Structured Professional Guidelines: International Applications

2011 ◽  
pp. 85-110 ◽  
Author(s):  
Martin Rettenberger ◽  
Stephen J. Hucker
Keyword(s):  
Professional Guidelines

scholarly journals Genetic Testing for Minors: Comparison between Italian and British Guidelines

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Pamela Tozzo ◽  
Luciana Caenazzo ◽  
Daniele Rodriguez
Keyword(s):  
Clinical Practice ◽  
Genetic Testing ◽  
Ethical Issues ◽  
Social Issues ◽  
Carrier Testing ◽  
European Countries ◽  
National Guidelines ◽  
Common Framework ◽  
Professional Guidelines

Genetic testing in children raises many important ethical, legal, and social issues. One of the main concerns is the ethically inappropriate genetic testing of minors. Various European countries established professional guidelines which reflect the different countries perspectives regarding the main ethical issues involved. In this paper, we analyze the Italian and the British guidelines by highlighting differences and similarities. We discuss presymptomatic, predictive, and carrier testing because we consider them to be the more ethically problematic types of genetic testing in minors. In our opinion, national guidelines should take into account the different needs in clinical practice. At the same time, in the case of genetic testing the national and supranational protection of minors could be strengthened by approving guidelines based on a common framework of principles and values. We suggest that the Oviedo Convention could represent an example of such a common framework or, at least, it could lead to articulate it.

The Privilege of Information—An Examination of the Defence of Therapeutic Privilege and its Implications for Pregnant Women

2021 ◽  
Author(s):  
Aoife M Finnerty
Keyword(s):  
Pregnant Women ◽  
Postpartum Period ◽  
Patient Autonomy ◽  
Common Law ◽  
Case Law ◽  
England And Wales ◽  
Judicial Scrutiny ◽  
Therapeutic Privilege ◽  
Professional Guidelines ◽  
In Pregnancy

Abstract Though apparently in existence across common law countries, the defence of ‘therapeutic privilege’ receives scant judicial analysis in case law. The extent of its reach is unclear and its underpinning justification is shaky. Often it forms a throwaway remark or poorly explored caveat when the duty of a physician to disclose information is being examined, rather than receiving any detailed judicial scrutiny in its own right. Furthermore, despite references to it in case law, it is questionable if it has ever successfully been invoked as a defence in either England and Wales or Ireland. This piece examines this lack of clarity and the often-vague references to the existence of therapeutic privilege in both case law and professional guidelines, followed by a consideration of why the defence may be particularly problematic and unjustified in the context of childbirth and the immediate postpartum period. Considering the dangers of therapeutic privilege in pregnancy presents a timely opportunity to examine the issues with the use of the defence in all other healthcare contexts, focusing particularly on its impact on individual patient autonomy. Finally, this piece concludes by contending that therapeutic privilege ought to be abolished, if it truly exists at all.

Aligning patient and physician views on educational pelvic examinations under anaesthesia: the medical student perspective

2020 ◽  
pp. medethics-2020-106473
Author(s):  
Sanjana Salwi ◽  
Alexandra Erath ◽  
Pious D Patel ◽  
Karampreet Kaur ◽  
Margaret B Mitchell
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Clinical Skill ◽  
Medical Community ◽  
Student Perspective ◽  
Physician Perspectives ◽  
Explicit Consent ◽  
Pelvic Examinations ◽  
Professional Guidelines

Recent media articles have stirred controversy over anecdotal reports of medical students practising educational pelvic examinations on women under anaesthesia without explicit consent. The understandable public outrage that followed merits a substantive response from the medical community. As medical students, we offer a unique perspective on consent for trainee involvement informed by the transitional stage we occupy between patient and physician. We start by contextualising the role of educational pelvic examinations under anaesthesia (EUAs) within general clinical skill development in medical education. Then we analyse two main barriers to achieving explicit consent for educational pelvic EUAs: ambiguity within professional guidelines on how to operationalize ‘explicit consent’ and divergent patient and physician perspectives on harm which prevent physicians from understanding what a reasonable patient would want to know before a procedure. To overcome these barriers, we advocate for more research on patient perspectives to empower the reasonable patient standard. Next, we call for minimum disclosure standards informed by this research and created in conjunction with students, physicians and patients to improve the informed consent process and relieve medical student moral injury caused by performing ‘unconsented’ educational pelvic exams.

scholarly journals Care to value. Preservation strategies in the Art Market’s context

2021 ◽  
Author(s):  
João Henrique Macedo Marrocano
Keyword(s):  
Contemporary Art ◽  
Art Market ◽  
Real Possibility ◽  
Commercial Practice ◽  
National Market ◽  
Diagnostic Models ◽  
Market Framework ◽  
Personal Testimony ◽  
Professional Guidelines ◽  
Value Preservation

In the art market, it is a real possibility that the conduct to be adopted in the preservation of contemporary art cannot be put into practice without secession with the conservation and restoration guidelines. The aim of this study is to analyse if the most prominent professional guidelines fit into the market framework, or if it is possible to find divergences or reasons to lay aside in commercial practice. The work compared the fundamental guidelines with the practical objectives of the art market, qualitatively analyzing the results with the personal testimony collected from the agents of the national market on the issue raised. From this analysis, it was possible to identify the need for diagnostic models balanced with the safeguard of the commercial circumstance of the assets, seeking to develop a line of diagnostic guidelines that offer analytical usefulness to the conservator, in actions in the context of the contemporary art market in Portugal.

