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1.
Recurso educacional aberto em Espanhol | ID: oer-3883

RESUMO

1º Jornada «Derecho a la Salud», organizada por el CVSP Nodo Argentina, la Sala de Derecho a la Salud del Colegio de Abogados de Córdoba y la Escuela de Salud Pública y Ambiente de la Facultad de Ciencias Médicas–UNC. La misma se llevó a cabo el día 4 de diciembre del corriente año en el Salón Rojo de la Secretaría de Graduados en Ciencias de la Salud FCM-UNC. La jornada contó con la presencia de Profesionales de la Salud, Profesionales del Derecho, alumnos de postgrado de las Carreras de Ciencias Médicas, Derecho y Ciencias Sociales y público en general. conferencia por el Dr. Andrés de León. Presidente del Consejo Médico de la Provincia de Córdoba.


Assuntos
Ética Médica/educação , Códigos de Ética/legislação & jurisprudência
3.
Zhonghua Yi Shi Za Zhi ; 49(5): 259-264, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31795591

RESUMO

Foshuo Wenshi Xiyu Zhongseng Jing (, Sutra on Bathing the Sangha in the Bathhouse) as an early Scripture of Han Buddhism, introduced the concept, methods and medical & health care function of bathhouse bathing in detail.The most prominent feature of it, was its distinct medical viewpoints. The medical thoughts were closely related to famous ancient Indian physician Jivaka and Buddhism's thoughts "Mahabhuta(■, great element)" and "Nidana (■, cause, motivation or occasion)" .It focused on the good concept of personal life, physical and mental health, objectively benefited human health.Even from the viewpoints of modern medicine, it is also very reasonable.In particular, its noble medical ethics and benevolence, is instructive for the return of humanistic spirit in the medical profession today.


Assuntos
Budismo , Ética Médica , Beneficência , Humanos
4.
N Engl J Med ; 381(23): 2196-2197, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31800985
7.
J Clin Ethics ; 30(4): 303-313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851621

RESUMO

A face transplant is as challenging a surgical procedure as any patient can undergo. In this introduction I present the medical aspects of this surgery, the profound ethical issues it raises, and optimal interventions that clinicians can pursue to help these patients and their loved ones. I then discuss how to help other kinds of patients and loved ones who confront similar stresses. I end by presenting a goal that author Sharrona Pearl puts forth after she studied many face transplant patients. The efforts she urges should maximize our capacity to see face transplant patients-and anyone-as they are, as opposed to how they look.


Assuntos
Face/cirurgia , Transplante de Face/ética , Consentimento Livre e Esclarecido/ética , Cirurgia Plástica/ética , Confidencialidade , Ética Médica , Transplante de Face/psicologia , Feminino , Humanos
8.
Br J Nurs ; 28(21): 1380-1386, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31778332

RESUMO

BACKGROUND: young-onset dementia (under age 65) varies in many respects to typical aged dementia. Health professionals are centrally involved in supporting individuals and families to cope with the unique challenges that young-onset dementia (YOD) brings. AIMS: this study aimed to explore professionals' perceptions of the key challenges faced by people living with YOD and their families, and how they provide support to this group. METHODS: qualitative interviews were conducted with nine health professionals from a range of health and social care contexts. Data were analysed using interpretative phenomenological analysis. FINDINGS: interviewees reported significant challenges in trying to enact support for people with YOD, and families. Particular challenges relate to delays in accessing timely diagnosis, and difficulty in accessing relevant, age-appropriate supports. Interviewees experienced ethical tensions working in this area; interviewees were keen to enact support for the person following diagnosis, but felt constrained by service options that were not relevant or readily accessible to the person, and in some instances, traditional dementia services added to, rather than lessened the stress experienced by those involved. CONCLUSION: dementia and health services should be cognisant of the unique challenges of YOD, and models of service provision should aim to respond accordingly. Nurses and other health professionals should be afforded the necessary structures to support people living with YOD. This relates to dedicated YOD models of care, specifically timely diagnosis, post-diagnosis support and community services that enhance personhood and resilience.


