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Ethical Issues (ethical + issues)
Selected AbstractsEffectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia: a systematic reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2007L. Robinson Abstract Background Wandering occurs in 15,60% of people with dementia. Psychosocial interventions rather than pharmacological methods are recommended, but evidence for their effectiveness is limited and there are ethical concerns associated with some non-pharmacological approaches, such as electronic tracking devices. Objective To determine the clinical and cost effectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia. Design A systematic review to evaluate effectiveness of the interventions and to assess acceptability and ethical issues associated with their use. The search and review strategy, data extraction and analysis followed recommended guidance. Papers of relevance to effectiveness, acceptability and ethical issues were sought. Results (i) Clinical effectiveness. Eleven studies, including eight randomised controlled trials, of a variety of interventions, met the inclusion criteria. There was no robust evidence to recommend any intervention, although there was some weak evidence for exercise. No relevant studies to determine cost effectiveness met the inclusion criteria. (ii) Acceptability/ethical issues. None of the acceptability papers reported directly the views of people with dementia. Exercise and music therapy were the most acceptable interventions and raised no ethical concerns. Tracking and tagging devices were acceptable to carers but generated considerable ethical debate. Physical restraints were considered unacceptable. Conclusions In order to reduce unsafe wandering high quality research is needed to determine the effectiveness of non-pharmacological interventions that are practically and ethically acceptable to users. It is important to establish the views of people with dementia on the acceptability of such interventions prior to evaluating their effectiveness through complex randomised controlled trials. Copyright © 2006 John Wiley & Sons, Ltd. [source] ETHICAL ISSUES IN CELLULAR AND MOLECULAR MEDICINE AND TISSUE ENGINEERINGJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 5b 2008Raymund E. Horch First page of article [source] OUTLINING ETHICAL ISSUES IN NANOTECHNOLOGIESBIOETHICS, Issue 7 2009ANTONIO G. SPAGNOLO ABSTRACT Nanotechnologies are an expression of the human ability to control and manipulate matter on a very small scale. Their use will enable an even and constant monitoring of human organisms, in a new and perhaps less invasive way. Debates at all levels , national, European and international , have pointed out the common difficulty of giving a complete, clear definition of nanotechnologies. This is primarily due to the variety of their components, to the fact that there is not just one technology but several. The most significant medical applications of nanotechnologies are in the diagnostic and the therapeutic fields, eg biosensors and molecular imaging, providing diagnosis and drug delivery with no invasive methods involved. Like any other emerging field, such technologies imply new possibilities for improving health but, on the other hand, they are still at an experimental stage and therefore should be implemented under rigorous safety testing before going on general release. For this purpose, the ethical, legal and social implications (ELSI) of nanotechnologies have been elaborated by study groups, in order to develop solutions before the results of the tests are diffused into medical practice. The aim of this paper is to define some of the ethical issues concerning biomedical applications and to evaluate whether there is a need for new or additional guidelines and regulations. [source] Ethical Issues in International Biomedical Research: A Casebook , Edited by James V. Lavery, Christine Grady, Elizabeth R. Wahl and Ezekiel J. EmanuelDEVELOPING WORLD BIOETHICS, Issue 2 2008JOHN R. WILLIAMS No abstract is available for this article. [source] Informed Consent and Ethical Issues in Military Medical ResearchACADEMIC EMERGENCY MEDICINE, Issue 11 2005John McManus MD Abstract Informed consent in military research shares many of the same fundamental principles and regulations that govern civilian biomedical research. In fact, much of modern research ethics is grounded in events that occurred in the context of war or government-sponsored research. Despite these similarities and common origins, research in the military has additional requirements designed to preserve service members' informed consent rights. The special nature of the superior,subordinate relationship in the military necessitates careful protections to avoid perceptions of coercion or undue influence on a military subject. Additionally, current legal and regulatory requirements for advanced informed consent significantly restrict the flexibility of the military to conduct research using waiver of consent. This has implications on the