1
|
Walker S. Debate: Involuntary treatment and detention are a necessary part of mental health care for children and young people. Child Adolesc Ment Health 2024; 29:200-202. [PMID: 38475676 DOI: 10.1111/camh.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
People of all ages are subject to involuntary psychiatric detention and treatment worldwide but there is current discussion about whether this complies with modern human rights law. The use of involuntary psychiatric hospitalisation among children and young people has largely eschewed research and policy interest to date. In this debate section, we hear from people with experience of child mental health services in the UK, USA and low- and middle-income countries about their views on the use of involuntary treatment in young people.
Collapse
Affiliation(s)
- Susan Walker
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| |
Collapse
|
2
|
Mitchell L, Walker S. Debate: The experience of involuntary psychiatric hospitalisation for children and young people. Child Adolesc Ment Health 2024; 29:211-213. [PMID: 38515366 DOI: 10.1111/camh.12696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
Involuntary treatment has been reported to be traumatic, stigmatising and frightening, as well as sometimes lifesaving. However, there has been little research into the experiences of people who have been hospitalised involuntarily prior to the age of 18. A greater understanding of this may help us to make changes which could improve the experience of involuntary psychiatric treatment for children and young people. Lizzie Mitchell is an expert by experience who was admitted to a psychiatric hospital in England under the Mental Health Act (MHA) when she was 16 years old. Here, in discussion with Susan Walker, a child and adolescent psychiatrist, Lizzie reflects on her own experiences alongside wider reflections around the involuntary hospitalisation of young people, including the potential short and long-term impact on mental health, education, friendships, family and identity.
Collapse
Affiliation(s)
| | - Susan Walker
- Division of Psychiatry, University College London Ringgold Standard Institution, London, UK
| |
Collapse
|
3
|
Paulann G, Andrew A, Moira V, Daniel V. Re-traumatised: The experience of injustice whilst seeking justice. J Psychiatr Ment Health Nurs 2024. [PMID: 38234185 DOI: 10.1111/jpm.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Affiliation(s)
- Grech Paulann
- Department of Mental Health, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Azzopardi Andrew
- Department of Youth and Community Studies, Faculty for Social Wellbeing, University of Malta, Msida, Malta
| | | | | |
Collapse
|
4
|
Pesut B, Thorne S, Chambaere K, Hall M, Schiller CJ. The Evolving Complexities of MAID Care in Canada From a Nursing Perspective. Glob Qual Nurs Res 2024; 11:23333936241228233. [PMID: 38433773 PMCID: PMC10908223 DOI: 10.1177/23333936241228233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 03/05/2024] Open
Abstract
Medical Assistance in Dying (MAID) legislation has evolved rapidly in Canada with significant impacts on nursing practice. The purpose of this paper is to describe evolving complexities in legislative context and practice standards that influence the experiences nurse practitioners and registered nurses have with MAID. Qualitative interviews were conducted with 25 registered nurses and 10 nurse practitioners from diverse contexts across Canada. Participants described their practices and considerations when discussing MAID as part of advance care planning; their use of, and challenges with, waivers of consent; their practice considerations in negotiating the complexities of clients for whom death is not reasonably foreseeable; and their moral wrestling with the inclusion of MAID for persons whose sole underlying medical condition is mental illness. Findings illustrate the moral complexities inherent in the evolving legislation and the importance of robust health and social care systems to the legal and ethical implementation of MAID in Canada.
Collapse
Affiliation(s)
- Barbara Pesut
- University of British Columbia Okanagan, Kelowna, Canada
| | - Sally Thorne
- University of British Columbia, Vancouver, Canada
| | | | | | | |
Collapse
|
5
|
Duffy A. Safeguarding adults at risk of abuse. Nurs Stand 2023:e12170. [PMID: 38221863 DOI: 10.7748/ns.2024.e12170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 01/16/2024]
Abstract
Safeguarding adults at risk of abuse presents complex ethical challenges. By knowing what counts as adult abuse, recognising the signs of adult abuse and appropriately addressing suspected adult abuse, nurses contribute to protecting patients' safety, well-being, autonomy and dignity. This article discusses categories and indicators of adult abuse, relevant legislation and standards, the principles of adult safeguarding and the key elements of a nursing assessment of suspected adult abuse. The author highlights that nurses need to approach safeguarding concerns sensitively and strike a balance between acting to safeguard the person and preserving their right to autonomy. There is a need for ongoing education and training to enhance nurses' understanding of safeguarding practices, legislation, policies and standards.
