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1.
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
4.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32690806

RESUMO

Long-acting reversible contraceptives are the most effective methods to prevent pregnancy and also offer noncontraceptive benefits such as reducing menstrual blood flow and dysmenorrhea. The safety and efficacy of long-acting reversible contraception are well established for adolescents, but the rate of use remains low for this population. The pediatrician can play a key role in increasing access to long-acting reversible contraception for adolescents by providing accurate patient-centered contraception counseling and by understanding and addressing the barriers to use.


Assuntos
Contracepção Reversível de Longo Prazo , Adolescente , Amenorreia/induzido quimicamente , Confidencialidade , Aconselhamento , Pessoas com Deficiência , Dismenorreia/tratamento farmacológico , Feminino , Acesso aos Serviços de Saúde , Humanos , Consentimento Livre e Esclarecido , Capacitação em Serviço , Dispositivos Intrauterinos , Contracepção Reversível de Longo Prazo/efeitos adversos , Contracepção Reversível de Longo Prazo/economia , Menorragia/tratamento farmacológico , Pediatras/educação , Relações Médico-Paciente , Gravidez , Gravidez na Adolescência/prevenção & controle , Estados Unidos
5.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32719089

RESUMO

Female genital mutilation or cutting (FGM/C) involves medically unnecessary cutting of parts or all of the external female genitalia. It is outlawed in the United States and much of the world but is still known to occur in more than 30 countries. FGM/C most often is performed on children, from infancy to adolescence, and has significant morbidity and mortality. In 2018, an estimated 200 million girls and women alive at that time had undergone FGM/C worldwide. Some estimate that more than 500 000 girls and women in the United States have had or are at risk for having FGM/C. However, pediatric prevalence of FGM/C is only estimated given that most pediatric cases remain undiagnosed both in countries of origin and in the Western world, including in the United States. It is a cultural practice not directly tied to any specific religion, ethnicity, or race and has occurred in the United States. Although it is mostly a pediatric practice, currently there is no standard FGM/C teaching required for health care providers who care for children, including pediatricians, family physicians, child abuse pediatricians, pediatric urologists, and pediatric urogynecologists. This clinical report is the first comprehensive summary of FGM/C in children and includes education regarding a standard-of-care approach for examination of external female genitalia at all health supervision examinations, diagnosis, complications, management, treatment, culturally sensitive discussion and counseling approaches, and legal and ethical considerations.


Assuntos
Circuncisão Feminina , Criança , Maus-Tratos Infantis , Cicatriz/etiologia , Circuncisão Feminina/efeitos adversos , Circuncisão Feminina/classificação , Circuncisão Feminina/legislação & jurisprudência , Circuncisão Feminina/psicologia , Competência Clínica , Confidencialidade , Documentação , Feminino , Doenças Urogenitais Femininas/etiologia , Procedimentos Cirúrgicos em Ginecologia , Humanos , Infecções/etiologia , Infertilidade Feminina/etiologia , Consentimento Livre e Esclarecido , Classificação Internacional de Doenças , Notificação de Abuso , Anamnese , Saúde Mental , Dor/etiologia , Pediatras , Exame Físico , Prevalência , Refugiados/legislação & jurisprudência , Sexualidade
7.
S Afr Med J ; 110(3): 172-174, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32657691

RESUMO

The Protection of Personal Information Act No. 4 of 2013 (POPIA) promises a new dispensation of privacy protection for research participants in South Africa. In a recent article, Staunton et al. proposed that a purposive interpretation of POPIA would allow for the retention of the status quo of broad consent in the context of genomic research. In this response article, we analyse the argument presented by Staunton et al., and conclude that it fails to convince: firstly, because Staunton et al. do not present empirical data for their factual assumption that moving up the consent benchmark is likely to stymie research; secondly, because genomic research does not have a monopoly on the public interest, but shares it with the privacy rights of research participants; and thirdly, because POPIA was designed to promote the protection of privacy, not simply to preserve the status quo as found in existing policy instruments. In contrast to the position advocated by Staunton et al., we suggest that a purposive interpretation of POPIA is aligned with the plain meaning of the statute - namely that specific (not broad) consent is a prerequisite for research on genomic information.This article, which comments on an article by Staunton et al. (Staunton C, Adams R, Botes M, et al. Safeguarding the future of genomic research in South Africa: Broad consent and the Protection of Personal Information Act No. 4 of 2013. S Afr Med J 2019;109(7):468-470. https://doi.org/10.7196/SAMJ.2019.v109i7.14148), is followed by a letter by Thaldar and Townsend (Privacy rights of human research participants in South Africa must be taken seriously. S Afr Med J 2020;110(3):175-176. https://doi.org/10.7196/SAMJ.2020.v110i3.14450); and a response to the article and letter by Staunton et al. (S Afr Med J 2020;110(3):175-176. https://doi.org/10.7196/SAMJ.2020.v110i3.14450).