ability of the nation to develop effective medical treatments for the global war on terrorism. Nevertheless, work is under way to realign defense research policy with the norms of civilian biomedical practice. Future directions include the adoption of waivers for military emergency research, and the cautious introduction of human subject studies on the battlefield. This paper discusses historical background, regulatory differences, and concerns and challenges of some of these regulatory differences for research personnel that apply to informed consent and waiver of said informed consent for emergency research conducted by the U.S. military. [source] Research Ethics: Ethical Issues of Data Reporting and the Quest for AuthenticityACADEMIC EMERGENCY MEDICINE, Issue 6 2000Catherine A. Marco MD Abstract. The search for truth and its unbiased reporting are ultimate goals of conducting scientific research. Ideally, the reporting of research data ought to be an objective task. In practice, however, it is fraught with numerous statistical and ethical pitfalls, seldom addressed in formal emergency medicine training. The lure of academic celebrity and related influences may persuade researchers to report results in ways that make data appear more interesting, or worthy of publication. Several examples of potentially misleading data reporting are illustrated, including using inappropriate statistical tests, neglecting negative results, omitting missing data points, failing to report actual numbers of eligible subjects, using inappropriate graph labels or terminology, data dredging, and others. Although potentially inaccurate or inflated methods of data reporting may not constitute overt scientific misconduct, the intentional misrepresentation of data is a form of fraud or deception. Publicly funded academic inquiry is a privilege and honor enjoyed by a trusted few. Regardless of outcome, every effort should be made to report data in the most scientifically accurate method. To this end, the Society for Academic Emergency Medicine Code of Conduct and American College of Emergency Physicians Code of Ethics provide important guidance toward the accurate, compassionate, competent, impartial, and honest conduct of scientific research. Accuracy and authenticity in data reporting are first and foremost a matter of individual integrity, and are crucial to the preservation of academic credibility, the protection of future patients, and the public's trust in the medical research enterprise. [source] Ethical Issues in HIV Research in Poor CountriesJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2001Gladys Mabunda Purpose: To increase awareness of the potential for conducting unethical research in poor nations in the name of scientific inquiry, and to enumerate ethical questions in HIV/AIDS research. Organizing construct: Principles of ethics and ethical analysis in clinical research. Sources and methods: Review of literature on ethical principles of research in developing nations. Findings: People who participate in clinical trials in poor countries often do so because that may be the only way to gain access to health care. However, access to tested drugs beyond clinical trials is not guaranteed. Participants often do not understand the consequences of being research subjects. Conclusions: Conducting research in poor nations requires recognition of ethical issues and maintenance of ethical standards, regardless of material wealth of the countries. Ethical standards also indicate including people from the target population in decisions relating to designing and conducting clinical trials. [source] Ethical Issues in NeuromodulationNEUROMODULATION, Issue 3 2010PhD Editor-in-Chief, Robert M. Levy MD First page of article [source] The Invitational Conference: A Strategy for Exploring Ethical IssuesNURSING FORUM, Issue 2 2000Betty Kupperschmidt RN The author describes an invitational conference format with prepared participants and Socratic questioning techniques used to facilitate exploration of the ethical implications of using unlicensed assistive personnel (UAP). Examples of the issues discussed are failure to treat UAP with respect, nurses not used to their fullest potential, and professional nurses' claims that UAP lack the knowledge and skills to permit effective delegation. The author recommends this strategy to facilitate exploration of other ethical issues. [source] Disparities in Pain: Ethical IssuesPAIN MEDICINE, Issue 6 2006Carmen Green MD First page of article [source] Ethical Issues for Psychologists in Pain ManagementPAIN MEDICINE, Issue 2 2001Mary Lou Taylor PhD Pain management is relatively young as a specialty. Although increasing attention is being paid to issues such as pain at the end of life and pain in underserved populations, only recently has an open discussion of ethical issues in chronic pain treatment come to the fore. Psychologists specializing in pain management are faced with a myriad of ethical issues. Although many of these problems are similar to those faced by general clinical