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Wiwanitkit S, Wiwanitkit V. Ethical concerns regarding heterologous COVID-19 vaccine administration. Hum Vaccin Immunother 2024; 20:2313250. [PMID: 38353267 PMCID: PMC10878430 DOI: 10.1080/21645515.2024.2313250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences Saveetha University India
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2
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Knopp MI, Warm EJ, Weber D, Kelleher M, Kinnear B, Schumacher DJ, Santen SA, Mendonça E, Turner L. AI-Enabled Medical Education: Threads of Change, Promising Futures, and Risky Realities Across Four Potential Future Worlds. JMIR Med Educ 2023; 9:e50373. [PMID: 38145471 PMCID: PMC10786199 DOI: 10.2196/50373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The rapid trajectory of artificial intelligence (AI) development and advancement is quickly outpacing society's ability to determine its future role. As AI continues to transform various aspects of our lives, one critical question arises for medical education: what will be the nature of education, teaching, and learning in a future world where the acquisition, retention, and application of knowledge in the traditional sense are fundamentally altered by AI? OBJECTIVE The purpose of this perspective is to plan for the intersection of health care and medical education in the future. METHODS We used GPT-4 and scenario-based strategic planning techniques to craft 4 hypothetical future worlds influenced by AI's integration into health care and medical education. This method, used by organizations such as Shell and the Accreditation Council for Graduate Medical Education, assesses readiness for alternative futures and effectively manages uncertainty, risk, and opportunity. The detailed scenarios provide insights into potential environments the medical profession may face and lay the foundation for hypothesis generation and idea-building regarding responsible AI implementation. RESULTS The following 4 worlds were created using OpenAI's GPT model: AI Harmony, AI conflict, The world of Ecological Balance, and Existential Risk. Risks include disinformation and misinformation, loss of privacy, widening inequity, erosion of human autonomy, and ethical dilemmas. Benefits involve improved efficiency, personalized interventions, enhanced collaboration, early detection, and accelerated research. CONCLUSIONS To ensure responsible AI use, the authors suggest focusing on 3 key areas: developing a robust ethical framework, fostering interdisciplinary collaboration, and investing in education and training. A strong ethical framework emphasizes patient safety, privacy, and autonomy while promoting equity and inclusivity. Interdisciplinary collaboration encourages cooperation among various experts in developing and implementing AI technologies, ensuring that they address the complex needs and challenges in health care and medical education. Investing in education and training prepares professionals and trainees with necessary skills and knowledge to effectively use and critically evaluate AI technologies. The integration of AI in health care and medical education presents a critical juncture between transformative advancements and significant risks. By working together to address both immediate and long-term risks and consequences, we can ensure that AI integration leads to a more equitable, sustainable, and prosperous future for both health care and medical education. As we engage with AI technologies, our collective actions will ultimately determine the state of the future of health care and medical education to harness AI's power while ensuring the safety and well-being of humanity.
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Affiliation(s)
- Michelle I Knopp
- Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Eric J Warm
- Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Danielle Weber
- Departments of Internal Medicine and Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Matthew Kelleher
- Departments of Internal Medicine and Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Benjamin Kinnear
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Daniel J Schumacher
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Sally A Santen
- Department of Medical Education, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Eneida Mendonça
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Laurah Turner
- Department of Medical Education, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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3
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Dobson R, Stowell M, Warren J, Tane T, Ni L, Gu Y, McCool J, Whittaker R. Use of Consumer Wearables in Health Research: Issues and Considerations. J Med Internet Res 2023; 25:e52444. [PMID: 37988147 DOI: 10.2196/52444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023] Open
Abstract
As wearable devices, which allow individuals to track and self-manage their health, become more ubiquitous, the opportunities are growing for researchers to use these sensors within interventions and for data collection. They offer access to data that are captured continuously, passively, and pragmatically with minimal user burden, providing huge advantages for health research. However, the growth in their use must be coupled with consideration of their potential limitations, in particular, digital inclusion, data availability, privacy, ethics of third-party involvement, data quality, and potential for adverse consequences. In this paper, we discuss these issues and strategies used to prevent or mitigate them and recommendations for researchers using wearables as part of interventions or for data collection.
