The Legal and Ethical Care of Patients Who are Deaf or Hard of Hearing with an Emphasis on Communication Methods

Background: As the deaf and hard of hearing population has increased over the last few decades, the prevalence of American Sign Language as a person’s primary language has increased with it. However, many optometrists are unsure as to how to approach an exam, and what the law requires to accommodate these patients. This literature review explores the legal and ethical considerations of examining and communicating with patients who are deaf or hard of hearing. Methods: Through literature review, information was gathered and summarized from many high quality publications and legal cases as to how to properly care for and communicate with a patient who is deaf or hard of hearing, with special attention to the legal and ethical requirements of an optometrist. Results: To optimize the health care environment for patients who are deaf or hard of hearing, the most important step is for optometrists to understand local resources, such as sign language interpreters, legal support, and community agencies, that can benefit both the patients and their chair time. This varies depending on what the deaf/hard of hearing patient needs and should be adjusted accordingly. The supplemental use of pictures or diagrams to illustrate tests or procedures may also help solidify communication between patient and doctor but may not be a substitute for “effective communication” as outlined in the Americans with Disabilities Act. Above all, it is important to meet these legal requirements, as well as address the specific needs of the patient, preferably with preparation before the exam. In addition, this information in this literature review is summarized in pamphlet format for distribution to the optometric community. Conclusion: The Americans with Disabilities Act lays out legal guidelines that physicians must follow when it comes to patients who are deaf or hard of hearing, including optometrists. It is important for optometrists to study these requirements and be aware of them, should the situation arise when a patient who is deaf or hard of hearing schedules or presents in a clinical setting.

PROTECTION OF THE RIGHT TO RESPECT FOR PRIVATE LIFE IN THE COURSE OF EDUCATIONAL ACTIVITIES IN THE PRACTICE OF THE EUROPEAN COURT OF HUMAN RIGHTS

The development of digitalization processes and their implementation in educational activities, the establishment of certain legal and ethical requirements for its participants determine the importance of ensuring privacy, identifying and preventing the actions that can be considered as interference with it, and specifying the limits of admissibility of such interference. The purpose of the article is to identify, analyze and generalize the rulings of the European Court of Human Rights regarding the protection of the right to respect for private life in relation to educational activities. Conclusions were made about broad understanding of private life and interference with it by the European Court of Human Rights in the framework of educational activities. It was pointed out that its content includes questions related to the teacher’s professional activity, the compliance of the participants in the educational activity with certain requirements for appearance and behavior, and control over their behavior using modern technologies. It was revealed that interference with private life in the course of educational activities is possible provided that certain criteria for its admissibility, connected with both moral attitudes of the subjects of such activities and with the developed international standards, are met.

Biobanking Across Europe Post-GDPR: A Deliberately Fragmented Landscape

This chapter seeks to provide insight into the ways in which Member States leveraged the regulatory discretion afforded to them by the GDPR. Specifically, it reviews the biobank regulatory environment; whether and how derogations under Article 89(2) GDPR are enabled; the legal basis for scientific research and the role of consent in biobanking post-GDPR; the balance between individual rights and public interest in national law; and finally, the GDPR’s impact and future possibilities for biobanking. In exercising self-determination, Member States can, to a certain extent, align data protection requirements with their values and aspirations. Such alignment, though, could jeopardize collaborative research. In light of the need to bridge divergent legal and ethical requirements at a national and supranational level, the role of Research Ethics Committees (RECs) might prove to be essential.

Monitoring of Heart Rate and Activity Using Telemetry Allows Grading of Experimental Procedures Used in Neuroscientific Rat Models

