Ethical and Legal Aspects of Using an Identical Twin as a Skin Transplant Donor for a Severely Burned Minor

2005 ◽  
Vol 31 (1) ◽  
pp. 87-116 ◽  
Author(s):  
Samuel J. Tilden
Keyword(s):  
Legal Aspects ◽  
Identical Twin ◽  
Parental Consent ◽  
Jefferson County ◽  
Newspaper Article ◽  
Acute Postoperative Pain ◽  
Twin Sister ◽  
Psychological Dysfunction ◽  
Harmful Effects

On January 7, 2003, Sydney Cowan, a healthy six-year-old girl, underwent skin harvesting, specifically to be used for her badly burned identical twin sister, Jennifer. A day earlier, the Probate Court of Jefferson County, Alabama, after considering whether a healthy minor twin sibling could serve as a skin donor for her severely burned sister, authorized parental consent to the surgery. More accurately, the court addressed whether Sydney could undergo surgical procedures that provided her with no physical benefit, but, rather, resulted in harmful effects, such as acute postoperative pain, permanent residua, and potential long-term emotional and psychological dysfunction.Although the transplants were extraordinarily successful, and the newspaper article depicted Sydney's participation in heroic terms, the harvesting of Sydney's skin was ethically problematic. Specifically, I assert that the use of an incompetent minor as a skin transplant donor, even if an identical twin, is not justified unless the transplant will save the recipient's life.

67. Loving your child to death: Considerations of the care of chronically-ill children and euthanasia in Emil Sher's Mourning Dove and implications for medical educations

2007 ◽  
Vol 30 (4) ◽  
pp. 65
Author(s):  
K. Mukhida
Keyword(s):  
Life Support ◽  
Terminally Ill ◽  
Chronically Ill ◽  
Legal Aspects ◽  
Mourning Dove ◽  
Medical Professionals ◽  
Constant Pain ◽  
Withdraw Life Support ◽  
Wheat Farmer

How do parents cope when their child is ill or dying, when he or she experiences constant pain or suffering? What do parents think of the contributions that medical professionals make to the care of their chronically or terminally ill child? Is it possible for a parent to love a child so much that the child is wished dead? The purpose of this paper is to explore those questions and aspects of the care of chronically or terminally ill children using Mourning Dove’s portrayal of one family’s attempt to care for their ill daughter. A play written by Canadian playwright Emil Sher, Mourning Dove is based on the case of Saskatchewan wheat farmer Robert Latimer who killed his 12 year old daughter Tracy who suffered with cerebral palsy and lived in tremendous pain. Rather than focusing on the medical or legal aspects of the care of a chronically ill child, the play offers a glimpse into how a family copes with the care of such a child and the effects the child’s illness has on a family. Reading and examination of non-medical literature, such as Mourning Dove, therefore serve as a useful means for medical professionals to better understand how illness affects and is responded to by patients and their families. This understanding is a prerequisite for them to be able to provide complete care of children with chronic or terminal illnesses and their families. Nuutila L, Salanterä S. Children with long-term illness: parents’ experiences of care. J Pediatr Nurs 2006; 21(2):153-160. Sharman M, Meert KL, Sarnaik AP. What influences parents’ decisions to limit or withdraw life support? Pediatr Crit Care Med 2005; 6(5):513-518. Steele R. Strategies used by families to navigate uncharted territory when a child is dying. J Palliat Care 2005; 21(2):103-110.

Research on the Economic Organization Environmental Impact

2017 ◽  
Vol 68 (3) ◽  
pp. 599-601
Author(s):  
Dan Paul Stefanescu ◽  
Oana Roxana Chivu ◽  
Claudiu Babis ◽  
Augustin Semenescu ◽  
Alina Gligor
Keyword(s):  
Economic Activity ◽  
Economic Organization ◽  
Economic Activities ◽  
Environmental Implications ◽  
Minimal Impact ◽  
Wide Range ◽  
Material Environment ◽  
Negative Effect ◽  
Harmful Effects

Any economic activity carried out by an organization, can generate a wide range of environmental implications. Particularly important, must be considered the activities that have a significant negative effect on the environment, meaning those which pollute. Being known the harmful effects of pollution on the human health, the paper presents two models of utmost importance, one of the material environment-economy interactions balance and the other of the material flows between environmental factors and socio-economic activities. The study of these models enable specific conditions that must be satisfied for the economic processes friendly coexist to the environment for long term, meaning to have a minimal impact in that the residues resulting from the economic activity of the organization to be as less harmful to the environment.