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Affiliation(s)
- Rosie Dobson
- School of Population Health, University of Auckland, Auckland, New Zealand
- Institute for Innovation and Improvement, Te Whatu Ora Waitematā, Auckland, New Zealand
| | - Melanie Stowell
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jim Warren
- School of Computer Science, University of Auckland, Auckland, New Zealand
| | - Taria Tane
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Lin Ni
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Yulong Gu
- School of Health Sciences, Stockton University, Galloway, NJ, United States
| | - Judith McCool
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- School of Population Health, University of Auckland, Auckland, New Zealand
- Institute for Innovation and Improvement, Te Whatu Ora Waitematā, Auckland, New Zealand
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4
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Tully LM, Nye KE, Ereshefsky S, Tryon VL, Hakusui CK, Savill M, Niendam TA. Incorporating Community Partner Perspectives on eHealth Technology Data Sharing Practices for the California Early Psychosis Intervention Network: Qualitative Focus Group Study With a User-Centered Design Approach. JMIR Hum Factors 2023; 10:e44194. [PMID: 37962921 PMCID: PMC10685281 DOI: 10.2196/44194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 07/26/2023] [Accepted: 09/23/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Increased use of eHealth technology and user data to drive early identification and intervention algorithms in early psychosis (EP) necessitates the implementation of ethical data use practices to increase user acceptability and trust. OBJECTIVE First, the study explored EP community partner perspectives on data sharing best practices, including beliefs, attitudes, and preferences for ethical data sharing and how best to present end-user license agreements (EULAs). Second, we present a test case of adopting a user-centered design approach to develop a EULA protocol consistent with community partner perspectives and priorities. METHODS We conducted an exploratory, qualitative, and focus group-based study exploring mental health data sharing and privacy preferences among individuals involved in delivering or receiving EP care within the California Early Psychosis Intervention Network. Key themes were identified through a content analysis of focus group transcripts. Additionally, we conducted workshops using a user-centered design approach to develop a EULA that addresses participant priorities. RESULTS In total, 24 participants took part in the study (14 EP providers, 6 clients, and 4 family members). Participants reported being receptive to data sharing despite being acutely aware of widespread third-party sharing across digital domains, the risk of breaches, and motives hidden in the legal language of EULAs. Consequently, they reported feeling a loss of control and a lack of protection over their data. Participants indicated these concerns could be mitigated through user-level control for data sharing with third parties and an understandable, transparent EULA, including multiple presentation modalities, text at no more than an eighth-grade reading level, and a clear definition of key terms. These findings were successfully integrated into the development of a EULA and data opt-in process that resulted in 88.1% (421/478) of clients who reviewed the video agreeing to share data. CONCLUSIONS Many of the factors considered pertinent to informing data sharing practices in a mental health setting are consistent among clients, family members, and providers delivering or receiving EP care. These community partners' priorities can be successfully incorporated into developing EULA practices that can lead to high voluntary data sharing rates.
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Affiliation(s)
- Laura M Tully
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Kathleen E Nye
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Sabrina Ereshefsky
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Valerie L Tryon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Christopher Komei Hakusui
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Mark Savill
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Tara A Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
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Affiliation(s)
| | - Viroj Wiwanitkit
- Chandigarh University, Ajitgarh, Punjab, India
- Joesph Ayobabalola University, Ikeji-Arakeji, Nigeria
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6
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Ferrari F. [ Ethical issues surrounding the donation process and support for loved ones]. Soins 2023; 68:37-40. [PMID: 37657869 DOI: 10.1016/j.soin.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
In France, since the 1970s and the so-called Cavaillet law, has the body of a deceased person been treated as a possible object of public health, and his or her organs as public property? It is first and foremost at the heart of intimate social relations and singular suffering.
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Affiliation(s)
- Frank Ferrari
- Hôpital Pitié-Salpêtrière, AP-HP, 47 boulevard de l'Hôpital, 75013 Paris, France.
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7
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Dave PA, Rohit RK, Tibrewal C, Modi NS, Bajoria PS, Gandhi SK, Patel P. Should Marijuana Be Legalized: A Scoping Review of Associations of Marijuana and Depression. Cureus 2023; 15:e42835. [PMID: 37664373 PMCID: PMC10474443 DOI: 10.7759/cureus.42835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
People with addiction to marijuana and those who have ever consumed marijuana at any time during their life suffer from depression at some point in their life. Depression has been associated with substance use as both a trigger and repercussion. A total of 3663 articles were analyzed, and 26 articles were collectively selected for this study. Consuming marijuana was linked to the development of depression in the majority of individuals. Marijuana consumption and its repercussions have both been connected to negative effects on the body, such as respiratory disorders and even psychological disorders, including stress and depressive disorders. Studies potentially point to a complicated causal relationship between marijuana consumption and depressive disorder, stating that early depressive symptoms enable marijuana usage, which then reduces depression. A research article clearly states that consuming marijuana can be helpful in elevating mood and anxiolytic initially, but it is subsequently followed by a rise in depressive symptoms, which manifest as mental distress and frustration. Discussions with patients about the extent of their marijuana consumption, techniques for reducing the use, and the impact of marijuana on depression may be beneficial in medical facilities where depressive disorder is treated. This research paper highlights the importance of understanding depression and the use of marijuana for temporary relief from depressive symptoms and its long-term consequences on mental health.
