30 found

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Forthcoming articles
  1. Annette Dufner (forthcoming). Blood Products and the Commodification Debate: The Blurry Concept of Altruism and the ‘Implicit Price’ of Readily Available Body Parts. HEC Forum:1-13.
    There is a widespread consensus that a commodification of body parts is to be prevented. Numerous policy papers by international organizations extend this view to the blood supply and recommend a system of uncompensated volunteers in this area—often, however, without making the arguments for this view explicit. This situation seems to indicate that a relevant source of justified worry or unease about the blood supply system has to do with the issue of commodification. As a result, the current health minister (...)
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  2. Ann Freeman Cook & Helena Hoas (forthcoming). Exploring the Potential for Moral Hazard When Clinical Trial Research is Conducted in Rural Communities: Do Traditional Ethics Concepts Apply? HEC Forum:1-17.
    Over the past 20 years, clinical research has migrated from academic medical centers to community-based settings, including rural settings. This evolving research environment may present some moral hazards or challenges that could undermine traditionally accepted standards for the protection of human subjects. The study described in this article was designed to explore the influence of motives driving the decisions to conduct clinical trial research in rural community settings. The researchers conducted semi-structured interviews with 80 participants who conducted clinical trials with (...)
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  3. Sarah Wall, Wendy J. Austin & Daniel Garros (forthcoming). Organizational Influences on Health Professionals’ Experiences of Moral Distress in PICUs. HEC Forum:1-15.
    This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...)
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  4. Rachelle Barina (forthcoming). New Places and Ethical Spaces: Philosophical Considerations for Health Care Ethics Outside of the Hospital. HEC Forum:1-14.
    This paper examines the meaning of space and its relationship to value. In this paper, I draw on Henri Lefebvre to suggest that our ethics produce and are produced by spaces. Space is not simply a passive material container or neutral geographic location. Space includes the ideas on which buildings are modeled, the ordering of objects and movement patterns within the space, and the symbolic meaning of the space and its objects. Although often unrecognized, space itself is value-laden, and its (...)
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  5. Gerald D. Coleman Ss (forthcoming). Direct and Indirect Abortion in the Roman Catholic Tradition: A Review of the Phoenix Case. [REVIEW] HEC Forum.
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  6. Simon Derpmann & Michael Quante (forthcoming). Money for Blood and Markets for Blood. HEC Forum:1-15.
    Ontario’s Bill 178 proposing a Voluntary Blood Donations Act declares the offer or acceptance of payment for the donation of blood a legal offence and makes it subject to penalty. The bill reinvigorates a fundamental debate about the ethical problems associated with the payment of money for blood. Scarcity of blood donors is a recurring problem in most health systems, and monetary remuneration of the willingness to donate blood is regularly discussed—and sometimes practiced—as a means to overcome scarcity in blood. (...)
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  7. Victoria Doudenkova & Jean-Christophe Bélisle Pipon (forthcoming). Duty to Inform and Informed Consent in Diagnostic Radiology: How Ethics and Law Can Better Guide Practice. HEC Forum:1-20.
    Although there is consensus on the fact that ionizing radiation used in radiological examinations can affect health, the stochastic nature of risk makes it difficult to anticipate and assess specific health implications for patients. The issue of radiation protection is peculiar as any dosage received in life is cumulative, the sensitivity to radiation is highly variable from one person to another, and between 20 % and 50 % of radiological examinations appear not to be necessary. In this context, one might (...)
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  8. Albert Farrugia, Joshua Penrod & Jan M. Bult (forthcoming). The Ethics of Paid Plasma Donation: A Plea for Patient Centeredness. HEC Forum:1-13.
    Plasma protein therapies are a group of essential medicines extracted from human plasma through processes of industrial scale fractionation. They are used primarily to treat a number of rare, chronic disorders ensuing from inherited or acquired deficiencies of a number of physiologically essential proteins. These disorders include hemophilia A and B, different immunodeficiencies and alpha 1-antitrypsin deficiency. In addition, acute blood loss, burns and sepsis are treated by PPTs. Hence, a population of vulnerable and very sick individuals is dependent on (...)
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  9. Shawn Floyd (forthcoming). Substantial Goodness and Nascent Human Life. HEC Forum:1-20.
    Many believe that moral value is—at least to some extent—dependent on the developmental states necessary for supporting rational activity. My paper rejects this view, but does not aim simply to register objections to it. Rather, my essay aims to answer the following question: if a human being’s developmental state and occurrent capacities do not bequeath moral standing, what does? The question is intended to prompt careful consideration of what makes human beings objects of moral value, dignity, or goodness. Not only (...)
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  10. Abraham D. Graber, Asha Bhandary & Matthew Rizzo (forthcoming). Ethical Practice Under Accountable Care. HEC Forum:1-14.
    Accountable Care Organizations are a key mechanism of the Patient Protection and Affordable Care Act . ACOs will influence incentives for providers, who must understand these changes to make well-considered treatment decisions. Our paper defines an ethical framework for physician decisions and action within ACOs. Emerging ethical pressures providers will face as members of an ACO were classified under major headings representing three of the four principles of bioethics: autonomy, beneficence, and justice . Conflicts include a bias against transient populations, (...)
