scholarly journals Carmi Syndrome in a Preterm Neonate: A Multidisciplinary Approach and Ethical Challenge

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Timothy D. Hicks ◽  
Himanshu Singh ◽  
Michel Mikhael ◽  
Anita R. Shah
Keyword(s):  
Multidisciplinary Approach ◽  
Preterm Neonate ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Health Care Teams ◽  
Best Interest ◽  
Pyloric Atresia ◽  
Tissue Separation ◽  
Multisystem Involvement ◽  
Carmi Syndrome

Epidermolysis bullosa (EB) is characterized by blistering of the skin and mucosal erosions caused by hemidesmosomal abnormalities. EB is divided into 3 major subgroups depending on the particular location of tissue separation: EB simplex, dystrophic EB, and junctional EB. Junctional EB (JEB) can further be broken down into Herlitz, non-Herlitz, and JEB with pyloric atresia (Carmi syndrome) depending on genetic and histologic testing. When extensive, management of a patient with EB can be challenging due to not only cutaneous but also extracutaneous manifestations as well. Families and health care teams are often faced with difficult decisions in their infant’s best interest. We report a case of a preterm neonate with Carmi syndrome and unique findings on immunofluorescence studies. The patient’s course was complicated by multisystem involvement and ultimately death. A multidisciplinary approach was crucial in the light of diagnostic, therapeutic, and ethical challenges.

Ethical challenges when using coercion in mental healthcare: A systematic literature review

2016 ◽  
Vol 25 (1) ◽  
pp. 92-110 ◽  
Author(s):  
Marit Helene Hem ◽  
Elisabeth Gjerberg ◽  
Tonje Lossius Husum ◽  
Reidar Pedersen
Keyword(s):  
Patient Autonomy ◽  
Moral Distress ◽  
Mental Healthcare ◽  
Healthcare Personnel ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Best Interest ◽  
Ethical Considerations ◽  
Search Terms ◽  
Healthcare It

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress.

scholarly journals Large Gastric Perforation in Carmi Syndrome: A Morbid Complication in a Rare Association

2012 ◽  
Vol 1 (4) ◽  
pp. 57 ◽  
Author(s):  
M Joshi ◽  
L Krishnan ◽  
S Kuruvila
Keyword(s):  
Epidermolysis Bullosa ◽  
Preterm Neonate ◽  
Gastric Perforation ◽  
Pyloric Atresia ◽  
Rare Association ◽  
Carmi Syndrome

The association between epidermolysis bullosa (EB) and congenital pyloric atresia (CPA) named Carmi Syndrome is rare. We report unusual and morbid complication of gastric perforation resulting in peritonitis in a preterm neonate born with Carmi Syndrome.

Intensive care nurses’ experiences of Covid-19 care: A practical and ethical challenge – a qualitative descriptive design

2021 ◽  
pp. 205715852110627
Author(s):  
Anna-Lena Stenlund ◽  
Gunilla Strandberg
Keyword(s):  
Intensive Care ◽  
Qualitative Content Analysis ◽  
Treatment Strategies ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Structured Interviews ◽  
Intensive Care Nurses ◽  
Qualitative Descriptive ◽  
Heavy Burden ◽  
New Treatment

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies, and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and its ethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis was used. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailored intensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protect ethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibility for the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was to strive to make the best of the situation.

“More Than Just Inventors”: RICHARD M. CUTTS, RICHARD M. CUTTS JR., AND THE ETHICAL CHALLENGE OF THE OFFICER-INVENTOR

2021 ◽  
Vol 6 (2) ◽  
pp. 24-44
Author(s):  
John A. Sheehan
Keyword(s):  
Interwar Period ◽  
Crucial Role ◽  
Marine Corps ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Private Business ◽  
Business Partners ◽  
Ethical Decisions ◽  
Conflicting Demands

This article examines the ethical decisions of two enterprising interwar period Marine officers, Colonel Richard M. Cutts and Brigadier General Richard M. Cutts Jr. Known for their development of a muzzle device used on the Thompson submachine gun, the Cuttses have been treated casually by historians as innocuous inventors. This article reveals their crucial role in generating interest in their device and energetic advocacy for official adoption of the Thompson submachine gun. Drawing support from other officers in the Marine Corps and allies in manufacturing, they eagerly pursued widespread sales of their device. Pulled by conflicting demands as Marines, inventors, and business partners, this article contends that they engaged in activity that blurred private business matters with their professional duties as Marines. Examination of the Cuttses invites scholars and practitioners to contemplate the ethical challenges faced by Marines past and present.

The Angler in the Environment: Social, Economic, Biological, and Ethical Dimensions

2011 ◽  
Keyword(s):  
Animal Welfare ◽  
Animal Rights ◽  
Mental States ◽  
Ethical Challenge ◽  
Recreational Fishing ◽  
Ethical Challenges ◽  
Catch And Release ◽  
Individual Fish ◽  
Recreational Angling ◽  
The Individual