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Affiliation(s)
| | - Ralph Kingsford Rohit
- Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Charu Tibrewal
- Department of Internal Medicine, Civil Hospital Ahmedabad, Ahmedabad, IND
| | | | - Parth S Bajoria
- Department of Internal Medicine, Gujarat Medical Education and Research Society Gandhinagar, Gandhinagar, IND
| | | | - Priyansh Patel
- Department of Internal Medicine, Medical College Baroda, Vadodara, IND
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Ataya J, Jamous I, Dashash M. Measurement of Humanity Among Health Professionals: Development and Validation of the Medical Humanity Scale Using the Delphi Method. JMIR Form Res 2023; 7:e44241. [PMID: 37129940 DOI: 10.2196/44241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Despite the importance of humanism in providing health care, there is a lack of valid and reliable tool for assessing humanity among health professionals. OBJECTIVE The aim of this study was to design a new humanism scale and to assess the validity of this scale in measuring humanism among Syrian health professional students. METHODS The Medical Humanity Scale (MHS) was designed. It consists of 27 items categorized into 7 human values including patient-oriented care, respect, empathy, ethics, altruism, and compassion. The scale was tested for internal consistency and reliability using Cronbach α and test-retest methods. The construct validity of the scale was also tested to assess the ability of the scale in differentiating between groups of health professional students with different levels of medical humanity. A 7-point Likert scale was adopted. The study included 300 participants including 97 medical, 78 dental, 82 pharmacy, and 43 preparatory-year students from Syrian universities. The Delphi method was used and factors analysis was performed. Bartlett test of sphericity and the Kaiser-Meyer-Olkin measure of sample adequacy were used. The number of components was extracted using principal component analysis. RESULTS The mean score of the MHS was 158.7 (SD 11.4). The MHS mean score of female participants was significantly higher than the mean score of male participants (159.59, SD 10.21 vs 155.48, SD 14.35; P=.008). The MHS mean score was significantly lower in dental students (154.12, SD 1.45; P=.005) than the mean scores of medical students (159.77, SD 1.02), pharmacy students (161.40, SD 1.05), and preparatory-year students (159.05, SD 1.94). However, no significant relationship was found between humanism and academic year (P=.32), university type (P=.34), marital status (P=.64), or financial situation (P=.16). The Kaiser-Meyer-Olkin test (0.730) and Bartlett test of sphericity (1201.611, df=351; P=.01) were performed. Factor analysis indicated that the proportion of variables between the first and second factors was greater than 10%, confirming that the scale was a single group. The Cronbach α for the overall scale was 0.735, indicating that the scale had acceptable reliability and validity. CONCLUSIONS The results of this study suggest that the MHS is a reliable and valid tool for measuring humanity among health professional students and the development of patient-centered care.
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Affiliation(s)
- Jawdat Ataya
- Medical Education Programme, Syrian Virtual University, Damascus, Syrian Arab Republic
- Faculty of Dental Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Issam Jamous
- Medical Education Programme, Syrian Virtual University, Damascus, Syrian Arab Republic
- Faculty of Dental Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Mayssoon Dashash
- Medical Education Programme, Syrian Virtual University, Damascus, Syrian Arab Republic
- Faculty of Dental Medicine, Damascus University, Damascus, Syrian Arab Republic
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9
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Henson C, Chapman F, Shepherd G, Carlson B, Rambaldini B, Gwynne K. How Older Indigenous Women Living in High-Income Countries Use Digital Health Technology: Systematic Review. J Med Internet Res 2023; 25:e41984. [PMID: 37071466 PMCID: PMC10155089 DOI: 10.2196/41984] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/21/2022] [Accepted: 03/15/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Research associated with digital health technologies similar to the technologies themselves has proliferated in the last 2 decades. There are calls for these technologies to provide cost-effective health care for underserved populations. However, the research community has also underserved many of these populations. Older Indigenous women are one such segment of the population. OBJECTIVE Our objective is to systematically review the literature to consolidate and document what we know about how older Indigenous women living in high-income countries use digital health technology to enhance their health. METHODS We analyzed the peer-reviewed literature by systematically searching 8 databases in March 2022. We included studies published between January 2006 and March 2022 with original data specific to older Indigenous women from high-income countries that reported on the effectiveness, acceptability, and usability of some user-focused digital health technology. We incorporated 2 measures of quality for each study. We also conducted a thematic analysis and a lived experience analysis, which examined each paper from the perspectives of older Indigenous women. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in this study. RESULTS Three papers met the inclusion criteria. The key findings were that older Indigenous women do not see themselves reflected in mainstream health messaging or other digital health offerings. They prefer an approach that considers their uniqueness and diversity. We also identified 2 significant gaps in the literature. First, research reporting on older Indigenous women from high-income countries' experiences with digital health technology is minimal. Second, the limited research related to older Indigenous women has not consistently engaged Indigenous people in the research process or governance. CONCLUSIONS Older Indigenous women want digital health technologies to respond to their needs and preferences. Research is needed to understand their requirements and preferences to ensure equity as we move toward greater adoption of digital health technology. Engaging older Indigenous women throughout the research is essential to ensuring that digital health products and services are safe, usable, effective, and acceptable for older Indigenous women.
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Affiliation(s)
- Connie Henson
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Djurali Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Sydney, Australia
| | - Felicity Chapman
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Gina Shepherd
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Bronwyn Carlson
- Centre for Global Indigenous Futures, Macquarie University, Sydney, Australia
- Department of Indigenous Studies, Faculty of Arts, Macquarie University, Sydney, Australia
| | - Boe Rambaldini
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Djurali Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Sydney, Australia
| | - Kylie Gwynne
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Djurali Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Sydney, Australia
- Centre for Global Indigenous Futures, Macquarie University, Sydney, Australia
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10
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Rashi T, Yom-Tov E. Ethics of Medical Archival Internet Research Data. J Med Internet Res 2023; 25:e43754. [PMID: 36719736 PMCID: PMC9929718 DOI: 10.2196/43754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/27/2022] [Accepted: 01/12/2023] [Indexed: 01/13/2023] Open
Abstract
Medical research based on internet archive data, which in some ways is quite different from other data-based studies, is becoming more and more common. Despite its uniqueness and the challenges that characterize it, clear ethical rules designed to guide practitioners in this field have not yet been written. This article points to the lacuna that exists in legal and ethical texts today and offers an ethically balancing alternative. Among other features, the balance is based on the famous three laws of robotics by Asimov and a series of values, including transparency, accountability, fairness, and privacy.
