scholarly journals The ethical tool of informed consent: How mutual trust is co-produced through entanglements and disentanglements of the body

2020 ◽  
pp. 133-153
Author(s):  
Markus Idvall
Keyword(s):  
Informed Consent ◽  
The Body ◽  
Mutual Trust

“We Need Not See the Church with the Eyes”

2018 ◽  
Author(s):  
Amanda Porterfield
Keyword(s):  
Sixteenth Century ◽  
Social Order ◽  
The Body ◽  
City Government ◽  
Body Of Christ ◽  
Black Death ◽  
Mutual Trust ◽  
Corpus Christi ◽  
The Church

Corpus Christi parades brought different groups together in medieval cities to venerate the eucharistic wafer, representing social order and membership in the body of Christ. When cities and trade recovered in the generations after the Black Death of the 1340s, the Eucharist became a source of contention, with reformers demanding that priests, cities, and merchant elites be held more accountable to Pauline ideals. Protest erupted in Florence as Medici bankers exploited Pauline ideals to manipulate kings, popes, and city government. Amsterdam’s ascendance as a hub of commerce in the sixteenth century depended on organizations of mutual trust rooted in Pauline ideals. London began its climb to overtake Amsterdam in commercial clout through the development of a nationwide system of law and taxation that coincided with new efforts to join commerce and Christianity.

scholarly journals P0612UTILITY OF BODY COMPOSITION MONITORING (BCM) TO CORRELATE FLUID STATUS AND AKI IN PATIENTS UNDERGOING MAJOR CARDIAC SURGERY AND OUTCOMES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rajeevalochana Parthasarathy ◽  
Madhusri Babu ◽  
Merina Alex ◽  
Preethi Nagesh ◽  
Milly Mathew ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Body Composition ◽  
Cardiac Surgery ◽  
Informed Consent ◽  
Fluid Overload ◽  
Statistical Significance ◽  
Extracellular Volume ◽  
Kidney Injury ◽  
The Body ◽  
Fluid Status

Abstract Background and Aims Technically assisted assessment of volume status before cardiac surgery may be useful to direct intraoperative fluid administration. Using a three-compartment physiologic tissue model, the body composition monitor (BCM, In Body) measures total body fluid volume, extracellular volume, intracellular volume and fluid overload as surplus or deficit of ‘normal’ extracellular volume. Fluid overload is a risk factor for infection, increased re intubation rates, pneumonia and acute kidney injury in these high risk patients. This study is planned to use BCM to assess fluid status in patients undergoing cardiac surgery and correlating it with the risk of AKI AIMS: To do BCM analysis of patients undergoing major cardiac surgery to assess fluid status and renal outcomes Primary Objective To use BCM to assess fluid status in patients undergoing cardiac surgery and correlate it with the risk of acute kidney injury Secondary Objectives To assess the correlation of fluid status obtained by BCM to assess 1. In hospital mortality in patients with and without AKI Method The studyis being conducted at Madras Medical Mission, Chennai. Time period : 1 year ( June 1 2019- May 31 2020) Inclusion criteria All consecutive patients above 18 years of age undergoing cardiac surgery Exclusion criteria 1. No informed consent 2. Patients having metal implants, pace makers 3. Pregnant and lactating mothers After informed consent, all adult patients undergoing cardiac surgery will have a BCM analysis done by the dietician .( Free of Charge) The BCM analysisInbody S10) will be done on Day 0( preoperative), Day 2 and Day 5 . Data will be collected according to a set proforma ( Attached) . Analysis will be performed using the SPSS platform. Results In this pilot study, 134 patients who underwent major cardiac surgery were enrolled. Of these 44 patients developed AKI as defined by KDIGO criteria( 22 Stage 1, 15 stage 2, and 7 stage 3). There was no statistical significance in the baseline characteristics when compared to age, gender, htn, ckd between patients with and without aki. Overhydration as measured by ECW/TBW ration of > 0.38 was significantly higher on day 2 and 5 in patients who developed AKI .(P<0.00, All 44 patients in aki versus 40 in the non aki group). The PBF, ICW, BMI nad overall BCM score was higher in patient with AKI ( p<0.00). 7 patients required RRT( 6 SLED and 1 Acute PD). There was 1 death in theAKI group. The mean duration of hospital stay was longer ( 14 +/- 5 vs 7 +/- 3.5 ) in the AKI grroup Conclusion There is not much data on BCM and fluid assessment in cardiac surgery patients. These patients have many risk factors and a failing heart and associated renal dysfunction in many makes it very difficult to guide volume therapy in these patients. Many of the so called standard objective measures in assessing volume are not fool- proof . This study will be one of the firsts from India to assess fluid status in these patients and help in guiding therapy and also knowing the outcomes of such an objective measurement

scholarly journals Dermal Filler

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Ferra O. Mawu
Keyword(s):  
Informed Consent ◽  
Side Effects ◽  
The Body ◽  
The Other ◽  
Dermal Filler ◽  
Dermal Fillers ◽  
Before And After ◽  
Long Acting ◽  
Good Preparation ◽  
The Ideal