<i>Abstract</i>.—Ever since fishing was called recreational fishing, a cruelty charge has hovered around somewhere in the background. In recent times, however, it has made it to the fore substantiated by anthropomorphic reasoning and fuelled by high-visibility papers claiming that fish can feel pain and suffer. Because some segments of the public perceive the infliction of these mental states to fish as abhorrent and not outweighing the costs imposed on the individual fish by appropriate benefits to the human, recreational fishing is coming under attack on moral grounds. Other challenges have also emerged that do not center on the issue of whether fish are sentient or not. In this paper, we describe five of the most prevalent moral challenges to recreational angling, two of which—animal welfare and wilderness-centered perspectives—can offer a constructive outlook by calling upon improved treatment of individual fish (animal welfare) and generally more sustainable management (wilderness perspective). In contrast, if one subscribes to animal liberation or animal rights philosophies, the outlook for recreational fishing is generally negative: it has to stop. A final challenge is associated with the motivations of anglers. The moral argument there is that the activity is carried out largely for angler pleasure rather than as a means of securing survival. The outlook of this ethical challenge sometimes leans towards only accepting one form of recreational fishing: catching, killing, and eating. Voluntary catch-and-release fishing and practices such as tournament fishing with a strict total catch-and-release policy would then not be ethically permissible. In this paper, we highlight the origin and background of each of the five ethical challenges and explain their implications for recreational fishing.

Moving Toward Interdisciplinary Pain Management

2005 ◽  
Vol 41 (5) ◽  
pp. 343-345
Author(s):  
Robin Downing
Keyword(s):  
Pain Management ◽  
Multidisciplinary Approach ◽  
Emotional Experience ◽  
Interdisciplinary Approach ◽  
Current Method ◽  
Single Patient ◽  
Best Interest ◽  
Animal Pain ◽  
Interdisciplinary Pain Management ◽  
Multiple Issues

Pain is an unpleasant and emotional experience associated with actual or potential tissue damage. The current method of caring for a person with multiple issues and problems is a "multidisciplinary" approach; however, the disadvantages of a multidisciplinary approach are many. A more desirable alternative is an "interdisciplinary" approach. Interdisciplinary care is predicated on professionals communicating with one another about a single patient and designing care that is in the overall best interest of the patient. This paper describes the formation of the International Veterinary Academy of Pain Management, whose objective is to promote the interdisciplinary approach to animal pain management.

scholarly journals SLE during pregnancy, maternal and perinatal outcome in teritary hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 507 ◽  
Author(s):  
. Leelavathi ◽  
Nayana D. H. ◽  
Triveni Kondareddy ◽  
Kaytri S.
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcome ◽  
Multidisciplinary Approach ◽  
High Rate ◽  
Therapeutic Interventions ◽  
Successful Management ◽  
Lupus Flare ◽  
Multisystem Involvement ◽  
Improved Outcomes ◽  
Child Bearing

Background: SLE is an autoimmune disease most frequently found in women of child bearing age and may co­exist with pregnancy. Its multisystem involvement and therapeutic interventions pose a high risk for both the mother and the foetus. Disease flares in pregnancy pose challenges with respect to distinguishing physiologic changes related to pregnancy from disease related manifestations. The present study analyzes the fetomaternal outcome of pregnant women with SLE.Methods: An analysis of fetomaternal outcome of pregnant women with SLE during April  2015 to May 2016 at JSS hospital.Results: During the period from April 2016 to May 2016, 3773 deliveries were conducted in the department. Eleven pregnant women with SLE were followed up during this period, giving an incidence of 0.29/1000 deliveries. A high rate of lupus flare during pregnancy was found in the current study. Even among women in remission for more than six months before pregnancy, the rate of lupus flare was not low (27%). Also other complications seen were pre-eclampsia 54.54%, HELLP syndrome in 9.09% , PPH in 50%, polyserositis seen in 9.09% and one maternal death was seen (9.09%). No neonate suffered from heart-blocker however there was 75 % NICU admissions among live borns.Conclusions: Advancing technology and better understanding of the maternal-foetal relationship in lupus have improved outcomes in lupus pregnancies over the last decade. The multisystem nature of the disease, the severity of the organ involvement needs to be assessed and a multidisciplinary approach is required for its diagnosis and successful management.

scholarly journals Hospital ethics reflection groups: a learning and development resource for clinical practice

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
H. Bruun ◽  
L. Huniche ◽  
E. Stenager ◽  
C. B. Mogensen ◽  
R. Pedersen
Keyword(s):  
Clinical Practice ◽  
General Hospital ◽  
Positive Impact ◽  
Reflection Group ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Reflection Groups ◽  
Patient Admissions ◽  
The Impact ◽  
Ethics Reflection

Abstract Background An ethics reflection group (ERG) is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark. Methods This is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis of significance. Results A recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG. Conclusion This study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives.

Catholic Social Teaching in an ERA of Economic Globalization: A Resource for Business Ethics

1997 ◽  
Vol 7 (2) ◽  
pp. 57-70 ◽  
Author(s):  
Dennis P. McCann
Keyword(s):  
Business Ethics ◽  
Work Ethic ◽  
Structural Changes ◽  
Catholic Social Teaching ◽  
Economic Globalization ◽  
Ethical Challenge ◽  
Social Teaching ◽  
Ethical Challenges ◽  
Knowledge Based ◽  
Robert Reich

Abstract:The paper attempts to provide a basis for exploring the continued relevance of Catholic social teaching to business ethics, by interpreting the historic development of a Catholic work ethic and the traditions of Catholic social teaching in light of contemporary discussions of economic globalization, notably those of Robert Reich and Peter Drucker. The paper argues that the Catholic work ethic and the Church’s tradition of social teaching has evolved dynamically in response to the structural changes involved in the history of modern economic development, and thus is well poised to speak to the ethical challenges implicit in the advent of a knowledge-based society. In order to test this thesis, the author sketches an approach to the ethical challenge of corporate downsizing that he believes illustrates the continued relevance of Catholic social teaching to business ethics.

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