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Affiliation(s)
- Tsuriel Rashi
- School of Communication, Ariel University, Ariel, Israel
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11
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Mavragani A, Banegas MP, Henrikson NB. Conceptions of Legacy Among People Making Treatment Choices for Serious Illness: Protocol for a Scoping Review. JMIR Res Protoc 2022; 11:e40791. [PMID: 36485023 PMCID: PMC9789496 DOI: 10.2196/40791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/04/2022] [Accepted: 11/05/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Legacy-what one leaves behind and how one hopes to be remembered after death-is an unexplored and important dimension of decision-making for people facing serious illnesses. A preliminary literature review suggests that patients facing serious illness consider legacy when making medical decisions, for example, forgoing expensive treatment with limited or unknown clinical benefit to preserve one's inheritance for their children. To date, very little is known about the conceptual foundations of legacy. No conceptual frameworks exist that provide a comprehensive understanding of how legacy considerations relate to patient choices about their medical care. OBJECTIVE The objective of this scoping review is to understand the extent and type of research addressing the concept of legacy by people facing serious illness to inform a conceptual framework of legacy and patient treatment choices. METHODS This protocol follows the guidelines put forth by Levac et al, which expands the framework introduced by Arksey and O'Malley, as well as the Joanna Briggs Institute Reviewer's manual. This scoping review will explore several electronic databases including PubMed, Medline, CINAHL, Cochrane Library, PsycINFO, and others and will include legacy-specific gray literature, including dissertation research available via ProQuest. An initial search will be conducted in English-language literature from 1990 to the present with selected keywords to identify relevant articles and refine the search strategy. After the search strategy has been finalized, 2 independent reviewers will undertake a 2-part study selection process. In the first step, reviewers will screen article titles and abstracts to identify the eligibility of each article based on predetermined exclusion or inclusion criteria. A third senior reviewer will arbitrate discrepancies regarding inclusions or exclusions. During the second step, the full texts will be screened by 2 reviewers, and only relevant articles will be kept. Relevant study data will be extracted, collated, and charted to summarize the key findings related to the construct of legacy. RESULTS This study will identify how people facing serious illness define legacy, and how their thinking about legacy impacts the choices they make about their medical treatments. We will note gaps in the literature base. The findings of this study will inform a conceptual model that outlines how ideas about legacy impact the patient's treatment choices. The results of this study will be submitted to an indexed journal. CONCLUSIONS Very little is known about the role of legacy in the treatment decisions of patients across the continuum of serious illness. In particular, no comprehensive conceptual model exists that would provide an understanding of how legacy is considered by people making decisions about their care during serious illness. This study will be among the first to construct a conceptual model detailing how considerations of legacy impact medical decision-making for people facing or living with serious illnesses. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40791.
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Affiliation(s)
| | - Matthew P Banegas
- Kaiser Permanente Center for Health Research, Portland, OR, United States.,Radiation Medicine and Applied Science School, University of California San Diego, La Jolla, CA, United States
| | - Nora B Henrikson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States.,Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, United States.,Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States
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12
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Goodday S, Karlin D, Suver C, Friend S. The Post-Roe Political Landscape Demands a Morality of Caution for Women's Health. J Med Internet Res 2022; 24:e41417. [PMID: 36264611 DOI: 10.2196/41417] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/08/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
The recent Supreme Court decision (ie, Dobbs v. Jackson Women's Health Organization), revoking the constitutional right to abortion in the United States, has the potential to dramatically disrupt progress in women's health research. The typical safeguards to ensure confidentiality and privacy of research participants in studies that collect certain types of personal health information may not hold against criminal investigations surrounding suspected pregnancy terminations. There are additional risks to participants in digital health research studies involving the use of wearable devices capable of tracking physiological measures, such as body temperature and heart rate, as these have shown promise for tracking conception and could be used to identify pregnancy termination signatures. There are strategies researchers can use to protect the safety of participants in health research who could get pregnant, while also maintaining integrity of research methods. The objective of this viewpoint is to discuss potential strategies to protect research participants' privacy that include the minimization of nonessential sensitive personal health information and anonymization protocols in the event of miscarriage or termination of pregnancy. We invite others to join this discussion so as to not let the current political landscape impede progress in women's health and reproductive research, while also protecting research participants.