Collapse
Affiliation(s)
- Anita Duffy
- Our Lady's Hospice & Care Services, Dublin, Republic of Ireland; adjunct lecturer in nursing, School of Nursing, Midwifery and Health Sciences, University College Dublin, Dublin, Ireland
| |
Collapse
|
6
|
Vaughan J. Ethical decision-making in the administration of 'as required' antipsychotics to people with dementia in care homes. Nurs Older People 2023:e1440. [PMID: 37161545 DOI: 10.7748/nop.2023.e1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/11/2023]
Abstract
Antipsychotic medicines are often prescribed 'as required' to manage behavioural and psychological symptoms of dementia, despite evidence that these medicines have little benefit for people with dementia and have numerous adverse side effects, including sedation. It is the nurse's role to decide if and when to administer antipsychotic medicines that have been prescribed on an as required basis. This decision-making is underpinned by complex ethical considerations such as mental capacity, chemical restraint, quality of life and autonomy. Adopting a person-centred approach and considering the ethics, guidelines and legislation related to such decisions can support nurses to act in patients' best interests. This article uses two ethical frameworks - the four principles of biomedical ethics and the 'four quadrants' approach - to examine this complex issue and to demonstrate their use in the context of ethical decision-making in nursing practice.
Collapse
Affiliation(s)
- Jessica Vaughan
- Adult Nursing BSc (hons), Coventry University, Coventry, England
| |
Collapse
|
7
|
Peel M. Understanding the nurse's role as a professional witness. Nurs Stand 2023; 38:29-34. [PMID: 36620950 DOI: 10.7748/ns.2023.e11978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 01/10/2023]
Abstract
Nurses working in any setting may be required to assist the courts or coroners by preparing statements or giving evidence in court. Nurses can act as 'professional witnesses' who provide evidence of something they have seen, heard or been involved with as part of their professional duties. This article outlines how nurses should respond to requests for written statements and suggests a format for providing such statements. It also explains the typical approach to providing oral evidence in court and how nurses should prepare and present themselves in the witness box.
Collapse
|
8
|
Zali M, Rahmani A, Powers K, Hassankhani H, Namdar-Areshtanab H, Gilani N. Nurses' experiences of ethical and legal issues in post-resuscitation care: A qualitative content analysis. Nurs Ethics 2023; 30:245-257. [PMID: 36318470 DOI: 10.1177/09697330221133521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation and subsequent care are subject to various ethical and legal issues. Few studies have addressed ethical and legal issues in post-resuscitation care. OBJECTIVE To explore nurses' experiences of ethical and legal issues in post-resuscitation care. RESEARCH DESIGN This qualitative study adopted an exploratory descriptive qualitative design using conventional content analysis. PARTICIPANTS AND RESEARCH CONTEXT In-depth, semi-structured interviews were conducted in three educational hospital centers in northwestern Iran. Using purposive sampling, 17 nurses participated. Data were analyzed by conventional content analysis. ETHICAL CONSIDERATIONS The study was approved by Research Ethics Committees at Tabriz University of Medical Sciences. Participation was voluntary and written informed consent was obtained. For each interview, the ethical principles including data confidentiality and social distance were respected. FINDINGS Five main categories emerged: Pressure to provide unprincipled care, unprofessional interactions, ignoring the patient, falsifying documents, and specific ethical challenges. Pressures in the post-resuscitation period can cause nurses to provide care that is not consistent with guidelines, and to avoid communicating with physicians, patients and their families. Patients can also be labeled negatively, with early judgments made about their condition. Medical records can be written in a way to indicate that all necessary care has been provided. Disclosure, withdrawing, and withholding of therapy were also specific important ethical challenges in the field of post-resuscitation care. CONCLUSION There are many ethical and legal issues in post-resuscitation care. Developing evidence-based guidelines and training staff to provide ethical care can help to reduce these challenges.
