Sujet(s)
Vaccins contre la COVID-19/ressources et distribution , COVID-19/prévention et contrôle , Santé publique/éthique , COVID-19/diagnostic , COVID-19/épidémiologie , COVID-19/virologie , Droits civiques/éthique , Documentation/éthique , Femelle , Équité en santé/éthique , Accessibilité des services de santé/éthique , Humains , Grossesse , SARS-CoV-2/génétique , SARS-CoV-2/isolement et purification , Vaccination/éthique , Organisation mondiale de la santé/organisation et administrationSujet(s)
Vaccins contre la COVID-19 , COVID-19/prévention et contrôle , Technologie numérique , Documentation , Pandémies/prévention et contrôle , Vaccination , Vaccins contre la COVID-19/ressources et distribution , Canada , Documentation/éthique , Liberté de circulation/éthique , Liberté de circulation/législation et jurisprudence , Humains , SARS-CoV-2 , Voyage , Vaccination/éthique , Vaccination/législation et jurisprudenceRÉSUMÉ
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.
Sujet(s)
COVID-19/immunologie , Documentation/éthique , Liberté de circulation/éthique , Immunité active , Santé publique/éthique , Humains , SARS-CoV-2/immunologieSujet(s)
Immunité acquise , Betacoronavirus/immunologie , Infections à coronavirus/immunologie , Documentation , Pandémies , Pneumopathie virale/immunologie , Discrimination sociale/législation et jurisprudence , Vaccins antiviraux , COVID-19 , Dépistage de la COVID-19 , Vaccins contre la COVID-19 , Techniques de laboratoire clinique , Infections à coronavirus/diagnostic , Infections à coronavirus/prévention et contrôle , Personnes handicapées/législation et jurisprudence , Documentation/éthique , Documentation/normes , Humains , SARS-CoV-2 , Classe sociale , États-UnisSujet(s)
Immunité acquise , Betacoronavirus/immunologie , Infections à coronavirus/immunologie , Documentation/éthique , Pneumopathie virale/immunologie , Vaccins antiviraux , COVID-19 , Vaccins contre la COVID-19 , Infections à coronavirus/prévention et contrôle , Humains , Pandémies , SARS-CoV-2 , VaccinationRÉSUMÉ
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).
Sujet(s)
Codes de déontologie , Infections à coronavirus , Pandémies , Pneumopathie virale , Psychologie/éthique , Télémédecine/éthique , Betacoronavirus , COVID-19 , Compétence clinique , Confidentialité/éthique , Documentation/éthique , Éthique de la recherche , Recommandations comme sujet , Humains , Consentement libre et éclairé/éthique , Édition/éthique , Recherche , SARS-CoV-2 , Sociétés savantesRÉSUMÉ
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.
Sujet(s)
Documentation/éthique , Dossiers médicaux électroniques/tendances , Médecins/normes , Adulte , Sujet âgé , Documentation/normes , Déontologie médicale , Femelle , Escroquerie/statistiques et données numériques , Humains , Mâle , Examen physique/éthique , Examen physique/méthodes , Médecins/statistiques et données numériquesRÉSUMÉ
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.
Sujet(s)
Documentation , Relations médecin-patient , Documentation/éthique , Documentation/tendances , Dossiers médicaux électroniques , HumainsRÉSUMÉ
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.
