scholarly journals Legal Challenges to ICU Triage Decisions in the COVID-19 Pandemic: How Effectively Does the Law Regulate Bedside Rationing Decisions in Australia?

2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Eliana Close ◽  
Simon Young ◽  
Tina Cockburn ◽  
Lindy Willmott ◽  
Ben P White
Keyword(s):  
Intensive Care ◽  
Critically Ill Patient ◽  
Human Rights Law ◽  
Intensive Care Admission ◽  
Legal Challenges ◽  
Decision Making Processes ◽  
Parens Patriae ◽  
Legal Position ◽  
The Law ◽  
Triage Decisions

The COVID-19 pandemic has raised the difficult question of how to ration scarce intensive care resources when a health system is overwhelmed. Despite substantial ethical scholarship addressing these rationing decisions, little is known about the legal position in Australia. This article considers various legal challenges in response to a clinical scenario denying intensive care admission and a ventilator to a critically ill patient with COVID-19. The article considers key challenges in negligence, criminal law, administrative law, human rights law, and under the parens patriae jurisdiction and guardianship legislation, and how they would apply to this scenario. The article concludes that while there are many obstacles to a successful legal challenge, the law can provide important scrutiny and guidance in the design of decision-making processes and triage policies. To adequately protect individual interests, the article supports calls in the ethical literature to make these policies transparent for public scrutiny.

Evaluation of triage decisions for intensive care admission

1999 ◽  
Vol 27 (6) ◽  
pp. 1073-1079 ◽  
Author(s):  
Charles L. Sprung ◽  
Debora Geber ◽  
Leonid A. Eidelman ◽  
Mario Baras ◽  
Reuven Pizov ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Admission ◽  
Triage Decisions

Risk Factors for Pediatric Intensive Care Admission among Asthmatic Children in Aseer, South-West Saudi Arabia

2020 ◽  
Vol 11 (2) ◽  
pp. 1684
Author(s):  
Mohammed Abdullah Alshehri ◽  
Mohannad Mohammed Al gossadi Alsheri ◽  
Reema Mohammed Al gossadi Alsheri ◽  
Renad Mohammed Al gossadi Alsheri
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Intensive Care Admission ◽  
Asthmatic Children ◽  
South West

The Impact of Emerging Technologies on the Law of Armed Conflict

2019 ◽  
Keyword(s):  
Armed Conflict ◽  
New Technologies ◽  
Emerging Technologies ◽  
Legal Issues ◽  
Technological Advancement ◽  
Law Of Armed Conflict ◽  
Legal Challenges ◽  
Challenges And Opportunities ◽  
The Law ◽  
The Impact

Emerging technologies have always played an important role in armed conflict. From the crossbow to cyber capabilities, technology that could be weaponized to create an advantage over an adversary has inevitably found its way into military arsenals for use in armed conflict. The weaponization of emerging technologies, however, raises challenging legal issues with respect to the law of armed conflict. As States continue to develop and exploit new technologies, how will the law of armed conflict address the use of these technologies on the battlefield? Is existing law sufficient to regulate new technologies, such as cyber capabilities, autonomous weapons systems, and artificial intelligence? Have emerging technologies fundamentally altered the way we should understand concepts such as law-of-war precautions and the principle of distinction? How can we ensure compliance and accountability in light of technological advancement? This book explores these critical questions while highlighting the legal challenges—and opportunities—presented by the use of emerging technologies on the battlefield.

Property in Human Body Parts

2020 ◽  
Author(s):  
Justine Pila
Keyword(s):  
Intellectual Property ◽  
Property Rights ◽  
Human Body ◽  
First Principles ◽  
The Political ◽  
Body Parts ◽  
Cautionary Tale ◽  
Regulatory Approach ◽  
Legal Position ◽  
The Law

This chapter surveys the current legal position concerning property in bodies and bodily materials. Of especial relevance in the current age of advanced genetic and other bio technologies, it looks beyond property in bodies and their materials ‘as such’ to consider also (a) the availability of rights of personal and intellectual property in objects incorporating or derived from them, and (b) the reliance on quasi-property rights of possession and consent to regulate the storage and use of corpses and detached bodily materials, including so-called ‘bio-specimens’. Reasoning from first principles, it highlights the practical and conceptual, as well as the political and philosophical, difficulties in this area, along with certain differences in the regulatory approach of European and US authorities. By way of conclusion, it proposes the law of authors’ and inventors’ rights as simultaneously offering a cautionary tale to those who would extend the reach of property even further than it extends currently and ideas for exploiting the malleability of the ‘property’ concept to manage the risks of extending it.

