Asunto(s)
Vacunas contra la COVID-19/provisión & distribución , COVID-19/prevención & control , Salud Pública/ética , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/virología , Derechos Civiles/ética , Documentación/ética , Femenino , Equidad en Salud/ética , Accesibilidad a los Servicios de Salud/ética , Humanos , Embarazo , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificación , Vacunación/ética , Organización Mundial de la Salud/organización & administraciónAsunto(s)
Vacunas contra la COVID-19 , COVID-19/prevención & control , Tecnología Digital , Documentación , Pandemias/prevención & control , Vacunación , Vacunas contra la COVID-19/provisión & distribución , Canadá , Documentación/ética , Libertad de Circulación/ética , Libertad de Circulación/legislación & jurisprudencia , Humanos , SARS-CoV-2 , Viaje , Vacunación/ética , Vacunación/legislación & jurisprudenciaRESUMEN
There is much debate about the use of immunity passports in the response to the COVID-19 pandemic. Some have argued that immunity passports are unethical and impractical, pointing to uncertainties relating to COVID-19 immunity, issues with testing, perverse incentives, doubtful economic benefits, privacy concerns, and the risk of discriminatory effects. We first review the scientific feasibility of immunity passports. Considerable hurdles remain, but increasing understanding of the neutralising antibody response to COVID-19 might make identifying members of the community at low risk of contracting and transmitting COVID-19 possible. We respond to the ethical arguments against immunity passports and give the positive ethical arguments. First, a strong presumption should be in favour of preserving people's free movement if at all feasible. Second, failing to recognise the reduced infection threat immune individuals pose risks punishing people for low-risk behaviour. Finally, further individual and social benefits are likely to accrue from allowing people to engage in free movement. Challenges relating to the implementation of immunity passports ought to be met with targeted solutions so as to maximise their benefit.
Asunto(s)
COVID-19/inmunología , Documentación/ética , Libertad de Circulación/ética , Inmunidad Activa , Salud Pública/ética , Humanos , SARS-CoV-2/inmunologíaAsunto(s)
Inmunidad Adaptativa , Betacoronavirus/inmunología , Infecciones por Coronavirus/inmunología , Documentación , Pandemias , Neumonía Viral/inmunología , Discriminación Social/legislación & jurisprudencia , Vacunas Virales , COVID-19 , Prueba de COVID-19 , Vacunas contra la COVID-19 , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Personas con Discapacidad/legislación & jurisprudencia , Documentación/ética , Documentación/normas , Humanos , SARS-CoV-2 , Clase Social , Estados UnidosAsunto(s)
Inmunidad Adaptativa , Betacoronavirus/inmunología , Infecciones por Coronavirus/inmunología , Documentación/ética , Neumonía Viral/inmunología , Vacunas Virales , COVID-19 , Vacunas contra la COVID-19 , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias , SARS-CoV-2 , VacunaciónRESUMEN
Psychologists are in a position to respond to the COVID-19 pandemic through research, practice, education, and advocacy. However, concerns exist about the ethical implications associated with transitioning from face-to-face to online or virtual formats as necessitated by stay-at-home orders designed to enforce the social distancing required to flatten the curve of new COVID-19 cases. The purpose of this article is to review potential ethical issues and to provide guidance to psychologists for ethical conduct in the midst of the current crisis and its aftermath. In addition to contextualizing relevant ethical considerations according to the principles and standards of the current American Psychological Association's ethics code, vignettes are presented to exemplify the ethical dilemmas psychologists in various roles may face when responding to COVID-19 and to offer suggestions and resources for resolving potential conflicts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Asunto(s)
Códigos de Ética , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Psicología/ética , Telemedicina/ética , Betacoronavirus , COVID-19 , Competencia Clínica , Confidencialidad/ética , Documentación/ética , Ética en Investigación , Guías como Asunto , Humanos , Consentimiento Informado/ética , Edición/ética , Investigación , SARS-CoV-2 , Sociedades CientíficasRESUMEN
The medical profession is increasingly dependent upon electronic health records. Along with documented benefits, a number of potential ethical abuses have been outlined. Herein, we describe an ethical abuse that has received almost no attention, namely falsified medical records. We present three cases in which the medical record cited facts from history that were not elicited and findings from physical examination that was not performed. This is fraud. Prepopulated templates were almost certainly responsible. If a template is used, it must begin free of results-a skeleton onto which flesh is placed. If coders and third-party payers insist on having information than health care providers think relevant, then we, as a profession should "push back," but a template that has been prepopulated puts fraudulent data into electronic health record, seriously damaging physician integrity.
Asunto(s)
Documentación/ética , Registros Electrónicos de Salud/tendencias , Médicos/normas , Adulto , Anciano , Documentación/normas , Ética Médica , Femenino , Fraude/estadística & datos numéricos , Humanos , Masculino , Examen Físico/ética , Examen Físico/métodos , Médicos/estadística & datos numéricosRESUMEN
A growing demand for transparency in medicine has the potential to strain the doctor-patient relationship. While information can empower patients, unrestricted patient access to the electronic medical record may have unintended consequences. Medical documentation is often written in language that is inaccessible to people without medical training, and without guidance, patients have no way to interpret the constellation of acronyms, diagnoses, treatments, impressions, and arguments that appear throughout their own chart. Additionally, full transparency may not allow physicians the intellectual or clinical freedom they need to authentically express questions, problematic impressions, and concerns about the patient's clinical and psychosocial issues. This article examines the ethical challenges of transparency in the digital era and suggests that selective redaction may serve as a means to maintain transparency, affirm physician's discretion, and uphold the core values of the doctor-patient relationship amidst disruptive technological change.
