scholarly journals Drawing the Line Between Essential and Nonessential Interventions on Intersex Characteristics With European Health Care Professionals

2020 ◽  
pp. 108926802096362
Author(s):  
Peter Hegarty ◽  
Marta Prandelli ◽  
Tove Lundberg ◽  
Lih-Mei Liao ◽  
Sarah Creighton ◽  
...  

Human rights statements on intersex characteristics distinguish legitimate “medically necessary” interventions from illegitimate normalizing ones. Ironically, this binary classification seems partially grounded in knowledge of anatomy and medical interventions; the very expertise that human rights statements challenge. Here, 23 European health professionals from specialist “disorder of sex development” (DSD) multidisciplinary teams located medical interventions on a continuum ranging from “medically essential” to nonessential poles. They explained their answers. Participants mostly described interventions on penile/scrotal, clitoral/labial, vaginal, and gonadal anatomy whose essential character was only partially grounded in anatomical variation and diagnoses. To explain what was medically necessary, health care professionals drew on lay understandings of child development, parental distress, collective opposition to medicalization, patients “coping” abilities, and patients’ own choices. Concepts of “medical necessity” were grounded in a hybrid ontology of patients with intersex traits as both physical bodies and as phenomenological subjects. Challenges to medical expertise on human rights grounds are well warranted but presume a bounded and well-grounded category of “medically necessary” intervention that is discursively flexible. Psychologists’ long-standing neglect of people with intersex characteristics, and the marginalization of clinical psychologists in DSD teams, may contribute to the construction of some controversial interventions as medically necessary.

The issues of Improper protection of rights and legal interests of the patients due to improper performance of professional duties by a medical or pharmaceutical worker are considered. In particular, problems arising during the application of the norm of criminal liability for specified socially dangerous acts are considered. At the same time, cases of serious consequences to the patient's life and health due to a medical error or actions of medical or pharmaceutical workers committed in the absence of fault are considered although they result in the death of the patient or other grave consequences. Particular attention is paid to iatrogenic mental illness, caused by improper professional activity of the medical workers and peculiarities of the psyche of the patients. Particular attention is paid to the study of the practice of the European Court of Human Rights regarding the legal guarantee of the right to life in Ukraine in the context of criminal proceedings. Ukraine is a party to virtually all international human rights treaties. It imposes on it the obligation to adhere to European norms in the field of human protection. The need for comparative study of laws and effectiveness of their application at the present stage of society's development is due to the process of globalization affecting today not only economic and political processes but also the process of lawmaking. This requires the lawyers of different countries to join in the development of the theoretical foundations of lawmaking to formulate in the aggregate knowledge about the effect of laws based on world legal traditions and experience of the separate states. The complex structure of the health care organizations has led to the need for new models of healthcare professionals to ensure the quality of care and patient safety. In the current situation, patient safety is one of the new challenges faced by the medical students in undergraduate and postgraduate education. This involves incorporating a patient safety culture into curricula, in particular for the doctors and other health care professionals. The scientific article is aimed at solving the issues of criminal law protection as the rights of people in need of the medical services as well as medical and pharmaceutical workers who provide these services.


2011 ◽  
Vol 7 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Muriel Hoffait ◽  
David Hanlon ◽  
Bernd Benninghoff ◽  
Stijn Calcoen

2017 ◽  
Vol 35 (2) ◽  
pp. 218-228 ◽  
Author(s):  
Joep van de Geer ◽  
Nic Veeger ◽  
Marieke Groot ◽  
Hetty Zock ◽  
Carlo Leget ◽  
...  

Objectives: Patients value health-care professionals’ attention to their spiritual needs. However, this is undervalued in health-care professionals’ education. Additional training is essential for implementation of a national multidisciplinary guideline on spiritual care (SC) in palliative care (PC). Aim of this study is to measure effects of a training program on SC in PC based on the guideline. Methods: A pragmatic multicenter trial using a quasi-experimental pretest–posttest design as part of an action research study. Eight multidisciplinary teams in regular wards and 1 team of PC consultants, in 8 Dutch teaching hospitals, received questionnaires before training about perceived barriers for SC, spiritual attitudes and involvement, and SC competencies. The effect on the barriers on SC and SC competencies were measured both 1 and 6 months after the training. Results: For nurses (n = 214), 7 of 8 barriers to SC were decreased after 1 month, but only 2 were still after 6 months. For physicians (n = 41), the training had no effect on the barriers to SC. Nurses improved in 4 of 6 competencies after both 1 and 6 months. Physicians improved in 3 of 6 competencies after 1 month but in only 1 competency after 6 months. Significance of Results: Concise SC training programs for clinical teams can effect quality of care, by improving hospital staff competencies and decreasing the barriers they perceive. Differences in the effects of the SC training on nurses and physicians show the need for further research on physicians’ educational needs on SC.