Collapse
Affiliation(s)
- Mahnaz Zali
- 48432Tabriz University of Medical Sciences, Iran
| | - Azad Rahmani
- 48432Tabriz University of Medical Sciences, Iran
| | - Kelly Powers
- 14727University of North Carolina at Charlotte, USA
| | | | | | - Neda Gilani
- 48432Tabriz University of Medical Sciences, Iran
| |
Collapse
|
9
|
Pettersson ABV, Ballardini RM, Mimler M, Li P, Salmi M, Minssen T, Gibson I, Mäkitie A. Legal issues and underexplored data protection in medical 3D printing: A scoping review. Front Bioeng Biotechnol 2023; 11:1102780. [PMID: 36923458 PMCID: PMC10009255 DOI: 10.3389/fbioe.2023.1102780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Introduction: 3D printing has quickly found many applications in medicine. However, as with any new technology the regulatory landscape is struggling to stay abreast. Unclear legislation or lack of legislation has been suggested as being one hindrance for wide-scale adoption. Methods: A scoping review was performed in PubMed, Web of Science, SCOPUS and Westlaw International to identify articles dealing with legal issues in medical 3D printing. Results: Thirty-four articles fulfilling inclusion criteria were identified in medical/technical databases and fifteen in the legal database. The majority of articles dealt with the USA, while the EU was also prominently represented. Some common unresolved legal issues were identified, among them terminological confusion between custom-made and patient-matched devices, lack of specific legislation for patient-matched products, and the undefined legal role of CAD files both from a liability and from an intellectual property standpoint. Data protection was mentioned only in two papers and seems an underexplored topic. Conclusion: In this scoping review, several relevant articles and several common unresolved legal issues were identified including a need for terminological uniformity in medical 3D printing. The results of this work are planned to inform our own deeper legal analysis of these issues in the future.
Collapse
Affiliation(s)
- Ante B V Pettersson
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Surgery, South Karelia Central Hospital, Lappeenranta, Finland
| | | | - Marc Mimler
- The City Law School City, University of London, London, United Kingdom
| | - Phoebe Li
- Sussex Law School, University of Sussex, Brighton, United Kingdom
| | - Mika Salmi
- Department of Mechanical Engineering, Aalto University, Espoo, Finland
| | - Timo Minssen
- Center for Advanced Studies in Biomedical Innovation Law (CeBIL), Faculty of Law, University of Copenhagen, Copenhagen, Denmark
| | - Ian Gibson
- Department of Design, Production and Management, University of Twente, Enschede, Netherlands
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| |
Collapse
|
10
|
Rizzo ML, Turco S, Spina F, Costantino A, Visi G, Baronti A, Maiese A, Di Paolo M. 3D printing and 3D bioprinting technology in medicine: ethical and legal issues. Clin Ter 2023; 174:80-84. [PMID: 36655649 DOI: 10.7417/ct.2023.2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Abstract There has been a surge of interest in new technologies in medicine because of their promising clinical applications. Extensive research on additive manufacturing and its applications in the medical field has been carried out with good results and very high expectations. Due to their disruptive nature and potential, 3D printing and even more 3D bioprinting raise many ethical and safety concerns that need to be adequately addressed to provide good regulation before entering clinical practice. This article aims to highlight the general ethical concerns associated with the use of additive manufacturing in medicine and the lack of current international regulatory directives to guide these experiments. Transparency about how these new medical devices are regulated and approved is a fundamental requirement to promote and improve public trust, efficiency, safety and quality.
Collapse
Affiliation(s)
- M L Rizzo
- Interdepartmental Centre for Research in the History of law and in Computer Science and Law, (CIRSFID), University of Bologna, Bologna, Italy
| | - S Turco
- Department of Legal Medicine, Azienda ULSS 2 Marca Trevigiana, Italy
| | - F Spina
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, Pisa (PI), Italy
| | - A Costantino
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, Pisa (PI), Italy
| | - G Visi
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, Pisa (PI), Italy
| | - A Baronti
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, Pisa (PI), Italy
| | - A Maiese
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, Pisa (PI), Italy
| | - M Di Paolo
- Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, Pisa (PI), Italy
| |
Collapse
|
11
|
Ogston-Tuck S. Access to pain management from a legal and human rights perspective. Nurs Stand 2022; 37:75-79. [PMID: 35968629 DOI: 10.7748/ns.2022.e11897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
Patients who experience pain require adequate pain management provided by healthcare professionals who have access to pain relief medicines and are trained in the assessment and treatment of pain. Patients also need their pain to be acknowledged, understood and believed. These patient needs in relation to pain management can be considered from a legal and human rights perspective. This article describes human rights legislation in the UK, how it affects healthcare practice and what it means for healthcare professionals. It discusses barriers to pain management, the concept of pain management as a human right, the obligation of healthcare organisations to provide pain management and the limits to patients' rights to pain management. Finally, it proposes strategies that nurses can use to uphold a patient's human rights in relation to pain management.