scholarly journals FRI0412 DOES SEVERE ACUTE POSTOPERATIVE PAIN RESULT IN MORE LONG-TERM PAIN AFTER TOTAL HIP OR KNEE ARTHROPLASTY (THA OR TKA) FOR OSTEOARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 805.2-805
Author(s):  
D. A. J. M. Latijnhouwers ◽  
C. H. Martini ◽  
R. G. H. H. Nelissen ◽  
H. M. J. Van der Linden ◽  
T. P. M. Vliet Vlieland ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Missing Values ◽  
Rating Scale ◽  
Acute Postoperative Pain ◽  
Preoperative Pain ◽  
Mixed Effect ◽  
Total Hip ◽  
Chronic Postsurgical Pain

Background:Chronic pain is a frequently reported unfavourable outcome of total hip and knee arthroplasties (THA/TKA) (7-23% and 10-34%, respectively) in osteoarthritis (OA) patients (1), which is difficult to treat as underlying mechanisms are not fully understood. Acute postoperative pain has been identified as risk factor for development of long-term pain in other surgical procedures, such as mastectomy and thoracotomy (2). However, the effect of acute postoperative pain on development of long-term pain in THA and TKA patients is unknown.Objectives:To investigate if acute pain following THA/TKA in OA patients is associated with long-term pain and if acute pain affects the course of pain up to 1-year postoperatively.Methods:From a longitudinal multicenter study, OA patients scheduled for primary THA or TKA were included. Acute pain scores, using Numeric Rating Scale (NRS), were routinely collected as part of standard care (≤72 hours after surgery). In case of ≥2 NRS scores the two highest scores were averaged (n=160), else the single score was taken. Pain was dichotomized into severe (NRS≥5) and mild (NRS<5). Pain was assessed preoperatively, at 3 (only THA), 6 and 12 months postoperatively using HOOS/KOOS subscale pain. Separate mixed-effect models for THA and TKA patients were used, with dichotomized acute pain as fixed-effect and long-term pain as outcome, while adjusting for confounders (age, sex, BMI, preoperative pain, mental component scale of the SF12 (MCS-12), and duration of the surgery and hospitalization). We included an interaction between time of measurement and acute postoperative pain to analyse whether effect modification was present. Missing values in preoperative pain and MCS-12 were imputed using multiple imputation methods.Results:81 THA and 87 TKA patients were included, of whom 32.1% and 56.3% reported severe acute pain. The results did not show an associated between severe acute pain and long term pain (THA: β=2.0, 95%-CI:-10.9-7.0; TKA: β=3.8, 95%-CI:-10.6-2.9). Furthermore, It seems that there is no effect present of difference in severity of acute pain and the course of pain over time (THA 6-months: β=6.4, 95%-CI:1.9-10.9 and 12-months: β=0.2, 95%-CI:-4.4-4.8; TKA 12-months: β=3.2, 95%-CI:-0.5-6.8).Conclusion:We did not find an association between acute pain and the development of long-term pain nor that severity of acute pain affects the course of postoperative pain in THA and TKA patients. The fact that THA and TKA patients often experience chronic preoperative pain might be a possible explanation for this finding. Nonetheless, future studies including additional measures of acute pain and pain sensitization in patients with chronic preoperative pain are necessary to draw stronger conclusions.References:[1]Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ open. 2012;2(1):e000435.[2]Katz J, Seltzer Ze. Transition from acute to chronic postsurgical pain: risk factors and protective factors. Expert review of neurotherapeutics. 2009;9(5):723-44.Acknowledgments:We would like to thank the study group that consists of: B.L. Kaptein, Leiden University Medical Center, Leiden; S.B.W Vehmeijer, Reinier de Graaf Hospital, Delft; R. Onstenk, Groene Hart Hospital, Gouda; S.H.M. Verdegaal, Alrijne Hospital, Leiderdorp; H.H. Kaptijn, LangeLand Hospital, Zoetermeer; W.C.M. Marijnissen, Albert Schweitzer Hospital, Dordrecht; P.J. Damen, Waterland Hospital, Hoorn; the NetherlandsDisclosure of Interests:None declared

Waste Disposal or Recycling: Changes in Waste Management in Russia and its Regions

Vestnik NSUEM ◽  
2022 ◽  
pp. 46-54
Author(s):  
G. P. Litvintseva ◽  
E. S. Oshmarina
Keyword(s):  
Cluster Analysis ◽  
Waste Management ◽  
Waste Disposal ◽  
National Economy ◽  
Legal Aspects ◽  
Regional Differentiation ◽  
Fixed Assets ◽  
Its Regions ◽  
Harmful Effects ◽  
Regions Of Russia

The article examines the theoretical and legal aspects of waste management, describes the state of the waste management sector in Russia and the problems associated with it. On the basis of cluster analysis, regional differentiation in the considered sphere is determined. The efficiency of waste management in terms of current costs and investments in fixed assets, aimed at preventing the harmful effects of waste, for the national economy and at the level of the regions of Russia is assessed. The directions of improving of waste management sphere in Russia are formulated.

