Informed Consent in the Military: Fighting a Losing Battle Against the Anthrax Vaccine

2002 ◽  
Vol 28 (2-3) ◽  
pp. 325-343
Author(s):  
Ruth K. Miller
Keyword(s):  
Informed Consent ◽  
Service Member ◽  
Individual Choice ◽  
Civilian Life ◽  
Medical Treatments ◽  
Employment History ◽  
Receive Treatment ◽  
The Right ◽  
The Military ◽  
To Receive

In civilian life, an individual has the right to refuse medical treatment in almost any circumstance. While a patient who refuses treatment may face adverse consequences such as prolonged illness, our society recognizes the importance of individual choice in health matters. Members of the military, however, enjoy no such right. Service members are required to submit to certain medical treatments as a part of their employment contract. Refusing such treatments is disobeying an order, and the service member then faces the prospect of a dishonorable or “other than honorable” discharge, and even imprisonment. Disobeying an order to receive treatment can thus result in the equivalent of a felony conviction on the individual's employment history forever.

scholarly journals Torsion Testicular Patient Characteristics

2021 ◽  
Vol 53 (2) ◽  
Author(s):  
Safendra Siregar ◽  
Devlin Alfiana ◽  
Jason Liarto ◽  
Zola Wijayanti
Keyword(s):  
Medical Records ◽  
Testicular Torsion ◽  
Patient Characteristics ◽  
Descriptive Study ◽  
Delayed Presentation ◽  
Testicular Pain ◽  
Left Testicle ◽  
Receive Treatment ◽  
The Right ◽  
To Receive

Testicular torsion is an emergency urological condition that is caused by the torsion of the spermatic cord structures, causing disruption of circulation of the affected testicle. This study aimed to describe the characteristics of patients with testicular torsion treated at Dr. Hasan Sadikin General Hospital Bandung from January 2016 to January 2020. This was a retrospective descriptive study on 34 medical records of patients diagnosed and treated for testicular torsion. Nine patients (29.4%) were <20 years old and 25 patients were >21 years old. The onset was mostly between 6 to 24 hours (38.2%), followed by between 2–7 days (23.5%), less than 6 hours (20.6%), between 1–2 weeks (8.8%), and between 2–4 weeks (8.8%). Left testicular torsion were more frequent than the right torsion (61.8% vs. 38.2%). The etiology of the torsion was mostly idiopathic with no identifiable precedent (88%). Orchidectomy was more frequently performed compared to orchiopexy (78.4% vs. 21.6%). All but one patient (97.1%) presented with testicular pain as the main symptom. Patients presented mostly with a high risk TWIST score (64.7%); however, more presented with low risk compared to the intermediate risk TWIST score (26.5% vs. 8.8%). Orchidectomy is the most frequently performed operation on pre-pubertal and adult patients, possibly due to relatively delayed presentation (>24 hours) to the hospital to receive treatment. Patients were mostly younger; predominantly with high TWIST score and affected left testicle.

Patient reactions to hospital choice in Norway, Denmark, and Sweden

2007 ◽  
Vol 2 (2) ◽  
pp. 125-152 ◽  
Author(s):  
KARSTEN VRANGBÆK ◽  
KATARINA ØSTERGREN ◽  
HANS OKKELS BIRK ◽  
ULRIKA WINBLAD
Keyword(s):  
Gradual Increase ◽  
Local Region ◽  
Limited Information ◽  
Utilization Pattern ◽  
Hospital Choice ◽  
Economic Barriers ◽  
Receive Treatment ◽  
The Individual ◽  
The Right ◽  
To Receive

AbstractThis article is a comparative study of three Scandinavian countries – Norway, Denmark, and Sweden – all of which have provided the individual patient with extensive rights to choose the hospital where he/she wishes to receive treatment. In the paper, we present an analysis of the utilization of the opportunity to choose between hospitals in these three countries. The analysis addresses two questions: (i) How many patients are exercising the right to choose between hospitals in these countries and who is making use of this opportunity? (ii) How can we explain the observed utilization pattern? The results of the study reveal clear similarities between the three countries and suggest that few patients have actually chosen their hospital. However, a gradual increase can be observed over the years. Few formal, legislative, or economic barriers exist for patients. Instead, limited knowledge amongst patients regarding reforms, combined with insufficient support from GPs and limited information, can explain why few patients choose to receive care outside of their local region.

Is patient care affected by the recent changes in junior doctors' training?

