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Medical Necessity (medical + necessity)

Distribution by Scientific Domains
Humanities and Social Sciences83%

Selected Abstracts

THE THERAPEUTIC EXCEPTION: ABORTION, STERILIZATION AND MEDICAL NECESSITY IN COSTA RICA

DEVELOPING WORLD BIOETHICS, Issue 2 2007
MARĶA CARRANZA
ABSTRACT Based on the case of Rosa, a nine-year-old girl who was denied a therapeutic abortion, this article analyzes the role played by the social in medical practice. For that purpose, it compares the different application of two similar pieces of legislation in Costa Rica, where both the practice of abortion and sterilization are restricted to the protection of health and life by the Penal Code. As a concept subject to interpretation, a broad conception of medical necessity could enable an ample use of the therapeutic exception and a liberal use of both surgeries. The practice of therapeutic sterilization has been generalized in Costa Rica and has become the legitimate way to distribute contraceptive sterilization. In contrast, therapeutic abortion is very rarely practiced. The analysis carried out proposes that it is the difference in social acceptance of abortion and sterilization that explains the different use that doctors, as gatekeepers of social morality, make of medical necessity. [source]

EQUALITY AND THE DUTY TO RETARD HUMAN AGEING

BIOETHICS, Issue 8 2010
COLIN FARRELLY
ABSTRACT Where does the aspiration to retard human ageing fit in the ,big picture' of medical necessities and the requirements of just healthcare? Is there a duty to retard human ageing? And if so, how much should we invest in the basic science that studies the biology of ageing and could lead to interventions that modify the biological processes of human ageing? I consider two prominent accounts of equality and just healthcare , Norman Daniels's application of the principle of fair equality of opportunity and Ronald Dworkin's account of equality of resources , and conclude that, once suitably amended and revised, both actually support the conclusion that anti-ageing research is important and could lead to interventions that ought to be considered ,medical necessities'. [source]

THE THERAPEUTIC EXCEPTION: ABORTION, STERILIZATION AND MEDICAL NECESSITY IN COSTA RICA

DEVELOPING WORLD BIOETHICS, Issue 2 2007
MARĶA CARRANZA
ABSTRACT Based on the case of Rosa, a nine-year-old girl who was denied a therapeutic abortion, this article analyzes the role played by the social in medical practice. For that purpose, it compares the different application of two similar pieces of legislation in Costa Rica, where both the practice of abortion and sterilization are restricted to the protection of health and life by the Penal Code. As a concept subject to interpretation, a broad conception of medical necessity could enable an ample use of the therapeutic exception and a liberal use of both surgeries. The practice of therapeutic sterilization has been generalized in Costa Rica and has become the legitimate way to distribute contraceptive sterilization. In contrast, therapeutic abortion is very rarely practiced. The analysis carried out proposes that it is the difference in social acceptance of abortion and sterilization that explains the different use that doctors, as gatekeepers of social morality, make of medical necessity. [source]

Validity and reliability of an inpatient severity of psychiatric illness measure

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2005
Bentson H. McFarland
Abstract Inpatient psychiatric severity measures are often used but few psychometric data are available. This study evaluated the psychometric properties (reliability and validity) of a measure used to assess severity of psychiatric illness among inpatients. Using the severity measure, minimally trained raters conducted retrospective patient record reviews to assess medical necessity for psychiatric hospitalization. The data analysis compared 135 civilly committed psychiatric inpatients with a heterogeneous group of 248 psychiatric inpatients at a general hospital. The severity measure showed acceptable inter-rater reliability in both populations. Two-way analysis of variance showed that the intra-class correlation coefficient for the total score was 0.65 for general hospital subjects and 0.63 for civilly committed subjects. Differences in mean scores were substantial (15 out of a possible 75 points for general hospital subjects versus 42 for civilly committed subjects, Mann-Whitney U = 562, p < 0.001). As expected, all civilly committed subjects were well above admission cut-off score of 12, versus only 64% of the general hospital patients. The measure is appropriate for retrospective severity assessment and may also be useful for pre-admission screening. Copyright © 2005 Whurr Publishers Ltd. [source]

Providers and Staff Respond to Medicaid Managed Care: The Unintended Consequences of Reform in New Mexico

MEDICAL ANTHROPOLOGY QUARTERLY, Issue 1 2005
LOUISE LAMPHERE
In 1997 a new Medicaid managed care (MMC) program called Salud! was implemented by the State of New Mexico. This article serves as an introduction to a special issue of Medical Anthropology Quarterly that assesses the unintended consequences of this reform and its impact on providers and staff who work in clinics, physician offices, and emergency rooms where Medicaid patients are served. MMC fused state and corporate bureaucracies, creating a complex system where enrollment and access was difficult. The special issue focuses on providers' responses to these new structures, including ways in which staff buffer the impact of reform and the role of the discourses of medical necessity and accountability in shaping the way in which MMC functions. [source]