This paper presents the concept of direct and indirect users, a key issue to cooperation between ergonomists, designers and managers involved in a sustainable approach to design. What issues for Ergonomics and Design are launched by this concept? User/consumer differences should be approached taking into account Ergonomics and Design theory ...

OBJECTIVE: The objective of the study was to evaluate the use of and attitudes toward complementary and alternative medicine (CAM) among midwives in Turkey. STUDY DESIGN: Information was requested from 129 midwives at family health centers in Samsun concerning their suggestions for the use of complementary and alternative medicine for ...

Background Chronic fatigue syndrome, or myalgic encephalomyelitis (CFS), is a severe disabling condition. Patients with CFS usually trial many different medicines, both conventional and complementary. An overview of the pharmacological treatments used by CFS patients and the available evidence underpinning the use of these treatments would be of great value ...

Lai J-S, Cella D, Choi S, Junghaenel DU, Christodoulou C, Gershon R, Stone A. How item banks and their application can influence measurement practice in rehabilitation medicine: a PROMIS fatigue item bank example. To illustrate how measurement practices can be advanced by using as an example the fatigue item bank ...

PURPOSE: As a group of European nurses familiar with treating patients with renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC) using targeted/chemo- therapies, we aimed to review strategies for managing adverse events (AEs) associated with one targeted therapy, sorafenib. METHOD: Focusing on the AEs we considered the most difficult to ...

There has been much discussion regarding the acceptable use of sedation for palliation. A particularly contentious practice concerns deep, continuous sedation given to patients who are not imminently dying and given without provision of hydration or nutrition, with the end result that death is hastened. This has been called 'early ...

Gamma knife stereotactic radiosurgery (SRS) has proven to be an effective management approach for trigeminal neuralgia and as a minimally invasive alternative management option for cluster headache (CH). In CH, patients undergo single-session focused irradiation of the trigeminal nerve root (TN), sometimes coupled with irradiation of the sphenopalatine ganglion (SPG) ...

This paper explores how local people in a province in southern Thailand perceive the practice of male and female genital cutting. In order to understand the importance placed on these practices, a comparison is drawn between the two and also between the male circumcision and the Buddhist ordination of monks ...

The article explores the communist ideology that has guided the formation of professional ethics of medicine in China. It first explores the constitutions of the People's Republic of China and the Chinese Communist Party and codes of practice for medicine enforced since 1949, showing that the core of the ideology ...

Traditionally, it has been assumed that metaphysical and practical questions about personhood and personal identity are inherently linked. Neo-Lockean views that draw such a link have been problematic, leading to an opposing view that metaphysical and ethical questions about persons should be sharply distinguished. This paper argues that consideration of ...

Concierge medicine (also called retainer practices or consumer-focused care) represents a new approach to the delivery of primary care. This model involves more personalized attention and greater resources for individual patients, thus limiting the number of patients who can be served at each practice. All enrolled members must pay an ...

The clinical management of intersex has undergone a significant change in values. Whereas in former times, benevolent medical paternalism was the rule, today, the patient's right to respect for dignity and self-determination is given priority. This paper discusses ethical considerations shaping the modern therapeutic management of intersex conditions that do ...

Case managers will occasionally witness colleagues from their own or other healthcare disciplines providing care in ways that frankly deviate from or violate standards of care, rules, regulations, policies, and procedures. This article will discuss the case manager's ethical obligation to speak up in such instances as well as list ...

The purpose of aesthetic medicine is embellishment and enhancement. As these procedures are elective in nature, media messages and misleading advertisements do influence those consumers seeking to improve or enhance their appearance. The role of provider demands that prudent guide these treatment options and not only succumb to patient demands. ...

The 'right to the truth' involves disclosing all the pertinent facts to a patient so that an informed decision can be made. However, this concept of a 'right to the truth' entails certain ambiguities, especially since it is difficult to apply the concept in medical practice based mainly on current ...

Over half a century ago, a Canadian judge defined a profession in a way that resonates still today, not only for lawyers and doctors, but for the current wide variety of professions and professionals. This article is a reflection on this definition. It briefly considers the historical context within which ...