2006 ◽  
Vol 88 (2) ◽  
pp. 58-60 ◽  
Author(s):  
C Mauffrey
Keyword(s):  
Public Health ◽  
Medical Journal ◽  
British Medical Journal ◽  
Medical Errors ◽  
Health Problem ◽  
Public Health Problem ◽  
Junior Doctors ◽  
Receive Treatment ◽  
The Right ◽  
To Receive

An article in the British Medical Journal stated, 'In the time it will take you to read this editorial eight patients will be injured, and one will die, from preventable medical errors. … When all sources of error are added up the likelihood that a mishap will injure a patient in hospital is at least 3% and probably much higher.' This is a serious public health problem. In recent years, patients' expectations of our healthcare system have shifted from 'the right to receive treatment' to 'the right to be cured'. This fact is illustrated by the growing numbers of trials involving cases of negligence or incompetence.

The Estelle Medical Professional Judgment Standard: The Right of Those in State Custody to Receive High-Cost Medical Treatments

1992 ◽  
Vol 18 (4) ◽  
pp. 347-368 ◽  
Author(s):  
Marc J. Posner
Keyword(s):  
Medical Care ◽  
Case Law ◽  
Medical Professional ◽  
Professional Judgment ◽  
Court Case ◽  
Lower Court ◽  
Medical Treatments ◽  
State Custody ◽  
The Right ◽  
To Receive

This Article discusses the rights of prisoners, pretrial detainees, and the involuntarily committed to receive high-cost medical treatments. More specifically, the Article analyzes U.S. Supreme Court and lower court case law dealing with the medical care rights of those in state custody and argues that, under a proper understanding of this case law, the financial considerations of states should play no role in determining the rights of these people to receive high-cost medical care. Finally, the Article defends the current medical care standard against various critiques.

Striking the Right Balance: Of High Walls and Divisions of Labor

2010 ◽  
Vol 8 (4) ◽  
pp. 1113-1116
Author(s):  
Ronald R. Krebs
Keyword(s):  
Social Sciences ◽  
Republican Party ◽  
Armed Forces ◽  
Academic Disciplines ◽  
Civilian Life ◽  
Officer Corps ◽  
Humanities And Social Sciences ◽  
The Right ◽  
The Military ◽  
Military Units

The academy and the military would seem to be radically different institutions. Militaries are fundamentally hierarchical: at the end of the day, orders must be obeyed. At least in principle—and the emphasis here is on principle, since anyone who has lived within the academy knows how far reality departs from this purported ideal—academic disciplines prize the questioning of presuppositions and foster an antiauthoritarian culture. In military units, individuals must sublimate themselves to the group. Scholarship, at least in the humanities and social sciences, is often a lonely enterprise, whose costs are borne by and whose rewards accrue to individuals. The contemporary US officer corps disproportionately identifies with the Republican Party, while academics tend to identify with Democrats, and sometimes farther to the left. Samuel Huntington (in)famously saw as inherent and necessary the cultural divergences between military and civilian life. This would all the more powerfully seem to apply to the armed forces and the academy, to uniform and gown.

Responding to Patients' Requests for Information

1980 ◽  
Vol 1 (4) ◽  
pp. 6-8
Author(s):  
Jane L. Greenlaw
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
Side Effects ◽  
Close Contact ◽  
Alternative Treatments ◽  
Recommended Treatment ◽  
Health Care Consumer ◽  
Pertinent Information ◽  
The Right ◽  
To Receive

There is little argument against the principle that the health care consumer has the right to all pertinent information regarding his condition and treatment. Nevertheless, there is resistance and patients frequently have difficulty obtaining important information.Generally, it is the responsibility of the physician to inform the patient of his diagnosis and condition, the recommended treatment, its risks and its side effects, and any alternative treatments. This is the essence of obtaining the patient's informed consent, without which treatment is illegal and unethical. An important aspect of the nurse's role is to safeguard the patient's right to receive this information, and, when necessary, to assist the patient in obtaining it. Since she is in frequent close contact with the patient, the nurse should evaluate the patient's understanding and should inform the physician when further information or clarification is needed. Furthermore, when the nurse realizes that the patient has not received or understood the necessary information, the nurse should advise the patient of his right to receive it before consenting to any treatment or procedure.

scholarly journals Pedagogical and Legal Activities Taken in Poland Towards People Addicted to Alcohol

1970 ◽  
Author(s):  
Hanna Karaszewska ◽  
Joanna Rajewska de Mezer ◽  
Ewelina Silecka-Marek
Keyword(s):  
Global Scale ◽  
Alcohol Addiction ◽  
Self Determination ◽  
Social Reintegration ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Receive Treatment ◽  
Independent Decision ◽  
The Right ◽  
To Receive

