An Alternative Perspective on Rationing Ventilators

2020 ◽  
Vol 45 (7) ◽  
pp. 5-6
Author(s):  
Tadeusz Pacholczyk ◽  
Keyword(s):  
Health Care Professionals ◽  
Clinical Status ◽  
Ethics Committees ◽  
Withdrawing Treatment ◽  
Medical Decisions ◽  
Psychological Strain ◽  
Exclusion Criteria ◽  
Scarce Resources ◽  
Alternative Perspective ◽  
Withholding Or Withdrawing Treatment

The COVID-19 pandemic has resulted in discussion on how to allocate scarce medical resources such as ventilators. Some bioethicists have suggested that difficult determinations about withholding or withdrawing treatment should be made by triage officers or committees to alleviate the psychological strain on frontline clinicians. However, this raises concerns about shifting important personal medical decisions away from physicians and their patients. According to the principle of subsidiarity, frontline clinicians, together with their patients, should be making these decisions, with ethics committees or triage committees serving only in an advisory capacity. Several ethical principles can help health care professionals allocate scarce resources. These include basing exclusion criteria on clinical status rather than nonmedical characteristics; randomizing treatment for clinically similar patients; obtaining free and informed consent when considering the withdrawal of treatment, even in situations where treatment is possibly futile; and emphasizing quality palliative care for all patients.

Webster and the Fundamental Right to Make Medical Decisions

1989 ◽  
Vol 15 (2-3) ◽  
pp. 184-188
Author(s):  
David Orentlicher
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
The State ◽  
Medical Decisions ◽  
Fetal Health ◽  
Religious Issues ◽  
Roe V Wade

The interest of the eight major organizations of health care professionals was not in debating the philosophical, ethical, moral or religious issues surrounding abortion. The members of the organizations differ on how to balance the woman's privacy right against the state's interests in maternal and fetal health, and in particular about whether the state has a compelling interest in fetal health before viability. Given the diversity of views, the brief neither endorsed nor opposed the Supreme Court's holding in Roe v. Wade that the state's interest in fetal health becomes compelling at viability.

Caring for Gravely Ill Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Ethics Committees ◽  
Well Being ◽  
Pediatric Health Care ◽  
Spiritual Well Being ◽  
Primary Focus

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

scholarly journals Strategies for Re-opening Physiotherapy OPDs Post COVID-19 Lockdown – A Cross-sectional Study

2021 ◽  
Author(s):  
Amarjot Singh Gill ◽  
Nistara Singh Chawla ◽  
Sandeep Singh Saini
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Practice Pattern ◽  
Evidence Based ◽  
Sectional Study ◽  
Cross Sectional Survey ◽  
Exclusion Criteria ◽  
Cross Sectional

Background: The practices of various health-care professionals have been improvised to accommodate the on-going covid-19 pandemic situation. Different guidelines have been set in place to ease the process of re-opening of non-elective healthcare services like out-patient physiotherapy clinics. Although the measures taken should be guided by evidence based information, major consensus amongst practicing therapists needs to guide the India physiotherapy clinics. Objective: To identify and present the opinions of different physiotherapists about the various strategies for re-opening the out-patient physiotherapy clinics. Methods: An online cross-sectional survey was conducted. Over 169 participants were selected to participate in the survey according to the pre-decided inclusion and exclusion criteria. The data was collected and saved via google forms. Result and conclusion: A majority of respondents had a consensus over different strategies for re-opening the physiotherapy OPDs. These were regarding different measures to be adapted including modifications in the clinic infrastructure and the practice pattern. This would help in smoothly re-instating the physiotherapy services post the covid-19 lockdown.

Making Ethics Work in Collaborative Projects

2005 ◽  
Vol 11 (3) ◽  
pp. 101
Author(s):  
Emily Mauldon
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Research Ethics ◽  
Health Care Professionals ◽  
Ethics Committees ◽  
Research Process ◽  
Ethical Review ◽  
Ethical Research ◽  
Team Members ◽  
Primary Health

This article discusses problems a research team had managing their ethical obligations during a short project, and considers the implications of these problems for better understanding and carrying out ethical research in the future. Two key points will be proposed. Initially, it will be argued that the culture of ethical research as articulated within the research community may not be universally accepted within the primary health care sector. The nature of "ethical conduct" within clinical practice, service provision and research is not the same. Further, practical difficulties the researchers experienced while trying to gain approval from ethics committees and implement the proposed research plan highlight some ways in which institutional ethical review processes are structurally unsuited to the requirements of small collaborative projects. Understanding the different ways in which the term "ethics" is used will allow for a more expedient translation of concepts between different health professionals. Recognising the practical constraints ethical review places on the research process may help reduce some of the frustration primary health care professionals can experience when faced with the requirements of research ethics committees. Due to the history of, and cultural commitment to, ethical research within the university sector, those with formal academic training in research are well placed to assume responsibility for managing the ethics process when involved in cross-sectoral research. This responsibility may include the need to educate team members and study participants about the importance of research ethics.

scholarly journals Clinical Ethics Committees in the United Kingdom: Towards Evaluation

2007 ◽  
Vol 8 (3) ◽  
pp. 221-237 ◽  
Author(s):  
Laura Williamson ◽  
Sheila McLean ◽  
Judith Connell
Keyword(s):  
United States ◽  
United Kingdom ◽  
Health Care Professionals ◽  
Clinical Ethics ◽  
Ethics Committees ◽  
The United States ◽  
Policy Support ◽  
Department Of Health ◽  
The United Kingdom ◽  
The Uk

In the United Kingdom there is a growing conviction that CECs have an important role to play in helping health care professionals address ethical dilemmas. For example, the Royal College of Physicians, the Nuffield Trust and the unofficial Clinical Ethics Network, which has received financial support from the Department of Health, commend the use of CECs in the UK. The growth of such committees has been influenced by the legal and policy support they have received in the United States. However, there is increasing concern about both the benefits and the quality of work produced by CECs. In addition, despite the rapid increase in the number of CECs in the UK, outside of the United States they remain under-researched and no formal mechanism exists to assess their performance. As a result we know little about the structure, function, impact and effectiveness of CECs. We are currently conducting a research project funded by the Wellcome Trust that seeks to interrogate the competing claims regarding the benefits and disbenefits of CECs. This initial account of our research provides a detailed analysis of theoretical issues that surround the development and use of CECs and points towards the questions that lie at the heart of the social science strand of our project.

Social Class and Medical Decisionmaking: A Neglected Topic in Bioethics

1998 ◽  
Vol 7 (1) ◽  
pp. 41-56 ◽  
Author(s):  
BETTY WOLDER LEVIN ◽  
NINA GLICK SCHILLER
Keyword(s):  
Social Class ◽  
Special Section ◽  
Access To Healthcare ◽  
Medical Decisions ◽  
Scarce Resources

As part of an effort to look at “what differences make a difference” for bioethicists interested in clinical decisionmaking, Erik Parens, the editor of this special section, asked us to look at social class. When we began our research for this paper, we were surprised to find that although bioethicists have written much on social class and such macrolevel issues as access to healthcare and the distribution of scarce resources, and have paid some attention to the effects of class on patient-provider relationships, bioethicists have written little specifically that looks at the implications of social class for medical decisions in individual cases.

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