psychologists or other health psychologists, they are often made more complex by the multidisciplinary nature of pain management and by the psychologists' relationships to third-party payers (health maintenance organizations, workers' compensation), attorneys, or other agencies. An open forum exploring ethical issues is needed. This article outlines major ethical considerations faced by pain management psychologists, including patient autonomy and informed consent, confidentiality, reimbursement and dual relationships, patient abandonment, assessment for medical procedures, clinical research, and the interface of psychology and medicine. American Psychological Association ethical principles and principles of biomedical ethics need to be considered in ethical decision making. Further exploration and discussion of ethics for pain management psychologists are recommended. [source] Ethical Issues in Rural Health CareTHE JOURNAL OF RURAL HEALTH, Issue 2 2010FAAFP, Mark K. Huntington MD No abstract is available for this article. [source] Ethical Issues in Clinical Drug Trials in Alzheimer's DiseaseAUSTRALASIAN JOURNAL ON AGEING, Issue 3 2001Elizabeth G. Cleland No abstract is available for this article. [source] End-of-Life Decision Making: Practical and Ethical Issues for Health ProfessionalsAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2000Colleen Cartwright Life-extending changes in medical technology and an ageing population pose practical and ethical problems relating to end-of-life decision making. Health professionals need to understand the fears and concerns of their patients, their preferred place to die, and to respect patient autonomy. Such wishes may be expressed verbally by a competent patient or through an advance directive (living will) or proxy by an incompetent patient. There is an urgent need for increased and improved training of health professionals in pain management and palliative care, and for the development of practical, ethical policies and guidelines with respect to withdrawing/withholding life-sustaining treatment. In addition, physician-assisted suicide and euthanasia, two of the important moral issues of the 90s, will continue to require open community debate as we move into the new millennium. Australia, in company with most other countries, has many challenges ahead in relation to end-of-life decision making. [source] Ethical Issues of Cardiopulmonary Resuscitation: Comparison of Emergency Physician Practices from 1995 to 2007ACADEMIC EMERGENCY MEDICINE, Issue 3 2009Catherine A. Marco MD Abstract Objectives:, The objectives were to determine current practice among emergency physicians (EPs) regarding the initiation and termination of cardiopulmonary resuscitative (CPR) efforts and to compare responses to those from a similar study performed in 1996. Methods:, This anonymous self-administered survey was mailed to 4,991 randomly selected EPs. Main outcome measures included responses regarding current practices related to advance directives and initiation and termination of resuscitative attempts. Results from 1995 and 2007 surveys were compared, using 95% confidence intervals (CIs) of the difference between groups. Results:, Among 928 respondents (18% response rate), most (86%) honor legal advance directives, an increase over 78% reported in 1996 (8% increase, 95% CI = 5% to 11%). Few honor unofficial documents (7%) or verbal reports (12%) of advance directives. Many (58%) make decisions regarding resuscitation because of fear of litigation or criticism. Most respondents (62%) attempt resuscitation in 10% or more of cases of cardiac arrest. A majority (56%) have attempted more than 10 resuscitations in the past 3 years, despite expectations that such efforts would be futile. Factors reported to be "very important" in making resuscitation decisions were advance directives (78%), witnessed arrest (77%), downtime (73%), family wishes (40%), presenting rhythm (38%), age (28%), and prearrest state of health (25%). A significant majority of respondents (80%) indicated that ideally, legal concerns should not influence physician practices regarding resuscitation, but that in the current environment, legal concerns do influence practice (92%). Other than the increase in respondents who honor legal advance directives, these results do not differ substantially from responses in 1996. Conclusions:, Most EPs attempt to resuscitate patients in cardiopulmonary arrest regardless of poor outcomes, except in cases where a legal advance directive is available. Many EPs' decisions regarding resuscitation are based on concerns of litigation and criticism, rather than professional judgment of medical benefit. Most results did not differ significantly from the previous study of 1995, although more physicians honor legal advance directives than previously noted. [source] Ethical Issues in eBusiness: A Proposal for Creating the eBusiness PrinciplesBUSINESS AND SOCIETY REVIEW, Issue 1 2002A. Graham Peace [source] Ethical issues in harm reduction for adolescent illicit drug users: