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1.
Acad Med ; 95(10): 1488-1491, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006868

RESUMO

In response to the COVID-19 pandemic, the Association of American Medical Colleges has called for a temporary suspension of clinical teaching activities for medical students. Planning for the continued involvement of learners in patient care during this pandemic should include teaching learners professional formation. The authors provide an ethical framework to guide such teaching, based on the ethical principle of beneficence and the professional virtues of courage and self-sacrifice from professional ethics in medicine. The authors show that these concepts support the conclusion that learners are ethically obligated to accept reasonable, but not unreasonable, risk. Based on this ethical framework, the authors provide an account of the process of teaching professional formation that medical educators and academic leaders should implement. Medical educators and academic leaders should embrace the opportunity that the COVID-19 pandemic presents for teaching professional formation. Learners should acquire the conceptual vocabulary of professional formation. Learners should recognize that risk of infection from patients is unavoidable. Learners should become aware of established ethical standards for professional responsibility during epidemics from the history of medicine. Learners should master understandable fear. Medical educators and academic leaders should ensure that didactic teaching of professional formation continues when it becomes justified to end learners' participation in the processes of patient care; topics should include the professionally responsible management of scarce medical resources. The COVID-19 pandemic will not be the last major infectious disease that puts learners at risk. Professional ethics in medicine provides powerful conceptual tools that can be used as an ethical framework to guide medical educators to teach learners, who will bear leadership responsibilities in responses to future pandemics, professional formation.


Assuntos
Educação Médica/ética , Ética Médica/educação , Pandemias/ética , Profissionalismo/educação , Betacoronavirus , Infecções por Coronavirus , Humanos , Pneumonia Viral , Profissionalismo/ética , Faculdades de Medicina , Sociedades Médicas
2.
Int J Pharm Compd ; 24(5): 386-387, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886636
4.
J Law Med ; 27(4): 981-984, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32880414

RESUMO

Clinical issues involving ethical dilemmas arise daily and confound physicians as they provide medical care. These dilemmas require difficult decisions as physicians must respect patients' values, lifestyles, and freedom of choice while protecting life and promoting health. This is made more challenging as values and lifestyles become more diverse, making third-party support necessary to accommodate the wishes of stakeholders, particularly patients. Collaborative work is important for addressing clinical ethics issues. Government agencies and professional organisations should discuss individual cases as public policy concerns and release guidelines based on their deliberations. Medical institutions should refer to such guidelines in their own discussions on ethically challenging cases. This is not the case today as each organisation creates its own guidelines; there is no consensus on how clinical ethics committees or consultations should be conducted. Support systems that are public in nature are needed to protect patients' rights and freedoms in medical care.


Assuntos
Tomada de Decisão Clínica , Médicos , Ética Médica , Liberdade , Humanos , Japão , Direitos do Paciente
6.
S Afr Med J ; 110(6): 456-457, 2020 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-32880550

RESUMO

In the midst of an unprecedented public health crisis, extraordinary containment measures must be implemented. These include both isolation and quarantine, either on a voluntary basis or enforced. In the transition from voluntary to mandatory isolation, conflicts arise at the intersection of ethics, human rights and the law. The Siracusa Principles adopted by the United Nations Economic and Social Council in 1985 and enshrined in international human rights legislation and guidelines specify conditions under which civil liberties may be infringed. In order for isolation processes in South Africa to claim legitimacy, it is important that these principles as well as national laws and constitutional rights are embedded in state action.


Assuntos
Infecções por Coronavirus/prevenção & controle , Direitos Humanos/legislação & jurisprudência , Pandemias/prevenção & controle , Isolamento de Pacientes/legislação & jurisprudência , Pneumonia Viral/prevenção & controle , Quarentena/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Ética Médica , Humanos , Pandemias/ética , Pneumonia Viral/epidemiologia , Saúde Pública , África do Sul/epidemiologia
7.
S Afr Med J ; 110(6): 461-462, 2020 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-32880552

RESUMO

Given the increasing numbers of ethical and legal issues arising from the COVID-19 epidemic, particularly in respect of patient-doctor confidentiality, doctors must explain to patients how the measures taken to combat the spread of the virus impact on their confidentiality. Patients must be reassured that doctors are ethically bound to continue to respect such confidentiality, but it should be made clear to them that doctors must also comply with the demands of the law. While the Constitution, statutory law and the common law all recognise a person's right to privacy, during extraordinary times such as the COVID-19 pandemic, confidentiality must be breached to a degree to halt the spread of the virus.


Assuntos
Confidencialidade/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Ética Médica , Relações Médico-Paciente/ética , Pneumonia Viral/epidemiologia , Confidencialidade/ética , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
8.
Rev Prat ; 70(2): 222-226, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32877146

RESUMO

Disabled child, care and ethical aspects. The child's doctor occupies a privileged place in the life of a child with a disability. At all times, he must be an adviser, favouring a global approach and support to ensure optimal autonomy. Discovery of a neurodevelopmental disorder justifies a systematic search for the various causes known to date. Identification and knowledge of a precise diagnosis is an essential element in constructing the life plan for a disabled child. The announcement of the diagnosis is an integral part of the care system, it only makes sense when combined with tailor-made and step by step support. This requires that the doctor has a good knowledge of the main childcare structures, guidance agencies, and available financial aid. Multidisciplinary consultations enable a global approach to support a child with a disability. More children with disabilities become adults as medical care progresses. Transition from "children" to "adult" consultations represents a major challenge. However, some cases could be life-threatening. The decision on whether to continue the various therapies have to be considered and discussed with the child and his family, with reference to the notion of "unreasonable obstinacy". Drafting an individual certificate of "remarkable patient" will best help the implementation of end-of-life support measures.


