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2.
J Law Med Ethics ; 51(3): 672-683, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38088597

RESUMEN

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.


Asunto(s)
Lesiones Encefálicas , Instituciones Académicas , Humanos
3.
JAMA Intern Med ; 183(4): 283-284, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36848080

RESUMEN

This Viewpoint suggests that professional societies should continue to advocate for equitable access for patients to all necessary medical care including abortion care.


Asunto(s)
Aborto Inducido , Embarazo , Femenino , Humanos , Sociedades Médicas
4.
Cell Rep Med ; 3(8): 100719, 2022 08 16.
Artículo en Inglés | MEDLINE | ID: mdl-35977463

RESUMEN

In the past two years, in 25 US states, bills have been introduced to restrict access to gender-affirming medical care for minors. Some have already become law. We show how these bills, while purporting to "protect" trans youth, are really an assault on their ability, along with their parents' and physicians', to make healthcare choices and to receive medically necessary care. We discuss the evidence-based guidelines for the care of these patients, the positions taken by major medical societies against these bills, and the landscape of legal challenges that are being brought against these enacted laws.


Asunto(s)
Personas Transgénero , Adolescente , Atención a la Salud , Identidad de Género , Instituciones de Salud , Humanos , Política
8.
AMA J Ethics ; 22(3): E209-216, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-32220267

RESUMEN

This article canvasses laws protecting clinicians' conscience and focuses on dilemmas that occur when a clinician refuses to perform a procedure consistent with the standard of care. In particular, the article focuses on patients' experience with a conscientiously objecting clinician at a secular institution, where patients are least likely to expect conscience-based care restrictions. After reviewing existing laws that protect clinicians' conscience, the article discusses limited legal remedies available to patients.


Asunto(s)
Conciencia , Legislación Médica , Médicos , Negativa al Tratamiento , Ética Médica , Humanos , Organizaciones , Médicos/ética , Médicos/legislación & jurisprudencia , Negativa al Tratamiento/ética , Negativa al Tratamiento/legislación & jurisprudencia
10.
J Law Med Ethics ; 48(4_suppl): 146-154, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33404303

RESUMEN

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of laws intended to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies.


Asunto(s)
Armas de Fuego/legislación & jurisprudencia , Violencia con Armas/prevención & control , Rol del Médico , Práctica Profesional/ética , Práctica Profesional/legislación & jurisprudencia , Heridas por Arma de Fuego/prevención & control , Consejo , Deber de Advertencia , Humanos , Notificación Obligatoria , Estados Unidos/epidemiología
11.
J Law Med Ethics ; 48(4_suppl): 142-145, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33404307

RESUMEN

Physicians play a critical role in preventing and treating firearm injury, although the scope of that role remains contentious and lacks systematic definition. This piece aims to utilize the fundamental principles of medical ethics to present a framework for physician involvement in firearm violence. Physicians' agency relationship with their patients creates ethical obligations grounded on three principles of medical ethics - patient autonomy, beneficence, and nonmaleficence. Taken together, they suggest that physicians ought to engage in clinical screening and treatment related to firearm violence. The principle of beneficence also applies more generally, but more weakly, to relations between physicians and society, creating nonobligatory moral ideals. Balanced against physicians' primary obligations to patient agency relationships, general beneficence suggests that physicians may engage in public advocacy to address gun violence, although they are not ethically obligated to do so. A fourth foundational principle - justice - requires that clinicians attempt to ensure that the benefits and burdens of healthcare are distributed fairly.


Asunto(s)
Ética Médica , Armas de Fuego/ética , Defensa del Paciente/normas , Salud Pública/normas , Heridas por Arma de Fuego , Beneficencia , Humanos , Autonomía Personal , Relaciones Médico-Paciente/ética , Justicia Social
13.
14.
Semin Perinatol ; 42(8): 515-521, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30420296

RESUMEN

CRISPR gene editing is poised to transform the therapeutic landscape for diseases of genetic origin. The ease and agility by which CRISPR can make specific changes to DNA holds great promise not only for the treatment of heritable diseases, but also their prevention through germline editing. CRISPR-based therapeutic strategies are currently under development for numerous monogenic diseases. These strategies range from proof of concept studies demonstrating pre-fertilization gamete editing to recently initiated clinical trials for postnatal ex vivo therapies. The promise of CRISPR's human genome editing potential has captivated the public's attention. It is of paramount importance that medical professionals who work with patients who may have or carry a monogenic heritable disease understand CRISPR technology in order to have informed and compassionate discussions with their patients. Understanding CRISPR means understanding its evolving therapeutic applications' nuances, limitations, and barriers to access as well as the regulatory landscape they inhabit. In this piece we provide a review of the promises and pitfalls of CRISPR germline gene editing and their implications for patient decision-making throughout various stages of the reproductive process.


Asunto(s)
Sistemas CRISPR-Cas , Miedo , Edición Génica/métodos , Predisposición Genética a la Enfermedad/genética , Terapia Genética/tendencias , Esperanza , Salud Reproductiva , Toma de Decisiones , Medicina Basada en la Evidencia , Edición Génica/tendencias , Humanos
15.
Semin Perinatol ; 42(8): 525-530, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30415764

RESUMEN

CRISPR-based therapeutics have the potential to revolutionize the treatment of hereditary diseases, but current efforts to translate research to the bedside face significant technical, regulatory, and ethical hurdles. In this article, we discuss an underappreciated application of CRISPR: diagnostic testing, and argue that: (1) CRISPR diagnostics are poised to disrupt diagnostic practices including perinatal screening and (2) since CRISPR diagnostics pose minimal technical, regulatory and ethical hurdles (unlike CRISPR therapeutic uses) they are likely to be clinically relevant before CRISPR-based therapies, and thus warrant medical community's attention.


Asunto(s)
Sistemas CRISPR-Cas , Edición Génica/métodos , Marcación de Gen/métodos , Técnicas de Diagnóstico Molecular/métodos , Perinatología/métodos , Prevención Secundaria/métodos , Edición Génica/tendencias , Marcación de Gen/tendencias , Humanos , Técnicas de Diagnóstico Molecular/tendencias , Perinatología/tendencias , Sistemas de Atención de Punto
16.
J Law Med Ethics ; 46(3): 602-609, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30336104

RESUMEN

This article examines five different Medical-Legal Partnerships (MLPs) associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, and best practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the "L" has been lacking and is overdue.


Asunto(s)
Personal de Salud , Relaciones Interprofesionales , Abogados , Determinantes Sociales de la Salud , Servicios de Salud Comunitaria/organización & administración , Connecticut , Estado de Salud , Humanos , Servicio Ambulatorio en Hospital/organización & administración , Patient Protection and Affordable Care Act , Pobreza
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