the Adolescent Forensic Health Service approachDRUG AND ALCOHOL REVIEW, Issue 4 2000Dr. FRIEDERIKE VEIT First page of article [source] Ethical issues related to epilepsy care in the developing worldEPILEPSIA, Issue 5 2009Chong-Tin Tan Summary There are three major issues of ethical concern related to epilepsy care in the developing world. First, is it ethical for a developing country to channel its limited resources from direct epilepsy care to research? The main considerations in addressing this question are the particular research questions to be addressed and whether such research will bring direct benefits to the local community. Second, in a country with limited resources, when does ignoring the high treatment gap become an ethical issue? This question is of particular concern when the community has enough resources to afford treatment for its poor, yet is not providing such care because of gross wastage and misallocation of the national resources. Third, do countries with plentiful resources have an ethical responsibility to help relieve the high epilepsy treatment gap of poor countries? Indeed, we believe that reasonable health care is a basic human right, and that human rights transcend national boundaries. Although health care is usually the responsibility of the nation-state, many modern states in the developing world are arbitrary creations of colonization. There is often a long process from the establishment of a political-legal state to a mature functional nation. During the long process of nation building, help from neighboring countries is often required. [source] Ethical issues associated with gifts provided to physicians by the pharmaceutical industryINTERNAL MEDICINE JOURNAL, Issue 5 2010P. A. Komesaroff No abstract is available for this article. [source] Ethical issues in biotechnologies and international tradeJOURNAL OF CHEMICAL TECHNOLOGY & BIOTECHNOLOGY, Issue 5 2002Joseph H Hulse Natural and physical sciences are based on determinable facts. What is ethical, as distinct from illegal, is largely a matter of opinion. Scientific and industrial activities related to ancient and modern biotechnologies are among the most critically scrutinised for ethical probity by social activists and journalists. The practices and products of biotechnologies should be judged both deontologically , by motivation and intention, and teleologically , by determinable consequence. Bioethical criteria have been proposed by governments, medical practitioners and philosophers for many centuries. During the past decade, various scientifically competent organisations, national and international, have formulated comprehensive protocols by which to determine effectiveness and safety of novel foods, pharmaceuticals and other biologicals, including those derived from genetically modified organisms. Means and opportunities by which to satisfy the health and nutritional needs of impoverished nations and communities differ significantly from those who enjoy greater affluence. It is distinctly unethical for Europeans and North Americans, whose food and health securities are not at risk, to impose their ethical predilections on poorer nations. Equally reprehensible are the diverse tariff and non-tariff barriers to equitable international trade, and acts of biopiracy inflicted upon poorer nations. As a wise Asian sage has observed, the planet's resources and scientific ingenuity are sufficient to satisfy everyone's need, but not everyone's greed. Present and predictable world-wide demand for bioscientists and bioengineers exceeds best estimates of supply. Systematically planned, long-term investments by governments and bioindustries to generate adequate qualified men and women are urgently needed. © 2002 Society of Chemical Industry. [source] Action research, change and methodological rigourJOURNAL OF NURSING MANAGEMENT, Issue 4 2000T. G. Badger BSC (HONS) Aim To critically examine concepts of methodological rigour in action research and consider how these affect its capacity to enable change. Key issues Action research is potentially attractive to managers of nursing because it is a problem-focused approach. As action research is identified as a continuum of definitions and philosophies rather than a single approach, caution is expressed that the search for definition may obscure the underlying process of change. Issues of reliability and validity are explored, suggesting that concern for methodological rigour may limit the potential for change and improvement in practice. Ethical issues in action research are considered identifying areas for tension between researchers, managers and practitioners. Some examples of action research in nursing are discussed. Conclusion Action research may be valuable in individual practitioners' development or in fostering collaboration between academe and practice. However the demands for methodological rigour in research limit its effectiveness as a strategy for managing change. [source] Ethical issues for parents of extremely premature infantsJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2008Judith Schroeder Abstract: Evidence suggests that NICU (neonatal intensive care unit) parents with an baby born at the threshold of viability do not always receive sufficient counselling during an emergency admission and as a consequence, are not well-informed to accept withdrawal of treatment or quality of life decisions. As prospective parents are not educated earlier in pregnancy about extreme premature delivery, crucial information and counselling explaining neonatal issues is only offered to labouring women during their emergency admission. As a result, most have difficulty understanding the risks and benefits of baby's treatment and therefore rely heavily on the perinatal physician to take responsibility for the initial treatment. However, this lack of understanding often leaves parents disadvantaged, as many are left unprepared to participate objectively in quality of life decisions. According to recent research, morbidity figures remain relatively high with one in five survivors at risk of a long-term disability. This shows that some parents will still be confronted by ethical decision of whether or not to continue treatment, and this may not be apparent until days after treatment has been established. As recent research has shown, parents do, in fact, want increased involvement in the decision-making process regarding their child's treatment. Therefore, it has been argued, that parents should be provided with information earlier in pregnancy to familiarise themselves with quality of life issues which they may encounter as the NICU parents of an extremely premature infant. [source] Ethical issues in pro-social advertising: the Australian 2006 White Ribbon Day campaignJOURNAL OF PUBLIC AFFAIRS, Issue 1 2009Robert John Donovan The Australian White Ribbon Day 2006 campaign was severely criticized by mental health professionals and those working in the family and domestic violence sector because of depictions of suicide and self-harm in the television advertisement and accompanying promotional materials. The White Ribbon Day (WRD) National Leadership Group (NLG) rejected all requests by concerned groups to not use these campaign materials. They and their apologists claimed that such violent imagery was necessary to attract men's attention and was being misinterpreted as depicting suicide attempts. With preliminary ethics approval we set out to assess reactions to the television advertisement. After 24 interviews, the testing was terminated by the university research ethics officer after two male respondents demonstrated significant distress after viewing the ad. Furthermore, the results by that stage showed that there were perceived messages of suicide in the ad. These results were sent to the WRD NLG with a request to reconsider proceeding with the television advertisement and associated materials. Mental health and domestic violence organizations lodged similar requests. All requests were rejected. The case raises a number of ethical issues for pro-social organizations when dealing with sensitive issues and using execution techniques that may impact negatively on vulnerable audiences. Copyright © 2009 John Wiley & Sons, Ltd. [source] Workplace literacy: Ethical issues through the lens of experienceNEW DIRECTIONS FOR ADULT & CONTINUING EDUCATION, Issue 123 2009Sue Folinsbee This chapter describes a number of ethical dilemmas faced as a workplace literacy practitioner and researcher. Each issue is analyzed along with the lessons learned. [source] Ethical issues in mentoring adults in higher educationNEW DIRECTIONS FOR ADULT & CONTINUING EDUCATION, Issue 123 2009Catherine A. Hansman This chapter examines practical problems encountered in mentoring adult learners in higher education through stories of ethical dilemmas. [source] Drug use investigation (DUI) and prescription-event monitoring in Japan (J-PEM),PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2001Katsutoshi Tanaka BSc Abstract Objective To present ethical issues and relevant problems in observational studies of drug safety in Japan. Methods The Pharmaceutical Affairs Law, associated ordinances, and notifications relevant to Drug Use Investigations (DUIs), and published documents for two pilot studies of prescription-event monitoring in Japan (J-PEM) were examined, particularly with regard to the protection of privacy. Information relevant to the proposed legislation intended to protect personal information and proposed guidelines on ethical issues in epidemiological studies were also collected. Results and Conclusion The formal studies inaugurated as the ,side-effect investigations' in the late 1960s and replaced by those of the DUI in 1980 have been conducted by drug manufacturers, in accordance with the Pharmaceutical Affairs Law. The first pilot study of J-PEM was started in 1997 and the second one is currently operated under a Health Sciences Research grant, supported by the Ministry of Health and Welfare. Those observational studies have been conducted while maintaining the confidentiality