15 found

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  1.  3
    A Pot Ignored Boils On: Sustained Calls for Explicit Consent of Intimate Medical Exams.Lori Bruce - 2020 - HEC Forum 32 (2):125-145.
    Unconsented intimate exams on men and women are known to occur for training purposes and diagnostic reasons, mostly during gynecological surgeries but also during prostate examinations and abdominal surgeries. UIEs most often occur on anesthetized patients but have also been reported on conscious patients. Over the last 30 years, several parties—both within and external to medicine—have increasingly voiced opposition to these exams. Arguments from medical associations, legal scholars, ethicists, nurses, and some physicians have not compelled meaningful institutional change. Opposition is (...)
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  2.  3
    Creating Space for Feminist Ethics in Medical School.Georgina D. Campelia & Ashley Feinsinger - 2020 - HEC Forum 32 (2):111-124.
    Alongside clinical practice, medical schools now confront mounting reasons to examine nontraditional approaches to ethics. Increasing awareness of systems of oppression and their effects on the experiences of trainees, patients, professionals, and generally on medical care, is pushing medical curriculum into an unfamiliar territory. While there is room throughout medical school to take up these concerns, ethics curricula are well-positioned to explore new pedagogical approaches. Feminist ethics has long addressed systems of oppression and broader structures of power. Some of its (...)
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  3.  1
    Introduction: Special Issue on Undergraduate Medical Education in Ethics and Professionalism.Brian H. Childs & Nasser Rizvi - 2020 - HEC Forum 32 (2):77-83.
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  4.  1
    Embedding Ethics Education in Clinical Clerkships by Identifying Clinical Ethics Competencies: The Vanderbilt Experience.Alexander Langerman, William B. Cutrer, Elizabeth Ann Yakes & Keith G. Meador - 2020 - HEC Forum 32 (2):163-174.
    The clinical clerkships in medical school are the first formal opportunity for trainees to apply bioethics concepts to clinical encounters. These clerkships are also typically trainees’ first sustained exposure to the “reality” of working in clinical teams and the full force of the challenges and ethical tensions of clinical care. We have developed a specialized, embedded ethics curriculum for Vanderbilt University medical students during their second year to address the unique experience of trainees’ first exposure to clinical care. Our embedded (...)
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  5.  1
    “You Took an Oath!”: Engaging Medical Students About the Importance of Oaths and Codes Through Film and Television.Kayhan Parsi & Nanette Elster - 2020 - HEC Forum 32 (2):175-189.
    In this paper, we will consider the role of oaths and codes of ethics in undergraduate medical education. Studies of ethics syllabi suggest that ethics educators typically use well-known bioethics texts such as Beauchamp and Childress. Yet, many issues that medical students will face are addressed by codes of ethics and oaths. We will first provide a historical survey of oaths and codes and then address how these sources of ethical guidance can be effectively used in ethics education of medical (...)
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  6.  1
    Medical Students’ Exposure to Ethics Conflicts in Clinical Training: Implications for Timing UME Bioethics Education.S. D. Stites, S. Rodriguez, C. Dudley & A. Fiester - 2020 - HEC Forum 32 (2):85-97.
    While there is significant consensus that undergraduate medical education should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that (...)
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  7.  2
    Enlightened Self-Interest in Altruism.Laura Vearrier - 2020 - HEC Forum 32 (2):147-161.
    Altruism and the medical profession have been linked throughout the history of medicine. Students are drawn to the calling of medicine because of altruistic values, dedication to service, and the desire to alleviate suffering and promote healing. Despite a dedication to these values, altruism in medicine is threatened by empathy erosion that develops in the clinical years of medical school and an increasing rate of medical student burnout. Currently, there are two widespread movements in medicine aimed at addressing the dual (...)
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  8.  1
    Clerkship Ethics: Unique Ethical Challenges for Physicians-in-Training.Danish Zaidi, Jacob A. Blythe, Benjamin W. Frush & Jay R. Malone - 2020 - HEC Forum 32 (2):99-109.
    Three ethical conflicts in particular are paradigmatic of what we define as “clerkship ethics.” First, a distinction that differentiates the clerkship student from the practicing physician involves the student’s principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student (...)
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  9.  7
    Making Medical Decisions for Incapacitated Patients Without Proxies: Part II.Eric Blackstone, Barbara J. Daly & Cynthia Griggins - 2020 - HEC Forum 32 (1):47-62.
