RESUMO
"The public expects members of the medical profession to conduct themselves according to the terms of the Hippocratic oath, yet few physicians and virtually no laypersons know what is iln that oath. For the oath to reach beyond its symbolic importance, ethical conduct must be learned and practised. There are many texts on the practice of medicine, surgery and all of the related disciplines, yet one is hard pressed to find anything on ethical practice in any of them..." "Scholarly texts on ethics tend to deal with the landmark issues and dilemmas that have occurred within particular jurisdictions or religions. This book is intended as a student-friendly text that seeks not to turn students into ethics scholars but to provide them with a practical guide to ethical conduct in everyday medical practice." Ethical Practice in Everyday Health Care is useful, practical and student friendly. The exercise and discussions will stimulate thought about ethical conduct and help students to develop and translate ethical principles into their daily practices as health-care workers. Dr. Waldrond offers a ready and concise source of information for medical students on ethical issues. The text is simple, comprehensive and factual, addressing issues encountered in everyday medical practices. Case studies provide practical illustrations of complex ethical issues (AU)
Assuntos
Humanos , Ética Médica , Atenção à Saúde , Confidencialidade , Estudos de Casos e Controles , Administração de Caso , Relações Médico-PacienteRESUMO
Since 1994, group health insurers in Trinidad and Tobago have been requesting more specific details diagnosis and other services rendered to patients on Health Claim Insurance Forms. The argument put forward by group health insurers is that "Health plans provide coverage on a "per ailment" basis with specified limits applicable to each ailment. It is therefore necessary to know what ailment is being treated to ensure that plan limits are not exceeded". This presented the problem of medical information passing from the doctor to the patient's place of work and then to the insurance company without confidential cover. In cases where the doctor limits the information to protect doctor/patient confidentially, the forms are often returned creating additional work and delay in reimbursement of claims. This is generally frustrating to all parties concerned. In 1984 a coding system was designed for 3 columns on existing forms - diagnosis, type of visit and services rendered - the aim being to provide, through the use of simple codes, specific information while preserving confidentially. Codes number only from 1 to 21 (major systems) with sub-code between the major systems makes it very simple to use. The coding system was accepted by group health carriers in Trinidad and Tobago in 1984 and has been computerized and used for both external and internal business. Doctors (mainly general practitioners and obstetrician-gynaecologists) have been coding with ease, and patients now submit health claim forms without reservations(AU)
Assuntos
Reembolso de Seguro de Saúde , Confidencialidade , Seguro Saúde , Trinidad e TobagoRESUMO
The AIDS epidemic has brought into sharp focus the ancient ethic of confidentiality of medical information. This report is part of a larger study commissioned by the Caribbean Community Secretariat on ethical and legal issues pertaining to the HIV/AIDS epidemic. Twenty-one persons in leadership posts were interviewed; these included Chief Medical Officers of 9 Ministries of Health, holders of top positions in 9 Non-governmental Organisations, including UWI's Faculties of Medical Sciences and Law, trade unions, professional organisations and 3 top Barbadian Civil Servants. The number of years' service by the respondents was 9.38 (SD 6.32). They were unanimous in their view that breaches of confidentiality by health care workers warranted disciplinary action by the relevant professional council, although 4 (19.0 percent) suggested more lenient approaches in certain cases. Despite this, 15 (71.4 percent) said that medical records should be complete and accurate, with all confidential information recorded, and that records should be more professionally managed. Sixteen respondents (76.2 percent) said that third parties, including insurance companies, immigration departments, CMOs' offices, etc., would be guilty of an offence in law if a patient's confidential matters were leaked by them. Most respondents thought that the duty to warn the spouse of an HIV-infected patient of the risk of infection was a very difficult issue. Eleven (52.4 percent) said the doctor should, if necessary, break a patient's confidentiality and warn his/her spose. In small Caribbean societies confidentiality is very important. If people feel that their private affairs will be divulged, they will stay away from health care workers, compromising their care and threatening public safety. It is recommended that the issue of confidentiality be given more attention in CME and in medical practice in the Caribbean (AU)
Assuntos
Confidencialidade , Atenção à Saúde , Barbados , HIV-1 , Ética Médica , Legislação HospitalarRESUMO
