scholarly journals Canadian Association of Gastroenterology Practice Guideline for Informed Consent – Gastrointestinal Endoscopy

1997 ◽  
Vol 11 (6) ◽  
pp. 533-534 ◽  
Author(s):  
H Miller MacSween
Keyword(s):  
Informed Consent ◽  
Practice Guideline ◽  
Gastrointestinal Endoscopy ◽  
Self Determination ◽  
Ethical Principles ◽  
Legal Doctrine ◽  
The Past ◽  
Canadian Association ◽  
Ethical Concept ◽  
Physician Liability

Informed consent has undergone a transformation from an ethical concept to a legal doctrine. It is based on the ethical principles of self-determination and autonomy. Over the past several years, courts have established physician liability based on the failure to obtain adequate informed consent. It is the duty of all gastrointestinal endoscopists to obtain legally adequate informed consent before performing any endoscopic procedure.

scholarly journals Canadian Association of Gastroenterology Practice Guideline for Granting of Privileges to Perform Gastrointestinal Endoscopy

1997 ◽  
Vol 11 (5) ◽  
pp. 429-432 ◽  
Author(s):  
H Miller MacSween
Keyword(s):  
Gastrointestinal Tract ◽  
Practice Guideline ◽  
Diagnostic Tool ◽  
Gastrointestinal Endoscopy ◽  
Flexible Sigmoidoscopy ◽  
Therapeutic Endoscopy ◽  
Endoscopic Techniques ◽  
The Past ◽  
Canadian Association

The purpose of this statement is to provide guidelines to assist hospital credentialling committees in their task of granting privileges to perform gastrointestinal endoscopy. Endoscopy of the gastrointestinal tract has evolved over the past 30 years as a potent tool to assist in the evaluation, diagnosis and therapy of patients with gastrointestinal tract disorders. Although gastrointestinal endoscopy was initially developed as a purely diagnostic tool, the development of therapeutic endoscopic techniques has dramatically expanded the role of gastrointestinal endoscopy, frequently to a therapeutic one. In setting guidelines for training and credentialling one must recognize that, excluding flexible sigmoidoscopy, endoscopists should be well trained in therapeutic endoscopy.

scholarly journals Propofol Use for Sedation during Endoscopy in Adults: A Canadian Association of Gastroenterology Position Statement

2008 ◽  
Vol 22 (5) ◽  
pp. 457-459 ◽  
Author(s):  
Michael F Byrne ◽  
Naoki Chiba ◽  
Harminder Singh ◽  
Daniel C Sadowski ◽  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Rapid Onset ◽  
Position Statement ◽  
Patient Comfort ◽  
Medical Evidence ◽  
Onset Of Action ◽  
Propofol Sedation ◽  
The Past ◽  
Canadian Association ◽  
Rapid Clearance

Over the past decade, multiple clinical reports have demonstrated that the use of propofol sedation for gastrointestinal endoscopy by gastroenterologists and trained endoscopy nurses is safe and effective in appropriately selected patients. Proposed benefits of propofol sedation include rapid onset of action, improved patient comfort and rapid clearance, as well as prompt recovery and discharge from the endoscopy unit. As a result of medical evidence, a number of international professional societies have endorsed the use of propofol in gastrointestinal endoscopy. In Canada, no formal guidelines currently exist. In the present article, the Clinical Affairs Committee of the Canadian Association of Gastroenterology presents a position statement, incorporating updated information on the use of propofol sedation for endoscopy in adult patients.

Informed consent, vulnerability and the risks of group-specific attribution

2014 ◽  
Vol 21 (7) ◽  
pp. 829-843 ◽  
Author(s):  
Berta M Schrems
Keyword(s):  
Informed Consent ◽  
Research Process ◽  
Relational Ethics ◽  
Self Determination ◽  
Ethical Principles ◽  
Nursing Research ◽  
Clinical Nursing ◽  
Co Morbidity ◽  
Vulnerable People ◽  
Principles Of Justice

People in extraordinary situations are vulnerable. As research participants, they are additionally threatened by abuse or exploitation and the possibility of harm through research. To protect people against these threats, informed consent as an instrument of self-determination has been introduced. Self-determination requires autonomous persons, who voluntarily make decisions based on their values and morals. However, in nursing research, this requirement cannot always be met. Advanced age, chronic illness, co-morbidity and frailty are reasons for dependencies. These in turn lead to limited abilities or opportunities for decision-making and self-determination. Exclusion of vulnerable people from research projects would disadvantage them by not covering their needs, which would violate the ethical principles of justice and beneficence. Commonly, vulnerability is attributed to social groups. The consequence for individuals, attributed as belonging to such a vulnerable group, is that the principles of respect for autonomy, justice and beneficence are subordinated to the principle of non-maleficence, understood as avoiding the risk to cause more harm than good. In addition, group-specific attribution could lead to stigmatizing because labelling a person as deviation from a norm violates integrity. For clinical nursing research, the question arises how the protection of vulnerable people could be granted without compromising ethical principles. The concept of relational ethics provides a possible approach. It defines vulnerability as the relation between a person’s health status and the extent to which this person is dependent on the researcher and the research context. Vulnerability is not attributed solely to a person but to a situation, meaning the person is viewed in context. By combining vulnerability as a context-related and situational concept with existing approaches of informed consent, the different ethical principles can be balanced and preserved at every step of the research process.

