scholarly journals Conjoined Twins Separation Leading to the Death of One Twin: An Expanded Ethical Analysis of Issues Facing the ICU Team

2018 ◽  
Vol 34 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Brian M. Cummings ◽  
John J. Paris
Keyword(s):  
Systematic Approach ◽  
Pediatric Intensive Care ◽  
Conjoined Twins ◽  
Ethics Committee ◽  
Ethical Analysis ◽  
Lessons Learned ◽  
Difficult Situation ◽  
Medical Standards ◽  
Hospital Ethics ◽  
Legal Frameworks

A recent case of conjoined twins required multiple hospitalizations in the pediatric intensive care unit and led to a difficult situation confronting staff regarding the potential separation where surgery would result in the death of one twin. The hospital ethics committee was consulted. A systematic approach was utilized to examine medical standards, historical precedents, and various ethical and legal frameworks. The ethics committee believed that either proceeding with or forgoing attempted separation surgery would be ethically acceptable. We share our reasoning and lessons learned for others facing this situation in the future.

scholarly journals A Connected Autonomous Vehicle Testbed: Capabilities, Experimental Processes and Lessons Learned

Automation ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 17-32
Author(s):  
Thomas Kent ◽  
Anthony Pipe ◽  
Arthur Richards ◽  
Jim Hutchinson ◽  
Wolfgang Schuster
Keyword(s):  
Autonomous Vehicles ◽  
Autonomous Vehicle ◽  
Lessons Learned ◽  
Urban Setting ◽  
Sensor Data ◽  
Stable Set ◽  
Research And Innovation ◽  
Legal Frameworks ◽  
High Level ◽  
Key Steps

VENTURER was one of the first three UK government funded research and innovation projects on Connected Autonomous Vehicles (CAVs) and was conducted predominantly in the South West region of the country. A series of increasingly complex scenarios conducted in an urban setting were used to: (i) evaluate the technology created as a part of the project; (ii) systematically assess participant responses to CAVs and; (iii) inform the development of potential insurance models and legal frameworks. Developing this understanding contributed key steps towards facilitating the deployment of CAVs on UK roads. This paper aims to describe the VENTURER Project trials, their objectives and detail some of the key technologies used. Importantly we aim to introduce some informative challenges that were overcame and the subsequent project and technological lessons learned in a hope to help others plan and execute future CAV research. The project successfully integrated several technologies crucial to CAV development. These included, a Decision Making System using behaviour trees to make high level decisions; A pilot-control system to smoothly and comfortably turn plans into throttle and steering actuation; Sensing and perception systems to make sense of raw sensor data; Inter-CAV Wireless communication capable of demonstrating vehicle-to-vehicle communication of potential hazards. The closely coupled technology integration, testing and participant-focused trial schedule led to a greatly improved understanding of the engineering and societal barriers that CAV development faces. From a behavioural standpoint the importance of reliability and repeatability far outweighs a need for novel trajectories, while the sensor-to-perception capabilities are critical, the process of verification and validation is extremely time consuming. Additionally, the added capabilities that can be leveraged from inter-CAV communications shows the potential for improved road safety that could result. Importantly, to effectively conduct human factors experiments in the CAV sector under consistent and repeatable conditions, one needs to define a scripted and stable set of scenarios that uses reliable equipment and a controllable environmental setting. This requirement can often be at odds with making significant technology developments, and if both are part of a project’s goals then they may need to be separated from each other.

Twenty-Five Years of Fetal Echocardiography in Conjoined Twins: Lessons Learned

2013 ◽  
Vol 26 (5) ◽  
pp. 530-538 ◽  
Author(s):  
Lilian M. Lopes ◽  
Maria L. Brizot ◽  
Regina Schultz ◽  
Adolfo W. Liao ◽  
Vera L.J. Krebs ◽  
...  
Keyword(s):  
Fetal Echocardiography ◽  
Conjoined Twins ◽  
Lessons Learned

scholarly journals Transformation to self-managing teams: lessons learned

2018 ◽  
Vol 17 (2) ◽  
pp. 81-84 ◽  
Author(s):  
Maarten Renkema ◽  
Tanya Bondarouk ◽  
Anna Bos-Nehles
Keyword(s):  
Design Methodology ◽  
Systematic Approach ◽  
Transformation Process ◽  
Healthcare Organization ◽  
Lessons Learned ◽  
Self Management ◽  
Content Type ◽  
Management Board ◽  
Stakeholder Groups

Purpose Although self-management is not a new phenomenon, there is a lack of understanding about how to transform organizations towards self-managing teams (SMTs). The purpose of this paper is to propose a guiding framework for how the empowerment process can be managed. Design/methodology/approach The paper sets out 12 guidelines on how to address the transition towards SMTs based on a case study at a large Dutch healthcare organization. The lessons are drawn from observations, documents and more than 55 interviews with key informants. Findings This paper provides a holistic overview of lessons learned from the transformation process towards SMTs. The 12 recommendations are targeted at four stakeholder groups, namely, the management/board, HRM department, coach-managers and members of the SMTs. Originality/value The originality lies in the systematic approach including lessons learned for all levels of the organization.

