The clinical neurology of problems with oral feeding

2020 ◽  
pp. 305-314
Author(s):  
Tom Richards ◽  
Tom Hughes
Keyword(s):  
Underlying Disease ◽  
Legal Issues ◽  
Oral Feeding ◽  
Clinical Neurology ◽  
Clinical Approach ◽  
Feeding Problem ◽  
Diagnosis And Prognosis ◽  
Nutrition And Hydration ◽  
Appropriate Therapy ◽  
Ethical And Legal Issues

Oral feeding comprises a number of composite functions, all of which have to be coordinated to ensure adequate nutrition and hydration. Voluntary swallowing is central to the process, but without preserved pulmonary function, including cough, the airway is vulnerable. Medical and surgical problems, and the environment in which the patient is nursed, also determine the success of attempted oral feeding. Using this framework of thinking may help structure the clinical approach to oral feeding failure and facilitate discussion of issues other than just swallowing and dysphagia when forming opinions about the diagnosis and prognosis of the underlying disease, the mechanism of the feeding problem, and the most appropriate therapy. The goals of any intervention should be informed by a detailed appreciation of clinical issues and a working knowledge of the relevant ethical and legal issues. The MEALTIME approach is suggested as an aide memoire to help ensure that the relevant issues are addressed.

The clinical neurology of problems with oral feeding

2015 ◽  
pp. 272-280
Author(s):  
Tom Hughes
Keyword(s):  
Underlying Disease ◽  
Legal Issues ◽  
Oral Feeding ◽  
Clinical Neurology ◽  
Clinical Approach ◽  
Feeding Problem ◽  
Adequate Nutrition ◽  
Composite Functions ◽  
Diagnosis And Prognosis ◽  
Ethical And Legal Issues

Oral feeding comprisesa number of composite functions, all of which have to be coordinated to ensure adequate nutrition and hydration.Voluntary swallowing is central to the process, but without adequate pulmonary functionthe airway isvulnerable.Medical and surgical problems, and the environment in which the patient is nursed also determine the success of attempted oral feeding.Using this framework of thinking may help structure the clinical approach to oral feeding failure and facilitate discussion of issues other than just swallowing and dysphagia when forming opinions about the diagnosis and prognosis of the underlying disease, the mechanism of the feeding problem, and the most appropriate therapy.The goals of any intervention should be informed by a detailed appreciation of clinical issues and a working knowledge of the relevant ethical and legal issues. The MEALTIME approach is suggested as an aide memoire to help ensure thatthe relevant issues are addressed.

Baby O and the Withdrawal of Life-Sustaining Medical Treatment in the Devastated Neonate: A Review of Clinical, Ethical, and Legal Issues

2016 ◽  
Vol 34 (10) ◽  
pp. 925-930 ◽  
Author(s):  
Joseph Sacco ◽  
Rebecca Virata
Keyword(s):  
Palliative Care ◽  
Clinical Practice ◽  
Clinical Research ◽  
Medical Treatment ◽  
Clinical Guidelines ◽  
Legal Issues ◽  
Artificial Nutrition ◽  
Artificial Nutrition And Hydration ◽  
Nutrition And Hydration ◽  
Ethical And Legal Issues

The discontinuation of life sustaining medical treatment (LSMT) in severely and permanently impaired neonates, especially artificial nutrition and hydration (ANH) is subject to uncertainty and controversy. Definitive clinical guidelines are lacking, clinical research is limited, ethical disagreement is commonplace, and while case and statutory law provide legal underpinning for the practice in defined circumstances, uncertainty in this realm likely influences clinical practice. We use the case of a neurologically devastated neonate to highlight and review these arenas, and show how, using available legal, ethical, and clinical standards and practice, the case of Baby O was resolved, and to underline the need for further research in neonatal palliative care.