Collapse
Affiliation(s)
- Sherri Ogston-Tuck
- Institute of Health and Society, University of Worcester, Worcester, England
| |
Collapse
|
12
|
Holt J. Ethical issues arising from the assisted dying debate. Nurs Stand 2022; 37:28-34. [PMID: 35694834 DOI: 10.7748/ns.2022.e11879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 11/09/2022]
Abstract
The assisted dying debate is complex, with confusion over definitions and the stance taken by professional bodies. It can also be challenging to make sense of the claims made by those who support changes in the law regarding assisted dying. End of life care is an important aspect of a nurse's role and therefore understanding the ethical issues arising from the debate is useful for nurses in clinical practice. This article outlines the legal position in the UK and the bills currently before the Westminster and Scottish parliaments proposing changes in the law. It also considers major ethical issues arising from the debate, along with the nurse's role in caring for patients requesting assisted dying.
Collapse
Affiliation(s)
- Janet Holt
- School of Healthcare, University of Leeds, Leeds, England
| |
Collapse
|
13
|
Kharb D. Sharing genetic resources fairly between nations. Med Leg J 2022; 90:104-105. [PMID: 34610773 DOI: 10.1177/00258172211031697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The global governance of natural resources was established initially by Convention on Biodiversity(CBD) in 1992 followed by Nagoya Protocol(NP) in 2010 with an objective of ensuring fairness and equitable benefit sharing arising from the exploitation of genetic resources creating incentive at the same time for the conservation and sustainable use of such resources. The framework has been criticized for its inefficiency in achieving its objectives. Recently it has been the subject of debate on whether digital sequence information is covered by the term 'genetic resources'. There are divergent views in different countries on how digital sequencing information (DSI) should be defined and whether the information derived or non-tangible aspect of genetic resources should also fall under the ABS regime. The present paper analyses the Indian position on these points.
Collapse
|
14
|
Kadiveti S, Vajawat B, Kumar CN, Hegde PR, Moirangthem S, Math SB. Free legal aid in hospitals for persons with mental illness: Is it helpful? An Indian prospective study. Indian J Psychiatry 2022; 64:322-325. [PMID: 35859558 PMCID: PMC9290419 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_510_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 04/19/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Legislative backing exists to set up free legal aid clinics in psychiatric hospitals to provide legal assistance to their patients. AIMS This study aimed to assess the utility of a free legal aid clinic running inside a mental health establishment. METHODS In this prospective study, 71 subjects (chosen via convenience sampling) were recruited. Assessments were carried out at baseline and two months after intake. Legal needs and the legal outcomes were assessed. RESULTS Most of the legal issues were either family-related (50.7%) or civil issues (28.2%). A majority of patients (64.4%) had implemented the advice given at the clinic. Those who had implemented the advice had a better legal outcome, defined as either resolution of the legal issue or that the legal issue was in an active proceeding compared to those who had not implemented the advice (P = 0.007). CONCLUSION The provision of free legal aid services in mental health establishments would benefit patients.
Collapse
Affiliation(s)
- Sriharsha Kadiveti
- Department of Psychiatry, Victorian Institute of Forensic Mental Health (Forensicare), Melbourne, Victoria, Australia
| | - Bhavika Vajawat
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Prakyath R Hegde
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sydney Moirangthem
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| |
Collapse
|
15
|
Milton CL. Book Review: Legal and Ethical Issues in Nursing Education: An Essential Guide by Glasgow, Dreher, Dahnke, & Gyllenhammer (2021). Springer. Nurs Sci Q 2022. [PMID: 35392721 DOI: 10.1177/08943184211070581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Legal and ethical issues abound in the discipline of nursing. Of specific interest are issues surrounding university nurse education. This article includes a review and critique of Glasgow et al.'s (2021) book on the essential guide for legal and ethical issues in nursing education.
