首页 > 最新文献

Clinical Ethics最新文献

英文 中文
Does the light at the end of the tunnel shine for everyone? The need for early paediatric participation in vaccine trials during infectious pandemics. 隧道尽头的光明会照耀每个人吗?传染病大流行期间儿童早期参与疫苗试验的必要性。
Q1 Arts and Humanities Pub Date : 2022-12-01 DOI: 10.1177/14777509211036661
Erin M Kwolek

While most of the mortality associated with severe acute respiratory syndrome coronavirus 2 has been in elderly populations and adults with significant medical comorbidities, there has been death and morbidity in paediatric populations. As vaccine trial data is released to the public, many people look to the future with hope ; with good vaccine uptake there is the opportunity to reduce the spread of infectious pandemics. Initial vaccine trials were completed with adults and were expanded to include paediatric populations delaying paediatric COVID-19 vaccine initiatives. The exclusion of children from initial vaccine trials during a pandemic is not morally justifiable and fosters distrust with the pharmaceutical and medical industries and inevitably postpones vaccinating children when there is a surplus of available vaccines. The delayed vaccination of children under twelve may have significant public health and economic consequences as there may be ongoing viral transmission in the context of reopening strategies. The safety and efficacy of these candidate vaccines in children should be assessed expeditiously so that distribution to vulnerable paediatric populations is not impacted. Vaccine uptake compliance in the general population is important in establishing herd immunity and ensuring that there is thorough scientific evidence to support vaccination for children is important in establishing community trust.

虽然与冠状病毒2型严重急性呼吸综合征相关的大多数死亡发生在老年人和有严重医疗合并症的成年人中,但在儿科人群中也有死亡和发病率。随着疫苗试验数据向公众公布,许多人满怀希望地展望未来;有了良好的疫苗接种,就有机会减少传染性大流行的传播。在成人中完成了最初的疫苗试验,并扩大到包括儿童人群,推迟了儿童COVID-19疫苗计划。在大流行期间,将儿童排除在最初的疫苗试验之外在道德上是不合理的,而且会助长人们对制药和医疗行业的不信任,在现有疫苗过剩的情况下,不可避免地推迟对儿童的疫苗接种。12岁以下儿童疫苗接种的延迟可能会产生重大的公共卫生和经济后果,因为在重新开放战略的背景下,病毒可能会持续传播。应迅速评估这些候选疫苗在儿童中的安全性和有效性,以便不影响向脆弱儿科人群分发疫苗。一般人群的疫苗接种依从性对于建立群体免疫力至关重要,确保有充分的科学证据支持儿童接种疫苗对于建立社区信任至关重要。
{"title":"Does the light at the end of the tunnel shine for everyone? The need for early paediatric participation in vaccine trials during infectious pandemics.","authors":"Erin M Kwolek","doi":"10.1177/14777509211036661","DOIUrl":"https://doi.org/10.1177/14777509211036661","url":null,"abstract":"<p><p>While most of the mortality associated with severe acute respiratory syndrome coronavirus 2 has been in elderly populations and adults with significant medical comorbidities, there has been death and morbidity in paediatric populations. As vaccine trial data is released to the public, many people look to the future with hope ; with good vaccine uptake there is the opportunity to reduce the spread of infectious pandemics. Initial vaccine trials were completed with adults and were expanded to include paediatric populations delaying paediatric COVID-19 vaccine initiatives. The exclusion of children from initial vaccine trials during a pandemic is not morally justifiable and fosters distrust with the pharmaceutical and medical industries and inevitably postpones vaccinating children when there is a surplus of available vaccines. The delayed vaccination of children under twelve may have significant public health and economic consequences as there may be ongoing viral transmission in the context of reopening strategies. The safety and efficacy of these candidate vaccines in children should be assessed expeditiously so that distribution to vulnerable paediatric populations is not impacted. Vaccine uptake compliance in the general population is important in establishing herd immunity and ensuring that there is thorough scientific evidence to support vaccination for children is important in establishing community trust.</p>","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9659690/pdf/10.1177_14777509211036661.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35210802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pandemic journey to prestige at nursing. 流行病之旅威望护理
Q1 Arts and Humanities Pub Date : 2022-12-01 DOI: 10.1177/14777509221091091
Nerıman Ozge Calıskan, Hayat Yalın, Fatma Eti Aslan

Respect, which is human virtue by its very nature, is a universal feeling and action. Prestige; it is expressed as being respected, valuable, and reliable. These intertwined concepts draw attention basically for nursing, in which interpersonal interactions stand out compared to other professions. Moreover, while continuing the services in a kind of mobilization environment during the pandemic process that we have been faced with since 11 March 2020 and will obviously be affected for a long time in our country, the most common sense and respectful perspectives and approaches are needed. Respectful actions and respectful practices which are also included in the scope of professional ethics are more strategically important as we experience such a mass and historical human experience in which each of us is responsible for each other's health. The reputation of nursing continues to be formed and differentiated with how this profession is perceived by members of the profession and society, influenced by various processes from past to present. In this article, the change/development of the reputation of the nursing profession during the COVID-19 pandemic period was discussed.