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Affiliation(s)
- Sarah Goodday
- 4YouandMe, Seattle, WA, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Daniel Karlin
- 4YouandMe, Seattle, WA, United States.,Department of Psychiatry, Tufts University School of Medicine, Boston, MA, United States.,MindMed Inc, New York, NY, United States
| | | | - Stephen Friend
- 4YouandMe, Seattle, WA, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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13
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Choi YK, Kim EJ. A case study on the evaluation of discussion and debate learning effectiveness in a dental hygiene ethics class. Eur J Dent Educ 2022; 26:223-231. [PMID: 33977601 DOI: 10.1111/eje.12690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/30/2021] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION This study introduces the curriculum of a discussion-based learning class for dental hygiene ethics education and evaluates the educational effect of discussion-based learning as applied to a dental hygiene ethics class. MATERIALS AND METHODS This study was conducted with 48 sophomores from the Department of Dental Hygiene who took dental hygiene ethics in the second semester of 2019. For the DBL class, the following steps were conducted: (1) a pre-class group activity (discussion); (2) a group presentation and team discussion; and (3) a discussion among all groups. To improve the ability to aggregate, organise, and prepare the learner's resources, data, information search skills, and opinions by the team and to improve communication skills by actively listening to other people's opinions, the presentation team's opinions were modified after the discussion, and the performance of rational opinions on topics was added. The professor provided feedback and summarised and ended the discussion. The survey was conducted before and after the DBL class. RESULTS Concerning critical thinking ability, critical objectivity increased significantly from 8.88 before to 9.38 after the DBL class, and critical confidence also increased significantly. The change in professional attitude significantly increased from 3.21 out of 5 points before the DBL class to 3.53 after the DBL class in the logical and critical thinking skills category and significantly increased from 3.27 to 3.66 in decision-making skills. CONCLUSION Teaching methods applied in DBL classes, not traditional lecture-style classes, consistent with changing educational paradigms, are very effective and should change gradually. These results will be particularly helpful to faculty members who are inexperienced in DBL courses and performance but interested in them.
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Affiliation(s)
- Yong-Keum Choi
- Department of Dental Hygiene, College of Health Science and Genome-based BioIT Convergence Institute, Sunmoon University, Chungcheong, Korea
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14
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Sun K, Ji T. The Relationship Between Perfectionism and Sports Ethics Among Young Athletes Based on Achievement Goal Theory. Front Psychol 2022; 13:771332. [PMID: 35360595 PMCID: PMC8961505 DOI: 10.3389/fpsyg.2022.771332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Exercise plays an important role in the process of socialization among young people and children by providing a context in which children can be exposed to the existing rules and values of society. However, the increasing news of unethical behaviors reported in competitive scenarios led the public to suspect the view “sports shape great characters.” To investigate the issue and explore potential influencing factors, the study examined the relationship among athletes’ perfectionism, achievement goals, and sports ethics based on the achievement goal theory. A total of 243 young athletes were recruited. The multidimensional perfectionism, achievement goals, and sports ethics were measured by a battery of questionnaires. A direct effect model that did not include mediation variables (achievement goals) and a mediation effect model that included mediation variables were analyzed by structural equation modeling (SEM). Results indicated that perfectionistic strivings may positively predict sports ethics, whereas perfectionistic concerns may negatively predict sports ethics. Mastery approach and mastery avoidance may positively predict sports ethics, whereas the performance approach and performance avoidance may negatively predict sports ethics. Achievement goals may partially mediate the relationship between perfectionism and sports ethics. Perfectionistic strivings may negatively predict sports ethics through performance approach and positively predict sports ethics through mastery approach. Perfectionistic concerns may negatively predict sports ethics through performance avoidance and positively predict sports ethics through mastery avoidance. To prevent athletes from using unethical behaviors, strategies should be developed to reduce perfectionistic concerns and increase their perfectionistic strivings.
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Affiliation(s)
- Kaihong Sun
- Department of Physical Education, Changzhou Vocational Institute of Textile and Garment, Changzhou, China.,Department of Physical Education, Yangzhou Polytechnic College, Yangzhou, China
| | - Tai Ji
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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15
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Dobrowolski Z, Drozdowski G, Panait M. Understanding the Impact of Generation Z on Risk Management-A Preliminary Views on Values, Competencies, and Ethics of the Generation Z in Public Administration. Int J Environ Res Public Health 2022; 19:3868. [PMID: 35409550 DOI: 10.3390/ijerph19073868] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 11/17/2022]
Abstract
Gen Z, people born in the Internet age, are entering the labour market and soon will be responsible for public administration. Such a situation creates the need to study their professional motivations and competencies. We aim to determine: (1) What are the motivating factors of Gen Z representatives? (2) What is the factor's structure of competencies of Gen Z employees? (3) Do Gen Z's interest in public administration result from their needs to realise the public interest? These questions are fundamental for the strategy of hiring and training newcomers. This original paper's insights have emerged iteratively based on a systematic literature searching method and data obtained from the surveys (n = 335). Research of Polish representatives of Gen Z showed that their expectations are similar to those found in other countries. However, their responses suggest that ethical issues are not the most important for them. The presence of generation G on the labor market will generate a paradigm shift in the activity of companies and public institutions that will be the employers of these young people. Reconfiguration of the principles of human resource management is necessary so that organizations benefit from the qualities of generation Z-they gravitate towards gamified processes because of mobile-centricity; they are natives of global communication, self-learners, and self-motivators; they appreciate transparency.