2006 ◽  
Vol 86 (9) ◽  
pp. 1203-1220 ◽  
Author(s):  
Monika E Finger ◽  
Alarcos Cieza ◽  
Juerg Stoll ◽  
Gerold Stucki ◽  
Erika O Huber

Abstract Background and Purpose. Disability or limitations in human functioning are universal experiences that concern all people. Physical therapists aim to improve functioning and prevent disability. With the approval of the new International Classification of Functioning, Disability and Health (ICF), we can now rely on a globally recognized framework and classification to be used in different health care situations by all health care professionals in multidisciplinary teams. The objective of this study was to identify ICF categories that describe the most relevant and common patient problems managed by physical therapists in acute, rehabilitation, and community health care situations taking into account 3 major groups of health conditions: musculoskeletal, neurological, and internal. Subjects. The subjects were physical therapists who were identified as possible participants by the heads of physical therapy departments who were members of the Swiss Association of Physical Therapy Department Heads or who were recruited from the membership of the Swiss Association of Physiotherapy. Methods. A consensus-building, 3-round, electronic-mail survey with 9 groups of physical therapists was conducted using the Delphi technique. Results. Two hundred sixty-three physical therapists participated in at least one round of the Delphi exercise. They had consensus levels of 80% or higher for categories in all ICF components (Body Functions, Body Structures, Activities and Participation, and Environmental Factors 1 and 2). Discussion and Conclusion. This study is a first step toward identifying a list of intervention categories relevant for physical therapy according to the ICF. The ICF, designed as a common language for multidisciplinary use, is also a very helpful framework for defining the core competence for the physical therapy profession.


2021 ◽  
Vol 21 (2) ◽  
pp. 116-146
Author(s):  
Fae Garland ◽  
Michael Thomson ◽  
Mitchell Travis ◽  
Joshua Warburton

Non-therapeutic medical interventions on the bodies of children born with disorders of sex development (DSD)/intersex variations have been subject to increasing critical scrutiny. In response to recent criticism directed at the United Kingdom, and early moves to consider reform, we report on a freedom of information exercise that sought to evaluate whether National Health Service England is meeting international standards on optimal clinical management of DSD/intersex variations. The study explored what medical protocols are being followed to help inform potential reform, particularly with regard to non-therapeutic surgery. While the exercise revealed limited examples of promising practice, current protocols in the majority of Trusts appear unlikely to meet the complex needs of these children. We identify areas where significant improvement is needed, including data management, consistency in guideline use, composition of multidisciplinary teams and addressing disciplinary hierarchies within teams. These concerns sharpen criticisms of the lack of recognition of children’s rights in this context.


10.2196/17004 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17004 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Pablo-David Rojas ◽  
Joscha Hofferbert ◽  
Alvaro Valera Sosa ◽  
Felix Balzer ◽  
...  

Background Until recently, developing health technologies was time-consuming and expensive, and often involved patients, doctors, and other health care professionals only as passive recipients of the end product. So far, users have been minimally involved in the ideation and creation stages of digital health technologies. In order to best address users’ unmet needs, a transdisciplinary and user-led approach, involving cocreation and direct user feedback, is required. In this context, hackathon events have become increasingly popular in generating enthusiasm for user-centered innovation. Objective This case study describes preparatory steps and the performance of a health hackathon directly involving patients and health care professionals at all stages. Feasibility and outcomes were assessed, leading to the development of systematic recommendations for future hackathons as a vehicle for bottom-up innovation in health care. Methods A 2-day hackathon was conducted in February 2017 in Berlin, Germany. Data were collected through a field study. Collected field notes were subsequently discussed in 15 informal meetings among the research team. Experiences of conducting two further hackathons in December 2017 and November 2018 were included. Results In total, 30 participants took part, with 63% (19/30) of participants between 25 and 34 years of age, 30% (9/30) between 35 and 44 years of age, and 7% (2/30) younger than 25 years of age. A total of 43% (13/30) of the participants were female. The participation rate of medical experts, including patients and health care professionals, was 30% (9/30). Five multidisciplinary teams were formed and each tackled a specific health care problem. All presented projects were apps: a chatbot for skin cancer recognition, an augmented reality exposure-based therapy (eg, for arachnophobia), an app for medical neighborhood connectivity, a doctor appointment platform, and a self-care app for people suffering from depression. Patients and health care professionals initiated all of the projects. Conducting the hackathon resulted in significant growth of the digital health community of Berlin and was followed up by larger hackathons. Systematic recommendations for conducting cost-efficient hackathons (n≤30) were developed, including aspects of community building, stakeholder engagement, mentoring, themes, announcements, follow-up, and timing for each step. Conclusions This study shows that hackathons are effective in bringing innovation to health care and are more cost- and time-efficient and potentially more sustainable than traditional medical device and digital product development. Our systematic recommendations can be useful to other individuals and organizations that want to establish user-led innovation in academic hospitals by conducting transdisciplinary hackathons.