    In the United States, there is no consensus about who should make decisions in acute but non-emergent situations for incapacitated patients who lack surrogates. For more than a decade, our academic medical center has utilized community volunteers from the hospital ethics committee to engage in shared decision-making with the medical providers for these patients. In order to add a different point of view and minimize conflict of interest, the volunteers are non-clinicians who are not employed by the hospital. Using case (...)
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  10.  18
    Differing Thresholds for Overriding Parental Refusals of Life-Sustaining Treatment.Hannah Gerdes & John Lantos - 2020 - HEC Forum 32 (1):13-20.
    When should doctors seek protective custody to override a parent’s refusal of potentially lifesaving treatment for their child? The answer to this question seemingly has different answers for different subspecialties of pediatrics. This paper specifically looks at different thresholds for physicians overriding parental refusals of life-sustaining treatment between neonatology, cardiology, and oncology. The threshold for mandating treatment of premature babies seems to be a survival rate of 25–50%. This is not the case when the treatment in question is open heart (...)
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  11.  6
    Making Medical Decisions for Incapacitated Patients Without Proxies: Part I.Cynthia Griggins, Eric Blackstone, Lauren McAliley & Barbara Daly - 2020 - HEC Forum 32 (1):33-45.
    To date no one has identified or described the population of incapacitated patients being treated in an inpatient setting who lack proxy decision-makers. Nor, despite repeated calls for protocols to be developed for decision-making, has any institution reported on the utilization of such a protocol. In 2005, our urban tertiary care hospital instituted a protocol utilizing community members of the ethics committee to meet with the medical providers and engage in shared decision-making for patients without proxies. We conducted a retrospective (...)
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  12.  6
    A Qualitative Study on Experiences and Perspectives of Members of a Dutch Medical Research Ethics Committee.Rien M. J. P. A. Janssens, Wieke E. Van der Borg, Maartje Ridder, Mariëlle Diepeveen, Benjamin Drukarch & Guy A. M. Widdershoven - 2020 - HEC Forum 32 (1):63-75.
    The aim of this research was to gain insight into the experiences and perspectives of individual members of a Medical Research Ethics Committee regarding their individual roles and possible tensions within and between these roles. We conducted a qualitative interview study among members of a large MREC, supplemented by a focus group meeting. Respondents distinguish five roles: protector, facilitator, educator, advisor and assessor. Central to the role of protector is securing valid informed consent and a proper risk-benefit analysis. The role (...)
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  13.  2
    A Qualitative Study on Experiences and Perspectives of Members of a Dutch Medical Research Ethics Committee.Rien M. J. P. A. Janssens, Wieke E. van der Borg, Maartje Ridder, Mariëlle Diepeveen, Benjamin Drukarch & Guy A. M. Widdershoven - 2020 - HEC Forum 32 (1):63-75.
    The aim of this research was to gain insight into the experiences and perspectives of individual members of a Medical Research Ethics Committee regarding their individual roles and possible tensions within and between these roles. We conducted a qualitative interview study among members of a large MREC, supplemented by a focus group meeting. Respondents distinguish five roles: protector, facilitator, educator, advisor and assessor. Central to the role of protector is securing valid informed consent and a proper risk-benefit analysis. The role (...)
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  14.  6
    Clinical Ethics Needs Assessment: Adapting Clinical Ethics to a Population Health Program.Etan Kuperberg - 2020 - HEC Forum 32 (1):21-32.
    The clinical encounter between providers and patients is insufficient: most factors influencing health outcomes occur outside the clinic. Community Health Needs Assessments address this insufficiency via collaboration between hospitals and the communities they serve to address systemic sociological-economic variables impacting health outcomes. Considering this, why are Health Care Ethics Consultation services limited to the clinical setting? We can cultivate better ethics outcomes by addressing systemic sociological-economic factors that cause recurring ethics issues in the hospital. In this article, I argue for (...)
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  15.  9
    Towards Ethically and Medically Sustainable Care for the Elderly: The Case of China.Wenye Xie & Ruiping Fan - 2020 - HEC Forum 32 (1):1-12.
    An enormous challenge facing China is how to provide sustainable care for its rapidly-increasing elderly population. Its recent policy directives include three medical forms—the institution-cooperation-form, the institution-medical-form, and the family-physician-form—to integrate medical care into ordinary care for the elderly. This essay indicates that China will not be able to maintain sustainable elderly care unless it places emphasis on the family-physician-form that focuses on family physicians and the use of primary care services. The essay constructs arguments for this policy suggestion based (...)
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