In animal experimentation, welfare and severity assessments of all procedures applied to animals are necessary to meet legal and ethical requirements, as well as public interests. So far, the methods suggested for this purpose are time consuming and personnel intensive. Also, evidence-based biostatistical methods for this purpose are still rare. We here tested whether the classification of heart rate (HR) and activity (Act) data monitored by telemetry in the home cage by unsupervised k-means-based class-labeling and subsequent Support Vector Machine (SVM) analysis allows severity assessment and grading of experimental procedures of different domains, including surgery, injection, behavioral testing, and routine handling for maintenance. Telemetric devices were subcutaneously implanted in young adult male Crl:CD(SD) and BDIX/UImHanZtm rats. After recovery, rats were randomly subjected to different experimental procedures, i.e., handling and cage change as routine maintenance, Rat Grimace Scale, burrowing, and social interaction for welfare assessment, as well as repeated subcutaneous injections. Thereafter, rats were either intracranially implanted with electrodes or injected with tumor cells. Directly after each procedure, HR and Act were monitored by telemetry in the home cage for 4 h. Application of k-means and SVM algorithms on the obtained data sets from baseline (as no stress), cage change (exploratory Act), and intracranial surgery (as burden) measurements computed three classes described as low HR/low Act, high HR/high Act, and high HR/low Act, respectively. Validation of the SVM model by entering data from all procedures confirmed the allocation to the high HR/low Act class (burden) after surgery, which lasted longer after subcutaneous transmitter implantation than after intracranial surgery. The majority of data points from repeated injections, behavioral testing, and maintenance handling were allocated to the low HR/low Act and high HR/high Act classes. Overall, the SVM model based on HR and Act data monitored in home cage after procedures may be useful for the classification and grading of experimental procedures of different domains.

Anatomical features of the extensor digitorum brevis muscle as a plastic material in reconstructive surgery of facial paralysis

Relevance. Facial paralysis is a common neurological illnesses of the maxillofacial region. Gold standard of dynamic correction of permanent facial paralysis is gracilis muscle transfer. However, using this flap is impractical or impossible in some cases. There are few domestic and international publications about extensor digitorum brevis muscle for facial reanimation surgery.Purpose. Assessment of muscle variability on the dorsum of the foot; analysis of blood supply and innervation of the extensor digitorum brevis muscle.Materials and methods. Operations performed on 10 unclaimed corpses: dissection of the extensor digitorum brevis muscle, as well as the blood vessels and nerves of the dorsum of the foot. The legal and ethical requirements for such studies were observed planning the design of the study and during work.Results. As a result, in 80% of cases, was found a typical anatomy of muscles, blood vessels, and nerves in the dorsum of the foot. In 10% was found a typical anatomy of muscles and nerves, but there was no lateral tarsal artery – the branch of the dorsal artery of the foot. Blood supply to the extensor digitorum brevis muscle performed by perforating branches of the peroneal artery. In 10% was found subtotal atrophy and fibrous degeneration of the extensor digitorum brevis muscle.Conclusions. The use of the extensor digitorum brevis muscle is a perspective method for the treatment of facial paralysis. Harvesting of this flap is complicated.

Modeling consent in the time of COVID-19

Effective responses to the COVID-19 pandemic require novel solutions for research and responsible data sharing. Biobanking presents itself as a key priority in furthering our understanding of COVID-19. In this article, we propose a tripartite approach to consent to create resources for research relating to COVID-19. The approach aims to link three levels of participation: COVID-19 patients, respiratory/infectious disease patients, and longitudinal study participants. We explore the potential approaches that can be taken to consent processes with these three participant groups. We furthermore describe an access model for both single-site and multi-site data and sample storage. Through dealing with these topics at a high level, the model may be adapted to local legal and ethical requirements while still pursuing its ultimate goal: the creation of a research infrastructure that supports transparent, strong, and open science.

Considerations in Closing a Private Practice

The prospect of closing a practice can be daunting. It is a task eventually faced by nearly all psychologists, counselors, family therapists, and social workers who provide psychotherapy, assessment, or forensic services in the context of an independent practice. Retirement, financial difficulties, license suspension or revocation, and serious health problems are among the circumstances prompting a practice closing. Clinicians must think through and develop a practice closing plan that takes into account client needs, legal and ethical requirements, and the need for emotional preparation. This chapter addresses related clinical issues such as client notification, continuity of care, transference, and countertransference. The authors describe common ethical challenges and make recommendations regarding informed consent, confidentiality, and the maintenance and storage of clinical records for both closing and selling a practice.

Mandatory Notification of Child Abuse and Neglect: Perspectives From Psychology

This comment responds to the primary article by Vanessa Deverson in this volume by giving some insights into the problem of mandatory reporting from the perspective of psychology. Parts I and II provide a survey of the legal and ethical requirements imposed on psychologists to report suspected child abuse and neglect. The article then moves on in Part III to discuss the way that psychologists balance the need to maintain client confidentiality with their duties to report. The article argues that lawyers should have the option to report child abuse and neglect, but warns that, before any reporting of child abuse and neglect can be successful, a vast improvement in the management of notifications is essential.