尊重本质上是人类的美德,是一种普遍的情感和行为。威信它被表达为受到尊重、有价值和可靠。这些相互交织的概念基本上引起了护理的注意,与其他职业相比,护理中的人际互动尤为突出。此外,在疫情期间,我们自2020年3月11日以来一直面临着一种动员环境,显然将在我国长期受到影响,在继续提供服务的同时,我们需要最常识和最尊重的观点和方法。同样包含在职业道德范围内的尊重行为和尊重做法在战略上更为重要,因为我们经历了这样一种大规模和历史性的人类经历,在这种经历中,我们每个人都对彼此的健康负责。护理的声誉继续形成,并随着职业和社会成员对这一职业的看法而不同,受到过去到现在各种过程的影响。本文对新冠肺炎疫情期间护理行业声誉的变化/发展进行了探讨。
{"title":"Pandemic journey to prestige at nursing.","authors":"Nerıman Ozge Calıskan, Hayat Yalın, Fatma Eti Aslan","doi":"10.1177/14777509221091091","DOIUrl":"10.1177/14777509221091091","url":null,"abstract":"<p><p>Respect, which is human virtue by its very nature, is a universal feeling and action. Prestige; it is expressed as being respected, valuable, and reliable. These intertwined concepts draw attention basically for nursing, in which interpersonal interactions stand out compared to other professions. Moreover, while continuing the services in a kind of mobilization environment during the pandemic process that we have been faced with since 11 March 2020 and will obviously be affected for a long time in our country, the most common sense and respectful perspectives and approaches are needed. Respectful actions and respectful practices which are also included in the scope of professional ethics are more strategically important as we experience such a mass and historical human experience in which each of us is responsible for each other's health. The reputation of nursing continues to be formed and differentiated with how this profession is perceived by members of the profession and society, influenced by various processes from past to present. In this article, the change/development of the reputation of the nursing profession during the COVID-19 pandemic period was discussed.</p>","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48739762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethical considerations and clinical trials during a pandemic: A blessing with a burden. 大流行期间的伦理考虑和临床试验:祝福与负担。
Q1 Arts and Humanities Pub Date : 2022-12-01 DOI: 10.1177/14777509211034138
Madhan Ramesh, Jehath Syed, Chalasani Sri Harsha

Any healthcare systems during a pandemic undergo tremendous pressure in pursuit of effective treatment to treat and limit the spread of the disease and its implications. Conducting clinical trials to find the potential therapy is the only way to battle the current coronavirus disease-2019 pandemic. The majority of the countries have joined the cause and are carrying out clinical studies in various capacities. As a result, the ethical committees have encountered a sudden inflow of a large number of trial proposals that have placed them under pressure. Although ethical committees play a vital role in protecting patient safety and preserving research integrity, they need to make sure the efficiency and integrity of review are preserved and the standards of review are not relaxed. Thus, the participants' dignity is well guarded while keeping a close check on their safety.

