scholarly journals P.009 Physician assisted death and the neurosurgeon

2016 ◽  
Vol 43 (S2) ◽  
pp. S23-S23
Author(s):  
SP Barry ◽  
I Fleetwood ◽  
K Reddy ◽  
C Ekong ◽  
P Gorman ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Position Statement ◽  
Criminal Code ◽  
Third Party ◽  
Care Providers ◽  
Assisted Death ◽  
Referral Service ◽  
Neurosurgical Society ◽  
The Creation ◽  
The Right

Background: The Supreme Court of Canada (SCC) recently rendered a decision striking down the Criminal Code absolute prohibition on providing assisted dying. End of life decisions are commonly encountered by neurosurgeons due to the nature of their practice. Neurosurgeons will be faced with patients requesting PAD in the near future. Methods: The recent SCC ruling heralds a change that will radically alter a most basic tenet that has historically guided physicians and surgeons. A subcommittee of the Canadian Neurosurgical Society (CNSS) was formed to generate a position statement to reflect the interests of both neurosurgeons and their patients. Results: Fundamental issues regarding the implementation of PAD identified include:Clarity of legislationThe creation of an independent, third party referral serviceEffective safeguards and oversight of the entire process-The right to “conscientious objection” on the part of hysicians who do not wish to be involved in PADConclusions: The CNSS urges clarity in legislation regarding PAD and strict oversight in its implementation to reduce potential harm. We also support the creation of an independent, third party referral service which would serve to respect the conscience of those health care providers who do not wish to actively participate in PAD.

12. Easements

2019 ◽  
pp. 434-467
Author(s):  
Martin George ◽  
Antonia Layard
Keyword(s):  
Land Ownership ◽  
Natural Rights ◽  
Third Party ◽  
Restrictive Covenants ◽  
Controversial Subject ◽  
Public Rights ◽  
The Creation ◽  
The Law ◽  
The Right

An easement is a form of third party right that allows one to enjoy the benefits of land ownership. Some examples of such rights are rights of way, rights of light, the right to use a washing line on a neighbour’s land, the right to use a neighbour’s lavatory, and the right to park a car on another person’s land. The easement must exist for the benefit of land and cannot exist in gross. The rule that an easement cannot exist in gross has been a controversial subject. This chapter, which explores the nature of easements and considers their related concepts such as natural rights, public rights, restrictive covenants, and licences, also discusses legal and equitable easements, the creation of easements, and proposals for reform of the law on easements.

Knowledge Based Commissioning: Can a National Clinical Effectiveness Policy Be Compatible with Seeking Local Professional Advice?

1996 ◽  
Vol 1 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Peter Littlejohns ◽  
Carol Dumelow ◽  
Sian Griffiths
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Care Providers ◽  
Professional Advice ◽  
Knowledge Based ◽  
Artery Disease ◽  
Health Care Purchasing ◽  
The Right

Objectives: To help develop a means, based on the views of purchasers and providers of health care, of incorporating national research on clinical effectiveness into local professional advisory mechanisms in order to inform health care purchasing and contracting. Methods: Three geographically based multidisciplinary workshops attended by National Health Service (NHS) staff drawn from the principal purchaser and provider groups in one English region were organized around the discussion of three health care purchasing case studies: Coronary artery disease, diabetes and management of clinical depression in general practice. The proceedings were transcribed and analyzed using content analysis methods. Results: 95 people took part. There were major differences between the purchasers' and health care providers' views on the right balance between local and national information and advisory sources for purchasing. In general, providers wanted the provision of advice to purchasers to be local, in which their opinion was sought, either individually or collectively, acted on and the results fed back to them. In contrast, health authority purchasers considered that local professionals were only one source of professional advice, albeit an important one, to be utilized in coming to decisions. General practitioner fundholders as purchasers, however, preferred to rely on their own experiences and contacts with local providers in making purchasing decisions. Conclusions: Professional specialist advisory groups are necessary to inform the purchasing of health care, but should extend beyond advising on the placement of individual contracts. Involving health care providers in all short-term contracting is unlikely to be cost-effective given the time commitment required. The emphasis at purchaser/provider meetings should be on education: Providing an opportunity for purchasers and providers to develop closer relationships to discuss political imperatives and financial constraints; increasing communication and understanding of providers' and purchasers' roles; and providing an environment for professionals and purchasers to share their views on purchasing. As currently presented, elements of the national policies in the NHS advocating the use of both national evidence on clinical effectiveness and local professional advice are contradictory and should be clarified.

