Professional Ethics in Obstetric Practice, Innovation, and Research

2021 ◽  
pp. 197-211
Author(s):  
Frank A. Chervenak ◽  
Laurence B. McCullough
Keyword(s):  
Medical Ethics ◽  
Professional Ethics ◽  
Home Birth ◽  
Ethical Framework ◽  
Ethical Challenges ◽  
Obstetric Practice ◽  
Ethical Concept ◽  
Practical Guidance ◽  
Planned Home Birth

Obstetric clinical practice, innovation, and research should be guided by professional ethics in obstetrics. In this chapter, the authors distinguish professional medical ethics from medical ethics and bioethics. They set out an ethical framework for obstetrics based on the invention of professional medical ethics by two eighteenth-century physician-ethicists, John Gregory (1724–1773) and Thomas Percival (1740–1804). Professional ethics in obstetrics appeals to the ethical principles of beneficence and respect for autonomy and the ethical concept of the fetus as a patient. This framework is deployed to provide ethically justified, practical guidance about two ethical challenges in obstetric practice: the professionally responsible role of nondirective counseling of pregnant women about induced abortion and the professionally responsible role of directive counseling about planned home birth. This framework is also deployed to provide ethically justified, practical guidance about professionally responsible obstetric innovation and research for fetal benefit.

scholarly journals Engaging Ethicists in Animal Research Policymaking

ILAR Journal ◽  
2020 ◽  
Author(s):  
Angela N Hvitved
Keyword(s):  
Professional Ethics ◽  
Research Policy ◽  
Human Subjects ◽  
Animal Research ◽  
Ethical Framework ◽  
Human Subjects Research ◽  
Deliberative Process ◽  
Ethical Considerations ◽  
Key Stakeholders

Abstract The significance of ethical considerations for animal research policy has long been acknowledged, but the role of philosophical ethics in the policymaking process has been less clear. By comparing the ethical framework of animal research policy with that for human subjects research, this article considers how the legacies of these two policy areas influence current policy and suggests that ethicists and ethical scholarship have been underutilized in developing animal research policy. An important aspect of policymaking is gathering and responding to input provided by various stakeholders. Given their expertise in a highly relevant area, ethicists should be considered key stakeholders in animal research policy deliberations. This article explores the role of ethicists and ethical scholarship in influencing animal research policy and suggests that a more robust engagement with the professional ethics community throughout the deliberative process is vital for policymakers to adequately account for ethical considerations.

Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine

2020 ◽  
Vol 48 (7) ◽  
pp. 728-732
Author(s):  
Rodrigo Ayala-Yáñez ◽  
Regina Ruíz-López ◽  
Laurence B. McCullough ◽  
Frank A. Chervenak
Keyword(s):  
Professional Ethics ◽  
Ethical Framework ◽  
Personal Safety ◽  
Ethical Challenges ◽  
Web Searches ◽  
Perinatal Medicine ◽  
Ethical Obligation ◽  
Academic Leaders ◽  
Critical Appraisal Tool ◽  
Medical Educators

AbstractObjectivesViolence against medical trainees confronts medical educators and academic leaders in perinatal medicine with urgent ethical challenges. Despite their evident importance, these ethical challenges have not received sufficient attention. The purpose of this paper is to provide an ethical framework to respond to these ethical challenges.MethodsWe used an existing critical appraisal tool to conduct a scholarly review, to identify publications on the ethical challenges of violence against trainees. We conducted web searches to identify reports of violence against trainees in Mexico. Drawing on professional ethics in perinatal medicine, we describe an ethical framework that is unique in the literature on violence against trainees in its appeal to the professional virtue of self-sacrifice and its justified limits.ResultsOur search identified no previous publications that address the ethical challenges of violence against trainees. We identified reports of violence and their limitations. The ethical framework is based on the professional virtue of self-sacrifice in professional ethics in perinatal medicine. This virtue creates the ethical obligation of trainees to accept reasonable risks of life and health but not unreasonable risks. Society has the ethical obligation to protect trainees from these unreasonable risks. Medical educators should protect personal safety. Academic leaders should develop and implement policies to provide such protection. Institutions of government should provide effective law enforcement and fair trials of those accused of violence against trainees. International societies should promulgate ethics statements that can be applied to violence against trainees. By protecting trainees, medical educators and academic leaders in perinatology will also protect pregnant, fetal, and neonatal patients.ConclusionsThis paper is the first to provide an ethical framework, based on the professional virtue of self-sacrifice and its justified limits, to guide medical educators and academic leaders in perinatal medicine who confront ethical challenges of violence against their trainees.

Midwife-assisted planned home birth: an essential component of improving the safety of childbirth in Sub-Saharan Africa

2018 ◽  
Vol 47 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Aliyu Labaran Dayyabu ◽  
Yusuf Murtala ◽  
Amos Grünebaum ◽  
Laurence B. McCullough ◽  
Birgit Arabin ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Developing World ◽  
Home Birth ◽  
Sub Saharan Africa ◽  
Ethical Challenges ◽  
Home Births ◽  
Mortality And Morbidity ◽  
Sub Saharan ◽  
Hospital Births ◽  
Planned Home Birth

Abstract Hospital births, when compared to out-of-hospital births, have generally led to not only a significantly reduced maternal and perinatal mortality and morbidity but also an increase in certain interventions. A trend seems to be emerging, especially in the US where some women are requesting home births, which creates ethical challenges for obstetricians and the health care organizations and policy makers. In the developing world, a completely different reality exists. Home births constitute the majority of deliveries in the developing world. There are severe limitations in terms of facilities, health personnel and deeply entrenched cultural and socio-economic conditions militating against hospital births. As a consequence, maternal and perinatal mortality and morbidity remain the highest, especially in Sub-Saharan Africa (SSA). Midwife-assisted planned home birth therefore has a major role to play in increasing the safety of childbirth in SSA. The objective of this paper is to propose a model that can be used to improve the safety of childbirth in low resource countries and to outline why midwife assisted planned home birth with coordination of hospitals is the preferred alternative to unassisted or inadequately assisted planned home birth in SSA.