在大流行期间,任何卫生保健系统在寻求有效治疗以治疗和限制疾病的传播及其影响方面都面临巨大压力。进行临床试验以寻找潜在的治疗方法是对抗当前冠状病毒病-2019大流行的唯一途径。大多数国家已加入这一事业,并正在以各种身份进行临床研究。结果,伦理委员会突然收到了大量的试验建议,使他们承受了压力。尽管伦理委员会在保护患者安全和维护研究诚信方面发挥着至关重要的作用,但他们需要确保审查的效率和诚信得到维护,审查的标准不放松。因此,参与者的尊严得到了很好的保护,同时也密切关注他们的安全。
{"title":"Ethical considerations and clinical trials during a pandemic: A blessing with a burden.","authors":"Madhan Ramesh,&nbsp;Jehath Syed,&nbsp;Chalasani Sri Harsha","doi":"10.1177/14777509211034138","DOIUrl":"https://doi.org/10.1177/14777509211034138","url":null,"abstract":"<p><p>Any healthcare systems during a pandemic undergo tremendous pressure in pursuit of effective treatment to treat and limit the spread of the disease and its implications. Conducting clinical trials to find the potential therapy is the only way to battle the current coronavirus disease-2019 pandemic. The majority of the countries have joined the cause and are carrying out clinical studies in various capacities. As a result, the ethical committees have encountered a sudden inflow of a large number of trial proposals that have placed them under pressure. Although ethical committees play a vital role in protecting patient safety and preserving research integrity, they need to make sure the efficiency and integrity of review are preserved and the standards of review are not relaxed. Thus, the participants' dignity is well guarded while keeping a close check on their safety.</p>","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9659689/pdf/10.1177_14777509211034138.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35210801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Bioethics after the COVID-19 pandemic: More research, fewer committees? COVID-19大流行后的生物伦理学:更多的研究,更少的委员会?
Q1 Arts and Humanities Pub Date : 2022-12-01 DOI: 10.1177/14777509221134243
Henri-Corto Stoeklé, Christian Hervé

In the face of the pandemic, bioethics, once again, proved its scientific utility. In France, in particular, the academic approach (= peer-reviewed, scientific publications, etc.) should be given priority over the institutional approach (= public surveys, public meetings, etc.), in hospitals, research institutes, universities, and companies, with the professionalization that this would imply (i.e. bioethicists).

面对疫情,生物伦理学再次证明了其科学效用。特别是在法国,在医院、研究机构、大学和公司,学术方法(=同行评审、科学出版物等)应优先于机构方法(=公开调查、公开会议等),并具有这意味着的专业化(即生物伦理学家)。
{"title":"Bioethics after the COVID-19 pandemic: More research, fewer committees?","authors":"Henri-Corto Stoeklé, Christian Hervé","doi":"10.1177/14777509221134243","DOIUrl":"10.1177/14777509221134243","url":null,"abstract":"<p><p>In the face of the pandemic, <i>bioethics</i>, once again, proved its scientific utility. In France, in particular, the academic approach (= peer-reviewed, scientific publications, etc.) should be given priority over the institutional approach (= public surveys, public meetings, etc.), in hospitals, research institutes, universities, and companies, with the professionalization that this would imply (i.e. <i>bioethicists</i>).</p>","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9597279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45864400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
We should not take abortion services for granted 我们不应该认为堕胎服务是理所当然的
Q1 Arts and Humanities Pub Date : 2022-11-20 DOI: 10.1177/14777509221140746
N. Emmerich
{"title":"We should not take abortion services for granted","authors":"N. Emmerich","doi":"10.1177/14777509221140746","DOIUrl":"https://doi.org/10.1177/14777509221140746","url":null,"abstract":"","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41635141","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}
引用次数: 0
Ethical challenges in clinical studies with adaptive design in oncology 肿瘤学适应性设计临床研究中的伦理挑战
Q1 Arts and Humanities Pub Date : 2022-11-17 DOI: 10.1177/14777509221133974
N. Paul, Hamideh Mahdiani
Novel immune therapies are increasingly based on the molecular differentiation of disease patterns. The related clinical studies are thus more often characterized by the so-called adaptive study designs (umbrella or basket studies including platform studies), which are continuously adjusted based on novel results. This paper analyses new study designs beyond the often-postulated need for regulation in order to identify ethical problems based on typical structural features and to—whenever possible—suggest solutions. To do so, it addresses the following topics: the relationship between social and scientific values of a study as well as aspects of the scientific validity of new forms of evidence; the inclusion of study subjects under the condition of relative uncertainty; specific challenges in the process of ethical approval, and ethical and practical challenges in the process of informing patients and receiving informed consent. Additionally, the topic of a potential risk–benefit assessment of such therapies is addressed.