Abstract: Dermal filler is a non-surgical procedure to improve facial volume or the anatomy of other parts of the body. It is also a rejuvenate therapy to achieve a younger appearance. Besides that, the need of lipodystrophy therapy is increasing. There are several types of fillers with their superiorities and inferiorities; therefore, it is pretty difficult to determine and choose the ideal filler. Dermal fillers vary in duration of therapeutic effect, filler technique, filler origin, and their physical properties. To date, there is no perfect filler so far. An ideal filler must be non-allergenic, non-carcinogenic, non-teratogenic, as well as has achievable cost and long acting effect. In case that dermal filler is therapeutical indicated, good preparation of doctor and patient is essentially needed. Consultation and information have to cover the therapy indication, filler technique, filler limitation, side effects, outcome, cost, and informed consent. As the other cosmetic procedures, to achieve optimal satis-faction, the doctor must be able to provide effective communication to the patient before and after the dermal filler therapy.Keywords: dermal fillerAbstrak: Dermal filler adalah prosedur non-bedah untuk penambahan volume wajah atau anatomi tubuh lainnya. Prosedur ini juga merupakan salah satu terapi rejuvenasi yang bertujuan untuk tampilan lebih muda. Selain itu, kebutuhan untuk terapi lipodistrofi juga makin meningkat. Terdapat berbagai jenis filler dengan keunggulan dan kekurangaood prepnnya masing-masing, sehingga agak sulit menentukan atau memilih produk filler yang ideal. Dermal filler bervariasi dalam hal lamanya efek terapi yang diperoleh, cara pemberian, asal filler, dan sifat fisiknya. Sampai saat ini tidak ada produk filler yang sempurna. Untuk menjadi ideal, produk filler harus nonalergenik, nonkarsinogenik, nonteratogenik, harga terjangkau dan berefek terapi yang panjang. Saat dermal filler menjadi pilihan terapi atau tindakan, persiapan yang tepat baik dokter maupun pasien merupakan hal yang esensial. Konsultasi dan informasi harus meliputi ketepatan indikasi pemberian filler, tehnik pemberian, keterbatasan filler, efek samping, kemungkinan hasil akhir, biaya, dan informed consent. Sebagaimana prosedur kosmetik lainnya, untuk kepuasan bersama, dokter harus mampu dan bersedia memberikan komunikasi efektif kepada pasien sebelum dan sesudah terapi dermal filler.Kata kunci: dermal filler

Recent Trends in Montaigne Scholarship: A Post-Structuralist Perspective

1984 ◽  
Vol 37 (1) ◽  
pp. 34-54 ◽  
Author(s):  
Richard L. Regosin
Keyword(s):  
Sixteenth Century ◽  
The Body ◽  
Good Faith ◽  
Mutual Trust ◽  
Reading Practice ◽  
Recent Trends ◽  
The Subject ◽  
Own Name ◽  
Authorial Voice ◽  
Shed Light

Montaigne scholarship has traditionally drawn its impetus from the identification of life and work and its sense of the overwhelming presence of Montaigne as the subject of his text. Bolstered by the essayist's own protestations of sincerity, of good faith and mutual trust between writer and reader, scholars have read the first-person discourse as affirming the truth of the “I” inside the writing and its unequivocal coincidence with its historical referent. The authorial voice announcing itself as self-portraiture, bearing its own name, has been taken to represent the man, his character and ideas, and to reflect the broader sixteenth-century intellectual and social context.This long-standing reading practice, with its conviction of mimesis, has undoubtedly achieved useful biographical and historical results. Scholars interested in the evolution of Montaigne's thought have shed light on his mode of composition through textual accretion by studying the successive additions and emendations which are identified as strata in the body of the work: A(1580, 1582), B(1588), C(after 1588).

scholarly journals Ethical considerations for HIV remission clinical research involving participants diagnosed during acute HIV infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Adam Gilbertson ◽  
Joseph D. Tucker ◽  
Karine Dubé ◽  
Maartje Dijkstra ◽  
Stuart Rennie
Keyword(s):  
Informed Consent ◽  
Hiv Infection ◽  
Lived Experience ◽  
The Body ◽  
Responsible Conduct Of Research ◽  
People Living With Hiv ◽  
Ethical Challenges ◽  
Acute Hiv Infection ◽  
Research Recruitment ◽  
Acute Hiv