The Corporate Transformation of Medical Specialty Care: The Exemplary Case of Neonatology

2008 ◽  
Vol 36 (4) ◽  
pp. 790-802 ◽  
Author(s):  
Eleanor D. Kinney
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Medical Specialty ◽  
Pharmaceutical Products ◽  
Health Care Sector ◽  
Third Party ◽  
Care Providers ◽  
Care Services ◽  
American Health Care

With new, effective, and expensive health care services, the American health care sector has become an even greater source of business and wealth opportunities. All kinds of health care providers and suppliers are competing for patients and dollars. The key to wealth in today’s health care sector is the physician. Only physicians can certify to third-party payers that health care services, medical devices, or pharmaceutical products are necessary for patient care. That certification initiates the process by which the item, service, or treatment modality is ordered, delivered, and paid for. Thus, organizations that can exert control over physicians stand to gain financially.

scholarly journals Challenges and approaches to implementing master/basket trials in oncology

2019 ◽  
Vol 3 (14) ◽  
pp. 2237-2243 ◽  
Author(s):  
Amy Burd ◽  
Richard L. Schilsky ◽  
John C. Byrd ◽  
Ross L. Levine ◽  
Vassiliki A. Papadimitrakopoulou ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Therapeutic Option ◽  
Clinical Trial Design ◽  
Care Providers ◽  
Rare Mutation ◽  
Medical Institutions ◽  
Number Of Patients ◽  
The Right ◽  
Tumor Types ◽  
Basket Trials

Abstract The appetite for cutting-edge cancer research, across medical institutions, scientific researchers, and health care providers, is increasing based on the promise of true breakthroughs and cures with new therapeutics available for investigation. At the same time, the barriers for advancing clinical research are impacting how quickly drug development efforts are conducted. For example, we know now that under a microscope, patients with the same type of cancer and histology might look the same; however, the reality is that most cancers are driven by genomic, transcriptional, and epigenetic changes that make each patient unique. Additionally, the immunologic reaction to different tumor types is distinct among patients. The challenge for researchers developing new therapies today is vastly different than it was in the era of cytotoxics. Today, we must identify a sufficient number of patients harboring a rare mutation or other characteristic and match this to the right therapeutic option. This summary provides a guide to help inform the scientific cancer community about the benefits and challenges of conducting umbrella or basket trials (master trials), and to create a roadmap to help make this new and evolving form of clinical trial design as effective as possible.

scholarly journals Making the Case for a P2P Personal Health Record

Information ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 512
Author(s):  
William Connor Horne ◽  
Zina Ben Miled
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Information ◽  
Third Party ◽  
Personal Health ◽  
Health Record ◽  
Care Providers ◽  
Health Records ◽  
Client Server ◽  
Proposed Model

Improved health care services can benefit from a more seamless exchange of medical information between patients and health care providers. This exchange is especially important considering the increasing trends in mobility, comorbidity and outbreaks. However, current Electronic Health Records (EHR) tend to be institution-centric, often leaving the medical information of the patient fragmented and more importantly inaccessible to the patient for sharing with other health providers in a timely manner. Nearly a decade ago, several client–server models for personal health records (PHR) were proposed. The aim of these previous PHRs was to address data fragmentation issues. However, these models were not widely adopted by patients. This paper discusses the need for a new PHR model that can enhance the patient experience by making medical services more accessible. The aims of the proposed model are to (1) help patients maintain a complete lifelong health record, (2) facilitate timely communication and data sharing with health care providers from multiple institutions and (3) promote integration with advanced third-party services (e.g., risk prediction for chronic diseases) that require access to the patient’s health data. The proposed model is based on a Peer-to-Peer (P2P) network as opposed to the client–server architecture of the previous PHR models. This architecture consists of a central index server that manages the network and acts as a mediator, a peer client for patients and providers that allows them to manage health records and connect to the network, and a service client that enables third-party providers to offer services to the patients. This distributed architecture is essential since it promotes ownership of the health record by the patient instead of the health care institution. Moreover, it allows the patient to subscribe to an extended range of personalized e-health services.

Clinical ethics and law in health care system

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Abhinav Gorea
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Clinical Ethics ◽  
Ethical Dilemmas ◽  
Care Providers ◽  
Complete Cure ◽  
Law And Ethics ◽  
Good For ◽  
The Right

Different situations arise while treating the patients when there are ethical dilemmas to give one or other type of treatment or not to do anything. Sometimes doctors and nurses consider that what is good for the patient must be done because the patient does not understand the situation and consequences. This may lead to complete cure and patient usually goes back to home happily but sometimes a complication may occur and the patient may sue the health care providers. When such situations are analyzed then principles of ethics and law are considered to see if any of these have been violated or not to reach the conclusion. In this study principles of law and ethics of treatment have been discussed to reach the right conclusion; which will be helpful in situations where there are ethical dilemmas during the treatment.

scholarly journals Towards Universal Quality Health Care through an Independent Accreditation Agency: A Review

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Gabriel R. Borlongan ◽  
Ma-Ann M. Zarsuelo ◽  
Michael Antonio F. Mendoza ◽  
Ma. Esmeralda C. Silva ◽  
Leonardo R. Estacio Jr.
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Providers ◽  
National Health ◽  
Technical Assistance ◽  
Development Program ◽  
Health Facilities ◽  
Third Party ◽  
Care Providers ◽  
Accreditation System

