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1.
J Clin Ethics ; 32(2): 87-96, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34129524

RESUMO

Clinical ethics consultants (CECs) must know key moral principles and have adequate psychosocial skills. This is, though, not enough. They must also have and hone "between-the-lines" skills that will change over time. This article discusses seven of these skills that CECs need before, during, and after consultations. They have in common the unusual primary goal of maximizing CECs' ability to bond with the patients and families with whom they consult. A focus on relationships, rather than on ethical outcomes, may paradoxically enhance the possibility of achieving an ethical outcome.


Assuntos
Eticistas , Consultoria Ética , Consultores , Ética Clínica , Humanos , Princípios Morais
2.
J Clin Ethics ; 32(2): 127-148, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34129529

RESUMO

Clinical ethics training programs are responsible for preparing their trainees to be competent ethics consultants worthy of the trust of patients, families, surrogates, and healthcare professionals. While the American Society for Bioethics and Humanities (ASBH) offers a certification examination for healthcare ethics consultants, no tools exist for the formal evaluation of ethics trainees to assess their progress toward competency. Medical specialties accredited by the Accreditation Council for Graduate Medical Education (ACGME) use milestones to report trainees' progress along a continuum of professional development as a means of "operationalizing and implementing" medical competencies. Utilizing the Core Competencies for Healthcare Ethics Consultation and the ACGME and American Board of Pediatrics' (ABP) Pediatric Milestones Project, we developed milestones for 17 subcompetencies in clinical ethics consultation and academic bioethics. As the field of clinical ethics becomes more standardized, such tools will be needed to promote the development of robust training programs and to certify that their graduates are competent practitioners.


Assuntos
Bioética , Consultoria Ética , Certificação , Criança , Competência Clínica , Atenção à Saúde , Eticistas , Humanos , Estados Unidos
3.
J Clin Ethics ; 32(2): 149-154, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34129530

RESUMO

As the field of clinical bioethics has moved from its pioneers, who turned their attention to ethics problems in clinical medicine and clinical and animal research, to today's ubiquity of university degrees and fellowships in bioethics, there has been a steady drumbeat to professionalize the field. The problem has been that the necessary next steps-to specify the skills, knowledge, and personal and professional attributes of a clinical bioethicist, and to have a method to train and evaluate mastery of these standards-are lacking. Ordinarily, the path to professionalism in medicine starts with the intellectual pioneers. Then come those who develop early experience in clinical settings. Then comes the specification of the skills, knowledge, and personal and professional attributes needed to perform the activities of the new specialty or subspecialty. And only then, after a method to train and evaluate levels of mastery from novice to advanced practitioner has been developed, comes credible credentialing and certification/licensing. Unfortunately, the field of clinical bioethics has skipped these steps. Rather, a credential, that is, the Healthcare Ethics Consultant (HEC) certification, was created by a small group within the bioethics professional association, the American Society of Bioethics and Humanities (ASBH), without community agreement or necessary input. Further, the testing of processes to train HECs and to evaluate their levels of mastery of competencies was prematurely forwarded as sufficient evidence of competence in clinical ethics. That is, the credential, offered by the ASBH for a fee upon passing an exam, based on how many hours one has been involved in clinical consultation, about which there is no field agreement on how such consultations ought to be conducted and for which controversial standards have been set by a few, is being touted as evidence of competence in clinical bioethics. In their article, "Competencies and Milestones for Bioethics Trainees," Sawyer and colleagues identify the central weakness of these claims to professionalization and provide the field the first substantive assessment tool and method to train and evaluate competencies. The tool these authors present is the real next step forward for true professionalization of the field of clinical bioethics.


Assuntos
Bioética , Consultoria Ética , Eticistas , Humanos , Competência Profissional , Profissionalismo , Estados Unidos
4.
Psychiatr Danub ; 33(Suppl 3): S257-S279, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34010252

RESUMO

One of the most controversial topics in modern bioethics, science, and philosophy is the beginning of individual human life. In the seemingly endless debate, strongly stimulated by recent technologic advances in human reproduction, a synthesis between scientific data and hypothesis, philosophical thought, and issues of humanities has become a necessity to deal with ethical, juridical, and social problems. Furthermore, in this field there is a temptation to ask science to choose between opinions and beliefs, which neutralize one another. The question of when human life begins requires the essential aid of different forms of knowledge. Here we become involved in the juncture between science and religion, which needs to be carefully explored. Modern bioethics and science are strongly concerned for the respect of human life at both ends of its existence (birth and death), but other sciences (eg. Philosophy, technology, psychology, sociology, law, and politics) consider the beginning of human life according to different points of view. However, bioethical topics like this one cannot be treated from only one perspective (eg. Biological, philosophical, or religious) because conclusions might be not good enough or reductive. This reality should be regarded in all its richness: An embryo gives a biologist and a geneticist substance for consideration, but because we are talking about the beginning of human life, it requires philosophical-anthropological consideration and confrontation with theology; in its protection we have to include ethics and law. In experiencing and investigating social behavior, other disciplines, such as the history of medicine and sociology, have to be included. It is hard to answer the question when human life should be legally protected. At the time of conception? At the time of implantation? At the time of birth? In all countries (except Ireland and Liechtenstein) juridical considerations are based on Roman law. Roman civil law says that the fetus has right when it is born or if it is born-nasciterus. Few countries agree with definition of beginning of human personality at the time of conception. The majority does not grant legal status to the human embryo in vitro (i.e., during the 14 days after fertilization). Thus, even in the absence of legal rights, there is no denying that the embryo constitutes the beginning of human life, a member of the human family. Therefore, whatever the attitude, every country has to examine which practices are compatible with the respect of that dignity and the security of human genetic material.The question when a human life begins and how to define it, could be answered only through the inner-connecting pathways of history, philosophy, medical science and religion. It has not been easy to determine where to draw the fine line between the competence of science and methaphysics in this delicate philosophical field. To a large extent the drawing of this line depends on one's fundamental philosophical outlook. The point at which human life begins will always be seen differently by different individuals, groups, cultures, and religious faiths. In democracy there are always at least two sides, and the center holds only when the majority realizes that without a minority democracy itself is lost. The minority in turn must realize its best chance lies in persuasion by reason and thoughtfulness rather than fanaticism.


Assuntos
Início da Vida Humana , Bioética , Humanos , Irlanda , Filosofia , Religião , Religião e Ciência
6.
Am J Bioeth ; 21(6): 22-25, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34036878
10.
Am J Bioeth ; 21(6): 72-73, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34036882

Assuntos
Bioética , Humanos
13.
Am J Bioeth ; 21(6): 63-66, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34036885
14.
Am J Bioeth ; 21(6): 19-22, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34036886
15.
Am J Bioeth ; 21(6): 66-68, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34036887
19.
Am J Bioeth ; 21(6): 26-28, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34036892
20.
Soins ; 66(854): 57-60, 2021 Apr.
Artigo em Francês | MEDLINE | ID: mdl-33962736

RESUMO

From donation to transplantation of hematopoietic stem cells, medullary origin, peripheral blood, placental or cord, legal provisions apply to the actors involved. Since 1994, the law on bioethics, its successive revisions and their implementing texts set the fundamental principles, rules and practical procedures to be followed.


Assuntos
Bioética , Transplante de Células-Tronco Hematopoéticas , Feminino , Células-Tronco Hematopoéticas , Humanos , Gravidez , Doadores de Tecidos
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