Asunto(s)
Documentación , Relaciones Médico-Paciente , Documentación/ética , Documentación/tendencias , Registros Electrónicos de Salud , HumanosRESUMEN
In the last decade, genetic testing for cardiovascular disorders has become more and more relevant. Progress in molecular genetics has led to new opportunities for diagnostics, improved risk prediction and could lead to novel therapeutic approaches. Genetic diagnostic testing is relevant for both confirming a diagnosis as well as deciding on therapeutic consequences, if applicable. Furthermore, predictive testing in family members for specific cardiovascular diseases is now a standard procedure in holistic patient management. The process of genetic testing as well as documentation requirements and discussion of test results with patients are subject to legal regulations. These regulations might be confusing for clinical practitioners/cardiologists. The aim of this article is to provide a clinical framework for genetic testing. First, we explain the legal and ethical background. Second, we illustrate the process of genetic testing step by step and present updates on remuneration. Finally, we discuss the significance of genetic testing and specific disease indications in cardiology.
Asunto(s)
Enfermedades Cardiovasculares/genética , Pruebas Genéticas/métodos , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/terapia , Documentación/ética , Documentación/normas , Ética Médica , Pruebas Genéticas/ética , Pruebas Genéticas/legislación & jurisprudencia , Alemania , Adhesión a Directriz/ética , Adhesión a Directriz/legislación & jurisprudencia , Humanos , RemuneraciónAsunto(s)
Artritis Reumatoide/terapia , Ensayos Clínicos como Asunto/ética , Ensayos Clínicos como Asunto/métodos , Comités de Ética , Acceso a la Información/ética , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antirreumáticos/uso terapéutico , Documentación/ética , Documentación/métodos , Industria Farmacéutica/ética , Industria Farmacéutica/métodos , Homeopatía/ética , Homeopatía/métodos , Humanos , Consentimiento Informado/ética , Gestión de Riesgos/ética , Gestión de Riesgos/métodos , Reino UnidoAsunto(s)
Certificación , Documentación/normas , Testimonio de Experto/normas , Mentol/efectos adversos , Fumar/efectos adversos , Industria del Tabaco/normas , Productos de Tabaco/efectos adversos , Toxicología/normas , Certificación/ética , Conflicto de Intereses , Seguridad de Productos para el Consumidor , Documentación/ética , Testimonio de Experto/ética , Humanos , Medición de Riesgo , Industria del Tabaco/ética , Toxicología/éticaRESUMEN
As part of an intervention to improve health care in nursing homes with the goal of reducing potentially avoidable hospital admissions, 1,877 resident records were reviewed for advance directive (AD) documentation. At the initial phases of the intervention, 50 percent of the records contained an AD. Of the ADs in the resident records, 55 percent designated a durable power of attorney for health care, most often a child (62 percent), other relative (14 percent), or spouse (13 percent). Financial power of attorney documents were sometimes found within the AD, even though these documents focused on financial decision making rather than health care decision making. Code status was the most prevalent health preference documented in the record at 97 percent of the records reviewed. The intervention used these initial findings and the philosophical framework of respect for autonomy to develop education programs and services on advance care planning. The role of the social worker within an interdisciplinary team is discussed.
Asunto(s)
Directivas Anticipadas , Documentación , Casas de Salud , Cuidados Paliativos , Directivas Anticipadas/ética , Toma de Decisiones , Documentación/ética , Documentación/normas , Femenino , Humanos , Masculino , Medicaid , Medicare , Missouri , Casas de Salud/ética , Casas de Salud/normas , Cuidados Paliativos/ética , Cuidados Paliativos/normas , Mejoramiento de la Calidad , Estados UnidosRESUMEN
The University of Michigan Human Research Protection Program formed a six-member committee to analyze the nature of Institutional Review Board (IRB) staff and board contingencies for the approval of informed consent documents. Of the 100 studies examined, 87% had one or more informed consent contingencies. "Omissions" in documentation (40%) and "better clarity" (24%) accounted for the majority, while "word-smithing" accounted for only 10%. This is one of the first studies to examine the nature of IRB contingencies as they relate to informed consent documents. Educational efforts targeting completeness in documentation and clarity on the part of study teams, and discouraging "word-smithing" on the part of IRBs, could reduce the number of informed consent contingencies and expedite the IRB approval process.
Asunto(s)
Formularios de Consentimiento/legislación & jurisprudencia , Documentación/métodos , Comités de Ética en Investigación/legislación & jurisprudencia , Experimentación Humana/legislación & jurisprudencia , Investigación Biomédica/ética , Investigación Biomédica/legislación & jurisprudencia , Formularios de Consentimiento/ética , Documentación/ética , Comités de Ética en Investigación/organización & administración , Experimentación Humana/ética , Humanos , Consentimiento Informado/ética , Consentimiento Informado/legislación & jurisprudencia , Estados UnidosRESUMEN
Documenting capacity assessments and identifying substitute decisionmakers (SDMs) in healthcare facilities is ethically required for optimal patient care. Lack of such documentation has the potential to generate confusion and contention among patients, their family members, and members of the healthcare team. An overview of our research at the Ottawa Hospital and issues that influence the consistency of documentation in the Canadian context are presented here, as well as ideas for the mitigation of these issues and ways to encourage better documentation.