新的免疫疗法越来越多地基于疾病模式的分子分化。因此,相关的临床研究通常以所谓的适应性研究设计为特征(包括平台研究在内的伞式或篮式研究),这些研究会根据新的结果不断调整。本文分析了超出通常假设的监管需求的新研究设计,以便根据典型的结构特征识别伦理问题,并尽可能提出解决方案。为此,它涉及以下主题:研究的社会价值观和科学价值观之间的关系,以及新形式证据的科学有效性方面;在相对不确定的条件下纳入研究对象;伦理审批过程中的具体挑战,以及告知患者和获得知情同意过程中的伦理和实践挑战。此外,还讨论了此类疗法的潜在风险-收益评估的主题。
{"title":"Ethical challenges in clinical studies with adaptive design in oncology","authors":"N. Paul, Hamideh Mahdiani","doi":"10.1177/14777509221133974","DOIUrl":"https://doi.org/10.1177/14777509221133974","url":null,"abstract":"Novel immune therapies are increasingly based on the molecular differentiation of disease patterns. The related clinical studies are thus more often characterized by the so-called adaptive study designs (umbrella or basket studies including platform studies), which are continuously adjusted based on novel results. This paper analyses new study designs beyond the often-postulated need for regulation in order to identify ethical problems based on typical structural features and to—whenever possible—suggest solutions. To do so, it addresses the following topics: the relationship between social and scientific values of a study as well as aspects of the scientific validity of new forms of evidence; the inclusion of study subjects under the condition of relative uncertainty; specific challenges in the process of ethical approval, and ethical and practical challenges in the process of informing patients and receiving informed consent. Additionally, the topic of a potential risk–benefit assessment of such therapies is addressed.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43595424","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}
引用次数: 0
Ethical reflections on how health professionals should answer the Question: What would you do if this were your family member? 关于健康专业人员应该如何回答这个问题的伦理思考:如果这是你的家人,你会怎么做?
Q1 Arts and Humanities Pub Date : 2022-11-15 DOI: 10.1177/14777509221138752
A. Asai, M. Fukuyama, M. Ohnishi
Patient families sometimes ask health professionals, ‘What would you do if this were your family member?’ The purpose of this paper is to examine appropriate responses to this Question. Health professionals may say, ‘It all depends on the patient's wishes’, or ‘I don't know what is best, because my family is different from yours in many ways’. Some may believe that the most favourable course of action is the same regardless of who the patient is and explain this to the patient's family, while others may refuse to answer the Question saying it is personal, or argue that such a Question should neither be asked nor answered because it is unreasonable and unprofessional to do so. We believe that, in principle, health professionals should give an honest answer as to what they would do if the patient was their family member, recognising and empathising with the fact that the patient's family is in a difficult and vulnerable position, and that their circumstances forced them to ask such a Question. Moreover, personal and emotional views of health professionals regarding treatment options may help the patient's family make important decisions. An honest answer will help strengthen the trusting relationship between health professionals and the patient's family and support their decision-making.
患者家属有时会问卫生专业人员,“如果这是你的家人,你会怎么做?”本文的目的是研究对这个问题的适当回应。卫生专业人员可能会说,“这完全取决于患者的意愿”,或者“我不知道什么是最好的,因为我的家人在很多方面与你的不同”。有些人可能认为,无论患者是谁,最有利的做法都是一样的,并向患者家属解释这一点,而另一些人可能会拒绝回答这个问题,说这是个人问题,或者认为这样的问题既不应该被问也不应该被回答,因为这样做是不合理和不专业的,卫生专业人员应该诚实地回答,如果患者是他们的家人,他们会怎么做,认识到并同情患者的家人处于困难和脆弱的境地,以及他们的情况迫使他们提出这样的问题。此外,卫生专业人员对治疗方案的个人和情感观点可能有助于患者家属做出重要决定。诚实的回答将有助于加强卫生专业人员与患者家属之间的信任关系,并支持他们的决策。
{"title":"Ethical reflections on how health professionals should answer the Question: What would you do if this were your family member?","authors":"A. Asai, M. Fukuyama, M. Ohnishi","doi":"10.1177/14777509221138752","DOIUrl":"https://doi.org/10.1177/14777509221138752","url":null,"abstract":"Patient families sometimes ask health professionals, ‘What would you do if this were your family member?’ The purpose of this paper is to examine appropriate responses to this Question. Health professionals may say, ‘It all depends on the patient's wishes’, or ‘I don't know what is best, because my family is different from yours in many ways’. Some may believe that the most favourable course of action is the same regardless of who the patient is and explain this to the patient's family, while others may refuse to answer the Question saying it is personal, or argue that such a Question should neither be asked nor answered because it is unreasonable and unprofessional to do so. We believe that, in principle, health professionals should give an honest answer as to what they would do if the patient was their family member, recognising and empathising with the fact that the patient's family is in a difficult and vulnerable position, and that their circumstances forced them to ask such a Question. Moreover, personal and emotional views of health professionals regarding treatment options may help the patient's family make important decisions. An honest answer will help strengthen the trusting relationship between health professionals and the patient's family and support their decision-making.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43454457","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}
引用次数: 0
Why algorithmic speed can be more important than algorithmic accuracy 为什么算法速度比算法精度更重要
Q1 Arts and Humanities Pub Date : 2022-11-13 DOI: 10.1177/14777509221138750
J. Mainz, L. Munch, Jens Christian Bjerring, Sissel Godtfredsen
Artificial Intelligence (AI) often outperforms human doctors in terms of decisional speed. For some diseases, the expected benefit of a fast but less accurate decision exceeds the benefit of a slow but more accurate one. In such cases, we argue, it is often justified to rely on a medical AI to maximise decision speed – even if the AI is less accurate than human doctors.