Collapse
Affiliation(s)
- Constance L Milton
- Professor Doctoral Programs, School of Nursing, Azusa Pacific University, Azusa, CA, USA
| |
Collapse
|
16
|
Barrense-Dias Y, Chok L, Stadelmann S, Berchtold A, Suris JC. Sending One's Own Intimate Image: Sexting Among Middle-School Teens. J Sch Health 2022; 92:353-360. [PMID: 35174499 PMCID: PMC9306908 DOI: 10.1111/josh.13137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/03/2021] [Accepted: 08/22/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND There is a gap in the literature regarding data on sexting among youth under the age of 16 whereas the problems related to this practice could affect them more because of their ongoing development. This study aims to determine the prevalence rate and characteristics of sending one's own sexually related image among middle-school teens. METHODS Data were obtained from a web-based in-school survey conducted between October 2019 and February 2020. The sample comprised 3006 (mean age 13.7; 50.2% males) 10th-grade pupils in the canton of Vaud (Switzerland). Participants were asked "Have you ever sent a sexually related/sexy image of yourself?". Analysis of variance/chi-square tests and multinomial regression analyses were used to compare the groups. RESULTS Overall, 93.0% reported never, 3.7% once and 3.3% several times. No gender differences were found. Sending was associated with older age, low academic performance, cyberbullying victimization and reception of unsolicited sexually related images. CONCLUSIONS Education and health professionals should be aware that it is necessary to discuss the theme, perhaps with a more global approach including pressure, consent, exchange of nonsexual images, and so on from an early age. The context and reasons for sending remain to be explored, particularly to determine if the pressure is greater at this age.
Collapse
Affiliation(s)
- Yara Barrense-Dias
- Research Manager, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Lorraine Chok
- Research Assistant, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Sophie Stadelmann
- Research Collaborator, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - André Berchtold
- Associate Professor, , Swiss Center of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
| | - Joan-Carles Suris
- Associate Professor, , Department of Epidemiology and Health Systems, Research Group on Adolescent Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
17
|
Hoke AM, Pattison KL, Hivner EA, Lehman EB, Kraschnewski JL. The Role of Technical Assistance in School Wellness Policy Enhancement. J Sch Health 2022; 92:361-367. [PMID: 35075644 PMCID: PMC10170666 DOI: 10.1111/josh.13136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/05/2021] [Accepted: 08/22/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND School settings offer an opportunity to impact student health and wellness. Quality wellness policies are important in establishing strong wellness environments, but current resources to support policy development, maintenance, and dissemination are lacking. The Building Healthy Schools Program aimed to develop capacity of school districts to improve the strength and comprehensiveness of wellness policies and sustain these activities. METHODS Fifteen school districts in Pennsylvania participated in a program to facilitate the improvement of district wellness policies and practices. Program staff provided technical assistance to evaluate wellness policies before and after program implementation. Professional development and tailored training was provided for school personnel to create sustainability. Statistical analysis was performed to evaluate policy improvement. RESULTS Thirteen of the 15 participating districts completed a policy revision. Median strength (p = .001) and comprehensiveness (p = .002) scores improved from baseline to post-program and there were significant improvements in most assessment sub-sections. Some districts were hesitant to make strong language improvements due to their limited capacity (ie, staff) for implementation. Champions (n = 13; 87%) reported confidence to revise wellness policy language independently in the future. CONCLUSIONS Technical assistance provided to districts facilitated significant improvements to wellness policy language, especially in the implementation, evaluation, and communication; critical components for policy impact on school wellness environments. In addition, participant feedback suggested an ability to sustain activities in the future. Both external (ie, technical assistance) and internal resources are needed to facilitate school districts' ongoing wellness policy improvement and implementation, including improved model wellness policy language and enforcement within schools, respectively.
Collapse
Affiliation(s)
- Alicia M Hoke
- Project Manager, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Krista L Pattison
- Project Manager, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Elizabeth A Hivner
- Project Manager, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Erik B Lehman
- Biostatistician, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Jennifer L Kraschnewski
- Professor of Medicine, Public Health Sciences, and Pediatrics, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| |
Collapse
|
18
|
Oakes LR, Ewald DR, Orsini MM, Strack RW. The Photovoice Decision Tree: Legal Considerations and Ethical Implications for Photographs and Captions. Health Promot Pract 2022; 23:250-261. [PMID: 35285321 DOI: 10.1177/15248399211053892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article presents a photovoice decision tree that serves as a guide for making lawful and ethical decisions during the portions of the photovoice process that involve photograph selection, caption development, and public display of photographs and captions. Lawful and ethical considerations encompass privacy of person, privacy of place, illegal acts and obscenity, defamation, representation of truth versus actual malice, and opinion versus assertion of fact, but do not address pursuing and obtaining institutional review board approval for photovoice projects and/or other important steps of photovoice projects that are beyond the scope of this article. The decision tree presumes that a comprehensive photo release process was completed with all photovoice participants and collected from any individual captured within a photograph. The decision tree has important implications for research and practice, including movement of photovoice practitioners beyond the required institutional review board approval for research projects to consider lawful and ethical issues associated with photograph selection, caption development, and public display of photographs and captions. This decision tree can serve as a meaningful tool for all photovoice practitioners and participants to guide their lawful and ethical decisions.