Assuntos
Confidencialidade/legislação & jurisprudência , Privacidade Genética/legislação & jurisprudência , Pesquisa em Genética/legislação & jurisprudência , Genômica , Humanos , África do Sul
10.
S Afr Med J ; 110(5): 364-368, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32657718

RESUMO

In everyday clinical practice, healthcare professionals (HCPs) are exposed to large quantities of confidential patient information, and many use WhatsApp groups to share this information. WhatsApp groups provide efficient mechanisms for clinical management advice, decision-making support and peer review. However, most HCPs do not fully understand the legal and ethical implications of sharing content in a WhatsApp group setting, which is often thought to be hosted on a secure platform and therefore removed from public scrutiny. In our paper, we unpack the legal and ethical issues that arise when information is shared in WhatsApp groups. We demonstrate that sharing content in this forum is tantamount to the publication of content; in other words, those who share content are subject to the same legal ramifications as a journalist would be. We also examine the role of the WhatsApp group administrator, who bears an additional legal burden by default, often unknowingly so. We consider the recommendations made by the Health Professions Council of South Africa in their guidelines for the use of social media, and highlight some areas where we feel the guidelines may not adequately protect HCPs from the legal repercussions of sharing content in a WhatsApp group. Finally, we provide a set of guidelines for WhatsApp group users that should be regularly posted onto the group by the relevant group administrator to mitigate some of the legal liabilities that may arise. We also provide guidelines for group administrators.


Assuntos
Responsabilidade Legal , Aplicativos Móveis/ética , Aplicativos Móveis/legislação & jurisprudência , Tomada de Decisão Clínica , Comunicação , Confidencialidade/legislação & jurisprudência , Humanos , Revisão por Pares , Mídias Sociais/legislação & jurisprudência , África do Sul
12.
Cien Saude Colet ; 25(suppl 1): 2487-2492, 2020 Jun.
Artigo em Português, Inglês | MEDLINE | ID: covidwho-594341

RESUMO

Data has become increasingly important and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies are being developed by governments and private companies to enable the tracking of the public's symptoms, contacts and movements. Considering the current scenario, initiatives designed to support infection surveillance and monitoring are essential and necessary. Nonetheless, ethical, legal and technical questions abound regarding the amount and types of personal data being collected, processed, shared and used in the name of public health, as well as the concomitant or posterior use of this data. These challenges demonstrate the need for new models of responsible and transparent data and technology governance in efforts to control SARS-COV2, as well as in future public health emergencies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Saúde Global , Registros de Saúde Pessoal , Pandemias , Pneumonia Viral/epidemiologia , Vigilância da População/métodos , Privacidade , Confidencialidade , Busca de Comunicante/métodos , Anonimização de Dados , Humanos , Mídias Sociais
13.
Indian J Public Health ; 64(Supplement): S117-S124, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-545657

RESUMO

Digital health interventions are globally playing a significant role to combat coronavirus disease 2019 (COVID-19), which is an infectious disease caused by Severe Acute Respiratory Syndrome coronavirus 2. Here, we present a very brief overview of the multifaceted digital interventions, globally, and in India, for maintaining health and health-care delivery, in the context of the Covid-19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Sistemas de Informação/organização & administração , Aplicativos Móveis , Pneumonia Viral/epidemiologia , Inteligência Artificial , Betacoronavirus , Confidencialidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Diagnóstico Precoce , Educação em Saúde/métodos , Humanos , Internet das Coisas/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Prevenção Primária/organização & administração , Design de Software , Telemedicina/métodos , Telemedicina/organização & administração , Dispositivos Eletrônicos Vestíveis
16.
Recenti Prog Med ; 111(6): 357-367, 2020 06.
Artigo em Italiano | MEDLINE | ID: mdl-32573551

RESUMO

The global emergency caused by the SARS-CoV-2 pandemic has suddenly changed how we communicate with families in all the CoViD-19 care settings, due to the obligation to maintain complete social isolation. Healthcare workers are isolated from their families, and must manage the consequences of this isolation just like the patients. They and their families perceive the personal attitudes, closeness and psychological support from the care teams. This perception of genuine participation by the healthcare workers during isolation is especially important when a patient dies, and it may influence the process of grief. This document is intended for all healthcare professionals caring for CoViD-19 patients, particularly those in more severe clinical conditions and it is aimed to help the care team to communicate with families distanced from the patient. The document consists of three parts: 1) presentation of the statements for communicating with patients family members during isolation; 2) discussion of key points as a theoretical framework for the statements; 3) instructions for telephone communication, with a checklist and a worksheet. The document was written by authors from different disciplines (doctors, nurses, psychologists, legal experts) and was then reviewed by a group of experts comprising professionals, people who have experienced ICU hospitalization, and their families. Finally, the document was approved by the National Boards of the Italian Society of Anesthesia and Intensive Care (SIAARTI), Italian Association of Critical Care Nurses (Aniarti), Italian Society of Emergency Medicine (SIMEU), and Italian Society of Palliative Care (SICP).


