Clinical Ethics最新文献_第3页

What is 'medical necessity'? 什么是“医疗需要”?

Clinical Ethics Pub Date : 2023-09-01 DOI: 10.1177/14777509231190521

Dominic Jc Wilkinson

引用次数: 2

'Maternal Request' Caesarean Sections and Medical Necessity. "产妇请求"剖腹产和医疗需要。

Clinical Ethics Pub Date : 2023-09-01 DOI: 10.1177/14777509231183365

Rebecca Ch Brown, Andrea Mulligan

引用次数: 1

Medical need and health need. 医疗需要和健康需要。

Clinical Ethics Pub Date : 2023-09-01 DOI: 10.1177/14777509231173561

Ben Davies

引用次数: 2

Navigating conflict: The role of mediation in healthcare disputes 导航冲突:调解在医疗纠纷中的作用

Clinical Ethics Pub Date : 2023-08-29 DOI: 10.1177/14777509231196699

Jaime Lindsey, M. Doyle, Katarzyna Wazynska-Finck

引用次数: 0

Changes in abortion legislation and admissions to paediatric intensive care in Ireland 爱尔兰堕胎立法的变化和儿科重症监护的入院情况

Clinical Ethics Pub Date : 2023-08-21 DOI: 10.1177/14777509231196700

N. Tierney, M. Healy, B. Lyons

{"title":"Changes in abortion legislation and admissions to paediatric intensive care in Ireland","authors":"N. Tierney, M. Healy, B. Lyons","doi":"10.1177/14777509231196700","DOIUrl":"https://doi.org/10.1177/14777509231196700","url":null,"abstract":"The Health (Regulation of Termination of Pregnancy) Act 2018 was commenced on 01/01/2019 in Ireland. The Act provides for legal termination of pregnancy under defined circumstances including for any reason at < 12 weeks gestation; and where two doctors agree there is ‘a condition affecting the foetus that is likely to lead to the death of the foetus either before, or within 28 days of, birth’. As such, abortion for congenital anomaly (CA) can occur at a number of time points, depending on the adjudged severity. Infants born with CAs frequently require significant medical intervention and account for a high proportion of admissions to paediatric intensive care units (PICUs). The purpose of this paper was to evaluate the number of infants with CAs admitted to an Irish PICU in the period before and after the implementation of the Act. All PICU admissions < 1 month of age to a single Irish paediatric hospital between 2012 and 2021 were analysed. CAs were recorded, and the periods before and after the commencement of the Act compared. We found a difference in admissions involving CAs, particularly those related to congenital heart disease involving single ventricle anatomy. It is plausible that this difference was as a result of improved access to abortion services following the implementation of the Act. This article explores the legal conditions related to the abortion of a foetus with a CA in Ireland, and the possible impact of the Independent Review of the Operation of the Health ( Regulation of Termination of Pregnancy) Act 2018.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46747647","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

Bodily integrity and autonomy of the youngest children and consent to their healthcare 最小儿童的身体完整和自主，并同意他们的医疗保健

Clinical Ethics Pub Date : 2023-07-27 DOI: 10.1177/14777509231188006

P. Alderson

{"title":"Bodily integrity and autonomy of the youngest children and consent to their healthcare","authors":"P. Alderson","doi":"10.1177/14777509231188006","DOIUrl":"https://doi.org/10.1177/14777509231188006","url":null,"abstract":"Children's autonomy includes, as far as possible, self-determination, bodily integrity and the right to influence outcomes. Limits to bodily integrity, which involves no touching without the child's consent or tacit agreement, are discussed. The clinical, legal and ethics literature tends to agree that children may give valid consent to major recommended treatment from around 12 years but may not refuse it until they are legal adults. Research shows that young children are more aware of their bodily integrity and autonomy, of morality and decision making, than was assumed in the past. Adults therefore need to inform children and respect their initially instinctive efforts to protect their bodily integrity. Unlike assent, consent involves patients being adequately informed and being able to accept or refuse proposed treatment. Reasons are given for adults’ need to consult with children when determining their best interests. Beyond words, giving or withholding consent also involves emotions of fear, trust and courage, besides embodied reactions of cooperating with treatment or resisting it, in which young children actively engage. Some clinicians work with the informed cooperation of young children who need lifesaving treatment, and at times accept their refusal. Reasons for differences between mainstream experts’ views and clinical practices are considered.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48486225","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: 1