2019 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Pablo-David Rojas ◽  
Joscha Hofferbert ◽  
Alvaro Valera Sosa ◽  
Felix Balzer ◽  
...  

BACKGROUND Until recently, developing health technologies was time-consuming and expensive, and often involved patients, doctors, and other health care professionals only as passive recipients of the end product. So far, users have been minimally involved in the ideation and creation stages of digital health technologies. In order to best address users’ unmet needs, a transdisciplinary and user-led approach, involving cocreation and direct user feedback, is required. In this context, hackathon events have become increasingly popular in generating enthusiasm for user-centered innovation. OBJECTIVE This case study describes preparatory steps and the performance of a health hackathon directly involving patients and health care professionals at all stages. Feasibility and outcomes were assessed, leading to the development of systematic recommendations for future hackathons as a vehicle for bottom-up innovation in health care. METHODS A 2-day hackathon was conducted in February 2017 in Berlin, Germany. Data were collected through a field study. Collected field notes were subsequently discussed in 15 informal meetings among the research team. Experiences of conducting two further hackathons in December 2017 and November 2018 were included. RESULTS In total, 30 participants took part, with 63% (19/30) of participants between 25 and 34 years of age, 30% (9/30) between 35 and 44 years of age, and 7% (2/30) younger than 25 years of age. A total of 43% (13/30) of the participants were female. The participation rate of medical experts, including patients and health care professionals, was 30% (9/30). Five multidisciplinary teams were formed and each tackled a specific health care problem. All presented projects were apps: a chatbot for skin cancer recognition, an augmented reality exposure-based therapy (eg, for arachnophobia), an app for medical neighborhood connectivity, a doctor appointment platform, and a self-care app for people suffering from depression. Patients and health care professionals initiated all of the projects. Conducting the hackathon resulted in significant growth of the digital health community of Berlin and was followed up by larger hackathons. Systematic recommendations for conducting cost-efficient hackathons (n≤30) were developed, including aspects of community building, stakeholder engagement, mentoring, themes, announcements, follow-up, and timing for each step. CONCLUSIONS This study shows that hackathons are effective in bringing innovation to health care and are more cost- and time-efficient and potentially more sustainable than traditional medical device and digital product development. Our systematic recommendations can be useful to other individuals and organizations that want to establish user-led innovation in academic hospitals by conducting transdisciplinary hackathons.


2016 ◽  
Vol 1 (2) ◽  
pp. 451 ◽  
Author(s):  
Inga Kudeikina

Nowadays increasing attention is paid to the issues of legal organization of the patient-health care professional relationship. One of the issues in this field is the institution of the rights and obligations of the patients and the medical practitioners. Cases when the doctor restricts the rights of the patient while fulfilling his duties or vice versa are rare. Interaction of the scope of rights and obligations of the patients and medical practitioners causes complicated situation. The author believes that solution to such situation is to be found in the human rights standards. The article discusses the issue regarding the grounds, on which the legal relationship of the patient and the health care professional are created, and how they are organized. The issues of the patient-health care professional relationship are viewed from the perspective of the human rights. Rights to life and health form the fundamental principle of the human rights, which is integrated in the national and international legal acts. The aim of the article is to provide insight to the role played by fundamental principle of the human rights, principles in the relationship of the patients and medical practitioners. Analyses show that human rights in relations between patients and health care professionals are absolute.


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