Fetuses with Neural Tube Defects: ethical approaches and the role of health care professionals in Turkish health care institutions

2005 ◽  
Vol 12 (1) ◽  
pp. 59-78 ◽  
Author(s):  
Hanzade Doğan ◽  
Serap Sahinoglu
Keyword(s):  
Health Care ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Health Care Professionals ◽  
Ethics Education ◽  
Ethical Decision Making ◽  
Ethics Committees ◽  
Ethical Frameworks ◽  
Ethical Approaches

Neural tube defects (NTDs) are very serious malformations for the fetus, causing either low life expectancy or a chance of survival only with costly and difficult surgical interventions. In western countries the average prevalence is 1/1000-2000 and in Turkey it is 4/1000. The aim of the study was to characterize ethical approaches at institutional level to the fetus with an NTD and the mother, and the role of health care professionals in four major centers in Turkey. The authors chose perinatology units of four university hospitals and prepared questionnaires for the responsible professionals concerning their own and their institution’s ethical approaches to the fetus with an NTD and the mother. The investigation revealed that there were no institutional ethical frameworks or ethics committees available to professional teams in the units. The roles of the health care professionals and their individual decisions and approaches based on ethical principles are described. The ethical decision-making process concerning fetuses with NTDs, examples of institutional approaches to the topic and institutional frameworks, and the role of nurses and other health care professionals are all discussed, based on a literature review. The authors suggest that institutional ethical frameworks, ethics committees, professionals’ ethics education and multidisciplinary teamwork should be established for critical situations such as fetuses with an NTD.

Knowledge and Use of Folic Acid: In Women of Reproductive Age

2011 ◽  
Vol 72 (4) ◽  
pp. 197-200 ◽  
Author(s):  
Kelly R.S. Fehr ◽  
Kelsey D.H. Fehr ◽  
Jennifer Lisa Penner Protudjer
Keyword(s):  
Health Care ◽  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Health Care Professionals ◽  
Household Income ◽  
Reproductive Age ◽  
Sources Of Information ◽  
Childbearing Age ◽  
Women Of Reproductive Age

Folic acid reduces the risk of neural tube defects. As approximately 50% of pregnancies are unintended, women of reproductive age should be aware of the importance of folic acid. We reviewed the existing literature on these women’s knowledge of folic acid and neural tube defects. Databases searched were PubMed, CINAHL, and Health Reference Center Academic. We used terms such as “folic acid knowledge” and “folic acid awareness” to search articles published from 1998 to 2010. Awareness of the benefits of folic acid before conception and during pregnancy was low, although knowledge levels were associated with education and household income. Women who were already knowledgeable about folic acid cited health care professionals, magazines and newspapers, and radio and television as common sources of information. Effective knowledge translation is needed to ensure that women are informed about the benefits of folic acid during the reproductive years. This knowledge will allow them to make informed decisions about folic acid consumption. Health care professionals play an influential role in promoting folic acid knowledge among women of childbearing age. Lower levels of knowledge among women with lower levels of education and/or household income must be addressed.

Caring for Gravely Ill Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Ethics Committees ◽  
Well Being ◽  
Pediatric Health Care ◽  
Spiritual Well Being ◽  
Primary Focus

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

The Role of Primary Health Care Professionals

2017 ◽  
pp. 329-335 ◽  
Author(s):  
Alfonso M. Cueto-Manzano ◽  
Héctor R. Martínez-Ramírez ◽  
Laura Cortés-Sanabria ◽  
Enrique Rojas-Campos
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Primary Health

scholarly journals The Efficacy of an Antioppression Curriculum for Health Professionals

2019 ◽  
Vol 51 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Diana Wu ◽  
Lamercie Saint-Hilaire ◽  
Andrew Pineda ◽  
Danielle Hessler ◽  
George W. Saba ◽  
...  
Keyword(s):  
Health Care ◽  
Teaching Methods ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Health Care Disparities ◽  
Unconscious Bias ◽  
Survey Response Rate ◽  
The Mean ◽  
Skill Building

Background and Objectives: Health professionals increasingly recognize the role that social determinants play in health disparities. However, little focus is placed on how health care professionals themselves contribute to disparities through biased care. We have developed a curriculum based on an antioppression framework which encourages health professionals to evaluate their biases and combat health care disparities through an active process of allyship. Methods: Teaching methods emphasize skill building and include lectures, guided reflections, and facilitated discussions. Pre- and postsurveys were administered to assess participants’ confidence level to recognize unconscious bias and to be an ally to colleagues, patients, and staff. In total, we conducted 20 workshops with a total of 468 participants across multiple disciplines. Results: The survey response rate was 80%. Using a paired t-test, the mean difference in the pre- and postsurveys revealed a statistically significant improvement across all measures. Participants showed the greatest improvements (large effect size d>0.8) in their understanding of the process of allyship, their ability to describe strategies to address, assess, and recognize unconscious bias, and their knowledge of managing situations in which prejudice, power, and privilege are involved. Conclusions: Results show that an antioppression curriculum can enhance health professionals’ confidence in addressing bias in health care through allyship. For those who value social justice and equity, moving from the role of bystander to a place of awareness and solidarity allows for one’s behaviors to mirror these values. Allyship is an accessible tool that all health professionals can use in order to facilitate this process.

scholarly journals Health Care Robotics: Qualitative Exploration of Key Challenges and Future Directions (Preprint)

2018 ◽  
Author(s):  
Kathrin Cresswell ◽  
Sarah Cunningham-Burley ◽  
Aziz Sheikh
Keyword(s):  
Health Care ◽  
International Health ◽  
Diverse Range ◽  
Health Care Settings ◽  
Ethical Frameworks ◽  
Legal Challenges ◽  
Future Challenges ◽  
Qualitative Exploration ◽  
Robotic Applications

BACKGROUND The emergence of robotics is transforming industries around the world. Robot technologies are evolving exponentially, particularly as they converge with other functionalities such as artificial intelligence to learn from their environment, from each other, and from humans. OBJECTIVE The goal of the research was to understand the emerging role of robotics in health care and identify existing and likely future challenges to maximize the benefits associated with robotics and related convergent technologies. METHODS We conducted qualitative semistructured one-to-one interviews exploring the role of robotic applications in health care contexts. Using purposive sampling, we identified a diverse range of stakeholders involved in conceiving, procuring, developing, and using robotics in a range of national and international health care settings. Interviews were digitally recorded, transcribed verbatim, and analyzed thematically, supported by NVivo 10 (QSR International) software. Theoretically, this work was informed by the sociotechnical perspective, where social and technical systems are understood as being interdependent. RESULTS We conducted 21 interviews and these accounts suggested that there are significant opportunities for improving the safety, quality, and efficiency of health care through robotics, but our analysis identified 4 major barriers that need to be effectively negotiated to realize these: (1) no clear pull from professionals and patients, (2) appearance of robots and associated expectations and concerns, (3) disruption of the way work is organized and distributed, and (4) new ethical and legal challenges requiring flexible liability and ethical frameworks. CONCLUSIONS Sociotechnical challenges associated with the effective integration of robotic applications in health care settings are likely to be significant, particularly for patient-facing functions. These need to be identified and addressed for effective innovation and adoption.

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