justin Oakley, Julian Savulescu","doi":"10.1007/s10728-020-00424-8","DOIUrl":"10.1007/s10728-020-00424-8","url":null,"abstract":"As the rising costs of lifestyle-related diseases place increasing strain on public healthcare systems, the individual's role in disease may be proposed as a healthcare rationing criterion. Literature thus far has largely focused on retrospective responsibility in healthcare. The concept of prospective responsibility, in the form of a lifestyle contract, warrants further investigation. The responsibilisation in healthcare debate also needs to take into account innovative developments in mobile health technology, such as wearable biometric devices and mobile apps, which may change how we hold others accountable for their lifestyles. Little is known about public attitudes towards lifestyle contracts and the use of mobile health technology to hold people responsible in the context of healthcare. This paper has two components. Firstly, it details empirical findings from a survey of 81 members of the United Kingdom general public on public attitudes towards individual responsibility and rationing healthcare, prospective and retrospective responsibility, and the acceptability of lifestyle contracts in the context of mobile health technology. Secondly, we draw on the empirical findings and propose a model of prospective intention-based lifestyle contracts, which is both more aligned with public intuitions and less ethically objectionable than more traditional, retrospective models of responsibility in healthcare.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"29 3","pages":"189-212"},"PeriodicalIF":1.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38805683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Here comes trouble. 麻烦来了。

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2021-07-15 DOI: 10.1142/9789811239564_0014

L. Repchull

引用次数: 0