Webinar RedETSA: uso de emergencia de intervenciones no probadas y fuera de la investigación

El 5 de agosto de 2020, tuvo lugar la 30ma edición del programa de Webinars de RedETSA. La Dra. Carla Sáenz, Asesora Regional en Bioética de la OPS dio una presentación sobre Uso de emergencia de intervenciones no probadas y fuera del ámbito de la investigación: Orientación ética para la pandemia de COVID-19.

Unesco sobre el Covid-19: directrices éticas para una respuesta global / Unesco on covid-19: ethical guidelines for a global response

No disponible

Addressing Spiritual and Religious Influences in Care Delivery.

PURPOSE: The impact of spiritual and religious factors on health and care delivery has been identified in case management field research. The purpose of this article is to examine how case managers, taking a holistic, patient-centered approach, are required under professional and ethical standards to address the spiritual and religious influences that may impact the individual's health, care choices, and care delivery. PRIMARY PRACTICE SETTINGS: Case managers across health or human services must be able to identify and address the spiritual and/or religious factors that may influence a care plan and care delivery. This includes case managers in acute care, primary care, workers' compensation, hospice, mental health counseling, and other practice settings. Regardless of their professional discipline, specialization, or practice setting, case managers must ensure that the voice of the individual is heard and that each person receives the support that is most relevant and meaningful. IMPLEMENTATIONS FOR CASE MANAGEMENT PRACTICE: The impact of spiritual and religious factors on health and care delivery has been identified in case management field research, known as role and function studies, which are conducted every 5 years, and which set the blueprint for the Certified Case Manager (CCM) certification examination. The most recent role and function study affirmed the knowledge domain of multicultural, spiritual, and religious factors that may affect the health status of the individual receiving case management services. Essential activities of case management include identifying multicultural, spiritual, and religious factors that may affect the client's health status and incorporating the effects of the client's multicultural, spiritual, and religious factors in the development of the plan of care and service delivery (). To demonstrate competency in the required knowledge domain and essential activities, case managers must be able to identify and address the spiritual and/or religious factors that may influence a care plan and care delivery.

Ethical Resources.

There is no way to underestimate the importance of the countless ways that ethics impacts case managers and the patients we serve. In fact, solid ethical decisions are such an integral part of case management practice that the Commission for Case Manager Certification has increased its number of continuing education units required for recertification. Discussion and resources are outlined in the Editorial.

Case Managers on the Front Lines of Ethical Dilemmas: Advocacy, Autonomy, and Preventing Case Manager Burnout.

PURPOSE: The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). PRIMARY PRACTICE SETTINGS: The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. IMPLEMENTATIONS FOR CASE MANAGEMENT PRACTICE: This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.

[New professional field in France: Analysis of the training needs of case managers]. / Nouveau champ professionnel en France. Les besoins de formation des gestionnaires de cas.

Case management is a relatively new career field in France. It was first introduced on an experimental basis in 2007-2008, and was then developedfollowing the National Alzheimer Plan and finally enshrined in legislation in 2012. This careerfield is based on a set of tasks widely described internationally: identifying the right level of intervention, standardized multidimensional assessment, planning all aid (care and social services), implementation of the plan, monitoring and reassessment and periodic reassessment of all needs in a continuous and long-term process. The specific, systematic and dedicated nature of these tasks to these tasks makes training essential. Regulations also stipulate that the professional must acquire additional training by a dedicated inter-university degree. This requirement is a French specificity The authors present the history of case management and training in France and analyze the various international training frameworks identified by an Internet search. Moreover, based on the opinions expressed by case managers at different times of the scientific assessment and a review ofseveral studies conducted by inter-university case management program students, this article highlights the specific training needs of case managers and how the proposed training can meet these needs.

Between the idea and the reality: GP liaison in a rural setting.

