Adapting Standards of Care Under Extreme Conditions

2009 ◽  
Vol 3 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Kristine M. Gebbie ◽  
Cheryl A. Peterson ◽  
Italo Subbarao ◽  
Kathleen M. White
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Control Policy ◽  
Standard Of Care ◽  
White Paper ◽  
Ethical Framework ◽  
Standards Of Care ◽  
State Legislation ◽  
Routine Tasks ◽  
Criminal Charges

ABSTRACTThe filing of criminal charges against a group of clinicians in New Orleans for failure to meet expected standards of care following the hurricanes of 2005 made the growing concern among health professionals about care provided during extreme emergencies or disasters all too real. Questions about what may lead to censure, penalties from licensing boards, or lawsuits have come from nurses, physicians, and many other licensed health professionals. A panel convened by the American Nurses Association that included representatives of medical, public health, hospital, and government agencies considered the ethical, professional, and practical aspects of meeting standards of care in such circumstances. Clinicians are reminded that in emergencies, it is only the circumstances that change (perhaps radically); neither the individual’s professional competency nor the basic professional standard of care is different. In making prioritized decisions under such circumstances, the individual’s ethical framework is utilitarian, and there are 3 areas for action, even when some routine tasks are set aside: maintain worker and patient safety; maintain airway, breathing, and circulation; and establish or maintain infection control. Policy recommendations such as state legislation for the adoption of comprehensive immunity for volunteer health care workers, and the establishment of a medical review panel as arbitration board are also suggested. The resulting white paper summarizes the issues and provides guidance to individual professionals, institutions in which they work, and emergency planners. (Disaster Med Public Health Preparedness. 2009;3:111–116)

scholarly journals How a Nutritional Deficiency Became Treated with Fluoride

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4361
Author(s):  
Philippe P. Hujoel
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Medical Profession ◽  
Standard Of Care ◽  
Professional Organizations ◽  
Standards Of Care ◽  
National Academy Of Sciences ◽  
Causes Of Disease ◽  
Academy Of Sciences ◽  
Health Experts

Ignoring evidence on causes of disease such as smoking can harm public health. This report explores how public health experts started to ignore evidence that pediatric vitamin D deficiencies are associated with dental caries. Historical analyses show that an organization of clinical specialists, the American Dental Association (ADA), initiated this view. The ADA was a world-leading organization and its governing bodies worked through political channels to make fluoride a global standard of care for a disease which at the time was viewed as an indicator of vitamin D deficiencies. The ADA scientific council was enlisted in this endeavor and authorized the statement saying that “claims for vitamin D as a factor in tooth decay are not acceptable”. This statement was ghost-written, the opposite of what the ADA scientific council had endorsed for 15 years, and the opposite of what the National Academy of Sciences concluded. Internal ADA documents are informative on the origin of this scientific conundrum; the ADA scientific council had ignored their scientific rules and was assisting ADA governing bodies in conflicts with the medical profession on advertising policies. The evidence presented here suggests that professional organizations of clinical specialists have the power to create standards of care which ignore key evidence and consequently can harm public health.

An Industrial Accident

2020 ◽  
pp. 175-180
Author(s):  
Chadd K. Kraus
Keyword(s):  
Public Health ◽  
Emergency Physician ◽  
Standard Of Care ◽  
Professional Autonomy ◽  
Standards Of Care ◽  
Emergency Physicians ◽  
Scarce Resources ◽  
Public Health Emergencies ◽  
Public Health Functions ◽  
Critical Public Health

Emergency physicians and emergency departments serve critical public health functions at all times and particularly during public health emergencies or disasters. Public health emergencies and disasters transform standards of care into crisis standards of care. In addition to traditional tenets of bioethics, during events requiring crisis standards of care, the emergency physician faces the dilemmas of balancing responsibilities of how to allocate scarce resources to individual patients with obligations to the community and with personal and professional autonomy. Crisis standards of care permit emergency physicians to allocate scarce resources to provide necessary treatments to patients most likely to benefit. In crisis standard-of-care situations, emergency physicians must adhere to ethical and professional norms. The emergency physician should focus on how to best use the available resources with the recognition that not all patients might be able to be treated.