AbstractHIV remission clinical researchers are increasingly seeking study participants who are diagnosed and treated during acute HIV infection—the brief period between infection and the point when the body creates detectable HIV antibodies. This earliest stage of infection is often marked by flu-like illness and may be an especially tumultuous period of confusion, guilt, anger, and uncertainty. Such experiences may present added ethical challenges for HIV research recruitment, participation, and retention. The purpose of this paper is to identify potential ethical challenges associated with involving acutely diagnosed people living with HIV in remission research and considerations for how to mitigate them. We identify three domains of potential ethical concern for clinicians, researchers, and ethics committee members to consider: 1) Recruitment and informed consent; (2) Transmission risks and partner protection; and (3) Ancillary and continuing care. We discuss each of these domains with the aim of inspiring further work to advance the ethical conduct of HIV remission research. For example, experiences of confusion and uncertainty regarding illness and diagnosis during acute HIV infection may complicate informed consent procedures in studies that seek to recruit directly after diagnosis. To address this, it may be appropriate to use staged re-consent procedures or comprehension assessment. Responsible conduct of research requires a broad understanding of acute HIV infection that encompasses its biomedical, psychological, social, and behavioral dimensions. We argue that the lived experience of acute HIV infection may introduce ethical concerns that researchers and reviewers should address during study design and ethical approval.

NSA Management Directive #424: Secrecy and Privacy in the Aftermath of Edward Snowden

2014 ◽  
Vol 28 (1) ◽  
pp. 29-38 ◽  
Author(s):  
George R. Lucas
Keyword(s):  
Public Policy ◽  
Informed Consent ◽  
National Security ◽  
Body Politic ◽  
The Body ◽  
Surveillance Program ◽  
National Security Agency ◽  
Public Input ◽  
Public Oversight

Whatever else one might say concerning the legality, morality, and prudence of his actions, Edward Snowden, the former U.S. National Security Agency (NSA) contractor, is right about the notion of publicity and informed consent, which together constitute the hallmark of democratic public policy. In order to be morally justifiable, any strategy or policy involving the body politic must be one to which it would voluntarily assent when fully informed about it. This, in essence, was Snowden's argument for leaking, in June 2013, the documents that revealed the massive NSA surveillance program:So long as there's broad support amongst a people, it can be argued there's a level of legitimacy even to the most invasive and morally wrong program, as it was an informed and willing decision. . . . However, programs that are implemented in secret, out of public oversight, lack that legitimacy, and that's a problem. It also represents a dangerous normalization of “governing in the dark,” where decisions with enormous public impact occur without any public input.

scholarly journals Vulnerability and the Consenting Subject: Reimagining Informed Consent in Embryo Donation

2019 ◽  
Vol 27 (3) ◽  
pp. 287-310
Author(s):  
Rebecca Hewer
Keyword(s):  
Informed Consent ◽  
Lived Experience ◽  
Feminist Theory ◽  
Health Research ◽  
The Body ◽  
Fertility Treatment ◽  
Embryo Donation ◽  
Feminist Theories ◽  
The Uk

AbstractInformed consent is medico-legal orthodoxy and the principal means by which research encounters with the body are regulated in the UK. However, biomedical advancements increasingly frustrate the degree to which informed consent can be practiced, whilst introducing ambiguity into its legal significance. What is more, feminist theory fundamentally disrupts the ideologically liberal foundations of informed consent, exposing it as a potentially inadequate mode of bioethical regulation. This paper explores these critiques by reference to a case study—embryo donation to health research, following fertility treatment, as regulated by the HFEA 1990—and contends that informed consent cannot adequately respond to the material realities of this research encounter. Thereafter, by drawing on feminist theories of vulnerability, this paper proffers an alternative bioethical approach, which calls for structural reform in recognition of the fundamentally bilateral constitution of self and society and a renewed appreciation for the affective/dispositional tenor of lived experience.

scholarly journals An Assessment of Usual Salt Intake among Older Normotensive Adults in Atonsu, a Suburb of Kumasi in the Ashanti Region of Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Rufai Safianu ◽  
Jacob Plange-Rhule
Keyword(s):  
Blood Pressure ◽  
Informed Consent ◽  
Diastolic Blood Pressure ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Urinary Sodium Excretion ◽  
The Body ◽  
Urinary Sodium ◽  
Ashanti Region ◽  
Urinary Potassium