Assuntos
Atitude do Pessoal de Saúde , Demência/terapia , Ética Médica , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Adaptação Psicológica , Idade de Início , Demência/psicologia , Família/psicologia , Humanos , Pessoa de Meia-Idade , Relações Profissional-Família , Relações Profissional-Paciente , Pesquisa Qualitativa , Apoio Social
9.
Lakartidningen ; 1162019 Oct 15.
Artigo em Sueco | MEDLINE | ID: mdl-31613375

RESUMO

This article highlights a special subtype of this dilemma, in which the patient requests a treatment that the physician judges to be substandard. Reasons for and against providing substandard treatment in the name of patient autonomy are presented and discussed. It is suggested that physicians carefully consider the risk of crowding out of other patients if substandard treatment is provided.


Assuntos
Necessidades e Demandas de Serviços de Saúde/ética , Preferência do Paciente , Qualidade da Assistência à Saúde/ética , Beneficência , Ética Médica , Prioridades em Saúde , Humanos , Participação do Paciente , Direitos do Paciente , Autonomia Pessoal , Papel do Médico
10.
Gesundheitswesen ; 81(11): 933-944, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31614386

RESUMO

OBJECTIVES: "Medical necessity" (MedN) is a fuzzy term. Our project aims at concretising the concept between medical ethics, social law, and social medicine to support health care regulation, primarily within Germany's statutory health insurance system. In a previous publication we identified MedN as a tripartite predicate: A specific clinical condition requires a specific medical intervention to reach a specific medical goal. Our two-part text searches for and discusses criteria to classify medical methods as generally medically necessary (medn), provided a non-trivial clinical condition and a relevant, legitimate, and reachable goal actually exist. In this paper we present the first part of our results. METHODS: Based on an extensive ethical, sociolegal and sociomedical body of literature, and starting with an non-controversial case vignette (thrombolysis in acute stroke), we generally followed a critical reconstructive approach. First we defined the term "medical method". In several interdisciplinary rounds, we then collected and discussed criteria from three sources: methods to develop clinical practice guidelines as compendia of indication rules, the National Model of Prioritisation in Swedish Health Care, and the HTA Core Model of the European Network for Health Technology Assessment as an instrument of political counselling. RESULTS: We identified general clinical efficacy and benefit as the 2 main "medical" criteria of MedN. As a third - epistemic - criterion, the corresponding bodies of evidence are always to be considered. Since clinical and prioritising guidelines grade their recommendations, the question arises whether MedN should be conceptualised as a dichotomous or finer graded predicate. In accord with German social law we advocate for the binary form. Further discussions focused on multifactorial MedN-configurations, the range of the term, and the variability of evidence requirements. CONCLUSIONS: No matter how the content of MedN is conceptualised, it seems impossible to include its criteria in an algorithm. So deliberative effort is indispensable at any stage of developing a programme to classify medical methods as medically necessary.


Assuntos
Ética Médica , Avaliação da Tecnologia Biomédica , Algoritmos , Alemanha , Humanos
14.
Gesundheitswesen ; 81(11): 945-954, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31597188

RESUMO

OBJECTIVES: "Medical necessity" (MedN) is a fuzzy term. Our project aims at concretising the concept between medical ethics, social law, and social medicine to support health care regulation, primarily within Germany's statutory health insurance system. In Part I, we identified efficacy, (net)benefit, and the corresponding bodies of evidence as obligatory criteria of MedN. This is the second part suggesting and discussing further criteria. METHODS: See Part I RESULTS: (Part II): As further MedN-criteria we critically assessed a method's effectiveness and acceptance in routine care, its potential beneficiaries, theoretical fundament, cost, and being without alternative as well as patients' self-responsibility, cooperation, and preferences. Since MedN has both lower and upper bounds, we had to consider certain cases of mis- and overuse, due for instance to "indication creep" or "disease mongering". CONCLUSIONS: The additional criteria neither establish MedN (when met singly or together) nor exclude it (when not met). If MedN is rejected in view of the 3 obligatory criteria then further information does not overturn the verdict. If a method is already assessed as being medn then further criteria do not make it "more or less necessary". Though we advocated for a binary MedN-concept (Part I) we are nonetheless convinced that not all medical methods deemed medn are equally medically relevant. Respective differences within the range of MedN could be assessed by techniques to prioritise medical conditions, methods, and aims.


