The Neuroscience of Cruelty as Brain Damage: Legal Framings of Capacity and Ethical Issues in the Neurorehabilitation of Motor Neurone Disease and Behavioural Variant Frontotemporal Dementia

2011 ◽  
pp. 283-308 ◽  
Author(s):  
Robin Mackenzie ◽  
Mohamed Sakel
1993 ◽  
Vol 7 (4_suppl) ◽  
pp. 31-36 ◽  
Author(s):  
Marie Oxtoby ◽  
Marit Eikaas

The Neuro-care approach offers a holistic, multidisciplinary, patient-centred, continuous strategy of care to unselected groups of neurological patients and their families including those with motor neurone disease (MND). The strategy for MND patients is an adapted version of one piloted on patients with Parkinson's disease. Between April 1990 and September 1992 12 MND patients were diagnosed, of whom five have died. The main features of the care strategy and the guidelines for giving the diagno sis are described. The characteristics of the patient group are identified and the high level of team activity vis-a-vis other patient groups is noted. The maintenance of patients in the community and the lack of resort to permanent institutional care are also recorded. Ethical issues arising during the project are discussed and the problems of measuring outcomes of care are acknowledged. General conclusions for MND management are drawn.


1993 ◽  
Vol 7 (4_suppl) ◽  
pp. 11-13
Author(s):  
Susan Carroll-Thomas

Ethical issues in health care are typically perceived as arising from extreme situations which do not usually confront the average clinician. However, knowingly or otherwise, clinicians working with motor neurone disease deal daily with ethical issues in the form of value judgements, the application of choice limiting principles and the language of clinician-patient interaction.


1993 ◽  
Vol 7 (4_suppl) ◽  
pp. 15-20 ◽  
Author(s):  
David Oliver

There are many ethical decisions to be made during palliative care of a patient with motor neurone disease. These may concern the physical and psychosocial care of the patient and will become highlighted when death approaches. By close involvement of the patient and his/her family with the interdisciplinary team the most appropriate decisions on the patient's care can be made.


1994 ◽  
Vol 15 (4) ◽  
pp. 252
Author(s):  
P. R. Talbot ◽  
P. J. Goulding ◽  
J. J. Lloyd ◽  
D. Neary ◽  
H. J. Testa

Author(s):  
Grace X Chen ◽  
Andrea’t Mannetje ◽  
Jeroen Douwes ◽  
Leonard H Berg ◽  
Neil Pearce ◽  
...  

Abstract In a New Zealand population-based case-control study we assessed associations with occupational exposure to electric shocks, extremely low-frequency magnetic fields (ELF-MF) and motor neurone disease using job-exposure matrices to assess exposure. Participants were recruited between 2013 and 2016. Associations with ever/never, duration, and cumulative exposure were assessed using logistic regression adjusted for age, sex, ethnicity, socioeconomic status, education, smoking, alcohol consumption, sports, head or spine injury and solvents, and mutually adjusted for the other exposure. All analyses were repeated stratified by sex. An elevated risk was observed for having ever worked in a job with potential for electric shocks (odds ratio (OR)=1.35, 95% confidence interval (CI): 0.98, 1.86), with the strongest association for the highest level of exposure (OR=2.01, 95%CI: 1.31, 3.09). Analysis by duration suggested a non-linear association: risk was increased for both short-duration (<3 years) (OR= 4.69, 95%CI: 2.25, 9.77) and long-duration in a job with high level of electric shock exposure (>24 years; OR=1.88; 95%CI: 1.05, 3.36), with less pronounced associations for intermediate durations. No association with ELF-MF was found. Our findings provide support for an association between occupational exposure to electric shocks and motor neurone disease but did not show associations with exposure to work-related ELF-MF.


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