scholarly journals Impact of Renal Replacement Therapy on Mortality in Critically Ill Patients—The Nephrologist’s View within an Interdisciplinary Intensive Care Team

2021 ◽  
Vol 10 (15) ◽  
pp. 3379
Author(s):  
Matthias Klingele ◽  
Lea Baerens
Keyword(s):  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Positive Impact ◽  
Kidney Injury ◽  
Care Team ◽  
Critically Ill Patient ◽  
Late Start

Acute kidney injury (AKI) is a common complication in critically ill patients with an incidence of up to 50% in intensive care patients. The mortality of patients with AKI requiring dialysis in the intensive care unit is up to 50%, especially in the context of sepsis. Different approaches have been undertaken to reduce this high mortality by changing modalities and techniques of renal replacement therapy: an early versus a late start of dialysis, high versus low dialysate flows, intermittent versus continuous dialysis, anticoagulation with citrate or heparin, the use of adsorber or special filters in case of sepsis. Although in smaller studies some of these approaches seemed to have a positive impact on the reduction of mortality, in larger studies these effects could not been reproduced. This raises the question of whether there exists any impact of renal replacement therapy on mortality in critically ill patients—beyond an undeniable impact on uremia, hyperkalemia and/or hypervolemia. Indeed, this is one of the essential challenges of a nephrologist within an interdisciplinary intensive care team: according to the individual situation of a critically ill patient the main indication of dialysis has to be identified and all parameters of dialysis have to be individually chosen with respect to the patient’s situation and targeting the main dialysis indication. Such an interdisciplinary and individual approach would probably be able to reduce mortality in critically ill patients with dialysis requiring AKI.

scholarly journals UK consultants’ experiences of the decision-making process around referral to intensive care: an interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044752
Author(s):  
Kaja Heidenreich ◽  
Anne-Marie Slowther ◽  
Frances Griffiths ◽  
Anders Bremer ◽  
Mia Svantesson
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Moral Responsibility ◽  
Critically Ill ◽  
Interpersonal Relationships ◽  
Qualitative Interviews ◽  
Working Environment ◽  
Critically Ill Patient ◽  
Decision Making Process ◽  
Moral Duties

ObjectiveThe decision whether to initiate intensive care for the critically ill patient involves ethical questions regarding what is good and right for the patient. It is not clear how referring doctors negotiate these issues in practice. The aim of this study was to describe and understand consultants’ experiences of the decision-making process around referral to intensive care.DesignQualitative interviews were analysed according to a phenomenological hermeneutical method.Setting and participantsConsultant doctors (n=27) from departments regularly referring patients to intensive care in six UK hospitals.ResultsIn the precarious and uncertain situation of critical illness, trust in the decision-making process is needed and can be enhanced through the way in which the process unfolds. When there are no obvious right or wrong answers as to what ought to be done, how the decision is made and how the process unfolds is morally important. Through acknowledging the burdensome doubts in the process, contributing to an emerging, joint understanding of the patient’s situation, and responding to mutual moral duties of the doctors involved, trust in the decision-making process can be enhanced and a shared moral responsibility between the stake holding doctors can be assumed.ConclusionThe findings highlight the importance of trust in the decision-making process and how the relationships between the stakeholding doctors are crucial to support their moral responsibility for the patient. Poor interpersonal relationships can damage trust and negatively impact decisions made on behalf of a critically ill patient. For this reason, active attempts must be made to foster good relationships between doctors. This is not only important to create a positive working environment, but a mechanism to improve patient outcomes.

Trans Rights Are Not Just Human Rights: Legal Strategies for Trans Justice

2020 ◽  
Vol 35 (2) ◽  
pp. 293-315 ◽  
Author(s):  
Samuel Singer
Keyword(s):  
Human Rights ◽  
Case Law ◽  
Social Benefits ◽  
Human Rights Law ◽  
Trans People ◽  
Legal Challenges ◽  
Legal Advocacy ◽  
And Gender ◽  
Legal Strategies ◽  
The Many

AbstractHuman rights instruments are but one of many legal advocacy tools used by trans people. Recent legal scholarship emphasizes that human rights laws are not sufficient to address legal challenges facing trans people, particularly intersectional and systemic barriers. This article looks to Canadian trans case law outside of human rights law to reveal the many instances in which trans people’s fight for legal recognition and redress occur outside of the human rights arena. It focuses on trans case law in three areas: family law, the use of name and gender in court, and access to social benefits. Canadian trans jurisprudence illustrates that not only are trans legal strategies outside of human rights plentiful and effective, they are also imperative. An agile and pragmatic approach to trans rights is necessary, particularly when minority rights are under threat, and for trans people on the margins of trans law reforms.

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