What are the ethical conflicts faced by Mexican internists?

2021 ◽  
pp. 147775092110366
Author(s):  
Octavio Márquez Mendoza ◽  
José de Jesús Garduño García ◽  
Marcela Veytia López ◽  
Jorge Rodríguez García ◽  
Rosalía García Peña ◽  
...  
Keyword(s):  
End Of Life ◽  
Ethics Committees ◽  
Ethical Problems ◽  
Doctor Patient Communication ◽  
Institutional Ethics ◽  
Capacity Decisions ◽  
Ethical Conflicts ◽  
Clinical Relationship ◽  
Incapacitated Patients ◽  
Relationship Communication

Background No studies have been conducted in Mexico to ascertain what ethical problems doctors working at hospitals deal with. This article aims to describe the ethical conflicts most commonly identified by Mexican internists and the importance they attribute to each of these conflicts. Methods Voluntary survey to the members of the Internal Medicine Association of Mexico. Results Responses were submitted by 347 internists. Half of those face ethical conflicts almost always or frequently. The most commonplace and relevant conflicts are those resulting from the clinical relationship (communication, confidentiality, informed consent, assessment of mental capacity, decisions involving incapacitated patients, and conflicts with family members), and secondly those problems related with the end of life (palliative care, withholding or withdrawing treatment, and “No CPR orders”). To resolve conflicts they seek support through protocols, Institutional Ethics Committees (IECs), and consultations with colleagues and, occasionally, with bioethics experts. Protocols and IECs are the tools most in demand among them. Conclusions 1) the most frequent and relevant conflicts are those caused by the clinical relationship, above all those due to doctor–patient communication, and secondly those due to problems which arise at the end of life; 2) though nearly all of them have doubts about how to resolve conflicts, the vast majority are satisfied with the way in which they do so; 3) to deal with conflicts, they seek support mainly in protocols, IECs, and consultation with colleagues; and 4) in order to resolve them better, what they most demand are protocols and IECs, but also bioethics consultants.

Death, taxes and uncertainty: Economic motivations in end-of-life decision making

2021 ◽  
pp. 147775092110114
Author(s):  
George Slade Mellgard ◽  
Jacob M Appel
Keyword(s):  
End Of Life ◽  
Ethical Issues ◽  
Conflicts Of Interest ◽  
Clinical Care ◽  
Third Party ◽  
Ethical Conflicts ◽  
Financial Interests ◽  
End Of Life Decision ◽  
Death Taxes

Economic motivations are key drivers of human behavior. Unfortunately, they are largely overlooked in literature related to medical decisionmaking, particularly with regard to end-of-life care. It is widely understood that the directions of a proxy acting in bad faith can be overridden. But what of cases in which the proxy or surrogate appears to be acting in good faith to effectuate the patient’s values, yet doing so directly serves the decision-maker’s financial interests? Such situations are not uncommon. Many patients care as deeply about economic wellbeing of their families as they do for their own lives and health. This brief work examines three scenarios that raise ethical issues regarding the role of pecuniary motives in making critical medical decisions. Each scenario presents a potential financial conflict of interest between an incapacitated patient and a third-party decision-maker and offers a framework for integrating ethical and legal concerns into clinical care. It is our hope that this work prepares physicians for unexpected ethical conflicts of interest and enables them to further the interests of his or her patients.

Community nurses' experiences of ethical problems in end-of-life care in the patient's own home

2012 ◽  
Vol 27 (4) ◽  
pp. 831-838 ◽  
Author(s):  
Margareta Karlsson ◽  
Christina Karlsson ◽  
António Barbosa da Silva ◽  
Ingela Berggren ◽  
Maud Söderlund
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Ethical Problems

scholarly journals Rotavirus vaccine impact assessment surveillance in India: protocol and methods

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024840 ◽  
Author(s):  
Nayana P Nair ◽  
Samarasimha Reddy N ◽  
Sidhartha Giri ◽  
Venkata Raghava Mohan ◽  
Umesh Parashar ◽  
...  
Keyword(s):  
Data Entry ◽  
Immunisation Programme ◽  
Ethics Committees ◽  
Rotavirus Vaccine ◽  
Routine Immunisation ◽  
National Immunisation Programme ◽  
National Immunisation ◽  
Institutional Ethics ◽  
Institutional Review ◽  
Vaccine Impact