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16
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Soleimani F, Aligholipour M, Aghal M, Aliafsari Mamaghani E. COVID 19 related perceived discrimination in medical settings, March and April 2020. Inquiry 2021; 58:469580211020884. [PMID: 34056947 PMCID: PMC8170338 DOI: 10.1177/00469580211020884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Global spread of a disease causes fear that can lead to discrimination against
the people infected with the disease. On December 2019, COVID-19 emerged in
Wuhan, China, and has spread throughout the world. In this descriptive and
analytic study Perceived discrimination of the patients admitted to COVID-19
wards was measured in medical settings. Data was collected of 176 patients
discharged in March and April 2020. Discrimination scale was used to collect
data in medical settings. Overall mean score of the scale was 11.51 ± 3.883
indicating low level of perceived discrimination. The highest level of
discrimination belonged to refusal of physicians and nurses to physically
examine the patients (0.992 ± 3.49). Low level of perceived discrimination was
reported in this study, which necessitated taking useful measures to identify
discrimination, determines causes and prevent discriminatory behaviors in
medical settings to improve the hospitalization experience and disease
outcomes.
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Affiliation(s)
| | | | - Moosa Aghal
- Maragheh university of Medical Sciences, Maragheh, Iran
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17
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Bailey JO, Patel B, Gurari D. A Perspective on Building Ethical Datasets for Children's Conversational Agents. Front Artif Intell 2021; 4:637532. [PMID: 34056578 PMCID: PMC8155711 DOI: 10.3389/frai.2021.637532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/09/2021] [Indexed: 11/20/2022] Open
Abstract
Artificial intelligence (AI)-powered technologies are becoming an integral part of youth's environments, impacting how they socialize and learn. Children (12 years of age and younger) often interact with AI through conversational agents (e.g., Siri and Alexa) that they speak with to receive information about the world. Conversational agents can mimic human social interactions, and it is important to develop socially intelligent agents appropriate for younger populations. Yet it is often unclear what data are curated to power many of these systems. This article applies a sociocultural developmental approach to examine child-centric intelligent conversational agents, including an overview of how children's development influences their social learning in the world and how that relates to AI. Examples are presented that reflect potential data types available for training AI models to generate children's conversational agents' speech. The ethical implications for building different datasets and training models using them are discussed as well as future directions for the use of social AI-driven technology for children.
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Affiliation(s)
- Jakki O. Bailey
- School of Information, University of Texas at Austin, Austin, TX, United States
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18
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Fechtner LC, Persino PR, Burke MS. Atypical Meningioma of the Sinonasal Tract. Cureus 2021; 13:e14908. [PMID: 34113518 PMCID: PMC8184111 DOI: 10.7759/cureus.14908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2021] [Indexed: 11/10/2022] Open
Abstract
This case report describes a patient with intellectual disability who presented with a neglected midline nasal mass eroding the anterior skull base, which was found to be a Grade II meningioma likely of the olfactory bulb. Points of interest include differential diagnosis of this atypical mass of the sinonasal tract, as well as decision-making in balancing appropriate management and quality of life in a patient with developmental delay who could not make decisions for herself. Literature review regarding the role of adjuvant radiation based on final diagnosis and extent of disease suggests that radiation can improve locoregional control and overall survival with atypical meningioma. Lack of clear information in the literature on these rare conditions can lead to poor understanding on the part of the treatment team and the healthcare proxies who are making decisions, making goals of care discussions and medical decision-making challenging. This case report seeks to add to the available data on management of atypical meningiomas of the sinonasal tract and olfactory bulb.
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Affiliation(s)
| | - Philip R Persino
- Otolaryngology - Head and Neck Surgery, University at Buffalo, Buffalo, USA
| | - Mark S Burke
- Head and Neck-Plastics and Reconstructive Surgery, Erie County Medical Center, Buffalo, USA
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19
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Przygodzki RM. Editorial: How Can Genomic Biobanks Provide the Bridge for Implementation of Effective Clinical Therapy? Front Public Health 2020; 8:581490. [PMID: 33072715 PMCID: PMC7537097 DOI: 10.3389/fpubh.2020.581490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/25/2020] [Indexed: 12/02/2022] Open
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20
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Vavilov S, Smith G, Starkey M, Pockney P, Deshpande AV. Parental decision regret in childhood hypospadias surgery: A systematic review. J Paediatr Child Health 2020; 56:1514-1520. [PMID: 32885548 DOI: 10.1111/jpc.15075] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 11/29/2022]
Abstract
We conducted a systematic review of the literature to establish the prevalence of and predictive factors for parental decision regret in hypospadias surgery. A search strategy without language restrictions was developed with expert help, and two reviewers undertook independent study selection. Five studies were included in this review (four for quantitative analysis) with a total of 783 participants. The mean overall prevalence of parental decision regret was 65.2% (moderate to severe - 20.3%). Although significant predictors of regret were identified (post-operative complications, small size glans, meatal location, decision conflict between parents, parental educational level and others), they had unexplained discordance between studies. Parental decision regret after proximal hypospadias surgery and refusing surgery was inadequately reported. In conclusion, even though the prevalence of parental decision regret after consenting for the hypospadias repair appears to be high, risk factors associated with it were discordant suggesting imprecision in estimates due to unknown confounders.