Collapse
Affiliation(s)
| | - D Rose Ewald
- University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | - Robert W Strack
- University of North Carolina at Greensboro, Greensboro, NC, USA
| |
Collapse
|
19
|
Naik N, Hameed BMZ, Shetty DK, Swain D, Shah M, Paul R, Aggarwal K, Ibrahim S, Patil V, Smriti K, Shetty S, Rai BP, Chlosta P, Somani BK. Legal and Ethical Consideration in Artificial Intelligence in Healthcare: Who Takes Responsibility? Front Surg 2022; 9:862322. [PMID: 35360424 PMCID: PMC8963864 DOI: 10.3389/fsurg.2022.862322] [Citation(s) in RCA: 95] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/18/2022] [Indexed: 01/04/2023] Open
Abstract
The legal and ethical issues that confront society due to Artificial Intelligence (AI) include privacy and surveillance, bias or discrimination, and potentially the philosophical challenge is the role of human judgment. Concerns about newer digital technologies becoming a new source of inaccuracy and data breaches have arisen as a result of its use. Mistakes in the procedure or protocol in the field of healthcare can have devastating consequences for the patient who is the victim of the error. Because patients come into contact with physicians at moments in their lives when they are most vulnerable, it is crucial to remember this. Currently, there are no well-defined regulations in place to address the legal and ethical issues that may arise due to the use of artificial intelligence in healthcare settings. This review attempts to address these pertinent issues highlighting the need for algorithmic transparency, privacy, and protection of all the beneficiaries involved and cybersecurity of associated vulnerabilities.
Collapse
Affiliation(s)
- Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
- International Training and Research in Uro-Oncology and Endourology Group, Manipal, India
| | - B. M. Zeeshan Hameed
- International Training and Research in Uro-Oncology and Endourology Group, Manipal, India
- Department of Urology, Father Muller Medical College, Mangalore, India
| | - Dasharathraj K. Shetty
- Department of Humanities and Management, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Dishant Swain
- Department of Instrumentation and Control Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Milap Shah
- International Training and Research in Uro-Oncology and Endourology Group, Manipal, India
- Robotics and Urooncology, Max Hospital and Max Institute of Cancer Care, New Delhi, India
| | - Rahul Paul
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Kaivalya Aggarwal
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Sufyan Ibrahim
- International Training and Research in Uro-Oncology and Endourology Group, Manipal, India
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Vathsala Patil
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Komal Smriti
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Suyog Shetty
- Department of Urology, Father Muller Medical College, Mangalore, India
| | - Bhavan Prasad Rai
- International Training and Research in Uro-Oncology and Endourology Group, Manipal, India
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University in Krakow, Kraków, Poland
| | - Bhaskar K. Somani
- International Training and Research in Uro-Oncology and Endourology Group, Manipal, India
- Department of Urology, University Hospital Southampton National Health Service (NHS) Trust, Southampton, United Kingdom
| |
Collapse
|
20
|
Abstract
The coronavirus crisis is causing considerable disruption and anguish. However, the COVID-19 pandemic and consequent explosion of telehealth services also provide an unparalleled opportunity to consider ethical, legal, and social issues (ELSI) beyond immediate needs. Ethicists, informaticians, and others can learn from experience, and evaluate information technology practices and evidence on which to base policy and standards, identify significant values and issues, and revise ethical guidelines. This paper builds on professional organizations' guidelines and ELSI scholarship to develop emerging concerns illuminated by current experience. Four ethical themes characterized previous literature: quality of care and the doctor-patient relationship, access, consent, and privacy. More attention is needed to these and to expanding the scope of ethical analysis to include health information technologies. An applied ethics approach to ELSI would addresses context-specific issues and the relationships between people and technologies, and facilitate effective and ethical institutionalization of telehealth and other health information technologies.
Collapse
|
21
|
Abstract
Consent to treatment is a common, albeit complex, aspect of nursing practice. Over the past few years, laws have been strengthened to provide increased recognition of patient autonomy. This has meant that there is a greater onus placed on nurses to understand how consent is obtained from patients, the elements required to ensure any consent is valid, and how to proceed when it has been determined that a patient does not have the mental capacity to consent to treatment. This article explores some of the legal considerations that nurses should keep in mind when seeking consent from a patient.