Background. Guaranteeing quality of health care services is part of the objectives of Republic Act No. 11223 or the Universal Health Care (UHC) Act of 2019. In assuring that quality services are delivered by health care providers, they must be accredited to participate in the National Health Insurance Program. The UHC Act mandates the Philippine Health Insurance Corporation (PhilHealth) to recognize third party mechanisms as basis of granting incentives for health facilities that deliver services of higher quality. This review aimed to identify lessons and experiences from literature that can be adopted and contextualized in the Philippine setting, for strategic policies on strengthening the national health facility accreditation system. Methods. A systematic review of literature was conducted to generate evidence-based recommendations from discussions on cross country experiences and local government initiatives towards improved accreditation system. Results. By virtue of the UHC Act, a form of strategic purchasing is further institutionalized through a rating system that incentivizes health facilities that provide better services in terms of quality, efficiency, and equity. It is imperative to consider the country’s previous and current gaps and challenges in accreditation and adopt the best practices of other countries, as appropriate to Philippine's local settings. A tool is proposed in creating a national hospital accreditation system using the domains of leadership and governance, financing and sustainability, standards development, program management, and continuing quality improvement. Conclusion and Recommendations. With the legitimacy of third party accreditation body mandated by the UHC Act, operationalization of the prescribed mechanisms and organizational structure must enjoin all pertinent stakeholders and be supported by sustainable funds and technical assistance by the government.

scholarly journals Teaching Health-Care Providers to Query Patients With Cancer About Sexual and Gender Minority (SGM) Status and Sexual Health

2019 ◽  
Vol 36 (6) ◽  
pp. 533-537 ◽  
Author(s):  
Elizabeth J. Cathcart-Rake ◽  
Carmen Radecki Breitkopf ◽  
Judith Kaur ◽  
Jennifer O’Connor ◽  
Jennifer L. Ridgeway ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
End Of Life ◽  
Health Care Providers ◽  
Position Statement ◽  
Care Providers ◽  
Related Data ◽  
Patients With Cancer ◽  
And Gender ◽  
American Society

End of life is difficult for all patients but sexual and gender minorities (SGM) are prone to isolation and loneliness, especially if their SGM status is unknown or unaccepted. In oncology clinics, where goals of care discussions about end of life are integral and frequent, querying patients about their SGM status and sexual health is of particular importance. The American Society of Clinical Oncology recently released a position statement that called for greater focus on SGM populations with the goal of reducing and eventually eliminating disparities in cancer care within this group. An important first step in addressing such disparities is learning how best to train cancer health-care providers to ask patients about their SGM status and about sexual health in general. This article summarizes the mandate for understanding cancer issues in SGM populations and the dearth of cancer-related data within this group. This article also describes an ongoing 3-part study intended to build a mini curriculum with the goal of helping cancer health-care providers to ask patients with cancer about SGM status and to ask all patients with cancer about sexual health issues. The results of this ongoing study could potentially improve end-of-life care for subgroups of patients.

The Importance of a Complete Allergy Assessment in Clinical Stewardship

2019 ◽  
Vol 34 (8) ◽  
pp. 510-513
Author(s):  
Vanessa Moreno ◽  
Charlie L. Nguyen ◽  
Amie Taggart Blaszczyk
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Care Providers ◽  
Opioid Use ◽  
Term Care ◽  
Care Facilities ◽  
The Right ◽  
Potential Challenge ◽  
Selection Of

National agencies have championed stewardship initiatives to enhance antimicrobial and opioid use in long-term care facilities. Health care providers for these residents have been given the task to ensure "the right drug is used for the right indication at the right time and duration." One potential challenge to this is incorrect or incomplete documentation of allergies. Many long-term care facilities have traditionally, and currently, used a "list format" of allergies in, or on, the resident's chart. This approach is incomplete as it rarely provides detailed information about the reaction to a particular drug. Senior care pharmacists and their students can play a role within long-term care facilities by helping ensure the optimal selection of drugs by providing a detailed allergy assessment that documents detailed reaction information, whenever possible.

CancerLinQ and the Future of Cancer Care

2013 ◽  
pp. 430-434 ◽  
Author(s):  
George W. Sledge ◽  
Robert S. Miller ◽  
Robert Hauser
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Cancer Care ◽  
Treatment Options ◽  
Tumor Biology ◽  
Real Life ◽  
Care Providers ◽  
The Right ◽  
Care System

Patients, health care providers, and payers all have a similar interest in a health care system that is both efficient and intelligent. The attributes of such a system are widely recognized: we want a system that provides widespread access to consistently high-quality, science-based medical care; we want that system to be efficient, avoiding unnecessary waste, while delivering the right treatments to the right patients in a timely fashion; we want a system that allows us to both learn from our experience and generate new knowledge that will inform future treatment options; and we want a system that is compassionate and caring. What we want from a health care system often runs up against real-life obstacles and challenges: a fragmented delivery system, varying levels (or lack of) insurance, a growing burden of regulation and paperwork, and an increasingly complex understanding of tumor biology and the therapeutic approaches derived from this biology. New challenges are on the horizon—emerging genomic and imaging technology, with their enormous cognitive and data burdens, and a looming demographic challenge, where inadequate personnel resources face an aging population and an explosion of new treatments. Not all problems have technologic solutions, but many of the issues described above have potential solutions related to information technology. ASCO's CancerLinQ, described in this article, is an evolving attempt by the Society to improve the quality and efficiency of cancer care, while supporting education and research in the cancer field.

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