of personal data, but without requiring either approval by institutional ethics boards or informed consent from patients. However, according to the Pharmaceutical Affairs Law, those involved in postmarketing surveillance studies must protect the privacy of study subjects and those who break this rule may be subject to penalties. Ethical issues associated with pharmacoepidemiological studies will be clearly determined in Japan before the end of 2001 when the law designed to protect personal information will be introduced and official guidelines on ethical issues in epidemiological studies will have come into effect. Copyright © 2001 John Wiley & Sons, Ltd. [source] Ethical issues in the management of sickle cell painAMERICAN JOURNAL OF HEMATOLOGY, Issue 2 2001Samir K. Ballas Abstract Care providers who manage patients with sickle cell disease (SCD) often face several questions. Most prominent among these pertain to the importance of pain and its treatment. The duties of the health care providers concerning pain management are often not well defined and vary considerably among providers and institutions. Despite the availability of national guidelines that address the ethical issues of pain management, patients with SCD often receive suboptimal pain control, especially during acute painful episodes. Although there are many reasons for this situation, an important aspect of the problem pertains to the complexity of applying ethical standards to specific patients with sickle cell pain. Decisions are frequently made according to perceptions and circumstances without taking ethical principles into consideration. The purpose of this paper is to present the range of ethical principles pertinent to sickle pain management and discuss specific examples of physician-patient interactions where ethical dilemmas occur. Am. J. Hematol. 68:127,132, 2001. © 2001 Wiley-Liss, Inc. [source] Ethical issues in archaeologyAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2005Helaine Silverman No abstract is available for this article. [source] Ethical issues faced by field primatologists: asking the relevant questionsAMERICAN JOURNAL OF PRIMATOLOGY, Issue 9 2010Linda Marie Fedigan Abstract Field primatologists face unusual ethical issues. We study animals rather than people and receive research approval from animal care rather than ethics committees. However, animal care evaluation forms are developed from concerns about laboratory animal research and are based on the "Three R's" for humane treatment of captive experimental subjects (replacement, reduction and refinement), which are only debatably relevant to field research. Scientists who study wild, free-ranging primates in host countries experience many ethical dilemmas seldom dealt with in animal care forms. This paper reviews the ethical issues many field primatologists say they face and how these might be better addressed by animal care forms. The ethical issues arising for field researchers are divided into three categories: "Presence, Protocols and People" and for each the most frequent issues are described. The most commonly mentioned ethical concern arising from our presence in the field is the possibility of disease transmission. Although most primate field studies employ only observational protocols, the practice of habituating our study animals to close human presence is an ethical concern for many since it can lessen the animals' fear of all humans, thereby facilitating undesirable behaviors (e.g., crop-raiding) and rendering them vulnerable to harm. Field primatologists who work in host countries must observe national laws and local traditions. As conservationists, primatologists must often negotiate between the resource needs and cultural practices of local people and the interests of the nonhuman primates. Many say they face more ethical dilemmas arising from human interactions than from research on the animals per se. This review concludes with suggestions for relevant questions to ask on animal care forms, and actions that field primatologists can take to better inform animal care committees about the common ethical issues we experience as well as how to develop guidelines for addressing them. Am. J. Primatol. 72:754,771, 2010. © 2010 Wiley-Liss, Inc. [source] Ethical issues in the publication of clinical material1THE JOURNAL OF ANALYTICAL PSYCHOLOGY, Issue 1 2005Barbara Wharton Abstract:, Some of the ethical issues involved in publishing clinical material are considered. These include the ,ownership' of such material, the responsibilities of the analyst towards patients and professional colleagues, the keeping and status of records, the nature of trust and confidentiality and its place in analysis, the question of obtaining consent for publication, the nature of consent, and its consequences for treatment. The issues of disguise, of authenticity, and of accuracy are also touched on, as is the potential role of the author's anonymity in protecting the anonymity of the patient. [source] | ||||||||||||||||||||||||||||||||||||||||||||||