scholarly journals Allocation of Ventilators in a Public Health Disaster

2008 ◽  
Vol 2 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Tia Powell ◽  
Kelly C. Christ ◽  
Guthrie S. Birkhead
Keyword(s):  
Public Health ◽  
New York ◽  
Clinical Guidelines ◽  
Task Force ◽  
New York State ◽  
Assessment System ◽  
Ethical Framework ◽  
Standards Of Care ◽  
York State Department ◽  
York State

ABSTRACTBackground: In a public health emergency, many more patients could require mechanical ventilators than can be accommodated.Methods: To plan for such a crisis, the New York State Department of Health and the New York State Task Force on Life and the Law convened a workgroup to develop ethical and clinical guidelines for ventilator triage.Results: The workgroup crafted an ethical framework including the following components: duty to care, duty to steward resources, duty to plan, distributive justice, and transparency. Incorporating the ethical framework, the clinical guidelines propose both withholding and withdrawing ventilators from patients with the highest probability of mortality to benefit patients with the highest likelihood of survival. Triage scores derive from the sepsis-related organ failure assessment system, which assigns points based on function in 6 basic medical domains. Triage may not be implemented by a facility without clear permission from public health authorities.Conclusions: New York State released the draft guidelines for public comment, allowing for revision to reflect both community values and medical innovation. This ventilator triage system represents a radical shift from ordinary standards of care, and may serve as a model for allocating other scarce resources in disasters. (Disaster Med Public Health Preparedness. 2008;2:20–26)

Malpractice Issues for the Private Practitioner

2017 ◽  
pp. 459-476
Author(s):  
David L. Shapiro ◽  
Jeffrey N. Younggren
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Management Strategies ◽  
Standard Of Care ◽  
Standards Of Care ◽  
Professional Relationship ◽  
Malpractice Litigation ◽  
Risk Management Strategies ◽  
Comparative Negligence

This chapter provides an overview of major concerns for practicing mental health professionals regarding issues of negligence. It discusses the concept of a professional relationship, the standard of care that derives from that relationship, the deviations from standards of care, and damages directly due to the deviations. Frequent areas of malpractice litigation are reviewed with illustrative cases presented. Common defenses against malpractice are discussed, focusing on challenging whether all four elements of malpractice have been met, and whether or not there have been contributions to the unfortunate outcomes by the patient or client herself or himself (contributory or comparative negligence). The guidance in this chapter also reduces the likelihood of administrative legal actions like board complaints. Do you want to narrow it so much. Risk management strategies are presented to assist practitioners to minimize the risk of malpractice occurring.

Advancing Public Health Policy in Louisiana Through Evidence-Based Strategies: Successes and Opportunities

2018 ◽  
Vol 20 (1) ◽  
pp. 128-134 ◽  
Author(s):  
Mary Kathryn Poole ◽  
Adrienne R. Mundorf ◽  
Naomi K. Englar ◽  
Donald Rose
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Health Professionals ◽  
Positive Influence ◽  
State Legislation ◽  
Public Health Agencies ◽  
Public Health Professionals ◽  
State Legislator ◽  
Research And Education ◽  
Health Legislation

In 2013, a team of public health professionals at Tulane University launched a project to explore strategies for shaping a healthier Louisiana. The team investigated methods for improving diet and physical activity behaviors in early childhood, school, and community settings that could be translated into specific policies. Through key informant interviews and scans of academic journals and reports issued by public health agencies, the team generated a set of actionable steps that could increase healthful behaviors. Previous efforts to address similar topics in Louisiana and other states, and their reception from policy makers, were also considered during analysis. Subsequently, a state legislator used the team’s work to introduce public health legislation in 2014. The legislation led to a number of incremental changes in state policy and resolutions for additional policy-relevant studies. This case study summarizes the promising physical activity and nutrition strategies that were considered by the Tulane team, how the team’s work product was integrated into state legislation, the outcomes of the legislation, and a set of recommendations for how Louisiana can expand on this work. This article demonstrates how the work of public health professionals can have a positive influence on the policy-making process through research and education.