人工智能(AI)在决策速度方面往往优于人类医生。对于某些疾病,快速但不太准确的决策的预期益处超过了缓慢但更准确的决策。在这种情况下,我们认为,依靠医学人工智能来最大限度地提高决策速度通常是合理的——即使人工智能不如人类医生准确。
{"title":"Why algorithmic speed can be more important than algorithmic accuracy","authors":"J. Mainz, L. Munch, Jens Christian Bjerring, Sissel Godtfredsen","doi":"10.1177/14777509221138750","DOIUrl":"https://doi.org/10.1177/14777509221138750","url":null,"abstract":"Artificial Intelligence (AI) often outperforms human doctors in terms of decisional speed. For some diseases, the expected benefit of a fast but less accurate decision exceeds the benefit of a slow but more accurate one. In such cases, we argue, it is often justified to rely on a medical AI to maximise decision speed – even if the AI is less accurate than human doctors.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45079245","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}
引用次数: 1
Some desiderata for a taxonomy of conscientious objection in health care: A reply to Gamble and Saad 一些人希望对医疗保健中的良心反对进行分类:对甘布尔和萨阿德的回复
Q1 Arts and Humanities Pub Date : 2022-11-13 DOI: 10.1177/14777509221138746
Michael Robinson, Jeffrey Byrnes
In a recent issue of this journal, Gamble and Saad offer a taxonomy of conscientious objection in health care with the aim of increasing the common ground in the debate over conscientious objection to prevent parties from talking past each other and help facilitate greater progress on this issue. Although we agree that this is an important and worthwhile project, Gamble and Saad's proposal suffers from several serious weaknesses that limit its ability to do the work set out for it. In this paper, we identify some of the major problems with this particular attempt in order to highlight some desiderata for a taxonomy of conscientious objection in health care that can serve as a guide for developing improved taxonomies of this kind in the future.
在最近一期的本刊中,甘布尔和萨阿德提出了医疗保健中良心反对的分类,目的是在关于良心反对的辩论中增加共同点,以防止各方各持己见,并帮助促进在这个问题上取得更大进展。虽然我们同意这是一个重要和有价值的项目,但甘布尔和萨阿德的建议存在几个严重的弱点,限制了其完成为其设定的工作的能力。在本文中,我们确定了这种特殊尝试的一些主要问题,以突出医疗保健中良心反对分类法的一些需求,这些分类法可以作为未来开发改进分类法的指南。
{"title":"Some desiderata for a taxonomy of conscientious objection in health care: A reply to Gamble and Saad","authors":"Michael Robinson, Jeffrey Byrnes","doi":"10.1177/14777509221138746","DOIUrl":"https://doi.org/10.1177/14777509221138746","url":null,"abstract":"In a recent issue of this journal, Gamble and Saad offer a taxonomy of conscientious objection in health care with the aim of increasing the common ground in the debate over conscientious objection to prevent parties from talking past each other and help facilitate greater progress on this issue. Although we agree that this is an important and worthwhile project, Gamble and Saad's proposal suffers from several serious weaknesses that limit its ability to do the work set out for it. In this paper, we identify some of the major problems with this particular attempt in order to highlight some desiderata for a taxonomy of conscientious objection in health care that can serve as a guide for developing improved taxonomies of this kind in the future.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65992259","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}
引用次数: 0
Ethical challenges in clinical practice during the COVID-19 pandemic in an academic healthcare institution in Malaysia: A qualitative study 马来西亚一家学术医疗机构在COVID-19大流行期间临床实践中的伦理挑战:一项定性研究
Q1 Arts and Humanities Pub Date : 2022-10-22 DOI: 10.1177/14777509221134499
S. Kaur, Mark Tan Kiak Min, S. Ng, C. Ng
Background Healthcare professionals (HCPs) face a myriad of ethical challenges during the coronavirus disease 2019 (COVID-19) pandemic. However, there is limited literature examining the ethical challenges faced by HCPs in low- and medium-income countries. The research was designed to explore the ethical challenges experienced by HCPs in a Malaysian hospital setting during the pandemic. Methods Semistructured interviews were conducted via video calls with 10 Malaysian HCPs across different clinical disciplines involved in managing patients diagnosed with COVID-19 infections. The calls were audio-recorded, transcribed verbatim and checked. Thematic analysis with constant comparison across transcripts was carried out to identify categories and themes. Results Three main themes emerged. Firstly, there was deprioritisation of care for non-COVID-19 patients resulting from resource limitations. HCPs raised concerns that there was curtailed access to various healthcare services by non-COVID-19 patients. There was also a trade-off between protecting individual patient safety and public health interests. Secondly, patients were disempowered from decision-making; the decision to segregate suspected COVID-19 patients to high-risk areas without seeking patients’ approval may result in an increased risk of infection. Lastly, HCPs expressed internal conflicts when balancing the professional duty of care against concerns about contracting COVID-19 and spreading it to their family members. Conclusion The study highlighted ethical issues faced by HCPs in Malaysia during the pandemic. It underscores the need for clinical ethics consultation services in hospitals to navigate the various ethical dilemmas.