The issue of alcohol consumption, addiction to it, and causes and effects of this phenomenon have already been explored many times. The article describes current pedagogical and legal activities taken in Poland towards people addicted to alcohol and related controversy . The authors drew attention to a number of problems concerning with alcohol addiction for an alcohol abuse person and his family. Starting from the current law on upbringing in sobriety and counteracting alcoholism because it takes up issues related to treatment, rehabilitation and social reintegration of people addicted to alcohol. There are institutions established on its basis and take up actions aimed at diagnosing the problem of an individual’s addiction to alcohol, leading to a ruling and requiring the person addicted to alcohol to undergo treatment. In the article the stages of treatment have been described in detail, requriments, important person for example probation officer and possible to receive treatment from non-governmental organizations that help those addicted and thus create an option for those addicted to alcohol to self-organize. The authors emphasized that the process of freeing from alcohol addiction is incredibly difficult and sometimes prolonged. Thus, the compulsory character of rehab treatment sparks a lot of controversy, as it contradicts the right to self-determination, i.e. independent decision of the person addicted to take up the treatment. There is a need to search new solutions in this respect, develop tools that increase the effectiveness of activities taken towards those addicted and exchange experiences on the global scale.

DMSA-scintigraphy in paediatrics: Is the evaluation of the geometric mean necessary for the calculation of the differential renal function?

2001 ◽  
Vol 40 (04) ◽  
pp. 107-110 ◽  
Author(s):  
B. Roßmüller ◽  
S. Alalp ◽  
S. Fischer ◽  
S. Dresel ◽  
K. Hahn ◽  
...  
Keyword(s):  
Renal Function ◽  
Geometric Mean ◽  
Region Of Interest ◽  
Posterior View ◽  
Renal Abnormality ◽  
Anterior View ◽  
Differential Renal Function ◽  
The Mean ◽  
The Right ◽  
To Receive

SummaryFor assessment of differential renal function (PF) by means of static renal scintigraphy with Tc-99m-dimer-captosuccinic acid (DMSA) the calculation of the geometric mean of counts from the anterior and posterior view is recommended. Aim of this retrospective study was to find out, if the anterior view is necessary to receive an accurate differential renal function by calculating the geometric mean compared to calculating PF using the counts of the posterior view only. Methods: 164 DMSA-scans of 151 children (86 f, 65 m) aged 16 d to 16 a (4.7 ± 3.9 a) were reviewed. The scans were performed using a dual head gamma camera (Picker Prism 2000 XP, low energy ultra high resolution collimator, matrix 256 x 256,300 kcts/view, Zoom: 1.6-2.0). Background corrected values from both kidneys anterior and posterior were obtained. Using region of interest technique PF was calculated using the counts of the dorsal view and compared with the calculated geometric mean [SQR(Ctsdors x Ctsventr]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p<0.01). The mean difference between the PFgeom and the PFdors was 1.5 ± 1.4%. A difference > 5% (5.0-9.5%) was obtained in only 6/164 scans (3.7%). Three of 6 patients presented with an underestimated PFdors due to dystopic kidneys on the left side in 2 patients and on the right side in one patient. The other 3 patients with a difference >5% did not show any renal abnormality. Conclusion: The calculation of the PF from the posterior view only will give an underestimated value of the right kidney compared to the calculation of the geometric mean. This effect is not relevant for the calculation of the differntial renal function in orthotopic kidneys, so that in these cases the anterior view is not necesssary. However, geometric mean calculation to obtain reliable values for differential renal function should be applied in cases with an obvious anatomical abnormality.

Research on Starvation in the Warsaw Ghetto – Ethical Problems

2010 ◽  
pp. 439-450
Author(s):  
Marta Janczewska
Keyword(s):  
Research Team ◽  
Ethical Dilemmas ◽  
Medical Profession ◽  
Research Work ◽  
Special Kind ◽  
Scientific Discipline ◽  
Medical Treatments ◽  
Warsaw Ghetto ◽  
Dying Patients ◽  
To Receive

Research team of physicians and lab technicians under Izrael Milejkowski’s direction undertook the effort to carry out a series of clinical and biochemical experiments on patients dying of starvation in the Warsaw ghetto so as to receive the fullest possible picture of hunger disease. The research was carried out according to all the rigors of strict scientific discipline, and the authors during their work on academic articles, published it after the war entitled: „Starvation disease: hunger research carried out in the Warsaw ghetto in 1942,” according to their own words, they “supplemented the gap in accordance with the progress of knowledge.” The article is devoted to the reflections over ethical dilemmas of the research team, who were forced in their work to perform numerous medical treatments of experimental nature on extremely exhausted patients. The ill, according to Dr Fajgenblat’s words,“demonstrated negativism toward the research and treatment, which extremely hindered the work, and sometimes even frustrated it.” The article attempts to look at the monumental research work of the Warsaw ghetto doctors as a special kind of response of the medical profession to the feeling of helplessness to the dying patients. The article analyzes the situation of Warsaw ghetto doctors, who undertook the research without support of any outer authority, which could settle their possible ethical dilemmas (Polish deontological codes, European discussions on the conditions of the admissibility of medical research on patients, etc.).

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