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How Seeking Transfer Often Fails to Help Define Medically Inappropriate Treatment 寻求转院如何经常无法帮助界定医疗不当治疗
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-04-19 DOI: 10.1002/hast.1572
Douglas B. White, Thaddeus M. Pope
{"title":"How Seeking Transfer Often Fails to Help Define Medically Inappropriate Treatment","authors":"Douglas B. White,&nbsp;Thaddeus M. Pope","doi":"10.1002/hast.1572","DOIUrl":"https://doi.org/10.1002/hast.1572","url":null,"abstract":"<div>\u0000 \u0000 <p><i>On September 1, 2023, Texas made important revisions to it its decades-old statute granting legal safe harbor immunity to physicians who withhold or withdraw life-sustaining treatment over the objection of critically ill patients’ surrogate decision-makers. However, lawmakers left untouched glaring flaws in a key safeguard for patients—the transfer option. The transfer option is ethically important because, when no hospital is willing to accept the patient in transfer, that fact is taken as strong evidence that the surrogates’ treatment requests fall outside accepted medical practice. But there are serious shortcomings in how the transfer option is carried out in Texas and many other states, which undermines the ethical usefulness of the process. We identify these shortcomings and recommend revisions to state statutes and professional guidelines to overcome them</i>.</p>\u0000 </div>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 2","pages":"2"},"PeriodicalIF":3.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hast.1572","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140619783","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
Additional Steps for Maintaining Public Trust in the FDA 维护公众对食品药物管理局信任的其他步骤
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-04-19 DOI: 10.1002/hast.1578
Mitchell Berger
{"title":"Additional Steps for Maintaining Public Trust in the FDA","authors":"Mitchell Berger","doi":"10.1002/hast.1578","DOIUrl":"https://doi.org/10.1002/hast.1578","url":null,"abstract":"<p><i>This letter responds to the essay “Securing the Trustworthiness of the FDA to Build Public Trust in Vaccines,” by Leah Z. Rand, Daniel P. Carpenter, Aaron S. Kesselheim, Anushka Bhaskar, Jonathan J. Darrow, and William B. Feldman, in the special report “Time to Rebuild: Essays on Trust in Health Care and Science,” in the September-October 2023 issue of the</i> Hastings Center Report.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 2","pages":"44"},"PeriodicalIF":3.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140619784","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: 0
The Ethic of Accompaniment 陪伴的伦理
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-04-19 DOI: 10.1002/hast.1571
Laura Haupt
{"title":"The Ethic of Accompaniment","authors":"Laura Haupt","doi":"10.1002/hast.1571","DOIUrl":"https://doi.org/10.1002/hast.1571","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Taking inspiration from liberation theology and physician Paul Farmer, the lead article in the March-April 2024 issue of the</i> Hastings Center Report <i>offers a “cautiously idealistic” argument for surgeons to follow the ethic of accompaniment, opening themselves to the lives of patients and communities who are poor, disabled, directly harmed by racism, and otherwise marginalized. Among other work in this issue are pieces on the ethics of approaches to mental health care in the United States. One essay, for example, illuminates three main phenomena that are contributing to a rise in the number of people with serious psychiatric conditions that are untreated or given inappropriate treatment. An At Law essay criticizes recent proposals by the mayors of New York City and Portland, Oregon, for expanding the use of involuntary commitment among people experiencing homelessness</i>.</p>\u0000 </div>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 2","pages":"inside_front_cover"},"PeriodicalIF":3.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hast.1571","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140619816","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
The Pandemic of Invisible Victims in American Mental Health 美国心理健康中的隐形受害者大流行
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-04-19 DOI: 10.1002/hast.1573
Jacob M. Appel
{"title":"The Pandemic of Invisible Victims in American Mental Health","authors":"Jacob M. Appel","doi":"10.1002/hast.1573","DOIUrl":"https://doi.org/10.1002/hast.1573","url":null,"abstract":"<p><i>Although considerable attention has been devoted to the concepts of “visible” and “invisible” victims in general medical practice, especially in relation to resource allocation, far less consideration has been devoted to these concepts in behavioral health. Distinctive features of mental health care in the United States help explain this gap. This essay explores three specific ways in which the American mental health care system protects potentially “visible” individuals at the expense of “invisible victims” and otherwise fails to meet the needs of great numbers of people with serious psychiatric conditions: prioritization of the wrong patients, incentivization of excessive caution among providers, and a narrow definition of psychiatry's purview. While each of these practices has been discussed elsewhere in the literature, they are rarely considered as part of an interrelated and systemic problem. Reconceptualizing these three issues as aspects of the larger conflict between the interests of “visible” and “invisible” victims may prove a path toward reform</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 2","pages":"3-7"},"PeriodicalIF":3.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140619813","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: 0
Contributors 贡献者
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-04-19 DOI: 10.1002/hast.1580
{"title":"Contributors","authors":"","doi":"10.1002/hast.1580","DOIUrl":"https://doi.org/10.1002/hast.1580","url":null,"abstract":"","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 2","pages":"46"},"PeriodicalIF":3.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140619819","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: 0
Residency Requirements for Medical Aid in Dying 临终医疗救助的居住要求。
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-03-15 DOI: 10.1002/hast.1570
Rebecca Dresser
