scholarly journals Particulate steroids in axial spinal blockade and the increasing role of patient consent: Les grains de sable dans l’engrenage

2020 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Rajesh Munglani ◽  
Roger Knaggs ◽  
Giles Eyre

The complexity of modern medical practice is such that it is very unlikely that on any single issue we can give a definitive answer in any circumstance, and in our view the medical debate as to the use of particulate corticosteroid medicines in axial spinal blockade is one such argument. The medical discussion of the use of particulate corticosteroids has to be set against the uncertain risk and benefits of axial spinal procedures in which the drugs are utilised, and in which the most likely catastrophic complication may occur with their use, and then, as the law now demands, involve the patient in the relevant consenting issues.

2020 ◽  
Vol 16 (1) ◽  
pp. 48-52
Author(s):  
John Finch

In BJNN 15(4) and BJNN 15(5), John Finch looked in detail at the role of the Mental Capacity Act 2005 and its accompanying Code in the practice of neuroscience nurses. He concluded, as have others, that the guidance offered by the Act and the Code falls short of what neuroscience nurses need in their practice. In this article, he turns his attention to the treatment of patients who can and do consent to proposed treatment. The law relating to such patients in this matter offers neither an act nor a code. The law is to be found in court decisions. It might, at first sight, appear that a practice situation in which a patient with undoubted mental capacity or, at least, sufficient mental capacity to understand and accept what is proposed, presents no legal problem. But a closer examination of mental processes encountered in patients who may be in pain, distress and pressing need reveals that communication between the treater and the treated may be subtle and complex, and that the meeting of minds required in law to ensure that a patient has genuinely agreed to a detailed proposal is anything but simple.


1998 ◽  
Vol 7 (1) ◽  
pp. 108-111
Author(s):  
Ben A. Rich

Anyone with so much as a passing familiarity with bioethics knows how significantly and persistently (at least since mid-century) the law has insinuated itself into healthcare and the process of bioethical decisionmaking. Viewed from the insular perspective of traditional medical practice and medical ethics, it is not surprising that the “legalization” of the patient–physician relationship and clinical judgment has been characterized by some as pernicious. What is much more surprising, however, is when a book by a professor of law evinces the same jaundiced view of the role of law in this area. Nonetheless, the “limits” that Professor Dworkin considers to be inherent in the capacity of the law to resolve bioethical issues are significant, and hence in his opinion the role of the law should be severely circumscribed. This gloomy portrait of the “havoc” wreaked by law upon the landscape of medical practice, painted by a lawyer, stands in stark contrast to an earlier and much more sympathetic account offered by Columbia University historian and medical humanities professor David J. Rothman in his 1991 book Strangers at the Bedside, the informative subtitle of which is A History of How Law and Bioethics Transformed Medical Decision Making.


2015 ◽  
Vol 4 (4) ◽  
pp. 310
Author(s):  
Nor Azian Ab Rahman ◽  
Sagiran Sukardi ◽  
Supyan Husin

<p>In South East Asia, patients often resort to various forms of complementary therapy apart from utilizing mainstream modern medicine in Hospitals. Islamic-based complementary therapy employs various forms of bio-physical, psychological, social, cultural, and spiritual interventional methods based on the prevailing belief and cultural system to provide a holistic <em>Syariah</em> compliant approach in patient management. The concept of diseases caused by sorcery and paranormal means using intermediaries like Jinn and evil spirits that have been in existence since time immemorial across religions, cultures and societies around the world, for example, Homer in Ancient Greece, the legendary Medea, and Witch of Endor in the Bible. Currently, the practice of black magic and the belief in the paranormal still widely exist in the midst of modern civilization in this region.  Modern medical practice has no definitive answer for a person with an unusual medical illness who is believed to have been afflicted by black magic because of its non-specific clinical presentation and non-response to conventional management paradigm which defies medical logic. In this paper, we describe a true case of a lady, 25 years-of-age, who suffered from more than 2000 nails embedded inside her body for one and a half years. Upon admission to a Hospital in Indonesia, she underwent a surgical procedure to remove all of the nails but to no avail; the nails re-appeared at other parts of her body. The surgical team later decided to conduct an Islamic complementary therapy on the patient, and subsequently, managed to extract all of the remaining nails without further bleeding. In conclusion, unusual or mysterious medical illness, sometimes referred to as idiopathic in etiology, not responding to conventional medical or surgical intervention, may potentially benefit from the use of Islamic complementary therapy.</p>