As the AIDS pandemic reaches the stage of maturity, in the sense of the highest rate of conversion from HIV positive status to full blown AIDS since the identification of the disease in the early eighties, a host of legal and ethical issues have been thrown into stark relief. The society must now attempt to grapple with the twin goals of caring for the sick and controlling the spread of the disease on the one hand, whilst on the other hand, grappling with the myriad issues pertaining to the rights and obligations of persons with HIV disease and those having contact with such persons. In respect of testing for HIV these concerns centre around the duty of health care personnel to obtain the consent of persons with HIV disease, but the consent must be informed and given in circumstances where the person is counselled as to the implications of an HIV status. In certain circumstances health care personnel have been held by our legal system to whom they know are having unsuspecting sexual contact with the person with HIV disease. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Adolescente , Síndrome de Imunodeficiência Adquirida/psicologia , Confidencialidade , Legislação Médica , Trinidad e TobagoRESUMO
The AIDs pandemic has brought in its wake a number of legal and ethical dilemmas for the members of the medical profession. The extent of the duty of the doctor care for the HIV-infected patient; how much exposure the health professional should be willing to risk; and whether the criteria for research and experimentation, terminal care and access to life-sustaining treatment should be modified for HIV-infected persons are some of the very vexed issues being currently debated. Problems of confidentiality; consent; reporting and notification of HIV status; disclosure to third parties at risk; discrimination; isolation and detention; irresponsible, violent or dangerous patients; mental competence; living wills and power of attorney all complicate the management of the HIV-infected. The HIV-infected doctor presents a particularly difficult quandary. While most people will readily accept the exposure of the doctor to the illnesses of patients, and the possibility of contagion comes with the territory, few seem to accept that the reverse is true. The World Health Organization estimates that by the year 2000, about 10 million infants and children will have been infected by the HIV and that an even greater number will be uninfected but orphaned as a result of the AIDS pandemic. In addition to the tremendous social and public health consequences, there are difficult legal and ethical problems to be grappled with in managing these children (AU)
Assuntos
Humanos , Lactente , Criança , Ética Médica , Corpo Clínico , Síndrome de Imunodeficiência Adquirida/psicologia , Confidencialidade/legislação & jurisprudência , BarbadosRESUMO
A general article in which the author deals with some key issues, e.g., notification of communicable diseases, testing, "the right to know", the right to work and examines the legal, social and ethical issues involved
Assuntos
Humanos , Adulto , Infecções por HIV/prevenção & controle , Ética Médica , Ética em Enfermagem , Ética , Confidencialidade , Consentimento Livre e Esclarecido , Aconselhamento Sexual/métodosRESUMO
This article examines the duties, obligations and legal liabilities of the nursing profession. Liabilities become operational not only in cases of acts of comission but also of omission and neglect. (AU)
Assuntos
Enfermagem/legislação & jurisprudência , Legislação de Enfermagem , Ética em Enfermagem , Confidencialidade/legislação & jurisprudência , Relações Enfermeiro-PacienteRESUMO
The target group studied was youths between the 15 to 19 years age group and who attended the high schools in Westmoreland. A sample of 100 youngsters were interviewed to determine their knowledge, attitudes and beliefs in respect of gonorrhoea and syphilis.(AU)
Assuntos
Humanos , Adolescente , Masculino , Feminino , Infecções Sexualmente Transmissíveis , Conhecimentos, Atitudes e Prática em Saúde , Gonorreia , Sífilis , Necessidades e Demandas de Serviços de Saúde , Confidencialidade , Jamaica , Educação SexualRESUMO
This paper uses data from 199 providers and 20 simulated clients at 50 public sector and Non Government Organization (NGO) health facilities islandwide in 1995 to compare the two groups' views on quality of care of family planning services. Each of the five components of quality of care studied can be improved in Jamaica. Nearly two-thirds of the simulated clients felt able to freely choose a contraceptive method; however, more adequate and appropriate information needs to be imparted to clients through improved counselling, including promotion of dual method use (against STD/HIV/AIDS and conception). The requirement that a woman must be menstruating to receive services has inadvertently resulted in many clients going away empty-handed (without counselling or condoms) when they visit family planning clinics. While providers generally treat clients well, training and service delivery practices need to be revised to improve the technical competence of providers. All of the providers would recommend these clients to others, compared to a little over half of the simulated clients. Both the providers and simulated clients said that privacy should be strengthened, particularly in small facilities in rural areas. Many of these aspects of quality of care are being improved in Jamaica's public sector health facilities. Managers can learn more about quality of care by seeking the knowledge, opinions and experiences of both providers and clients. (AU)