Assuntos
Crianças com Deficiência , Ética Médica , Adulto , Criança , Família , Humanos , Masculino , Encaminhamento e Consulta
11.
Can Bull Med Hist ; 37(2): 461-489, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822548

RESUMO

This paper uses the history of kidney transplantation in South Africa as a lens through which to write a racialized, micro history that illustrates the politics of medical discoveries and medical research at one of South Africa's most prestigious medical research universities, the University of the Witwatersrand (Wits) in Johannesburg. Between 1966 and the 1980s, the Wits team became the most advanced and prolific kidney transplant unit in the country. Yet the racist, oppressive Apartheid system fundamentally shaped these developments. Transplantation, as this paper shows, became an elite medical procedure, performed by a select group of white doctors on mostly white patients. For these doctors, transplantation showed their medical prowess and displayed the technical advancements they were able to make in research and clinical practice as they strove to position South Africa as a significant international player in medical research, despite academic boycotts and increasing sanctions. Transplantation became a symbol of white supremacy in a country where the black majority were excluded from anything but the most basic health care.


Assuntos
Centros Médicos Acadêmicos/história , Apartheid/história , Ética Médica/história , Transplante de Rim/história , Racismo/história , Grupo com Ancestrais do Continente Africano , Pesquisa Biomédica/ética , Pesquisa Biomédica/história , Grupo com Ancestrais do Continente Europeu , Transplante de Coração/ética , Transplante de Coração/história , História do Século XX , Humanos , Imunossupressão/história , Transplante de Rim/ética , África do Sul
14.
World J Gastroenterol ; 26(29): 4182-4197, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32848328

RESUMO

Mobile health apps (MHAs) and medical apps (MAs) are becoming increasingly popular as digital interventions in a wide range of health-related applications in almost all sectors of healthcare. The surge in demand for digital medical solutions has been accelerated by the need for new diagnostic and therapeutic methods in the current coronavirus disease 2019 pandemic. This also applies to clinical practice in gastroenterology, which has, in many respects, undergone a recent digital transformation with numerous consequences that will impact patients and health care professionals in the near future. MHAs and MAs are considered to have great potential, especially for chronic diseases, as they can support the self-management of patients in many ways. Despite the great potential associated with the application of MHAs and MAs in gastroenterology and health care in general, there are numerous challenges to be met in the future, including both the ethical and legal aspects of applying this technology. The aim of this article is to provide an overview of the current status of MHA and MA use in the field of gastroenterology, describe the future perspectives in this field and point out some of the challenges that need to be addressed.


Assuntos
Gastroenterologia/métodos , Aplicativos Móveis , Autogestão , Telemedicina , Dispositivos Eletrônicos Vestíveis , Betacoronavirus , Alfabetização Digital , Segurança Computacional , Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Registros Eletrônicos de Saúde , Ética Médica , Comportamentos Relacionados com a Saúde , Humanos , Pandemias , Educação de Pacientes como Assunto , Relações Médico-Paciente , Pneumonia Viral/epidemiologia , Smartphone
15.
J Med Ethics ; 46(10): 662-667, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32769094

RESUMO

In March 2020, the Government produced a document entitled "Responding to COVID-19: The Ethical Framework for Adult Social Care" ('The Ethical Framework'). In this article, we summarise the key features of the proposed ethical framework and subject it to critical analysis. We highlight three primary issues. First, the emphasis placed on autonomy as the primary ethical principle. We argue if ever there was a context in which autonomy should dominate the ethical analysis, this is not it. Second, we examine the interface between ethics and law which is largely overlooked in the document. Finally, we explore the surprising lack of attention paid to the concept of responsibility and communal obligations within the framework.


Assuntos
Infecções por Coronavirus/terapia , Tomada de Decisões/ética , Análise Ética , Ética Médica , Legislação Médica/ética , Autonomia Pessoal , Pneumonia Viral/terapia , Responsabilidade Social , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Teoria Ética , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Medicina Estatal/ética , Medicina Estatal/legislação & jurisprudência , Reino Unido
17.
Am J Bioeth ; 20(8): 54-64, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32757910

RESUMO

Dementia patients in the moderate-late stage of the disease can, and often do, express different preferences than they did at the onset of their condition. The received view in the philosophical literature argues that advance directives which prioritize the patient's preferences at onset ought to be given decisive moral weight in medical decision-making. Clinical practice, on the other hand, favors giving moral weight to the preferences expressed by dementia patients after onset. The purpose of this article is to show that the received view in the philosophical literature is inadequate and is out of touch with real clinical practice. I argue that having dementia is a cognitive transformative experience and that preference changes which result from this are legitimate and ought to be given moral weight in medical decision-making. This argument ought to encourage us to reduce our confidence in the moral weight of advance directives for dementia patients.


Assuntos
Diretivas Antecipadas/ética , Cognição , Demência , Ética Médica , Competência Mental , Preferência do Paciente , Tomada de Decisões/ética , Dissidências e Disputas , Humanos , Princípios Morais
20.
Rev Med Chil ; 148(3): 399-403, 2020 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-32730386

RESUMO

The code of ethics of the Medical College of Chile was modified in December 2019. The amendment was mainly to article 8, which refers to the doctor's duty to care for the pregnant woman and the child she is carrying. The change maintains this duty, but allows doctors to perform abortions, introducing three considerations that act as new principles or values for the medical profession: the plurality of values existing in society, the autonomy of women and what is established by law. This paper is a reflection on codes of ethics, their relationship with values, and with legislation. Also it shows the consequences that this modification represents for the principles governing medical activity, the status of medical specialties, the commitment of doctors to their patients and the validity of the code of ethics.


Assuntos
Códigos de Ética , Aborto Induzido , Chile , Ética Médica , Feminino , Humanos , Médicos , Gravidez
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