2015 ◽  
Vol 4 (4) ◽  
pp. 310 ◽  
Author(s):  
Nor Azian Ab Rahman ◽  
Sagiran Sukardi ◽  
Supyan Husin

<p>In South East Asia, patients often resort to various forms of complementary therapy apart from utilizing mainstream modern medicine in Hospitals. Islamic-based complementary therapy employs various forms of bio-physical, psychological, social, cultural, and spiritual interventional methods based on the prevailing belief and cultural system to provide a holistic <em>Syariah</em> compliant approach in patient management. The concept of diseases caused by sorcery and paranormal means using intermediaries like Jinn and evil spirits that have been in existence since time immemorial across religions, cultures and societies around the world, for example, Homer in Ancient Greece, the legendary Medea, and Witch of Endor in the Bible. Currently, the practice of black magic and the belief in the paranormal still widely exist in the midst of modern civilization in this region.  Modern medical practice has no definitive answer for a person with an unusual medical illness who is believed to have been afflicted by black magic because of its non-specific clinical presentation and non-response to conventional management paradigm which defies medical logic. In this paper, we describe a true case of a lady, 25 years-of-age, who suffered from more than 2000 nails embedded inside her body for one and a half years. Upon admission to a Hospital in Indonesia, she underwent a surgical procedure to remove all of the nails but to no avail; the nails re-appeared at other parts of her body. The surgical team later decided to conduct an Islamic complementary therapy on the patient, and subsequently, managed to extract all of the remaining nails without further bleeding. In conclusion, unusual or mysterious medical illness, sometimes referred to as idiopathic in etiology, not responding to conventional medical or surgical intervention, may potentially benefit from the use of Islamic complementary therapy.</p>


2014 ◽  
Vol 5 (1) ◽  
pp. 32-58
Author(s):  
Boris Liebrenz

Little is known about the role of surgery in pre-modern medical practice in general, and in the lands under Muslim dominance in particular. There is an acknowledged gap between theoretical knowledge and medical practice, but evidence of the latter is difficult to find. Many fundamental questions therefore remain unanswered. For example, was there a division of labour between surgeons and physicians? We are also mostly ignorant about who practiced surgery, the legal context surrounding this practice, and its financial aspects. This article offers an analytical edition of two documents from the Syrian town Hamah dating from 1212/1798, which can help answer some of these questions. They concern a respected and learned physician who also personally performed the removal of bladder stones and was paid well for his services.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Rizky Maulana Hakim

We realize that in the community, it is still close to the night world which can plunge the nation's next generation, through drinking, gambling, and especially Narcotics. There are many rules related to this problem, it is still possible that the minimum knowledge of the community is what causes users to become victims of the rigors of using drugs.In discussing this paper, we will take and discuss the theme of "Legal Certainty and Role of Laws on Narcotics (Narcotics and Drugs / Hazardous Materials) by Users and Distributors." The purpose of accepting this paper is, first, to be agreed by the reader which can be understood about the dangers that need to be discussed regarding the subjectivity of the drug itself; secondly, asking the reader to get a clue about actually addressing the urgency about the distribution of drugs; round, which is about knowing what the rules of the law and also the awareness in the surrounding community.Keywords: Narcotics, Role of Laws, Problem, Minimum Knowledge, awareness


2020 ◽  
Vol 24 (2) ◽  
pp. 232-250
Author(s):  
Stephanie Dropuljic

This article examines the role of women in raising criminal actions of homicide before the central criminal court, in early modern Scotland. In doing so, it highlights the two main forms of standing women held; pursing an action for homicide alone and as part of a wider group of kin and family. The evidence presented therein challenges our current understanding of the role of women in the pursuit of crime and contributes to an under-researched area of Scots criminal legal history, gender and the law.


2012 ◽  
Vol 153 (3) ◽  
pp. 83-92
Author(s):  
Sándor Gődény

In Hungary healthcare finance has decreased in proportion with the GDP, while the health status of the population is still ranks among the worst in the European Union. Since healthcare finance is not expected to increase, the number of practicing doctors per capita is continuously decreasing. In the coming years it is an important question that in this situation what methods can be used to prevent further deterioration of the health status of the Hungarian population, and within this is the role of the quality approach, and different methods of quality management. In the present and the forthcoming two articles those standpoints will be summarized which support the need for the integration of quality assurance in the everyday medical practice. In the first part the importance of quality thinking, quality management, quality assurance, necessity of quality measurement and improvement, furthermore, advantages of the quality systems will be discussed. Orv. Hetil., 2012, 153, 83–92.


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