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  11. Jill Graper Hernandez (forthcoming). Human Value, Dignity, and the Presence of Others. HEC Forum:1-15.
    In the health care professions, the meaning of—and implications for—‘dignity’ and ‘value’ are progressively more important, as scholars and practitioners increasingly have to make value judgments when making care decisions. This paper looks at the various arguments for competing sources of human value that medical professionals can consider—human rights, autonomy, and a higher-order moral value—and settles upon a foundational model that is related to the Kantian model that is popular within the medical community: human value is foundational; human dignity, autonomy, (...)
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  12. Anita Ho, Lisa Mei-Hwa MacDonald & David Unger (forthcoming). Preventive Ethics Through Expanding Education. HEC Forum:1-6.
    Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having (...)
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  13. Alexander A. Kon & Melissa Garcia (forthcoming). Telemedicine as a Tool to Bring Clinical Ethics Expertise to Remote Locations. HEC Forum:1-11.
    The American Society for Bioethics and Humanities promulgated standards for clinical ethics consultants and is currently developing a national Quality Attestation in Clinical Ethics Consultation to assist facilities in ensuring that those performing clinical ethics consultations meet minimum standards. As the field moves towards such professionalization, there is a need to provide access to qualified clinical ethicists at a broad range of medical facilities. Currently, however, there are insufficient numbers of trained clinical ethicists to staff all healthcare facilities, and many (...)
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  14. Brian S. Marcus, Jestin N. Carlson, Gajanan G. Hegde, Jennifer Shang & Arvind Venkat (forthcoming). Evaluation of Viewpoints of Health Care Professionals on the Role of Ethics Committees and Hospitals in the Resolution of Clinical Ethical Dilemmas Based on Practice Environment. HEC Forum:1-18.
    We sought to evaluate whether health care professionals’ viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals . The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be (...)
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  15. Stephen Napier (forthcoming). Perception of Value and the Minimally Conscious State. HEC Forum:1-22.
    The “disability paradox” is the idea that for those who become severely disabled, their own quality of life assessment remains at or slightly below the QoL assessments of normal controls. This is a source of skepticism regarding third-person QoL judgments of the disabled. I argue here that this skepticism applies as well to those who are in the minimally conscious state . For rather simple means of sustaining an MCS patient’s life , the cost of being wrong that the patient (...)
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  16. William A. Nelson, Paul J. Barr & Mary G. Castaldo (forthcoming). The Opportunities and Challenges for Shared Decision-Making in the Rural United States. HEC Forum:1-14.
    The ethical standard for informed consent is fostered within a shared decision-making process. SDM has become a recognized and needed approach in health care decision-making. Based on an ethical foundation, the approach fosters the active engagement of patients, where the clinician presents evidence-based treatment information and options and openly elicits the patient’s values and preferences. The SDM process is affected by the context in which the information exchange occurs. Rural settings are one context that impacts the delivery of health care (...)
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  17. Jennifer A. Parks (forthcoming). Home-Based Care, Technology, and the Maintenance of Selves. HEC Forum:1-15.
    In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also (...)
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  18. Joshua Penrod & Albert Farrugia (forthcoming). Errors and Omissions: Donor Compensation Policies and Richard Titmuss. HEC Forum:1-12.
    Many global and national systems of regulation of blood donors and donor compensation rely for intellectual support on Richard Titmuss’s views, represented in The Gift Relationship. Based on selective interpretation of data from the 1960s, Titmuss engineered an ethical view pertaining to donors and, in so doing, created not only ongoing stereotypes, but created a cause for followers to perpetuate misunderstandings about the nature of such donations. In many cases, donors are, in fact compensated, but regulatory systems persevere in using (...)
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  19. Bryan C. Pilkington (forthcoming). Do No Evil: Unnoticed Assumptions in Accounts of Conscience Protection. HEC Forum:1-10.
    In this paper, I argue that distinctions between traditional and contemporary accounts of conscience protections, such as the account offered by Aulisio and Arora, fail. These accounts fail because they require an impoverished conception of our moral lives. This failure is due to unnoticed assumptions about the distinction between the traditional and contemporary articulations of conscience protection. My argument proceeds as follows: First, I highlight crucial assumptions in Aulisio and Arora’s argument. Next, I argue that respecting maximal play in values, (...)
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  20. M. Berry Roberta, Sylvia Caley Lisa Bliss, A. Lombardo Paul, Jonathan Todres Jerri Nims Rooker & E. Wolf Leslie (forthcoming). Recent Developments in Health Care Law: Partners in Innovation. HEC Forum.
    This article reviews recent developments in health care law, focusing on the engagement of law as a partner in health care innovation. The article addresses: the history and contents of recent United States federal law restricting the use of genetic information by insurers and employers; the recent federal policy recommending routine HIV testing; the recent revision of federal policy regarding the funding of human embryonic stem cell research; the history, current status, and need for future attention to advance directives; the (...)