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Affiliation(s)
- Sergey Vavilov
- Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.,Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Grahame Smith
- Urology Unit, Department of Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Malcolm Starkey
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Priority Research Centre GrowUpWell, Faculty of Health and Medicine, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Peter Pockney
- Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.,Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Aniruddh V Deshpande
- Urology Unit, Department of Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Priority Research Centre GrowUpWell, Faculty of Health and Medicine, The University of Newcastle, Newcastle, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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21
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Yao T, Metzler T, Gorrell B. Truth-telling or Not: A Dilemma for Health Care Providers Regarding Disclosure of Cancer in China. J Law Med 2019; 27:316-324. [PMID: 32129038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Truth-telling to cancer patients challenges health care providers in China. Providers confront a series of cultural, ethical, and legal dilemmas in terms of patients' right to know and autonomy. Underlying reasons for truth-telling dilemmas include traditional culture, the role of family, and ambiguity about patients' right to know in accordance with Chinese laws and regulations. These factors complicate ethical judgment by requiring interaction with traditional Chinese culture and laws before health care providers deliver bad news to patients with a range of conditions, including cancer. In this article ethical questions are raised, and strategies concerning breaking bad news are suggested for Chinese health care providers.
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Affiliation(s)
- Ting Yao
- Kramer School of Nursing, Oklahoma City University, Oklahoma City, USA. Jianghan University, Wuhan, China
| | - Ted Metzler
- Kramer School of Nursing, Oklahoma City University, Oklahoma City, USA
| | - Betty Gorrell
- Kramer School of Nursing, Oklahoma City University, Oklahoma City, USA
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22
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Hertrampf K, Groß D, Karsten G, Wenz HJ. The influence of clinical experience on dental students' ethical awareness. Eur J Dent Educ 2019; 23:101-109. [PMID: 30472787 DOI: 10.1111/eje.12408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/06/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION There has been no structured integration of ethical issues into the dental curriculum and currently no data for certain ethics modules exists in Germany. The study aimed at evaluating the attitudes to ethical issues that affect students at the Dental School in Kiel during patient treatment. MATERIAL AND METHODS In the summer of 2017, students were recruited from the 6th and 10th semesters. A qualitative study design with interviews was chosen. The dimensions included, for example, experience with ethical issues, definitions and expectations of teaching content and methods. A qualitative content analysis was performed. RESULTS Twelve and eleven students from semesters (32% each) participated. No student was able to name an ethical question based on his own experience (private/study). The need to address ethical issues was justified solely by personal treatment experiences. DISCUSSION The study revealed a lack of basic ethical knowledge resulting in a lack of ability to deal with ethical issues. Instead, participants described experiences of psychological pressure, feelings of helplessness. CONCLUSION The results suggest that ethical-theoretical foundations should be taught before the beginning of patient treatment. A didactic combination with clinical facts and case vignettes is recommended.
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Affiliation(s)
- Katrin Hertrampf
- Clinic of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Dominik Groß
- Institute for History, Theory and Ethics of Medicine, University Hospital Aachen RWTH Aachen University, Aachen, Germany
| | - Gudrun Karsten
- Dean's Office of Education, Faculty of Medicine, Kiel University, Kiel, Germany
| | - Hans-Jürgen Wenz
- Clinic of Prosthodontics, Propaedeutics and Dental Materials, University Hospital Schleswig-Holstein, Kiel, Germany
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23
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Brown K, Solomon MJ, Young J, Seco M, Bannon PG. Addressing the ethical grey zone in surgery: a framework for identification and safe introduction of novel surgical techniques and procedures. ANZ J Surg 2019; 89:634-638. [PMID: 30974516 DOI: 10.1111/ans.15104] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/07/2019] [Accepted: 01/09/2019] [Indexed: 11/29/2022]
Abstract
While the introduction of new surgical techniques can radically improve patient care, they may equally expose patients to unforeseen harms associated with untested procedures. The enthusiastic uptake of laparoscopic cholecystectomy in the early 1990s saw a dramatic increase in the rate of common bile duct injuries, and was described by Alfred Cuschieri as 'the biggest unaudited free-for-all in the history of surgery' due to 'a lack of effective centralised control'. Whether a new surgical intervention is considered an acceptable 'minor' variation of an established procedure, or is sufficiently 'novel' to constitute experimentation on human subjects is often unclear. Furthermore, once a new technique is identified as experimental, there is no agreed protocol for safety evaluation in a first-in-human setting. In phase I (first-in-human) pharmacological trials only small, single arm cohorts of highly selected patients are enrolled in order to establish the safety profile of a new drug. This exposes only a small number of patients to the unknown or unforeseen risks that may be associated with a new agent, in a highly regulated and scientifically rigorous manner. There is no equivalent study design for the introduction of new and experimental surgical procedures. This article proposes a practical stepwise approach to the safe introduction of new surgical procedures that surgeons and surgical departments can adopt. It includes criteria for new surgical techniques which require formal prospective ethical evaluation, and a novel study design for conducting a safety evaluation at the 'first in human' stage.
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Affiliation(s)
- Kilian Brown
- Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia.,Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michael J Solomon
- Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia.,Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Young
- Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia.,Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Seco
- The University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Paul G Bannon
- Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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24
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Abstract
AIM To obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice. DESIGN A hermeneutic design were used. METHOD Data were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation. FINDINGS The texts revealed two main themes: A formal external responsibility and personal ethical value. Responsibility that the patient was not exposed to risks, protecting the patient's body, systematically planning and organizing work in the surgical team. The personal ethical value meant confirming the patient as a person, caring for the patient and preserving the patient's dignity. A new understanding emerged that the operating theatre nurse always have the patient in mind.
