Brain Death and Brainstem Death: Philosophical and Ethical Considerations

1987 ◽  
Vol 22 ◽  
pp. 231-249
Author(s):  
David Lamb
Keyword(s):  
Brain Death ◽  
Ethical Issues ◽  
Ethical Considerations ◽  
Brainstem Death ◽  
Human Death

This paper examines the development of the concept of brain death and of the criteria necessary for its recognition. Competing formulations of brain death are assessed and the case for a ‘brainstem’ concept of death is argued. Attention is finally drawn to some of the ethical issues raised by the use of neurological criteria in the diagnosis of human death.

Brain Death and Brainstem Death: Philosophical and Ethical Considerations

1987 ◽  
Vol 22 ◽  
pp. 231-249
Author(s):  
David Lamb
Keyword(s):  
Brain Death ◽  
Ethical Issues ◽  
Ethical Considerations ◽  
Brainstem Death ◽  
Human Death

This paper examines the development of the concept of brain death and of the criteria necessary for its recognition. Competing formulations of brain death are assessed and the case for a ‘brainstem’ concept of death is argued. Attention is finally drawn to some of the ethical issues raised by the use of neurological criteria in the diagnosis of human death.

Utilising Indigenous Knowledge or Crime against Humanity?: A Critical Engagement with the Debate Generated by Alick Macheso’s Use of Manhood to Treat Nhova (Sunken Fontanelle)

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Charles Tembo ◽  
Allan Maganga ◽  
Peterson Dewah
Keyword(s):  
Ethical Issues ◽  
General Tendency ◽  
Ethical Values ◽  
Ethical Considerations ◽  
Lower Back ◽  
African Ethics ◽  
Cultural Grounding ◽  
The Face ◽  
Left And Right ◽  
Points Of View

 This article presents various points of view regarding the treatment of sunken fontanelle by various communities as ignited by the controversial practice of kutara(a practice that involves the father of a child sliding his penis from the lower part of the left and right cheeks to the top of the head, as well as from the lower part of the face to the top of the head, and from the lower back part of the head to the top). The story of Alick Macheso’s use of his manhood to treat nhova (sunken fontanelle) opened a Pandora’s box. The story not only attracted the attention of critics from diverse cultural and ethical backgrounds, but revealed multi-ethnic positions. That is, reactions were steeped in a multiplicity of intellectual, religious and even cultural grounding. Reactions ranged from accusations of backwardness and absurdity, through to medical and Christian orientations toward the treatment of nhova. The overarching idea is that there is a general tendency to dismiss the age-old practice of kutara,coupled with an uncritical celebration of certain positions. The debate that ensued following publication of the story seemed to revolve around ethical considerations. The school of thought that dismisses kutara with disdain regards it as unethical and unimaginable in the present-day world—it is redolent with insinuations of absurdity on the part of those that live and celebrate it. We contend that the raging debate that followed the publication of the story can best be conceptualised within the context of African ethics. We note that kutara has relevance to the spirituality, ethical values, privacy, and protection of children’s rights, among other ethical issues. It is hoped that the article will stir further debate and encourage more research among information practitioners, scholars and researchers into the ethical issues surrounding the treatment of sunken fontanelle in various African communities. It argues for an Afrocentric conceptualisation of phenomena in order to contribute to debates on the renaissance of African cultures, and stresses that it is imperative to harness the life-furthering age-old traditions in African ontological existence.

Recruitment Policies of Non-EU/EEA Nurses and Ethical Issues

2018 ◽  
Author(s):  
Angèle Flora Mendy
Keyword(s):  
Public Opinion ◽  
Health Professionals ◽  
Ethical Issues ◽  
Health Workers ◽  
Ethical Considerations ◽  
Host Countries ◽  
Ethical Argument ◽  
The Past ◽  
The United Kingdom ◽  
Institutional Legacies

By examining policies of recruiting non-EU/EEA health workers and how ethical considerations are taken into account when employing non-EU/EEA nurses in the United Kingdom, France, and Switzerland, this chapter intends to show that the use of the so-called ‘ethical’ argument to convince national public opinion of the relevance of restrictive recruitment policies is recent (since the 1990s). The analysis highlights the fact that in addition to the institutional legacies, qualification and skills—through the process of their recognition—play an important role in the opening or restriction of the labour market to health professionals from the Global South. The legacy of the past also largely determines the place offered to non-EU/EEA health professionals in the different health systems of host countries.

scholarly journals Ethical Considerations on Pediatric Genetic Testing Results in Electronic Health Records