The best interest standard and children: clarifying a concept and responding to its critics

2018 ◽  
Vol 45 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Johan Christiaan Bester
Keyword(s):  
Medical Ethics ◽  
Medical Practice ◽  
General Principle ◽  
Prima Facie ◽  
Ethical Principle ◽  
Ethical Framework ◽  
Best Interest ◽  
Best Interest Standard ◽  
The Family

This work clarifies the role of the best interest standard (BIS) as ethical principle in the medical care of children. It relates the BIS to the ethical framework of medical practice. The BIS is shown to be a general principle in medical ethics, providing grounding to prima facie obligations. The foundational BIS of Kopelman and Buchanan and Brock are reviewed and shown to be in agreement with the BIS here defended. Critics describe the BIS as being too demanding, narrow, opaque, not taking the family into account and not suitable as limiting principle. This work responds to these criticisms, showing that they do not stand up to scrutiny. They either do not apply to the BIS, only apply to misuses of the BIS or criticise a BIS that is not seriously defended in the literature.

Surgeon proficiency in robot-assisted spine surgery

2020 ◽  
Vol 102-B (5) ◽  
pp. 568-572
Author(s):  
Jake Michael McDonnell ◽  
Daniel P. Ahern ◽  
Tiarnan Ó Doinn ◽  
Denys Gibbons ◽  
Katharina Nagassima Rodrigues ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Spinal Surgery ◽  
New Technologies ◽  
Conflicts Of Interest ◽  
Surgical Robotics ◽  
Ethical Framework ◽  
Ethical Challenges ◽  
Surgical Robots ◽  
Simultaneous Application

Continuous technical improvement in spinal surgical procedures, with the aim of enhancing patient outcomes, can be assisted by the deployment of advanced technologies including navigation, intraoperative CT imaging, and surgical robots. The latest generation of robotic surgical systems allows the simultaneous application of a range of digital features that provide the surgeon with an improved view of the surgical field, often through a narrow portal. There is emerging evidence that procedure-related complications and intraoperative blood loss can be reduced if the new technologies are used by appropriately trained surgeons. Acceptance of the role of surgical robots has increased in recent years among a number of surgical specialities including general surgery, neurosurgery, and orthopaedic surgeons performing major joint arthroplasty. However, ethical challenges have emerged with the rollout of these innovations, such as ensuring surgeon competence in the use of surgical robotics and avoiding financial conflicts of interest. Therefore, it is essential that trainees aspiring to become spinal surgeons as well as established spinal specialists should develop the necessary skills to use robotic technology safely and effectively and understand the ethical framework within which the technology is introduced. Traditional and more recently developed platforms exist to aid skill acquisition and surgical training which are described. The aim of this narrative review is to describe the role of surgical robotics in spinal surgery, describe measures of proficiency, and present the range of training platforms that institutions can use to ensure they employ confident spine surgeons adequately prepared for the era of robotic spinal surgery. Cite this article: Bone Joint J 2020;102-B(5):568–572.

The Health of Refugees

2019 ◽  
Keyword(s):  
Age Groups ◽  
Refugee Health ◽  
Mass Movements ◽  
Ethical Challenges ◽  
Displaced Populations ◽  
Political Landscape ◽  
The Media ◽  
Multidisciplinary Perspective ◽  
The Impact

There have been significant changes in the numbers, patterns, and circumstances of refugees and in the political landscape to support humanitarianism since the publication of the first edition of this collection. Like the first edition, this volume provides a multidisciplinary perspective on refugee health, tracing the health repercussions on individuals and populations from the drivers of forced mass movements of populations from situations of conflict and other disasters through to the process of resettlement in countries other than their countries of origin. Drawing on the expertise of academics, practitioners, and UN frontline experts, the collection covers three main aspects of refugee health: the concepts, definitions, and context from a human rights, humanitarianism, and social determinants of health perspective; the intersection of vulnerabilities across age groups and settings; and the ethical challenges for practitioners and researchers working with forcibly displaced populations seeking to resettle. The collection concludes with an analysis of the role of the media in shaping our perceptions of refugees and the impact on policy and access to care.

scholarly journals From audiences to data points: The role of media agencies in the platformization of the news media industry

2021 ◽  
pp. 016344372110298
Author(s):  
Ida Willig
Keyword(s):  
Digital Media ◽  
News Media ◽  
Media Industry ◽  
Ethical Challenges ◽  
Media Audiences ◽  
Data Points ◽  
The Public Sphere ◽  
The Many ◽  
Marketing Budgets

Media agencies have become one of the key actors in the contemporary media industry: by channelling marketing budgets to some media and some platforms and not to others, media agencies play an important role in creating the digital media infrastructure and laying the tracks of the public sphere. Yet we know very little about these commercial middlemen between advertisers and audiences, what they do, and how we should understand their role in the digital media ecology. This article discusses the role of media agencies in relation to platformization with a focus on the news media sector. Based on interviews, publicly available material and trade journals, the article depicts an industry deeply engaged in digitizing, tracking and commodifying media audiences, while at the same time aware of ethical challenges of the digital media infrastructure. This leads to a call for more political attention and critical research on the democratic implications of the new value chains between platforms, advertisers, audiences, media agencies and news media as well as the many tech companies providing derived digital services and products.

Sign in / Sign up

Export Citation Format

Share Document