 | | Medical Ethics: Ethical frameworks for complex medical decision making in older patients: A narrative review | Medical Ethics: Ethical frameworks for complex medical decision making in older patients: A narrative review
Medical Ethics: Ethical frameworks for complex medical decision making in older patients: A narrative review
Overview With an ageing population, physicians are more and more faced with complex medical and moral situations. Medical professional guidelines are often of limited use in these cases. To assist the decision-making process, several ethical frameworks have been proposed. Ethical frameworks are analytical tools that are designed to assist physicians and other involved healthcare workers in complex moral decision-making situations. Most frameworks are step-by-step plans that can be followed chronologically during moral case deliberations. Some of these step-by-step plans provide specific moral guidance as to what would constitute a morally acceptable conclusion, while others do not. In this narrative review we will present and discuss the ethical frameworks used for medically complex situations in older people that have been proposed in literature. Twenty-three studies were included in the review, containing seventeen different frameworks. Twenty studies described step-by-step-frameworks, with the number of steps varying from three to twelve. In four studies suggestions were made as how to balance conflicting moral values. Ethical frameworks are meant to assist healthcare professionals who are faced with morally complex decisions in older patients. In our view, these frameworks should contain a step-by-step plan, moral values and an approach to balancing moral values.
Acknowledgements: Authors Rozemarijn Lidewij van Bruchem-Visser, Gert van Dijk, Inez de Beaufort, Francesco Mattace-Raso Journal Archives of Gerontology and Geriatrics | 3 | | R 465.00 |  |
| | Medical Ethics: Managed Health Care: Protestation and Dissent? | Medical Ethics: Managed Health Care: Protestation and Dissent?
Medical Ethics: Managed Health Care: Protestation and Dissent?
Overview Recent times has put the words ‘dissent’ and ‘protest’ at the centre of our vocabulary. Practitioners are speaking out against perceived injustices, voicing opposition to interventions they disagree with and organising to effect change. ‘Dissent’ is an expression of opinions at variance with those commonly or officially held. ‘Protest’ is closely related to ‘dissent’ but they are different. ‘Protest is an expression or declaration of objection or disapproval, often in opposition to something where a person is considered powerless to prevent or avoid’. Managed care for SA healthcare in general, is a fact of life.
In essence, for the purpose of this article, Managed Health Care can be defined as a group of activities intended to reduce costs of health care provision and providing health insurance whilst improving the quality of care. Managed care, in practical terms encompasses the management of cost, management of information and management of risk.
It is important for practitioners to have a reasonable understanding of the principles of managed care and the role of the Managed Care Organisations. At times, there are cries of foul play aimed at the interventions instituted by the managed Care Organisations where, in fact, such interventions are indeed lawful.
Author Harry Rosen
| 3 | | R 465.00 | |
| | Medical Ethics: Ethics in Practice -The Obligations that Define a Profession | Medical Ethics: Ethics in Practice -The Obligations that Define a Profession
Medical Ethics: Ethics in Practice -The Obligations that Define a Profession
Overview The use of the word ‘profession’ has expanded so far beyond its original meaning that a clear definition has become obscured and marred by colloquial usage. It is not uncommon to find the term ‘professional’ misused to describe sportsmen, tradesmen and even politicians. Yet, when we speak about a ‘professional’ there is a tacit understanding that only individuals engaged in certain occupations belong to that category: doctors, lawyers, teachers. A fundamental distinction between a profession and any other occupation, is that individuals engaged in a profession have an ethical obligation to whomever they provide their services. In other words, a profession is required to have a Code of Ethics. Unlike laws and regulations, which are prescriptive and rigid, the principles of ethics are flexible and how they are applied depends on the individual practitioner. It is these responsibilities and expectations that are the hallmarks of a profession.
Author Harry Rosen
| 3 | | R 485.00 | |
| | Medical Ethics: Social Media Violations | Medical Ethics: Social Media Violations
Medical Ethics: Social Media Violations
“I remember when Blackberry and Apple were just fruits.”
Overview
In practical terms, social media increase connectivity and is one of the fastest growing industries in the world.
Social media are forms of electronic communication (such as websites for social networking and microblogging) through which users create online communities to share information, ideas, personal messages, and other content (such as videos)
Businesses large and small are turning to social media as an outreach to potential customers worldwide, to advertise their products and services, and to engage with customers. In recent times we have seen how social signals are becoming an important part of search engine optimization.
There is no doubt that a well- planned social media strategy has the potential to make or take down a brand. For example, Lady Gaga (personal branding) quickly became a smash hit, and social media played a major role in her rise to stardom. Facebook, Twitter, Instagram and all other social media websites are great communication tools. After all, they help us be connected to people from all over the world. However, if poorly managed they can cause huge damage.