Electronic Fetal Monitoring: Physician Liability and Informed Consent

1984 ◽  
Vol 10 (1) ◽  
pp. 31-91
Author(s):  
Myra Gerson Gilfix
Keyword(s):  
Informed Consent ◽  
Fetal Monitoring ◽  
Standard Of Care ◽  
Legal Issues ◽  
Standards Of Care ◽  
Monitoring Technique ◽  
Electronic Fetal Monitoring ◽  
Monitoring Procedure ◽  
Practice Standard ◽  
Physician Liability

AbstractElectronic fetal monitoring (EFM) has been criticized as ineffective, unsafe and costly. Despite existing controversy regarding the risks involved in using EFM, this monitoring procedure continues to be widely employed. In many jurisdictions, in fact, the use of EFM during labor may be considered the customary practice. This Article analyzes the medical and legal issues arising from a physician's use of or failure to use EFM. The Author argues that EFM subjects the mother and the fetus to risks which may be avoided if auscultation, a less intrusive monitoring technique, is employed. The ‘customary practice’ standard of care, the ordinary negligence standard of care, and the ‘best judgment’ and ‘duty to keep abreast’ standards of care are compared and applied to the physician's decision to use EFM. The Author contends that physicians who employ auscultation may not be liable for failing to use EFM; however, physicians who use EFM despite the evidence of its risks may be liable for failing to ‘keep abreast’ or to use their ‘best judgment’ or for negligence. Finally, the Author contends that both physicians and their patients are best protected when the physician elicits the mother's informed consent to employ a particular monitoring technique during labor.

Certified Patient Decision Aids: Solving Persistent Problems with Informed Consent Law

2017 ◽  
Vol 45 (1) ◽  
pp. 12-40 ◽  
Author(s):  
Thaddeus Mason Pope
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Treatment ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Legal Doctrine ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Decision Making Processes

The legal doctrine of informed consent has overwhelmingly failed to assure that the medical treatment patients get is the treatment patients want. This Article describes and defends an ongoing shift toward shared decision making processes incorporating the use of certified patient decision aids.

More Than Cheating: Deception, IRB Shopping, and the Normative Legitimacy of IRBs

2012 ◽  
Vol 40 (4) ◽  
pp. 990-996 ◽  
Author(s):  
Ryan Spellecy ◽  
Thomas May
Keyword(s):  
Informed Consent ◽  
Multicenter Trial ◽  
Federal Regulations ◽  
Approval Process ◽  
Emergency Research ◽  
Moral Issues ◽  
The Past ◽  
Significant Attention

Deception, cheating, and loopholes within the IRB approval process have received significant attention in the past several years. Surveys of clinical researchers indicate common deception ranging from omitting information to outright lying, and controversy surrounding the FDA's decision not to ban “IRB shopping” (the practice of submitting protocols to multiple IRBs until one is found that will approve the protocol) has raised legitimate concerns about the integrity of the IRB process. One author has described a multicenter trial as being withdrawn from consideration at one institution when rejection was imminent, in order to avoid informing other IRBs reviewing the protocol of the study's rejection (a requirement under the federal regulations for emergency research with an exception from informed consent). This practice and IRB shopping seem at odds with the spirit, if not the “letter,” of the regulations. While at first blush these practices seem to cast aspersions on the integrity of clinical researchers, the moral issues raised go deeper than the ethics of cheating.

Audientia sacerdotalis?—Remarks on the Legal Nature of Dispute Resolution by Ecclesiastics in Late Antiquity

2021 ◽  
Vol 25 (1) ◽  
pp. 108-149
Author(s):  
Marzena Wojtczak
Keyword(s):  
Dispute Resolution ◽  
Late Antiquity ◽  
Simultaneous Increase ◽  
Legal Practice ◽  
Legal Doctrine ◽  
The Past ◽  
Lower Rank ◽  
Literary Sources ◽  
Legal Nature ◽  
The Subject

Abstract The problem of audientia episcopalis in late antiquity has been the subject of extensive research in the past. Previous studies have usually focussed on the legal doctrine, as well as the picture of bishop courts in the light of the literary sources. In contrast, the question of how audientia episcopalis functioned in the legal practice as shown by papyri has caused scholars much difficulty, due to the limited material available as well as the obscure nature of the institution. One could therefore ask: how is it possible that such allegedly common practice of dispute resolution by the bishops—as literary sources make us believe—is so elusive in the papyri? How to explain the simultaneous increase for that period of the papyrological attestations regarding arbitration/mediation carried out by the clergy of lower rank? Could we be dealing with some sort of audientia sacerdotalis functioning in the legal practice? How widespread was in fact the audientia episcopalis, and was this institution homogeneous or rather heterogeneous in nature? The paper presents the attempt to answer these questions by confronting the imperial law with the evidence of legal practice.

Obtaining Informed Consent in an Egyptian Research Study

2004 ◽  
Vol 11 (4) ◽  
pp. 394-399 ◽  
Author(s):  
Amina M Rashad ◽  
Fiona MacVane Phipps ◽  
Melanie Haith-Cooper
Keyword(s):  
Informed Consent ◽  
Academic Research ◽  
Codes Of Ethics ◽  
Theoretical Work ◽  
Ethical Principles ◽  
Arab Muslim ◽  
Ethical Approval ◽  
The Uk ◽  
Collection Phase ◽  
British Research

This article explores the concept of internationally acceptable codes of ethics within the context of an Egyptian nurse’s PhD studies. Theoretical work, including gaining ethical approval for the project, took place in the UK, while the data collection phase of the study was done in Egypt. This highlighted areas where the Arab Muslim interpretation of some ethical principles, especially around the issue of gaining informed consent, differed from that currently accepted in British research ethics. The authors argue that it may not be possible, or even desirable, to standardize codes of ethics globally in areas such as academic research. Ethical principles develop from a unique mix of culture and religion. It may be more important to develop cultural competence that includes the ability to understand and respect the way in which ethical principles are interpreted by various societies.

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