Background. Globally, sodium intake has been found to be far above the normal level required by the body. Within countries, variations in salt intake exist between rural communities and urban communities. Experimental and epidemiological studies as well as studies involving clinical trials show the existence of adverse effect of salt consumption on the blood pressure of adults. The study evaluated salt intake among older normotensive adults in Atonsu, a suburb of Kumasi in the Ashanti region of Ghana. Methods. Participants were randomly selected from five churches which constituted cluster samples. A questionnaire was administered to participants for demographic information and dietary and lifestyle assessments. The study targeted 100 participants, twenty from each of the five churches. Eighty-two individuals gave their informed consent. Out of the 82 who gave their informed consent, 15 withdrew and 67 completed the course. The 67 participants comprised 36 (53.7%) men and 31 (46.3%) women. Systolic and diastolic blood pressure, BMI, urinary sodium, urinary potassium, serum creatinine, serum sodium, and serum potassium concentrations were also measured. Results. Participants’ mean age was 52.3 ± 8.7 years. Participants had 24 hr urinary sodium excretion of 153.0 ± 26.9 mmol/day. All participants indicated that they consume foods high in salt even though none of them added salt to their diet at table. Mean 24 hr urinary potassium was 52.5 ± 12.9 mmol/day. Mean systolic blood pressure was 119.9 ± 10.8 mmHg and mean diastolic blood pressure was 72.5 ± 7.3 mmHg. Their mean BMI was 23.7 ± 3.5 kg/m2. Conclusion. The participants who can be described as quite old and normotensive were high salt consumers, indicated by their dietary assessment and urinary sodium excretion, even though they had normal blood pressure.

scholarly journals A consideration of the needs of the adult patient with dementia attending for radiotherapy and its impact on the practical consent process

2010 ◽  
Vol 9 (2) ◽  
pp. 107-116 ◽  
Author(s):  
Joan Mowbray ◽  
Helen Mowbray
Keyword(s):  
Informed Consent ◽  
Memory Impairment ◽  
The Body ◽  
Legal Responsibility ◽  
Progressive Decline ◽  
Memory Impairments ◽  
Dementia Patients ◽  
Mental Abilities ◽  
Enormous Variation ◽  
Radiotherapy Treatment

AbstractDementia, which affects about 5% of those aged over 65 years, is the progressive decline in cognitive function due to damage or disease in the body beyond that expected from normal aging. It causes the loss of mental abilities such as thinking, remembering and reasoning and memory impairment, which is important when considering informed consent in radiotherapy. Radiotherapy treatment often involves many visits for a patient and each time it is the legal responsibility of staff to ensure that patient is aware of what is happening and why. Informed consent is challenging in patients with dementia because of the memory impairments and the nature of the information. There is enormous variation in how this illness affects people, depending on the type of dementia and the individuals themselves. Full information about the treatment itself, the benefits and risks of the treatment and the availability of any other reasonable alternatives to the proposed treatment or procedure must be made available. Dementia patients respond well to set approaches and these are detailed. It is important for staff to be familiar with the most effective approaches and consider these in obtaining informed consent.

scholarly journals FEATURES OF CLINICAL MANIFESTATIONS OF GONARTHRITIS IN WOMEN WITH HYPERTENSION AND OVERWEIGHT

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
I. M. Fushtey ◽  
A. M. Pidlubna
Keyword(s):  
Informed Consent ◽  
Musculoskeletal System ◽  
Social Problem ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
The Body ◽  
City Hospital ◽  
The City ◽  
Passive Movements

Abstract One of the diseases that is quite common in modern rheumatology and leads to dysfunction of the musculoskeletal system and creates a major medical and social problem, is gonarthrosis. The incidence of degenerative-dystrophic diseases in HA in women is two to four times higher than in men. In order to establish the patterns of clinical manifestations of GA in women with hypertension (GC) and overweight (HB) of the body, on the basis of the rheumatology department of the city KNP «City Hospital №10» ZMR (Zaporozhye), with informed consent, was prospectively examined 198 women for the period 2018–2020. According to the results of the study, a significant (p <0.05) deterioration of clinical symptoms in women with a combined course of HA with GC and HB, relative to the isolated course of HA, on the indicators: pain during active and passive movements and palpation, stiffness, crepitation and swelling of the joints. The correlations between clinical manifestations of HA, arthrosonographic data and BMI have been established. The characteristics of the pain syndrome associated with exercise, impaired mobility and functionality of the joints significantly increased with increasing stage of GA, joining comorbid pathology and increased BMI.  Keywords: gonarthrosціis, comorbidity, hypertension, overweight.

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