Collapse
Affiliation(s)
- Iwan Dowie
- University of South Wales, Pontypridd, Wales
| |
Collapse
|
22
|
McCarthy L, Teague B, Rowe K, Janes K, Rhodes T, Hackmann C, Samad L, Wilson J. Practice-informed guidance for undertaking remotely delivered mental health research. Nurse Res 2021; 29:8-16. [PMID: 33855819 DOI: 10.7748/nr.2021.e1770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The assessment and monitoring of health conditions using remote or online delivery is an emerging interest in healthcare systems globally but is not routinely used in mental health research. There is a growing need to offer remotely delivered appointments in mental health research. There is a lack of practical guidance about how nurse researchers can undertake remote research appointments ethically and safely, while maintaining the scientific integrity of the research. AIM To provide mental health nurse researchers with information about important issues to consider when assessing the appropriateness of remotely delivered research and methods to support the development of a supportive research relationship. DISCUSSION The practice guidance and checklist include issues a nurse researcher should consider when assessing suitability and eligibility for remotely delivered research visits, such as ethical considerations and arrangements, safety, communication, and identifying participants requiring further support. This article addresses processes to follow for assessing mental capacity, obtaining informed consent and collaboratively completing research measures. CONCLUSION Remotely delivered research appointments could be acceptable and efficient ways to obtain informed consent and collect data. Additional checks need to be in place to identify and escalate concerns about safeguarding or risks. IMPLICATIONS FOR PRACTICE Practical guidance for mental health nurse researchers when determining the appropriateness of remote research visits for participants, and an adaptable checklist for undertaking remote research appointments are outlined.
Collapse
Affiliation(s)
- Louise McCarthy
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| | - Bonnie Teague
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| | - Kayte Rowe
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| | - Kathryn Janes
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| | - Tom Rhodes
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| | - Corinna Hackmann
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| | - Lamiya Samad
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| | - Jon Wilson
- Research department, Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, England
| |
Collapse
|
23
|
Abstract
Nurses have a duty to promote the values of equality and diversity during their interactions with patients and their families and carers, as well as peers and colleagues. This article defines the terms equality, diversity and inclusion, and explains the importance of the Equality Act 2010 and the Human Rights Act 1998 in protecting people from various types of discrimination. It also outlines nurses' responsibilities in promoting equality and diversity by treating all patients and colleagues with respect and dignity, providing compassionate leadership, and practising in accordance with the ethical principle of justice. The article encourages and empowers nurses to recognise and challenge discrimination wherever they see it, thereby delivering high-quality care to all patients.
Collapse
|
24
|
Abstract
Research is important because it underpins evidence-based care. However, people who lack capacity to consent are often excluded from research, due partly to ethical concerns and practical challenges, and partly to a lack of awareness among professionals of the legal framework that supports their inclusion. The COVID-19 pandemic, which has extensively affected care home residents, has reinforced the importance of including older people with cognitive impairment in research. Nurses who care for older people with impaired cognition have an important role in ensuring these people have the opportunity to contribute to and benefit from research. This article discusses some of the challenges associated with the inclusion in research of older people who lack capacity to consent, including the involvement of relatives and friends in decision-making. The article describes the findings of recent research and shares resources with the aim of supporting nurses to ensure that older people in their care who lack capacity can participate in research.
Collapse
|
25
|
Abstract
BACKGROUND Arab countries account for almost 6% of the global population, yet they make up only 5% of the total cases and less than 3% of the global death toll attributed to COVID-19. COVID-19 has put the health systems in the various Arab Countries and their ability to deliver healthcare services under tremendous strain. The capacity and stability of any health system is important in any type of response to the pandemic, in order to ensure an effective and efficient delivery of care to the public through COVID-19 and beyond. The objective of this study is to identify the various response of health systems in Arab Countries to COVID-19, and highlight the legal and health challenges faced during the pandemic. The study identified both gaps and good practices that may be utilized in order to guide the efforts in response to COVID-19 and the recovery efforts once the pandemic is over. METHODS To determine why the response of some health systems in Arab Countries responses are more effective than others, a three-step framework is adopted which includes, detection, containment, and treatment stages. In order to identify which countries are excelling at detection, containment, and treatment stages, several indicators were selected for each stage. To be able to understand the legal and health challenges of response to the COVID-19 pandemic, an analysis of the health systems, the resources in terms of quality and access, health workforce, and finance was conducted. Secondary data published by the Global Burden of Disease Study, and the Global Change Data Lab of the University of Oxford was used to study identified gaps and good practices to guide the responses to COVID-19 and recovery efforts once the pandemic is over. RESULTS The epidemiologic record demonstrates that that certain Arab countries are managing to control the pandemic, through a combination of mitigation strategies, suppression strategy and elimination strategy. There are several barriers and challenges in Arab health systems which have been amplified due to COVID-19 and if ignored may pose a further significant challenge in the future. Health systems in Arab countries are not sufficiently equipped to handle all healthcare needs related to COVID-19, in particular issues relating to administration, equity, finances, the supply side of healthcare, and usage of information technology. CONCLUSION In Arab counties, the standard response to COVID-19 was enforced by new health laws, which consist of a combination of the traditional disease control measures (testing, contact-tracing, social distancing), population-based physical distancing (including stay-at-home orders, school and business closures, and social gathering bans), travel limits (including travel bans, and border closures), and economic support measures. Acceptable healthcare quality and access, sufficient health workforce, and sufficient funds are the most imperative needs in the health system in Arab counties to provide a sustainable response to the COVID-19 pandemic.
