In this case study, I consider Mr. A, a Jehovah’s Witness with chronic vertebral osteomyelitis in need of surgical debridement. Prior to proceeding to the OR, he was unwilling either to explicitly consent to or refuse blood transfusion, while indicating he was open to transfusion intraoperatively, if the team judged it necessary. Ethics was consulted to determine if it would be morally justifiable for the team to proceed with blood transfusion during the course of surgery without Mr. A’s documented consent to being transfused. I argue that in this case, what might be termed indirect consent—namely, delegating decision-making regarding some possible course of action without explicitly consenting to the course of action itself—may be sufficient for discharging the clinician’s ethical obligation to obtain consent. Identifying information has been changed or omitted to protect patient confidentiality.
{"title":"Jehovah’s Witnesses and the Normative Function of Indirect Consent","authors":"Joanna Smolenski","doi":"10.1353/nib.0.0031","DOIUrl":"https://doi.org/10.1353/nib.0.0031","url":null,"abstract":"In this case study, I consider Mr. A, a Jehovah’s Witness with chronic vertebral osteomyelitis in need of surgical debridement. Prior to proceeding to the OR, he was unwilling either to explicitly consent to or refuse blood transfusion, while indicating he was open to transfusion intraoperatively, if the team judged it necessary. Ethics was consulted to determine if it would be morally justifiable for the team to proceed with blood transfusion during the course of surgery without Mr. A’s documented consent to being transfused. I argue that in this case, what might be termed indirect consent—namely, delegating decision-making regarding some possible course of action without explicitly consenting to the course of action itself—may be sufficient for discharging the clinician’s ethical obligation to obtain consent. Identifying information has been changed or omitted to protect patient confidentiality.","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"355 1","pages":"-"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80127480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vertical Transmission: The Patient, the Student, the Teacher","authors":"Miguel Paniagua","doi":"10.1353/nib.2023.0007","DOIUrl":"https://doi.org/10.1353/nib.2023.0007","url":null,"abstract":"","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"47 1","pages":"17 - 18"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86544993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
[...]it may have been difficult to get him admitted since it is not our current practice to admit patients with mild COVID-19 infections. [...]our financial incentives are to see many patients each shift, which does not always leave time to care for more socially challenging cases. Burnout is rising in the field of emergency medicine, and I think a part of that burnout can be attributed to the uphill battle that providers are fighting daily to care for patients that our health system leaves behind.
{"title":"It's Not Always Just a Rash","authors":"Adam Bossert","doi":"10.1353/nib.2023.0011","DOIUrl":"https://doi.org/10.1353/nib.2023.0011","url":null,"abstract":"[...]it may have been difficult to get him admitted since it is not our current practice to admit patients with mild COVID-19 infections. [...]our financial incentives are to see many patients each shift, which does not always leave time to care for more socially challenging cases. Burnout is rising in the field of emergency medicine, and I think a part of that burnout can be attributed to the uphill battle that providers are fighting daily to care for patients that our health system leaves behind.","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"22 1","pages":"24 - 26"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78718282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A placebo is an intervention that is believed to lack specific pharmacological or physiological efficacy for a patient's condition. While placebo-controlled trials are considered the gold standard when it comes to researching and testing new pharmacological treatments, the use of placebos in clinical practice is more controversial. The focus of this case study is an undisclosed placebo trial used as an attempt to diagnose a patient's complex and unusual symptomology. In this case, the placebo was used not just as a treatment, but as a diagnostic intervention in order to determine the best course of treatment for a patient. Could the deceptive use of a placebo be justified in clinical practice on the grounds of beneficence?
{"title":"Undisclosed Placebo Trials in Clinical Practice: Undercover Beneficence or Unwarranted Deception?","authors":"Daniel Edward Callies","doi":"10.1353/nib.2023.0017","DOIUrl":"https://doi.org/10.1353/nib.2023.0017","url":null,"abstract":"A placebo is an intervention that is believed to lack specific pharmacological or physiological efficacy for a patient's condition. While placebo-controlled trials are considered the gold standard when it comes to researching and testing new pharmacological treatments, the use of placebos in clinical practice is more controversial. The focus of this case study is an undisclosed placebo trial used as an attempt to diagnose a patient's complex and unusual symptomology. In this case, the placebo was used not just as a treatment, but as a diagnostic intervention in order to determine the best course of treatment for a patient. Could the deceptive use of a placebo be justified in clinical practice on the grounds of beneficence?","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134950017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Tincture of the Doctor's Time","authors":"Holland M. Kaplan","doi":"10.1353/nib.2023.0005","DOIUrl":"https://doi.org/10.1353/nib.2023.0005","url":null,"abstract":"","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"1 1","pages":"12 - 14"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90938656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Am I the Bad Guy?","authors":"Tavishi Chopra","doi":"10.1353/nib.2023.0023","DOIUrl":"https://doi.org/10.1353/nib.2023.0023","url":null,"abstract":"","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"7 1","pages":"E8 - E9"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80149831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：