Women's perception of choice and support in making decisions regarding management of breech presentation

2021 ◽  
Vol 29 (7) ◽  
pp. 392-400
Author(s):  
Antonio Sierra
Keyword(s):  
Breech Presentation ◽  
Study Data ◽  
External Cephalic Version ◽  
Structured Interviews ◽  
Management Options ◽  
Lower Segment Caesarean Section ◽  
Postnatal Women ◽  
Phenomenological Research Design ◽  
Colaizzi's Method ◽  
Professional Guidelines

Background Professional guidelines recommend midwives and obstetricians actively involve women in making decisions about their care. To date, breech research has focused mainly on assessing the effectiveness of different management options. Aim This research explores women's experience of breech presentation and their perception of choice and support in making decisions with regards to breech management. Methods This study uses a phenomenological research design. Semi-structured interviews took place in hospital or women's homes. A total of six postnatal women who were diagnosed with breech presentation after 36 weeks' gestation took part in the study. Data was analysed using Colaizzi's method. Findings A total of 84 significant statements were clustered into four main emerging themes. These include women's feelings, their healthcare expectations, their preferences and their values. Results Breech discussions mostly occurred between obstetricians and women. These primarily focused on external cephalic version, Elective Lower Segment Caesarean Section and Breech Vaginal Birth. These options did not always become choices available to women.

USE IT to Create Patient-Relation Management for Multiple Sclerosis Patients

2008 ◽  
pp. 1909-1924
Author(s):  
Margreet B. Michel-Verkerke ◽  
Roel W. Schuring ◽  
Ton A.M. Spil
Keyword(s):  
Multiple Sclerosis ◽  
Healthcare Providers ◽  
Care Process ◽  
Care Providers ◽  
Web Based ◽  
Information And Communication ◽  
A Chain ◽  
Multiple Sclerosis Patients ◽  
Professional Guidelines ◽  
Technological Area

Patients with multiple sclerosis (MS) visit various healthcare providers during the course of their disease. It was suggested that information and communication technology might help to orchestrate their care provision. We have applied the USE IT tool to get insight in the relevant problems, solutions, and constraints of MS care both in the organizational and the information-technological area. There is hardly a chain of healthcare, but rather, a network in which informal communication plays an important role. This informal network worked reasonably effective, but it was inefficient and slow. The MS patient count is small for most care providers. Patients thought that a lack of experience caused their major problems: insufficient and inadequate care. To improve care, we proposed a solution that combines an MS protocol, the introduction of a central coordinator of care and a patient-relation management (PRM) system. This is a simple Web-based application based on an agreement by the caregivers that supports routing, tracking, and tracing for an MS patient and supplies the caregivers with professional guidelines. It is likely that we would have suggested a far more complicated ICT solution if we had only analyzed the MS care process as such without specific consideration of the dimensions in the USE IT tool.

If in Doubt, Cut It Out

2021 ◽  
pp. 150-188
Author(s):  
Louise Marie Roth
Keyword(s):  
Medical Training ◽  
Standard Of Care ◽  
Care Providers ◽  
Medical Risk ◽  
Legal Risk ◽  
Cesarean Deliveries ◽  
Obstetric Medicine ◽  
The Us ◽  
Liability Risk ◽  
Professional Guidelines

This chapter examines the effects of malpractice on cesarean deliveries in light of historical trends and changes in the standard of care. Nearly one third of births in the US involve a cesarean delivery, and cesareans are usually the first thing that people think about when they think about defensive obstetric medicine. While some popular accounts attribute the rise in cesareans to women’s requests, most maternity care providers and public health experts are skeptical of the idea that “choice” is driving the trend. This chapter highlights the ways that providers respond to three types of risk when they do cesarean deliveries: medical risk, iatrogenic risk, and legal risk. A culture of malpractice fear encourages obstetricians to prioritize legal risk, and they know that patients are more likely to sue them for not doing a cesarean than for doing an unnecessary one. Providers also described expedience, organizational efficiency, and changes in medical training as important causes of medically questionable cesareans. Analyses reveal that the odds of a cesarean are higher in states where providers face more liability risk, but the effect is extremely small. Professional guidelines, which changed over time, also mediate this effect.

Concluding Thoughts and Future Directions

2019 ◽  
pp. 396-402
Author(s):  
Lyn R. Greenberg ◽  
Barbara J. Fidler ◽  
Michael A. Saini ◽  
Robert Schnider ◽  
Ashley-Lauren Reyes
Keyword(s):  
Current Knowledge ◽  
Integrated Models ◽  
Future Directions ◽  
Detailed Case ◽  
Sufficient Knowledge ◽  
Future Needs ◽  
Professional Guidelines ◽  
General Guidance ◽  
And Training ◽  
Do So

In this chapter, the authors identify central themes that unite the disparate chapters in this volume and offer suggestions for future directions. The chapters have ranged from research reviews to integrated models, based on research-supported components, detailed case applications, and general guidance and practice tools. A common uniting theme is the importance of seeking and maintaining current knowledge relevant to treatment and other interventions, including research from related fields as appropriate. Judicious application and understanding of the literature is important. Future needs include addressing the training gap among both specialized providers and other professionals, addressing resource gaps, and including in our professional guidelines the requirement that professionals who make recommendations about services have sufficient knowledge to do so. Issues in cross-disciplinary communication and training of lawyers and judges are also addressed.

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