Emotional Support for Health Care Professionals: A Therapeutic Role for the Hospital Ethics Committee

2016 ◽  
Vol 12 (3) ◽  
pp. 277-288 ◽  
Author(s):  
David M. Chooljian ◽  
James Hallenbeck ◽  
Stephen C. Ezeji-Okoye ◽  
Robert Sebesta ◽  
Hasan Iqbal ◽  
...  
Keyword(s):  
Health Care ◽  
Emotional Support ◽  
Health Care Professionals ◽  
Ethics Committee ◽  
Therapeutic Role ◽  
Hospital Ethics

Factors Associated With The Relapse In Ponseti Treated Congenital Club Foot

2021 ◽  
Author(s):  
Wei Hu ◽  
Baoyi Ke ◽  
Niansu Xiao ◽  
Sen Li ◽  
Cheng Li ◽  
...  
Keyword(s):  
Club Foot ◽  
Ethics Committee ◽  
Ponseti Method ◽  
Ethical Standards ◽  
Factors Associated ◽  
Pirani Score ◽  
Walking Age ◽  
The Mean ◽  
Hospital Ethics

Abstract Objectives. We retrospectively investigated the clinical materials to seek the factors that lead to relapse after using the Ponseti method.Methods. We retrospectively reviewed all children with congenital club foot treated with the Ponseti method in our hospital from June 2008 to June 2013. The data included the following factors: age, gender, initial Pinari score, number of casts, number of feet (unilateral or bilateral), age at the first casting, age of mother, tenotomy, walking age, and compliance with using bracing. All investigations were conducted in conformity with ethical standards. This study was approved by Guilin Peoples’ Hospital Ethics Committee.Results. In this study, there were 148 cases with 164 feet in total that underwent the Ponseti method. Of them, 64 children presented with left side, 58 with right side, and 26 with bilateral cases. This study included 75 males and 73 females; sex did not affect the outcomes. The mean age of the first casting was 2.50±2.15 months. The average initial Pirani score was 4.98±1.33, 2 and the average number of casts was 5.71±2.28 times. The mean age of mothers at birth was 25.81±2.38 years old. The walking age of children was at a mean of 14.83±1.18 months. Forty-nine cases could not tolerate using braces, namely the rate of noncompliance in this study was 33.1%. Tenotomy was performed on 113 feet (76.4%). The average follow–up period was 7.27±1.29 years (from 5 to 10 years). The rate of relapse was 21.6% (32 cases) at the end of the follow-up. The rate of relapse in the noncompliance with using bracing group was significantly higher compared to the compliance group.Conclusion. The initial Pirani score, compliance with the foot abduction brace and the age at the first casting are three independent factors for relapse in clubfoot.

Invoking the Law in Ethics Consultation

1993 ◽  
Vol 2 (4) ◽  
pp. 457-467 ◽  
Author(s):  
Bethany Spielman
Keyword(s):  
Ethical Issues ◽  
Ethics Consultation ◽  
Ethics Committee ◽  
Legal Issues ◽  
University Hospital ◽  
Recent Book ◽  
Consultation Process ◽  
Legal Information ◽  
Case Consultation ◽  
Hospital Ethics

A request that an ethics committee or consultant analyze the ethical issues in a case, delineate ethical options, or make a recommendation need not automatically but often does elicit legal information. In a recent book in which ethics consultants described cases on which they had worked, almost all cited a legal case or statute that had shaped the consultation process. During a period of just a few months, case consultation done under the auspices of one university hospital ethics committee involved interpretation of statutes on living wills, durable powers of attorney, competency, confidentiality, guardianship, AIDS testing, and disability (personal observation). At another hospital, 30% of ethics consultations were thought to involve legal issues. Attorneys at a third hospital estimated that virtually every case involves legal issues. The notion that ethics consultation is an “amalgam” of medicine, ethics, interpersonal skills, and law is gaining currency. Ethics consultation has become a channel through which law enters the clinical setting.

Sign in / Sign up

Export Citation Format

Share Document