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25
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Bijlsma RM, Wouters RHP, Wessels H, May AM, Ausems MGEM, Voest EE, Bredenoord AL. Managing unsolicited findings in genomics: A qualitative interview study with cancer patients. Psychooncology 2018; 27:1327-1333. [PMID: 29471587 DOI: 10.1002/pon.4676] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 02/08/2018] [Accepted: 02/10/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Next-generation sequencing (NGS) is increasingly being employed in the context of personalized cancer treatment. Anticipating unsolicited findings that may arise during a NGS procedure is a key consideration; however, little is known about cancer patients' intentions, needs, and preferences concerning the return of unsolicited findings. METHODS A qualitative design using individual semi-structured interviews with 24 cancer patients was utilized to explore patients' decisions on whether to receive unsolicited findings from NGS. These interviews were subsequently analyzed using the constant comparative method to develop codes and themes. RESULTS We identified 4 interrelated themes that emerged in the context of the return of unsolicited findings. First, we describe how cancer patients expressed a strong need to control their lives. Second, we show the importance of family dynamics. Third, the NGS procedure regarding unsolicited findings is perceived as cognitively complex, and fourth, the procedure is also considered emotionally complex. CONCLUSIONS The results of our study contribute to a better understanding of what cancer patients consider important and what may motivate and influence them when making decisions on the disclosure of unsolicited findings following NGS. We show how Joel Feinberg's classification of autonomy may help clinicians to better understand cancer patients' desire for autonomous decision making while also acknowledging the emotional and cognitive difficulties regarding the disclosure of unsolicited findings. These insights could be helpful for clinicians to guide patients through this complex process.
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Affiliation(s)
- R M Bijlsma
- Cancer Center, Department of Medical Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - R H P Wouters
- Julius Center, Department of Medical Humanities, University Medical Center Utrecht, Utrecht, Netherlands
| | - H Wessels
- Department of Corporate Communications, University Medical Center Utrecht, Utrecht, Netherlands
| | - A M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - M G E M Ausems
- Department of Genetics, University Medical Center Utrecht, Utrecht, Netherlands
| | - E E Voest
- Netherlands Cancer Institute Antoni van Leeuwenhoek, Department of Medical Oncology, Amsterdam, Netherlands
| | - A L Bredenoord
- Julius Center, Department of Medical Humanities, University Medical Center Utrecht, Utrecht, Netherlands
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26
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Di Iorio B. [Liquid society and ethical relativism]. G Ital Nefrol 2017; 34:4-7. [PMID: 28682559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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27
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Lecointre B. [Nursing care at home and secularism]. Rev Infirm 2015; 64:34-36. [PMID: 26654502 DOI: 10.1016/j.revinf.2015.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The question of secularism, long-time confined to schools and the relationships between the Church and State, is today being raised in the field of public health. Nurses are directly affected and are integrating this dimension of secularism into their care practices. A private practice nurse describes the effect these changes are having on her practice in patients' homes.
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28
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Bruno MA, Bernheim JL, Ledoux D, Pellas F, Demertzi A, Laureys S. A survey on self-assessed well-being in a cohort of chronic locked-in syndrome patients: happy majority, miserable minority. BMJ Open 2011; 1:e000039. [PMID: 22021735 PMCID: PMC3191401 DOI: 10.1136/bmjopen-2010-000039] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objectives Locked-in syndrome (LIS) consists of anarthria and quadriplegia while consciousness is preserved. Classically, vertical eye movements or blinking allow coded communication. Given appropriate medical care, patients can survive for decades. We studied the self-reported quality of life in chronic LIS patients. Design 168 LIS members of the French Association for LIS were invited to answer a questionnaire on medical history, current status and end-of-life issues. They self-assessed their global subjective well-being with the Anamnestic Comparative Self-Assessment (ACSA) scale, whose +5 and -5 anchors were their memories of the best period in their life before LIS and their worst period ever, respectively. Results 91 patients (54%) responded and 26 were excluded because of missing data on quality of life. 47 patients professed happiness (median ACSA +3) and 18 unhappiness (median ACSA -4). Variables associated with unhappiness included anxiety and dissatisfaction with mobility in the community, recreational activities and recovery of speech production. A longer time in LIS was correlated with happiness. 58% declared they did not wish to be resuscitated in case of cardiac arrest and 7% expressed a wish for euthanasia. Conclusions Our data stress the need for extra palliative efforts directed at mobility and recreational activities in LIS and the importance of anxiolytic therapy. Recently affected LIS patients who wish to die should be assured that there is a high chance they will regain a happy meaningful life. End-of-life decisions, including euthanasia, should not be avoided, but a moratorium to allow a steady state to be reached should be proposed.
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Affiliation(s)
- Marie-Aurélie Bruno
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Jan L Bernheim
- Department of Human Ecology and End-of-Life Care Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Didier Ledoux
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Frédéric Pellas
- Médecine Rééducative, Hôpital Caremeau, CHU Nîmes, Nîmes and Association for Locked-in Syndrome (ALIS), Paris, France
| | - Athena Demertzi
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium
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29
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Elli L. Coeliac disease: between "pizza" and ethics. Gut 2006; 55:1672. [PMID: 17047123 PMCID: PMC1860136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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