Oral health diseases among the older people: a general health perspective

2020 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Older People ◽  
Health Professionals ◽  
General Health ◽  
Oral Health Care ◽  
Oral Diseases ◽  
Public Health Professionals ◽  
The Relationship

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.

Instagramming our way through public health communication: why and who is using it?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Vareda ◽  
T Garcia ◽  
J Rachadell
Keyword(s):  
Public Health ◽  
Social Media ◽  
Health Promotion ◽  
Health Professionals ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Healthy Lifestyles ◽  
Communication Tool ◽  
Cross Sectional ◽  
Non Communicable Diseases

Abstract Background From disease prevention to health promotion, communication is key for Public Health (PH) practice and, according to the 9th Essential Public Health Operation its goal is to improve populations health literacy and capacity to access, understand and use information. Though social media is frequently presented as a potentially useful tool for PH communication, there is a lack of evidence about its effectiveness and impact on PH outcomes. This study researches Instagram® as a PH tool and aims to know who is using it, what content is shared on the platform and how much engagement there is. Methods This cross-sectional study regards information on 1000 Instagram® posts with the hashtags publichealth, publichealthpromotion, healthpromotion, publichealthmatters and publichealtheducation. Authors categorized post content and creators, and reviewed the number of likes and comments per post to determine engagement. Data analysis was performed on IBM SPSS® Statistics. Results The most common content categories were communicable diseases (n = 383), non-communicable diseases (n = 258) and healthy lifestyles (n = 143). Health professionals post more about communicable diseases (43,6%) and non-professionals about healthy lifestyles (36,1%). Non-professionals (n = 191) post about PH issues almost as much as health professionals (n = 220) and PH associations (n = 201). Most don't reference their sources (n = 821). Posts on communicable diseases have the most likes and comments per post (mean of 172 likes and 3,1 comments). Conclusions Half the Instagram® posts analysed in this study were made by health professionals or organizations. Communicable diseases, non-communicable diseases and healthy lifestyles were the most frequent content categories and had the most engagement. The majority of posts didn't reference their sources. Though Instagram® seems to be a potential PH communication tool, further research is needed to confirm its benefits for PH. Key messages Social media platforms like Instagram® are potentially powerful tools for PH communication. There is a need to understand the efficacy of social media as health promotion tools.

Men's perception and understanding of male-factor infertility in the UK

2021 ◽  
Vol 30 (9) ◽  
pp. S8-S16
Author(s):  
Eleanor L Stevenson ◽  
Cheng Ching-Yu ◽  
Chang Chia-Hao ◽  
Kevin R McEleny
Keyword(s):  
Public Health ◽  
Emotional Support ◽  
Health Professionals ◽  
Male Fertility ◽  
Public Knowledge ◽  
Evidence Based ◽  
Male Factor Infertility ◽  
Male Factor ◽  
The Public ◽  
The Uk

Male-factor infertility is a common but stigmatised issue, and men often do not receive the emotional support and the information they need. This study sought to understand awareness of male fertility issues compared to female fertility among the UK general male public, and also what were perceived as being the optimum methods for providing support for affected men, emotionally and through information. Men feel that male infertility is not discussed by the public as much as female infertility. Lifestyle issues that affect male fertility are not well understood, and men affected by infertility desire more support, including online, from health professionals and through peer support. Health professionals, including those in public health, could offer evidence-based programmes to reduce stigma and increase public knowledge about infertility, as well as offer emotional support to men with infertility problems.

Sign in / Sign up

Export Citation Format

Share Document