2020 ◽  
Vol 11 (05) ◽  
pp. 755-763
Author(s):  
Shibani Kanungo ◽  
Jayne Barr ◽  
Parker Crutchfield ◽  
Casey Fealko ◽  
Neelkamal Soares
Keyword(s):  
Genetic Testing ◽  
Best Practices ◽  
Health Care Providers ◽  
Genetic Information ◽  
Ethical Issues ◽  
Interdisciplinary Approach ◽  
Care Providers ◽  
Ethical Considerations ◽  
Electronic Health ◽  
Genetic Results

Abstract Background Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this leads to challenges in both storage and disclosure of genetic results, particularly when parental results are combined with child genetic results. Privacy and Ethical Considerations Accidental disclosure and erroneous documentation of genetic results can occur due to the nature of their presentation in the EHR and documentation processes by clinicians. Genetic information is both sensitive and identifying, and requires a considered approach to both timing and extent of disclosure to families and access to clinicians. Methods This article uses an interdisciplinary approach to explore ethical issues surrounding privacy, confidentiality of genetic data, and access to genetic results by health care providers and family members, and provides suggestions in a stakeholder format for best practices on this topic for clinicians and informaticians. Suggestions are made for clinicians on documenting and accessing genetic information in the EHR, and on collaborating with genetics specialists and disclosure of genetic results to families. Additional considerations for families including ethics around results of adolescents and special scenarios for blended families and foster minors are also provided. Finally, administrators and informaticians are provided best practices on both institutional processes and EHR architecture, including security and access control, with emphasis on the minimum necessary paradigm and parent/patient engagement and control of the use and disclosure of data. Conclusion The authors hope that these best practices energize specialty societies to craft practice guidelines on genetic information management in the EHR with interdisciplinary input that addresses all stakeholder needs.

Situating requests for medical aid in dying within the broader context of end-of-life care: ethical considerations

2018 ◽  
Vol 45 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Lori Seller ◽  
Marie-Ève Bouthillier ◽  
Veronique Fraser
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Ethical Issues ◽  
Retrospective Chart Review ◽  
Median Number ◽  
Life Care ◽  
Ethical Considerations ◽  
Term Care ◽  
Medical Aid ◽  
Aid In Dying

BackgroundMedical aid in dying (MAiD) was introduced in Quebec in 2015. Quebec clinical guidelines recommend that MAiD be approached as a last resort when other care options are insufficient; however, the law sets no such requirement. To date, little is known about when and how requests for MAiD are situated in the broader context of decision-making in end-of-life care; the timing of MAiD raises potential ethical issues.MethodsA retrospective chart review of all MAiD requests between December 2015 and June 2017 at two Quebec hospitals and one long-term care centre was conducted to explore the relationship between routine end-of-life care practices and the timing of MAiD requests.ResultsOf 80 patients requesting MAiD, 54% (43) received the intervention. The median number of days between the request for MAiD and the patient’s death was 6 days. The majority of palliative care consults (32%) came less than 7 days prior to the MAiD request and in another 25% of cases occurred the day of or after MAiD was requested. 35% of patients had no level of intervention form, or it was documented as 1 or 2 (prolongation of life remains a priority) at the time of the MAiD request and 19% were receiving life-prolonging interventions.InterpretationWe highlight ethical considerations relating to the timing of MAiD requests within the broader context of end-of-life care. Whether or not MAiD is conceptualised as morally distinct from other end-of-life options is likely to influence clinicians’ approach to requests for MAiD as well as the ethical importance of our findings. We suggest that in the wake of the 2015 legislation, requests for MAiD have not always appeared to come after an exploration of other options as professional practice guidelines recommend.

Brain death and ethical issues

2018 ◽  
pp. 473-486
Author(s):  
Chiara Robba ◽  
Basil Matta
Keyword(s):  
Brain Death ◽  
Ethical Issues

scholarly journals Epistemic and ethical considerations in the direct-to-consumer health and ancestry genetic testing process

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katherine Huerne
Keyword(s):  
Genetic Testing ◽  
Quantitative Methods ◽  
Ethical Issues ◽  
Social Issues ◽  
Clear Understanding ◽  
Feminist Ethics ◽  
Ethical Considerations ◽  
Ethical Implications ◽  
Direct To Consumer ◽  
The Cost

Background: Direct-to-consumer genetic testing (DTC-GT) is a popular and fast-growing field within the healthcare industry. Consumers often pursue DTC-GT without a clear understanding of its epistemic and medical limitations. This report will present the current state of DTC-GT technology, and highlight the ethical, legal and social issues of DTC-GT. Methods: Quantitative methods such as systematic reviews were used to evaluate the field of DTC-GT. Experimental data was taken from randomized control trials and case studies of 23andMe. Qualitative methods such as newspaper articles and surveys were also used. Relevant policies and regulatory information were analyzed in the context of 23andMe. Broader ethical issues are analyzed from the social disability model and feminist ethics frameworks. Results: Several aspects of direct-to-consumer genetic testing are outlined: (i) regulatory and legal distinctions of DTC-GT that separate its use from conventional genetic testing, (ii) epistemic issues of the genetic testing process within the direct-to-consumer context, and (iii) ethical considerations of DTC-GT in regard to genetic health and genetic ancestry. Conclusion: This report does not take a position for or against the use of DTC-GT; rather, it highlights the key ethical issues often missed in the DTC-GT process. There is no perfect method for understanding genetic health and race. DTC-GT offer consumers the ease and power of taking genetic data ‘in their own hands’, at the cost of exacerbating geneticization and race essentialism. Until further work is done to address the epistemic, regulatory and legal issues, ethical implications of DTC-GT usage will continue to exist.