Author Harry Rosen
| 3 | | R 465.00 | |
| | Medical Ethics: Artificial Intelligence Ethics – Too Principled to Fail? | Medical Ethics: Artificial Intelligence Ethics – Too Principled to Fail?
Medical Ethics: Artificial Intelligence Ethics – Too Principled to Fail?
Overview
AI Ethics is now a global topic of discussion in academic and policy circles. At least 63 public-private initiatives have produced statements describing high-level principles, values, and other tenets to guide the ethical development, deployment, and governance of AI. According to recent meta-analyses, AI Ethics has seemingly converged on a set of principles that closely resemble the four classic principles of medical ethics. Despite the initial credibility granted to a principled approach to AI Ethics by the connection to principles in medical ethics, there are reasons to be concerned about its future impact on AI development and governance. Significant differences exist between medicine and AI development that suggest a principled approach in the latter may not enjoy success comparable to the former. Compared to medicine, AI development lacks (1) common aims and fiduciary duties, (2) professional history and norms, (3) proven methods to translate principles into practice, and (4) robust legal and professional accountability mechanisms. These differences suggest we should not yet celebrate consensus around high-level principles that hide deep political and normative disagreement.
Acknowledgment Author
Brent Mittelstadti Journal
Nature Machine Intelligence November 2019
| 3 | | R 420.00 | |
| | Medical Ethics: What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics | Medical Ethics: What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics
Medical Ethics: What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics
Overview This extended essay seeks to unpack some of the key aspects of philosophy which are applicable to medical thought and practice. It proceeds via an analytical discussion of the contemporary debate in three key areas of medical ethics: euthanasia, concepts of health and disease and psychiatry. The main claims are as follows:
1. The case for legalising euthanasia is strong on philosophical grounds but there are numerous practical obstacles. 2. Elements from the normative and naturalistic definitions of disease are necessary for a thorough definition that dodges common objections to either. 3. Mental health cannot be subsumed under a purely physicalist model of health rendering it distinctly different from other fields in Medicine.
Through a detailed discussion of three salient issues in the philosophy of medicine, it is argued that the application of profound philosophical thought to medicine and its practices reveals a depth that necessitates exploration before simply following the aims of curing all. Philosophical rigour matched with modern medicine has the potential to engage patients and help them make independent, informed decisions and assist physicians to think more clearly, analytically and empathetically.
Acknowledgement
Author Richard Fenton Journal Philosophy, Ethics and Humanities in Medicine
| 3 | | R 465.00 | |
| | Medical Ethics: Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa. | Medical Ethics: Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa.
Medical Ethics: Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa.
Overview
The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa.
This article discusses some of the ethical challenges that were encountered in these research projects. Among these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor.
In conclusion it is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa.
Acknowledgement
Author:
Heathfield LJ, Maistry S, Martin LJ, Ramesar R, de Vries J
Journal:
BMC medical ethics.
Publisher:
BioMed Central
| 3 | | R 370.00 | |
| | Medical Ethics: Ethics of the Placebo in Clinical Practice. | Medical Ethics: Ethics of the Placebo in Clinical Practice.
Medical Ethics: Ethics of the Placebo in Clinical Practice.
OVERVIEW
The placebo is not easy to define. As a matter of fact, some scholars are despaired of the possibility of ever finding an adequate definition for the term. However, many current definitions invoke the non-specific nature of the treatment effects as the leading feature of the placebo.
The object of this article was however to address the question of the placebo in clinical practice. This article nonetheless argued that the placebo could be an effective treatment. The article further argued that the use of the placebo does not entail deception. This article equally highlighted guidelines under which the placebo may be used for clinical purposes. This article further suggested that in selected cases, the use of the placebo may also be morally imperative. It is imperative to state that the arguments in this article were presented by three case vignettes.
The article was concluded that the placebo can be beneficial to physicians of many clinical situations
ACKNOWLEDGEMENT
AUTHORS:
Lichtenberg U Heresco-Levy, U Nitzan
JOURNAL:
BMJ Journal of Medical Ethics
| 3 | | R 425.00 | |
| | Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics | Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics
Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics
OVERVIEW
The question of ‘which is an ethical issue and which is not’ often arises doing research ethics. There are however many internationally known ethic guidelines and depending on which ethics guideline we consult, we may have various answers to this question. It is however ironical that we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus.
For this study, we extracted relevant information or imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. Results of this research nonetheless indicated that there is no consensus on many of the imperatives and that in only 8.2 % of the imperatives were there at least moderate consensus. The results further indicated that there was a lack of consensus in most of imperatives from the five internationally-known ethics guidelines.
The reason was however partly attributed to the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences.
ACKNOWLEDGEMENT
AUTHORS:
Rosemarie D. L. C. Bernabe, Ghislaine J. M. W. van Thiel and Johannes J. M. van Delden
JOURNAL: BMC Medical Ethics
| 3 | | R 330.00 | |