Lovotics

2017 ◽  
Author(s):  
Adrian David Cheok ◽  
Kasun Karunanayaka ◽  
Emma Yann Zhang
Keyword(s):  
Science Fiction ◽  
Intimate Relationships ◽  
Intelligent Systems ◽  
Humanoid Robots ◽  
Legal Issues ◽  
Sex Communication ◽  
Ethical And Legal Issues ◽  
Recent Activity ◽  
Academic Area ◽  
Robot Companions

Intimate relationships, such as love and sex, between human and machines, especially robots, has been one of the themes of science fiction. However, this topic has never been treated in the academic area until recently. It was first raised and discussed by David Levy in his book Love and Sex with Robotics (2007). Since then, researchers have come up with many implementations of robot companions, like sex robots, emotional robots, humanoid robots, and artificial intelligent systems that can simulate human emotions. This chapter presents a summary of significant recent activity in this field, predicts how the field is likely to develop, and discusses ethical and legal issues. We also discuss our research in physical devices for human–robot love and sex communication.

scholarly journals The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Pomey ◽  
M. de Guise ◽  
M. Desforges ◽  
K. Bouchard ◽  
C. Vialaron ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Patient Experience ◽  
Emotional Support ◽  
Social Care ◽  
Legal Issues ◽  
Care Services ◽  
Health And Social Care ◽  
Ethical And Legal Issues ◽  
The Impact

Abstract Background Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. Methods/design We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients’ experience of emotional support throughout their care trajectory. Discussion This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.

Perception of the general public towards the ethical and legal issues surrounding DNA paternity testing in Lebanon

2021 ◽  
Vol 17 ◽  
pp. 100640
Author(s):  
M. Azoury ◽  
F.A. Mrad ◽  
I. Mansour ◽  
J.-N. Ibrahim ◽  
Z.A. Rjeily ◽  
...  
Keyword(s):  
General Public ◽  
Legal Issues ◽  
Paternity Testing ◽  
Ethical And Legal Issues

Identifying ethical and legal issues in elder care

2021 ◽  
pp. 096973302098176
Author(s):  
Nertila Podgorica ◽  
Emiljano Pjetri ◽  
Andreas W Müller ◽  
Daniela Deufert
Keyword(s):  
Elder Care ◽  
Qualitative Content Analysis ◽  
Wide Spectrum ◽  
Legal Education ◽  
European Union Member State ◽  
Patient Rights ◽  
Legal Issues ◽  
Structured Interviews ◽  
Ethical Conflicts ◽  
Ethical And Legal Issues

Background: As a non–European Union member state, Albania is increasingly orienting itself on Western models regarding human rights, patient rights, and legal regulations for healthcare. Due to its limited fiscal and legal power, enforcing legal and ethical regulations poses a major problem. Aim: The aim of this study is to investigate nurse’s knowledge and experiences regarding ethical and legal issues in Albanian elder care in state-funded and privately run institutions. Research design: The study was conducted using an inductive and qualitative design, utilizing a focused ethnographic approach, based on Roper and Shapira’s framework. Method: Data were collected between June 2017 and September 2018 using participant observation, field notes, and semi-structured interviews with 15 nurses in seven different elder care institutions. In total, 100 h of observation and 15 interviews were performed. Data analysis was based on Mayring’s qualitative content analysis. Ethical consideration: The approval for the study was obtained from UMIT—The Health and Life Sciences University, Austria. Findings: The findings of the study fell into the following main categories: “Everyday care issues,” “End-of-life issues,” “Legal issues,” and “Ethical-legal education and conflicts.” Discussion: The participants reported many ethical and legal issues when describing their everyday challenges and displayed a strong lack of ethical and legal education. Despite a wide spectrum in the quality of care between private and state-funded nursing homes, older people mostly do not know their own diagnosis. Conclusion: This study indicates that further ethical and legal education is needed. Furthermore, nurses need to be better prepared for ethical conflicts with families, as strengthening patient rights could come into conflict with traditional rights of the Albanian family.

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