Recent years have seen huge advances in medicine and the science of medicine. Nuclear medicine has been no exception and there has been rapid acceptance of new concepts, new technologies and newer ways of working. Ethical principles have been traditionally considered as generic skills applicable to wide groups of scientists ...

Retainer-medicine primary care practices, commonly referred to as "luxury" or "concierge" practices, provide enhanced services to patients beyond those available in traditional practices for a yearly retainer fee. Adoption of retainer practices has been largely absent in academic health centers (AHCs). Reasons for this trend stem primarily from ethical concerns, ...

New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the ...

Many enhancement technologies are distributed by healthcare professionals-by physicians-who are held to the Hippocratic Oath and the goals of medicine. While the ethics of enhancement has been widely discussed with regard to the social justice, humanism, morals and normative values of these interventions, their place in medicine has not attracted ...

OBJECTIVES: The aim of this paper is to examine whether advertising in the College journals and at RANZCP Congress, in particular from pharmaceutical companies, gives rise to a conflict of interests, and to discuss how this should be managed. CONCLUSIONS: While advertising will often represent a conflict of interests, banning ...

Advances in modern medicine invite the assumption that medicine can control human biology. There is a perilous logic that leads from expectations of medicine's control over reproductive biology to the expectation of having a perfect baby. This article proposes that obstetricians should take a preventive ethics approach to the care ...

Permanent neurological impairment or death arising from hospital-acquired hyponatremia in both children and adults is well documented. The choice of intravenous fluids for fluid resuscitation in critically ill patients is a top priority in evidence-based medicine. The question of whether colloids in comparison to crystalloids can improve mortality in such ...

This article examines ethics (the philosophic study of "doing the right thing") and risk management (the practice that seeks to manage the likelihood of "doing the wrong thing") and the relationship between them in the context of administrative child and adolescent psychiatry. Issues that affect child and adolescent psychiatrists who ...

There are many ethical dilemmas that are unique to sports medicine because of the unusual clinical environment of caring for players within the context of a team whose primary objective is to win. Many of these ethical issues arise because the traditional relationship between doctor and patient is distorted or ...

Clinical trials in neonates are essential in order to provide scientific evidence in relation to the efficacy and safety of medicines. European legislation has recently been passed in order to stimulate clinical research in this area. This should hopefully result in more licensed medicines in the neonatal period. It is ...

The induction of sedation at the end of life is a much debated practice and not very documented. The goal of this study was to explore the practice from both a clinical and ethical point of view. Data were collected through semistructured interviews with 19 Quebec physicians working in palliative ...

Ethical challenges are prevalent in modern-day medicine. Whether arising in the daily practice of medicine, in the conduct of research, or in our educational practices, physicians need to understand the relevance ethics plays in our professional lives. This paper examines the ethical foundations of medical ethics, suggests qualities that define ...

The ultimate goal of evidence-based medicine (EBM) is to develop a scientific basis for choosing interventions that will benefit individuals with defined characteristics under specified conditions. By referencing practice recommendations to the strength of the scientific evidence gleaned from systematic reviews, EBM avoids the influence of professional biases. The randomised ...

Socioeconomic pressures on medicine have redefined traditional relationships between physicians and patients, researchers and regulatory bodies, and consultants and device companies. Physicians are disheartened that the public perception of medicine, reinforced by the media, is often negative. Ethical lapses are frequently the focus of criticism. A recent example that received ...

OBJECTIVES: To discuss translational medicine advances challenging biomedical and health informatics. METHODS: Reviewing material presented at the Heidelberg 35th Anniversary Workshop, summarizing results from the 1st AMIA Summit on Translational Bioinformatics and discussing the opportunities, difficulties, and ethical dilemmas confronting researchers, practitioners, and healthcare managers in transitional bioinformatics. RESULTS: The ...

Pharmacogenomic developments hold promise for personalized medicine in psychiatry with adjusted therapeutic doses, predictable responses, reduced adverse drug reactions, early diagnosis, and personal health planning. The prospects are exciting, but at the same time, these new techniques stand faced with important scientific, ethical, legal, and social challenges that need to ...

Molecular medicine is transforming everyday clinical practice from an empirical art to a rational ortho-molecular science. The prevailing concept in this emerging framework of molecular medicine is a personalized approach to disease prevention, diagnosis, prognosis, and treatment. In this mini-review, we discuss the educational and social-ethical issues raised by the ...