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  21. Erica K. Salter (forthcoming). The Re-Contextualization of the Patient: What Home Health Care Can Teach Us About Medical Decision-Making. HEC Forum:1-14.
    This article examines the role of context in the development and deployment of standards of medical decision-making. First, it demonstrates that bioethics, and our dominant standards of medical decision-making, developed out of a specific historical and philosophical environment that prioritized technology over the person, standardization over particularity, individuality over relationship and rationality over other forms of knowing. These forces de-contextualize the patient and encourage decision-making that conforms to the unnatural and contrived environment of the hospital. The article then explores several (...)
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  22. Erica K. Salter & Joseph T. Norris (forthcoming). Introduction: Clinical Ethics Beyond the Urban Hospital. HEC Forum:1-5.
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  23. Jeremy Frank Shearmur (forthcoming). The Gift Relationship Revisited. HEC Forum:1-17.
    If unremunerated blood donors are willing to participate, and if the use of them is economical from the perspective of those collecting blood, I can see no objection to their use. But there seems to me no good reason, moral or practical, why they should be used. The system of paid plasmapheresis as it currently operates in the United States and in Canada would seem perfectly adequate, and while there may always be ways in which the safety and efficiency of (...)
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  24. Jung-hye Shin (forthcoming). Declining Body, Institutional Life, and Making Home—Are They at Odds? HEC Forum:1-19.
    This study examines elderly residential life in long-term care settings, focusing on the ways residents interact with their physical and social environments. It further proposes that the residential environment is an important player for everyday ethics in long-term care settings, and is also an important factor in enhancing the quality of life for residents. By employing the theories of place identity and environmental meanings and listening to the voices of the elderly collected through an ethnographic field study in elderly homes (...)
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  25. William Swiggart, Charlene Dewey, Marine Ghulyan & Anderson Spickard Jr (forthcoming). Spanning a Decade of Physician Boundary Violations: Are We Improving? HEC Forum:1-12.
    Sexual boundary violations can negatively impact the culture of safety within a medical practice or healthcare institution and severely compromise the covenant of care and physician objectivity. Lack of education and training is one factor associated with physician misconduct that leads to high financial and personal cost. This paper presents a follow-up study of physicians referred to a professional development course in 2001 and presents demographic data from 2001 to present. The paper focuses on the education and remediation progress regarding (...)
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  26. Arvind Venkat & David Kim (forthcoming). Ethical Tensions in the Pain Management of an End-Stage Cancer Patient with Evidence of Opioid Medication Diversion. HEC Forum:1-7.
    At the end of life, pain management is commonly a fundamental part of the treatment plan for patients where curative measures are no longer possible. However, the increased recognition of opioid diversion for secondary gain coupled with efforts to treat patients in the home environment towards the end of life creates the potential for ethical dilemmas in the palliative care management of terminal patients in need of continuous pain management. We present the case of an end-stage patient with rectal cancer (...)
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  27. Katherine Wasson, Kayhan Parsi, Michael McCarthy, Viva Jo Siddall & Mark Kuczewski (forthcoming). Developing an Evaluation Tool for Assessing Clinical Ethics Consultation Skills in Simulation Based Education: The ACES Project. HEC Forum:1-11.
    The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (...)
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  28. Steven Weimer (forthcoming). “I Can’T Eat If I Don’T Plass”: Impoverished Plasma Donors, Alternatives, and Autonomy. HEC Forum:1-25.
    One of the central considerations to be taken into account in evaluating the ethics of compensation for donated plasma is respect for donor autonomy. And one of the main arguments against compensated donation systems is that many donors do or would come from circumstances of poverty that restrict their alternatives in a way that compromises those donors’ autonomy. In this paper, I develop and defend a novel version of this “compromised autonomy argument” which improves upon extant versions by employing a (...)
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  29. Lucie White (forthcoming). Does Remuneration for Plasma Compromise Autonomy? HEC Forum:1-14.
    In accordance with a recent statement released by the World Health Organization, the Canadian province of Ontario is moving to ban payment for plasma donation. This is partially based on contentions that remuneration for blood and blood products undermines autonomy and personal dignity. This paper is dedicated to evaluating this claim. I suggest that traditional autonomy-based arguments against commodification of human body parts and substances are less compelling in the context of plasma donation in Canada, but that there is another (...)
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  30. H. Colby William, John Lantos Constance Dahlin & Myra Christopher John Carney (forthcoming). The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines Domain 8: Ethical and Legal Aspects of Care. HEC Forum.
    In 2001, leaders with palliative care convened to discuss the standardization of palliative care and formed the National Consensus Project for Quality Palliative Care. In 2004, the National Consensus Project for Quality Palliative Care produced the first edition of Clinical Guidelines for Quality Palliative Care. The Guidelines were developed by leaders in the field who examined other national and international standards with the intent to promote consistent, accessible, comprehensive, optimal palliative care through the health care spectrum. Within the guidelines there (...)
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