{"title":"Residency Requirements for Medical Aid in Dying","authors":"Rebecca Dresser","doi":"10.1002/hast.1570","DOIUrl":"10.1002/hast.1570","url":null,"abstract":"<p><i>In 1997, when Oregon became the first U.S. jurisdiction authorizing medical aid in dying (MAID), its law included a requirement that patients be legal residents of the state. Other U.S. jurisdictions legalizing MAID followed Oregon in adopting residency requirements. Recent litigation challenges the legality, as well as the justification, for such requirements. Facing such challenges, Oregon and Vermont eliminated their MAID residency requirements. More states could follow this move, for, in certain circumstances, the U.S. Constitution's privileges and immunities clause protects citizens’ right to travel to secure medical care. Policy considerations could also motivate states to reexamine whether such requirements are justified in light of existing evidence of how MAID laws have been applied</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 3","pages":"3-5"},"PeriodicalIF":3.3,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133335","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: 0
Neuroscience and Society: Supporting and Unsettling Public Engagement 神经科学与社会：支持和颠覆公众参与。
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-02-23 DOI: 10.1002/hast.1565
Gregory E. Kaebnick
{"title":"Neuroscience and Society: Supporting and Unsettling Public Engagement","authors":"Gregory E. Kaebnick","doi":"10.1002/hast.1565","DOIUrl":"10.1002/hast.1565","url":null,"abstract":"<p><i>Advancing neuroscience is one of many topics that pose a challenge often called “the alignment problem”—the challenge, that is, of assuring that science policy is responsive to and in some sense squares with the public's values. This issue of the</i> Hastings Center Report <i>launches a series of scholarly essays and articles on the ethical and social issues raised by this vast body of medical research and bench science. The series, which will run under the banner “Neuroscience and Society,” is supported by the Dana Foundation and seeks to promote deliberative public engagement, broadly understood, about neuroscience. As a social goal, deliberative public engagement is both ubiquitous and elusive—called for everywhere yet difficult to undertake at a national level on a complex scientific topic. To be meaningful, deliberative public engagement must occur in many locations in a society and be carried forward by many actors. Scholarly writing might contribute in several ways</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 1","pages":"20-23"},"PeriodicalIF":3.3,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934351","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: 0
Care or Complicity? Medical Personnel in Prisons 关怀还是共谋？监狱中的医务人员。
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-02-23 DOI: 10.1002/hast.1560
Rebecca L. Walker
{"title":"Care or Complicity? Medical Personnel in Prisons","authors":"Rebecca L. Walker","doi":"10.1002/hast.1560","DOIUrl":"10.1002/hast.1560","url":null,"abstract":"<p><i>Imprisonment may sometimes be a justified form of punishment. Yet the U.S. carceral system suffers from appalling problems of justice—in who is put into prisons, in how imprisoned people are treated, and in downstream personal and community health impacts. Medical personnel working in prisons and jails take on risky work for highly vulnerable and underserved patients. They are to be lauded for their professional commitments. Yet at the same time, prison care undercuts the ability of medical personnel to uphold their own professional standards and sometimes fails in even basic health protection. Doctors in prisons are stuck between their commitment to vulnerable patients and complicity in a system that requires their participation to uphold its constitutionality. Medical ethics is frayed in prisons, and the problem deserves our attention</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 1","pages":"2"},"PeriodicalIF":3.3,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934345","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: 0
Brain Pioneers and Moral Entanglement: An Argument for Post-trial Responsibilities in Neural-Device Trials 大脑先驱与道德纠葛：神经设备审判中的审后责任论证。
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-02-23 DOI: 10.1002/hast.1566
Sara Goering, Andrew I. Brown, Eran Klein
{"title":"Brain Pioneers and Moral Entanglement: An Argument for Post-trial Responsibilities in Neural-Device Trials","authors":"Sara Goering,&nbsp;Andrew I. Brown,&nbsp;Eran Klein","doi":"10.1002/hast.1566","DOIUrl":"10.1002/hast.1566","url":null,"abstract":"<p><i>We argue that in implanted neurotechnology research, participants and researchers experience what Henry Richardson has called “moral entanglement.” Participants partially entrust researchers with access to their brains and thus to information that would otherwise be private, leading to created intimacies and special obligations of beneficence for researchers and research funding agencies. One of these obligations, we argue, is about continued access to beneficial technology once a trial ends. We make the case for moral entanglement in this context through exploration of participants’ vulnerability, uncompensated risks and burdens, depth of relationship with the research team, and dependence on researchers in implanted neurotechnology trials</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 1","pages":"24-33"},"PeriodicalIF":3.3,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934344","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: 0
Challenging Disability Discrimination in the Clinical Use of PDMP Algorithms 挑战 PDMP 算法临床使用中的残疾歧视。
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2024-02-23 DOI: 10.1002/hast.1561
Elizabeth Pendo, Jennifer Oliva
{"title":"Challenging Disability Discrimination in the Clinical Use of PDMP Algorithms","authors":"Elizabeth Pendo,&nbsp;Jennifer Oliva","doi":"10.1002/hast.1561","DOIUrl":"10.1002/hast.1561","url":null,"abstract":"<p><i>State prescription drug monitoring programs (PDMPs) use proprietary, predictive software platforms that deploy algorithms to determine whether a patient is at risk for drug misuse, drug diversion, doctor shopping, or substance use disorder (SUD). Clinical overreliance on PDMP algorithm-generated information and risk scores motivates clinicians to refuse to treat—or to inappropriately treat—vulnerable people based on actual, perceived, or past SUDs, chronic pain conditions, or other disabilities. This essay provides a framework for challenging PDMP algorithmic discrimination as disability discrimination under federal antidiscrimination laws, including a new proposed rule interpreting section 1557 of the Affordable Care Act</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"54 1","pages":"3-7"},"PeriodicalIF":3.3,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934346","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: 0
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