Sujet(s)
Maladies cardiovasculaires/génétique , Dépistage génétique/méthodes , Maladies cardiovasculaires/diagnostic , Maladies cardiovasculaires/thérapie , Documentation/éthique , Documentation/normes , Déontologie médicale , Dépistage génétique/éthique , Dépistage génétique/législation et jurisprudence , Allemagne , Adhésion aux directives/éthique , Adhésion aux directives/législation et jurisprudence , Humains , RémunérationSujet(s)
Polyarthrite rhumatoïde/thérapie , Essais cliniques comme sujet/éthique , Essais cliniques comme sujet/méthodes , Comités d'éthique , Accès à l'information/éthique , Anticorps monoclonaux humanisés/usage thérapeutique , Antirhumatismaux/usage thérapeutique , Documentation/éthique , Documentation/méthodes , Industrie pharmaceutique/éthique , Industrie pharmaceutique/méthodes , Homéopathie/éthique , Homéopathie/méthodes , Humains , Consentement libre et éclairé/éthique , Gestion du risque/éthique , Gestion du risque/méthodes , Royaume-UniSujet(s)
Attestation , Documentation/normes , Expertise/normes , Menthol/effets indésirables , Fumer/effets indésirables , Industrie du tabac/normes , Produits du tabac/effets indésirables , Toxicologie/normes , Attestation/éthique , Conflit d'intérêts , Sécurité des produits de consommation , Documentation/éthique , Expertise/éthique , Humains , Appréciation des risques , Industrie du tabac/éthique , Toxicologie/éthiqueRÉSUMÉ
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.
Sujet(s)
Directives anticipées , Documentation , Maisons de repos , Soins palliatifs , Directives anticipées/éthique , Prise de décision , Documentation/éthique , Documentation/normes , Femelle , Humains , Mâle , Medicaid (USA) , Medicare (USA) , Missouri , Maisons de repos/éthique , Maisons de repos/normes , Soins palliatifs/éthique , Soins palliatifs/normes , Amélioration de la qualité , États-UnisRÉSUMÉ
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.
Sujet(s)
Formulaires de consentement/législation et jurisprudence , Documentation/méthodes , Comités d'éthique de la recherche/législation et jurisprudence , Expérimentation humaine/législation et jurisprudence , Recherche biomédicale/éthique , Recherche biomédicale/législation et jurisprudence , Formulaires de consentement/éthique , Documentation/éthique , Comités d'éthique de la recherche/organisation et administration , Expérimentation humaine/éthique , Humains , Consentement libre et éclairé/éthique , Consentement libre et éclairé/législation et jurisprudence , États-UnisRÉSUMÉ
La metodología del portafolio se usa ampliamente, incluida la formación médica permanente y la formación de especialistas por el sistema de residencias. Algunas instituciones españolas (la Universidad Nacional de Educación a Distancia y la Escuela Nacional de Sanidad) están aplicando un portafolio de siete dimensiones al ámbito de la Gestión Clínica, que podría ser utilizado como marco conceptual y lista de comprobación para elaborar diferentes documentos de planificación, programación, o evaluación en las nuevas experiencias innovadoras de Unidades de Gestión Clínica. Este artículo expone brevemente el Protocolo, considera sus potencialidades, y concluye señalando la importancia del buen gobierno y la rendición de cuentas en el nuevo profesionalismo médico
Portfolio methodology is widely applied to training, particularly in medical education and for medical trainees. Some Spanish Institutions (National University of Distance Learning and National School of Public Health) are using a seven dimension Portfolio in the field of Clinical Management, which could be used as conceptual framework and checklist for building up different documents for planning, programming and evaluating the new experiences of Clinical Units based on clinical management initiatives. This paper describe the Portfolio in short, takes into consideration its potential use, and concludes addressing the relevance of good governance and accountability for the medical professionalism
Sujet(s)
Humains , Mâle , Femelle , Service hospitalier d'urologie/éthique , Service hospitalier d'urologie/organisation et administration , Administration d'établissement de santé/enseignement et éducation , Administration d'établissement de santé/éthique , Sociétés/méthodes , Documentation/éthique , Administration d'établissement de santé/législation et jurisprudence , Administration d'établissement de santé/méthodes , Sociétés/législation et jurisprudence , Documentation/classificationSujet(s)
Droits de l'homme/législation et jurisprudence , Ordres de réanimation/législation et jurisprudence , Prise de décision/éthique , Documentation/éthique , Humains , Soins palliatifs , Autonomie personnelle , Relations entre professionnels de santé et patients/éthique , Ordres de réanimation/éthique , Royaume-UniRÉSUMÉ
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.