IntroductionRotavirus infection accounts for 39% of under-five diarrhoeal deaths globally and 22% of these deaths occur in India. Introduction of rotavirus vaccine in a national immunisation programme is considered to be the most effective intervention in preventing severe rotavirus disease. In 2016, India introduced an indigenous rotavirus vaccine (Rotavac) into the Universal Immunisation Programme in a phased manner. This paper describes the protocol for surveillance to monitor the performance of rotavirus vaccine following its introduction into the routine childhood immunisation programme.MethodsAn active surveillance system was established to identify acute gastroenteritis cases among children less than 5 years of age. For all children enrolled at sentinel sites, case reporting forms are completed and a copy of vaccination record and a stool specimen obtained. The forms and specimens are sent to the referral laboratory for data entry, analysis, testing and storage. Data from sentinel sites in states that have introduced rotavirus vaccine into their routine immunisation schedule will be used to determine rotavirus vaccine impact and effectiveness.Ethics and disseminationThe Institutional Review Board of Christian Medical College, Vellore, and all the site institutional ethics committees approved the project. Results will be disseminated in peer-reviewed journals and with stakeholders of the universal immunisation programme in India.

scholarly journals Institutional Ethics Committee Regulations and Current Updates in India

2017 ◽  
Vol 18 (8) ◽  
pp. 738-741
Author(s):  
Amit V Mahuli ◽  
Simpy A Mahuli
Keyword(s):  
Ethics Committees ◽  
Ethics Committee ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Multiple Factors ◽  
Research Guidelines ◽  
Institutional Ethics ◽  
Controller General ◽  
Human Participants ◽  
Indian Scenario

ABSTRACT Aim The aim of the review is to provide current updates on regulations for ethics committees and researchers in India. Background Ethical dilemmas in research since time immemorial have been a major concern for researchers worldwide. The question “what makes clinical research ethical” is significant and difficult to answer as multiple factors are involved. Review results The research involving human participants in clinical trials should follow the required rules, regulations, and guidelines in one's own country. It is a dynamic process, and updates have to be learned by researcher and committee members. The review highlights the ethical regulation from the Drug Controller General of India, Clinical Trial Registry of India, and Indian Council of Medical Research guidelines. Conclusion In this article, the updates on Indian scenario of the Ethical Committee and guidelines are compiled. Clinical significance The review comes handy for clinical researchers and ethics committee members in academic institutions to check on the current updates and keep abreast with the knowledge on regulations of ethics in India. How to cite this article Mahuli AV, Mahuli SA, Patil S, Bhandi S. Institutional Ethics Committee Regulations and Current Updates in India. J Contemp Dent Pract 2017;18(8):738-741.

Are Students Really Human? Observations on Institutional Ethics Committees

1994 ◽  
Vol 29 (2) ◽  
pp. 145-146 ◽  
Author(s):  
Mark R. Diamond ◽  
Daniel D. Reidpath
Keyword(s):  
Ethics Committees ◽  
Institutional Ethics

The Ethics of Suicide Research

Crisis ◽  
2009 ◽  
Vol 30 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Richard Lakeman ◽  
Mary FitzGerald
Keyword(s):  
Content Analysis ◽  
Online Survey ◽  
Ethics Committees ◽  
Ethics Committee ◽  
Ethical Practice ◽  
Potential Harm ◽  
Ethical Problems ◽  
Formidable Challenge ◽  
Population Potential ◽  
Research Findings

Background. Good quality, ethically sound research is needed in order to better understand, appropriately respond to, and reduce the incidence of suicide. There is, however, a lack of clarity around the nature of ethical problems associated with suicide research and how to resolve them. This is a formidable challenge for ethics committee members in approving and monitoring research. Aims. To describe the views that members of health research ethics committee hold regarding ethical problems and ethical practice in research involving people who are, or who have, been suicidal. Methods. Ethics committee members were invited to complete an online survey addressing the risks, benefits, and ethical problems associated with suicide research. Findings were aggregated into themes using an inductive form of content analysis. Results. Concerns of ethics committees centered on accessing the population, potential harm to participants or the researcher, researcher competency, maintaining confidentiality, providing support to participants, and responding sensitively to the needs of family. Conclusions. Ethical research involving suicidal people requires both procedures to protect participants, and consideration of ethics as an ongoing negotiated process. The findings of this research provide a snapshot of views held by a number of ethics committee members.

A Qualitative Metasynthesis From Nurses' Perspective When Dealing With Ethical Dilemmas and Ethical Problems in End-of-Life Care

2015 ◽  
Vol 19 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Margareta Karlsson ◽  
Ingela Berggren ◽  
Anne Kasén ◽  
Carola Wärnå-Furu ◽  
Maud Söderlund
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Ethical Dilemmas ◽  
Life Care ◽  
Ethical Problems
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