Solitary Confinement, Loneliness, and Psychological Harm

2019 ◽  
pp. 129-152
Author(s):  
Craig Haney
Keyword(s):  
Adverse Effects ◽  
Social Exclusion ◽  
Psychological Research ◽  
Solitary Confinement ◽  
Social Psychological ◽  
Psychological Harm ◽  
Social Psychological Research ◽  
Harmful Effects ◽  
Very High

Solitary confinement subjects prisoners to extreme forms of social isolation and social exclusion that, in turn, produce very high levels of suffering and pathology and nearly unprecedented degrees of loneliness. This chapter briefly reviews the scientific literature on harmful effects of solitary confinement, connecting it more directly to social psychological research on the adverse effects of social exclusion and isolation. The author discusses findings from a recent study of loneliness among long-term isolated prisoners, as well as an earlier study performed in an especially harsh solitary confinement unit—the Security Housing Unit (SHU) at the Pelican Bay State Prison in California—which systematically assessed the prevalence of symptoms of psychological stress, trauma, and isolation-related psychopathology.

scholarly journals Vaping-induced lung injury: brief report for the practicing clinician

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Bashar Khiatah ◽  
Alex Murdoch ◽  
Charles Hubeny ◽  
Carl Constantine ◽  
Amanda Frugoli
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Case Vignette ◽  
Cigarette Use ◽  
Lung Injuries ◽  
Teenagers And Young Adults ◽  
The Usa ◽  
Physician Awareness ◽  
Harmful Effects

ABSTRACT The USA is witnessing an outbreak of vaping-induced lung injuries associated with the drastic rise in e-cigarette use, especially among teenagers and young adults. Our understanding of the harmful effects of these products is expanding as an increasing amount of consumers seek medical care for lung-related illnesses. The knowledge of the long-term sequelae of e-cigarette use is limited due to their novelty, but a growing association exists between use and acute lung injury. We describe a case vignette of vaping-induced lung injury to increase physician awareness and discuss the applicability of preliminary diagnostic criteria.

scholarly journals PAYROLL LOANS AND ITS RELATIONSHIP WITH THE AGGREGATE ECONOMIC ACTIVITY (2004-2014)

2017 ◽  
Vol 18 (1) ◽  
pp. 148-173
Author(s):  
ALINE BEATRIZ SCHUH ◽  
DANIEL ARRUDA CORONEL ◽  
REISOLI BENDER FILHO
Keyword(s):  
Economic Activity ◽  
Legal Aspects ◽  
Impulse Response Functions ◽  
Short Term ◽  
Causality Test ◽  
Vector Error Correction ◽  
Vector Error ◽  
Methodological Aspects ◽  
Macroeconomic Aggregates

ABSTRACT Purpose: Identify the relationship between the granting of payroll loans and macroeconomic aggregates, from 2004 to 2014, through an analysis of the influence of this type of credit on the aggregate economic activity in Brazil. Originality/gap/relevance/implications: Payroll loans are very representative in the Brazilian credit market, and the discussion on this topic is very extensive, because it is directly linked to the economic growth of a country. However, there is a gap in the literature on this subject, since most studies stress behavioral finances, or the legal aspects of contracts, and also because this type of credit is recent in the Brazilian economy. Key methodological aspects: This is quantitative approach performed through the estimation of the Vector Error Correction Model (VECM), which enabled the computation of impulse-response functions, the variance decomposition and the Granger causality test. Summary of key results: The results indicate that the granting of payroll loans causes an increase on macroeconomic aggregates in the short term, but over longer periods of time this increase tends to be eliminated. Key considerations/conclusions: The granting of payroll loans influences the behavior of the economic activity. However, despite the fact that its concession provides leverage in the short term, this growth is not sustainable in the long-term. In this scenario, there is exponential growth in household consumption over the past decade; however, the industry productivity and the investments did not follow this evolution. It is inferred from this that the current growth model generates expansion, but its effects are limited.

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