Assuntos
Betacoronavirus , Comunicação , Infecções por Coronavirus , Pandemias , Isolamento de Pacientes , Pneumonia Viral , Relações Profissional-Paciente , Isolamento Social , Atitude do Pessoal de Saúde , Lista de Checagem , Barreiras de Comunicação , Confidencialidade , Correio Eletrônico , Relações Familiares , Pessoal de Saúde/psicologia , Humanos , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Preferência do Paciente , Relações Profissional-Família , Isolamento Social/psicologia , Apoio Social , Telefone , Revelação da Verdade
17.
BMC Med Inform Decis Mak ; 20(1): 106, 2020 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-32522216

RESUMO

BACKGROUND: Infectious diseases that can cause epidemics, such as COVID-19, SARS-CoV, and MERS-CoV, constitute a major social issue, with healthcare providers fearing secondary, tertiary, and even quaternary infections. To alleviate this problem, telemedicine is increasingly being viewed as an effective means through which patients can be diagnosed and medications prescribed by doctors via untact Thus, concomitant with developments in information and communication technology (ICT), medical institutions have actively analyzed and applied ICT to medical systems to provide optimal medical services. However, with the convergence of these diverse technologies, various risks and security threats have emerged. To protect patients and improve telemedicine quality for patient safety, it is necessary to analyze these risks and security threats comprehensively and institute appropriate countermeasures. METHODS: The security threats likely to be encountered in each of seven telemedicine service areas were analyzed, and related data were collected directly through on-site surveys by a medical institution. Subsequently, an attack tree, the most popular reliability and risk modeling approach for systematically characterizing the potential risks of telemedicine systems, was examined and utilized with the attack occurrence probability and attack success probability as variables to provide a comprehensive risk assessment method. RESULTS: In this study, the most popular modelling method, an attack tree, was applied to the telemedicine environment, and the security concerns for telemedicine systems were found to be very large. Risk management and evaluation methods suitable for the telemedicine environment were identified, and their benefits and potential limitations were assessed. CONCLUSION: This research should be beneficial to security experts who wish to investigate the impacts of cybersecurity threats on remote healthcare and researchers who wish to identify new modeling opportunities to apply security risk modeling techniques.


Assuntos
Segurança Computacional , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Gestão de Riscos/organização & administração , Telemedicina/organização & administração , Betacoronavirus , Confidencialidade , Assistência à Saúde , Humanos , Modelos Organizacionais , Segurança do Paciente , Reprodutibilidade dos Testes
19.
Med Leg J ; 88(2): 73-76, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32490713

RESUMO

The Covid-19 pandemic and the resulting fear, quarantine and lockdown measures implemented in Italy and other countries to contain the risk of contagion have seriously impacted the mental health of a large number of people. The need to offer psychological and psychotherapeutic support to these people, while respecting the government's pressing calls to "stay home", have led many psychologists and psychotherapists, both in the public and private sectors, to provide their professional services via teleconference, telephone, smartphone, etc. The aim of this work is to highlight some critical issues related to the sudden switch from the traditional method of providing psychological services to the digital one in Italy.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Serviços de Saúde Mental , Pneumonia Viral/epidemiologia , Quarentena , Telemedicina , Segurança Computacional , Confidencialidade , Humanos , Consentimento Livre e Esclarecido , Itália/epidemiologia , Pandemias
20.
F1000Res ; 92020.
Artigo em Inglês | MEDLINE | ID: mdl-32494358

RESUMO

The practice of anesthesiology is inextricably dependent upon technology. Anesthetics were first made possible, then increasingly safe, and now more scalable and efficient in part due to advances in monitoring and delivery technology. Herein, we discuss salient advances of the last three years in the technology of anesthesiology. Consumer technology and telemedicine have exploded onto the scene of outpatient medicine, and perioperative management is no exception. Preoperative evaluations have been done via teleconference, and copious consumer-generated health data is available. Regulators have acknowledged the vast potential found in the transfer of consumer technology to medical practice, but issues of privacy, data ownership/security, and validity remain. Inside the operating suite, monitoring has become less invasive, and clinical decision support systems are common. These technologies are susceptible to the "garbage in, garbage out" conundrum plaguing artificial intelligence, but they will improve as network latency decreases. Automation looms large in the future of anesthesiology as closed-loop anesthesia delivery systems are being tested in combination (moving toward a comprehensive system). Moving forward, consumer health companies will search for applications of their technology, and loosely regulated health markets will see earlier adoption of next-generation technology. Innovations coming to anesthesia will need to account for human factors as the anesthesia provider is increasingly considered a component of the patient care apparatus.


Assuntos
Anestesia/tendências , Telemedicina , Inteligência Artificial , Segurança Computacional , Confidencialidade , Humanos
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