AIM: To determine the prevalence of difficulties in managing ethical dilemmas in family practice. METHODS: The study included a random sample of 259 family medicine physicians, representing 30% of the population of family physicians in Slovenia. Participants were given a self-administered questionnaire on perceived ethical dilemmas in their practice, with ...

Conservation efforts and emergency medicine face comparable problems: how to use scarce resources wisely to conserve valuable assets. In both fields, the process of prioritising actions is known as triage. Although often used implicitly by conservation managers, scientists and policymakers, triage has been misinterpreted as the process of simply deciding ...

This essay asks how we might best elaborate an ethics of authentic practice. Will we be able to agree on a set of shared terms through which ethical practice will be understood? How will we define ethics and the subject's relation to authoritative structures of power and knowledge? We begin ...

OBJECTIVE: To determine opinions and attitudes of the German general population toward the treatment methods of reproductive medicine: egg donation, surrogate mothering, and reproductive cloning. DESIGN: Representative survey. SETTING: German general population: face-to-face interviews at home with 2,110 persons, aged 18-50 years. PATIENT(S): Patients were not included. INTERVENTION(S): No interventions ...

In this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline ...

The Association for Palliative Medicine (APM) produced a previous undergraduate palliative medicine syllabus in 1992. This study describes the process of developing the new APM consensus syllabus against the background of changes in medical education and palliative medicine since 1992. The syllabus was derived by means of a Delphi study ...

Sports medicine is a rapidly expanding area of clinical practice. The pitchside physician faces many ethical challenges in managing the injuries and wellbeing of sports men and women. This brief essay describes some of the dilemmas frequently encountered by the pitchside physician and calls for a discussion of the issues ...

The practice of "concierge" or "retainer" medicine is growingly steadily due to economic and legal pressures on physicians. This practice model, which typically involves charging access or subscription fees to a limited pool of patients, raises legal hazards, contractual challenges, and ethical dilemmas for physicians interested in converting to concierge ...

The study and practice of medicine, in its most personal and intimate functions, its most sophisticated scientific and technological manifestations, and its philosophical and ethical ramifications, are central to our understanding of the human condition. Homeopathic medicine: its insights, the questions that it begs, and the scientific and philosophical challenges ...

The relationship between the health care professional and the patient is universally seen, in medicine, as the core of medical practice. Through it, the doctor acquires professional abilities and pursues the objectives of medicine, among them, that of curing. This relation is contextualized here by using articles 47 and 48, ...

The call for a narrative medicine has been touted as the cure-all for an increasingly mechanical medicine. It has been claimed that the humanities might create more empathic, reflective, professional and trustworthy doctors. In other words, we can once again humanise medicine through the addition of humanities. In this essay, ...

The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective. Very old people tend to use more medicines, and without proper medication, many of them would not function well and would ...

BACKGROUND: Setting priorities and the subsequent allocation of resources is a major ethical issue facing healthcare facilities, including the Veterans Health Administration (VHA), the largest integrated healthcare delivery network in the United States. Yet despite the importance of priority setting and its impact on those who receive and those who ...

Philosophy of medicine cannot be precisely defined because neither philosophy nor medicine can be precisely defined. Furthermore, philosophers of medicine do not constitute a well-defined class because they come not only from the fields of philosophy and medicine, but also from various other disciplines. Hence, I argue for a broad ...

A comprehensive discussion of professionalism in medicine must include its impact on successive generations of physicians. Fifty years ago, doctors acting professionally emphasized medicine as a calling and an ability to act as the authority for patients in crisis at home and in hospitals. Therapeutic options were limited relative to ...

Healthcare practitioners make many important ethical decisions in their day-to-day practices. Questions arising in daily practice require practitioners to make prudent, balanced and good decisions, which are most effectively made interpersonally and reflectively. It is commonly assumed that the team-based structure of healthcare delivery can provide practitioners with the support ...

Evidence-informed practice and policy at the macro level offers great potential for honoring ethical guidelines to integrate practice and research, to involve clients as informed participants, to respond ethically to problems of scarce resources, to enhance social and economic justice, and to empower clients. The process and philosophy of evidence-informed ...