背景医疗保健专业人员(HCP)在2019冠状病毒病(新冠肺炎)大流行期间面临着无数的道德挑战。然而,研究中低收入国家HCP面临的道德挑战的文献有限。这项研究旨在探讨疫情期间马来西亚医院医务人员所面临的伦理挑战。方法通过视频电话对10名马来西亚HCP进行半结构化访谈,这些HCP来自不同的临床学科,参与管理被诊断为新冠肺炎感染的患者。通话经过录音、逐字转录和核对。进行了主题分析,并不断对转录本进行比较,以确定类别和主题。结果出现了三个主要主题。首先,由于资源限制,非COVID-19患者的护理优先级降低。HCP对非COVID-19患者获得各种医疗保健服务的机会减少表示担忧。在保护个人患者安全和公共卫生利益之间也存在权衡。其次,患者被剥夺了决策权;在未经患者批准的情况下将疑似新冠肺炎患者隔离到高风险地区的决定可能会增加感染风险。最后,HCP在平衡专业护理义务与感染新冠肺炎并将其传播给家人的担忧时,表达了内部冲突。结论该研究强调了马来西亚HCP在疫情期间面临的伦理问题。它强调了医院临床伦理咨询服务应对各种伦理困境的必要性。
{"title":"Ethical challenges in clinical practice during the COVID-19 pandemic in an academic healthcare institution in Malaysia: A qualitative study","authors":"S. Kaur, Mark Tan Kiak Min, S. Ng, C. Ng","doi":"10.1177/14777509221134499","DOIUrl":"https://doi.org/10.1177/14777509221134499","url":null,"abstract":"Background Healthcare professionals (HCPs) face a myriad of ethical challenges during the coronavirus disease 2019 (COVID-19) pandemic. However, there is limited literature examining the ethical challenges faced by HCPs in low- and medium-income countries. The research was designed to explore the ethical challenges experienced by HCPs in a Malaysian hospital setting during the pandemic. Methods Semistructured interviews were conducted via video calls with 10 Malaysian HCPs across different clinical disciplines involved in managing patients diagnosed with COVID-19 infections. The calls were audio-recorded, transcribed verbatim and checked. Thematic analysis with constant comparison across transcripts was carried out to identify categories and themes. Results Three main themes emerged. Firstly, there was deprioritisation of care for non-COVID-19 patients resulting from resource limitations. HCPs raised concerns that there was curtailed access to various healthcare services by non-COVID-19 patients. There was also a trade-off between protecting individual patient safety and public health interests. Secondly, patients were disempowered from decision-making; the decision to segregate suspected COVID-19 patients to high-risk areas without seeking patients’ approval may result in an increased risk of infection. Lastly, HCPs expressed internal conflicts when balancing the professional duty of care against concerns about contracting COVID-19 and spreading it to their family members. Conclusion The study highlighted ethical issues faced by HCPs in Malaysia during the pandemic. It underscores the need for clinical ethics consultation services in hospitals to navigate the various ethical dilemmas.","PeriodicalId":53540,"journal":{"name":"Clinical Ethics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42898280","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}
引用次数: 0
期刊
Clinical Ethics
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1