OBJECTIVES: To describe the organisational, clinical and pragmatic features of a GP liaison service established by the Division of Mental Health in the Darling Downs Hospital and Health Service catchment to facilitate the care of rural patients and improve communication between primary and specialist care. CONCLUSIONS: The GP liaison service was created using funding from the Commonwealth STP initiative to provide weekly registrar clinics to primary care providers in the Darling Downs. The service was eagerly accepted by providers who saw patient benefits outweighing financial considerations. Expectations of a greater level of care than the assessment and advice provided reflects the large unmet need for mental health services in rural areas. GPs expressed enthusiasm for true collaborative care, such as case management overseen by the public mental health service but based at GP offices.

[Change in therapy target and therapy limitations in intensive care medicine. Position paper of the Ethics Section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine]. / Therapiezieländerung und therapiebegrenzung in der intensivmedizin. Positionspapier der Sektion Ethik der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin.

The task of physicians is to maintain life, to protect and re-establish health as well as to alleviate suffering and to accompany the dying until death, under consideration of the self-determination rights of patients. Increasingly more and differentiated options for this are becoming available in intensive care medicine. Within the framework of professional responsibility physicians must decide which of the available treatment options are indicated. This process of decision-making is determined by answering the following question: when and under which circumstances is induction or continuation of intensive care treatment justified? In addition to the indications, the advance directive of the patient is the deciding factor. Medical indications represent a scientifically based estimation that a therapeutic measure is suitable in order to achieve a defined therapy target with a given probability. The ascertainment of the patient directive is achieved in a graded process depending on the state of consciousness of the patient. The present article offers orientation assistance to physicians for these decisions which are an individual responsibility.

Respect in mental health: reconciling the rhetorical hyperbole with the practical reality.

Although there is a high degree of consensus in the existing literature regarding the importance of respect in mental health care, a realistic appraisal suggests that there is something of a disconnect between what is espoused in policy documents and what actually occurs in practice. As a result, this article seeks to explore and advance our understanding of the phenomenon of respect in mental health care and draws on real practice situations to illustrate this schism. To this end, the authors present three case studies that focus on the following: "use of seclusion," "respecting professional boundaries," and "horizontal workplace violence." The authors advance the, perhaps for some, provocative argument that it is relatively easy to write/speak about respect, while the reality of communicating respect to others is more difficult, challenging, and makes significant demands on the individual psychiatric/mental health nurse.

Ethical issues in the introduction of case management for elderly people.

As case management is under development in France for elderly people, this study sets out to identify and analyse key situations responsible for ethical dilemmas for French case managers. We based our study on the analyses of individual interviews made with case managers and focus-group discussions, bringing together all case managers working in local organisations running for at least a year. We identified three situations giving rise to ethical dilemmas: in the order of importance, the refusals of care, the practicalities of collecting and sharing personal data and the allocation of resources. These three situations can lead to conflict between the principle of beneficence and those of respect for autonomy, non-maleficence and justice. We describe here how French case managers practically deal with these situations.

Sport, scales, or war? Metaphors speech-language pathologists use to describe caseload management.

Professionals' experiences, perceptions, and attitudes may be reflected in the metaphors they use to describe and discuss important professional issues. This qualitative study explored speech-language pathologists' experiences of caseload management through metaphorical analysis. Metaphors provided a lens for reflecting participants' lived experiences and professional knowledge construction. Data was obtained from 16 practising speech-language pathologists during individual work place interviews. Participants included new graduate and experienced speech-language pathologists who were employed in hospital and community settings. Metaphors for caseload management were identified from participants' transcribed narratives, then coded and organized into themes. Participants produced a total of 297 metaphors during professional practice narratives. Thematic analysis indicated that participants used three salient metaphors of sport, measuring scales, and war when they addressed caseload issues. Metaphors of sport, scales, and war reflected speech-language pathologists' concerns about managing clients efficiently, perceived caseload burdens, and the conflict they experienced when resources were inadequate. These metaphors may also represent a continuum in speech-language pathologists' personal and professional responses to caseload demands. Shared metaphors may contribute to the professional socialization of individuals entering a profession and to changing or maintaining workplace culture. Hence, speech-language pathologists need to consider the impact of using metaphors of sport, measuring scales, and war during interactions with clients and colleagues.