Human death or brain death? Christian view. Part II. Death criterion problem

2019 ◽  
pp. 75-96
Author(s):  
Дамиан Воронов
Keyword(s):  
Brain Death ◽  
Health System ◽  
Final Phase ◽  
Right To Life ◽  
Human Right ◽  
Ethical Assessment ◽  
Life And Death ◽  
Christian View ◽  
Fundamental Freedoms ◽  
Human Death

Вторая часть статьи посвящена анализу фундаментальной этико-мировоззренческой проблемы медицинской этики, находящей своё отражение в отношении врача к вопросам жизни и смерти, актуализируя проблемы трансплантологии. Основным положением ключевых международных документов в связи с применением научно-технических достижений в сфере биологии и медицины является защита достоинства и индивидуальной целостности человека, гарантируемое всем без исключения соблюдение неприкосновенности личности и прочих прав и основных свобод. Рассматриваемая проблема напрямую затрагивает права, свободы и достоинство человека. Право человека на жизнь, воспринимаемое высшей ценностью и охватывающее все этапы земного бытия, как правило, не оспаривается обществом и не вызывает сомнений. Тотальная технологизация порождает новые вопросы о праве человека свободно распоряжаться не только своей жизнью, но и смертью. Помимо этической оценки права человека на жизнь, автор даёт христианскую оценку такой заключительной фазе человеческого бытия как умирание, в связи с чем остро выступает проблема установления границ жизни и смерти, поскольку именно на ней делаются гуманистические акценты современной прагматичной системы здравоохранения. The second part of the article is devoted to analyzing the fundamental ethical and ideological problems of medical ethics, which are reflected in a physician’s attitude to the issues of life and death, thereby actualizing the problems of transplantology. The main provision of key international documents concerning the application of scientific and technological achievements in the field of biology and medicine are: the protection of the dignity and individual integrity of the person, guaranteed to all, without exception; the respect for the integrity of the person and other rights and fundamental freedoms. The problem in question directly affects the rights, freedoms and dignity of the person. The human right to life, perceived as the highest value and encompassing all stages of earthly existence, as a rule, is not disputed by society and is not in doubt. Total technologization raises new questions about the human right to freely dispose of not only his life, but also death. In addition to the ethical assessment of the human right to life, the author gives a Christian assessment of such a final phase of human existence as dying, in connection with which the problem of establishing the boundaries of life and death is catalyzed due to the fact that this problem in particular is the particular focus of humanistic scrutiny of the modern pragmatic health system.

De glazen deur

KWALON ◽  
2019 ◽  
Vol 24 (2) ◽  
Author(s):  
Sofie Sergeant ◽  
Leendert van de Merbel
Keyword(s):  
Ethical Issues ◽  
Collaborative Reflection ◽  
Participatory Action ◽  
Ethical Considerations ◽  
Policy And Practice ◽  
Target Groups ◽  
Collective Inquiry ◽  
Creative Research ◽  
Working Together ◽  
Group Members

Access to the target group In participatory action research (PAR) the research team should include researchers and experts by experience (and their allies affected by the issue). PAR emphasizes collective inquiry and contribution to changes in policy and practice. In their opening essay Sergeant and Van de Merbel state that it is not enough to promote PAR as a vital way in bringing positive change in policy and practice. In order to conduct PAR in an ethical and just way, one needs to create room, space and time for PAR. PAR is more than a method; it needs time, good overthinking, collaborative reflection, creative research methods, coaching and training for all research group members, and – as Xavier Moonen states in his reply – sometimes also protection of vulnerable people. Moonen argues that this vulnerability should be taken into account and experts by experience should be protected from tokenism and research that does not meet their interests. This means, according to Moonen, that ethical considerations must be made. Gatekeepers should keep in mind that participation is a basic right and that pro’s and con’s should be considered in that light. In reaction to Moonen, Sergeant presents the ‘Working together, learning together’ and the results that come from this research project. She pleads for respecting intergroup-diversity within target groups and for looking beyond procedural ethical issues towards crossing the boundaries between dis- and ability.

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