Assuntos
Assistência à Saúde , Ética Médica , Alemanha , Humanos , Legislação Médica , Programas Nacionais de Saúde
15.
Am J Bioeth ; 19(11): 63-64, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31661409
16.
Am J Bioeth ; 19(11): 62-63, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31661413
19.
Z Gerontol Geriatr ; 52(Suppl 4): 243-248, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31602507

RESUMO

The use of freedom-depriving measures (physical and medicinal restraints) in people with cognitive impairment or dementia in clinical care settings is of ongoing importance. At the same time, these coercive measures are not only heavily debated but also in most cases ethically questionable from the perspective of the ethics of human dignity. Usually, the ethical evaluation of freedom-depriving measures follows classical paradigms of medical ethics, such as the Principles of Biomedical Ethics by Beauchamp and Childress. To enrich the debate at this point, the ethical category of embodiment ("Leiblichkeit" ) is introduced and discussed after a short summary of the ethical problem at hand. The phenomenon of the living body that has received increasingly more attention in several sciences since the proclaimed "corporeal turn" enables new perspectives towards human dignity, freedom and deprivation of freedom: freedom-depriving measures do not take place in an invisible realm of ideas but are directly applied to the psychophysical unity that is the living body of a person. Thus, freedom-depriving measures are an intervention into the bodily autonomy of the human being and the personal freedom that is manifested in the living body. The concept of the living body ("Leib") that is applied here, signifies more than just a physical object and is especially apt to capture the (inter)subjective dimension that has to be taken into account here. Finally, it will have to be investigated whether the use of medicinal restraints represents an especially serious interference into the sphere of human embodiment. Once introduced into the debate on freedom-depriving measures in clinical care, the category of embodiment can warrant decisive new emphases.


Assuntos
Cuidados Críticos/ética , Demência/terapia , Liberdade , Direitos do Paciente/ética , Autonomia Pessoal , Respeito , Cuidados Críticos/psicologia , Tomada de Decisões , Ética Médica , Humanos
20.
J Clin Ethics ; 30(3): 223-231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31573966

RESUMO

While the best interest standard (BIS) enjoys wide endorsement as ethical and decision-making standard in pediatrics, it has been criticized as vague and indeterminate. Alternate decision-making standards have been proposed to replace or augment the BIS, notably the harm principle (HP) and constrained parental autonomy (CPA) model. In this edition of The Journal of Clinical Ethics, Lainie Friedman Ross argues that CPA is a better standard than the BIS or the HP as both guide and limiter in pediatrics. In response, I review the important work done by the BIS in pediatrics, and argue that neither the HP nor the CPA can take over these functions or replace the BIS. Among other things I argue: (1) The BIS provides more robust protections for the moral claims of children. (2) The CPA model and the HP do not resolve the indeterminacy and vagueness present in complex medical situations, and the BIS is better suited to deal with this vagueness and indeterminacy. (3) The BIS is a general principle of medical ethics with special application in pediatrics; it fits seamlessly into the system of medical ethics and fulfills many functions within pediatrics. The HP and the CPA model do not fit in so readily within medical ethics, and are not equipped to take over the functions of the BIS.


Assuntos
Tomada de Decisões , Redução do Dano , Pais , Pediatria , Autonomia Pessoal , Criança , Ética Clínica , Ética Médica , Humanos , Padrão de Cuidado
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