The child's right to bodily integrity and autonomy: A conceptual analysis 儿童身体完整和自主的权利:概念分析

Clinical Ethics Pub Date : 2023-07-25 DOI: 10.1177/14777509231188817

J. Pugh

{"title":"The child's right to bodily integrity and autonomy: A conceptual analysis","authors":"J. Pugh","doi":"10.1177/14777509231188817","DOIUrl":"https://doi.org/10.1177/14777509231188817","url":null,"abstract":"It is widely accepted that children enjoy some form of a right to bodily integrity. However, there is little agreement about the precise nature and scope of this right. This paper offers a conceptual analysis of the child's right to bodily integrity, in order to further elucidate the relationship between the child's right to bodily integrity and considerations of autonomy. Following a discussion of Leif Wenar's work on the structure and justification of rights, I first explain how the adult's right to bodily integrity can be distilled into separate elements that may plausibly be justified by different moral considerations. In particular, I claim that this analysis suggests that whilst the adult's right to bodily integrity is not wholly reducible to bodily autonomy, autonomy nonetheless remains entwined with our understanding of this right in a number of ways. On the basis of this discussion, I go on to outline three important complexities that arise when we consider the child's right to bodily integrity, before particularly focusing on the question of how third parties should determine whether or not to perform a physical interference upon a child who lacks decision-making capacity. Here, I raise some objections to Earp and Mazor's recent attempts to answer this question, before briefly defending an ‘autonomy-based interests’ account of permissible interference, an account that shares in what I take to be the spirit, if not the precise letter, of these earlier views.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43915505","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: 3

The paradox of medical necessity 医疗需要的悖论

Clinical Ethics Pub Date : 2023-07-17 DOI: 10.1177/14777509231188830

S. Godwin, B. Earp

引用次数: 2

Fixing bodies and shaping narratives: Epistemic injustice and the responses of medicine and bioethics to intersex human rights demands 修复身体和塑造叙事:认识上的不公正以及医学和生物伦理学对双性人人权要求的反应

Clinical Ethics Pub Date : 2023-06-25 DOI: 10.1177/14777509231180412

Morgan Carpenter

{"title":"Fixing bodies and shaping narratives: Epistemic injustice and the responses of medicine and bioethics to intersex human rights demands","authors":"Morgan Carpenter","doi":"10.1177/14777509231180412","DOIUrl":"https://doi.org/10.1177/14777509231180412","url":null,"abstract":"Children with innate variations of sex characteristics (also termed differences of sex development or intersex traits) are routinely subjected to medical interventions that aim to make their bodies appear or function more typically female or male. Many such interventions lack clear evidence of benefit, they have been challenged for thirty years, and they are now understood to violate children’s rights to bodily autonomy and bodily integrity. In this paper I argue that these persist in part due to epistemic injustices and biomedical authority. Epistemic injustices include limited disclosure of current practices, the systemic marginalisation of community voices and psychosocial professionals, and attempts to discredit or misrepresent testimony. Bioethics has largely failed to change medical practice, and sometimes plays a role in perpetuating epistemic injustices. I find that the development of an intersex movement provides opportunities for epistemic justice and liberation by engaging with other disciplines and promoting oversight of medical decision-making. The paper draws particularly on Australian sources, including internationally influential ethical principles.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47405020","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: 1

Viability, abortion and extreme prematurity: a critique 生存能力、流产和极端早产:批判

Clinical Ethics Pub Date : 2023-06-19 DOI: 10.1177/14777509231182000

L. de Proost, E. Verweij, R. Geurtzen, Geertjan Zuijdwegt, E. Verhagen, H. Ismaili M'hamdi

引用次数: 0