Collapse
|
26
|
Abstract
BACKGROUND As a non-European Union member state, Albania is increasingly orienting itself on Western models regarding human rights, patient rights, and legal regulations for healthcare. Due to its limited fiscal and legal power, enforcing legal and ethical regulations poses a major problem. AIM The aim of this study is to investigate nurse's knowledge and experiences regarding ethical and legal issues in Albanian elder care in state-funded and privately run institutions. RESEARCH DESIGN The study was conducted using an inductive and qualitative design, utilizing a focused ethnographic approach, based on Roper and Shapira's framework. METHOD Data were collected between June 2017 and September 2018 using participant observation, field notes, and semi-structured interviews with 15 nurses in seven different elder care institutions. In total, 100 h of observation and 15 interviews were performed. Data analysis was based on Mayring's qualitative content analysis. ETHICAL CONSIDERATION The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria. FINDINGS The findings of the study fell into the following main categories: "Everyday care issues," "End-of-life issues," "Legal issues," and "Ethical-legal education and conflicts." DISCUSSION The participants reported many ethical and legal issues when describing their everyday challenges and displayed a strong lack of ethical and legal education. Despite a wide spectrum in the quality of care between private and state-funded nursing homes, older people mostly do not know their own diagnosis. CONCLUSION This study indicates that further ethical and legal education is needed. Furthermore, nurses need to be better prepared for ethical conflicts with families, as strengthening patient rights could come into conflict with traditional rights of the Albanian family.
Collapse
Affiliation(s)
- Nertila Podgorica
- UMIT-Private University for Health Sciences, Medical Informatics and Technology, Austria; FH Gesundheit-Health University of Applied Sciences Tyrol, Austria
| | | | | | - Daniela Deufert
- UMIT-Private University for Health Sciences, Medical Informatics and Technology, Austria
| |
Collapse
|
27
|
Terry L, Newham R. Understanding the relevance of human rights in healthcare and nursing practice. Nurs Stand 2020; 36:e11490. [PMID: 33164471 DOI: 10.7748/ns.2020.e11490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2019] [Indexed: 06/11/2023]
Abstract
While the NHS aims to respect the human rights of every individual, it also has a wider social duty to promote equality in the services it provides. This means that the rights of individual patients are not absolute, because the aim of the NHS is to improve the overall health and well-being of the nation. For example, certain treatments may be withheld from individuals because of the excessive cost to the NHS, or concerns about its clinical effectiveness. This article explains the origins of human rights and their function, and examines the relationship between nursing care and human rights.
Collapse
Affiliation(s)
| | - Roger Newham
- School of Nursing, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England
| |
Collapse
|
28
|
Ramer SJ, Reid MC, Unruh ML. Patient reactions to witnessed medical events in the dialysis center or to the sudden absence of other patients from the center: A qualitative study. Hemodial Int 2020; 25:220-231. [PMID: 33103350 DOI: 10.1111/hdi.12898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/21/2020] [Accepted: 10/10/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients receiving in-center maintenance hemodialysis (HD) spend a significant amount of time together. To date, little or no research has examined how these patients perceive and process other patients' medical events in and absences from their centers. We therefore undertook this qualitative study using semi-structured interviews to explore these phenomena from the patient perspective. METHODS Patients at a suburban Pittsburgh HD center participated in semi-structured interviews in April to May 2011, reporting on their impressions of their relationships with other patients in the center; their experiences of witnessing clinical decompensations in the center; and their reactions to absences of fellow patients from the center. Trained coders developed a codebook and applied it to interview transcripts. FINDINGS There were 17 participants, 47% women, 29% black, with median age 63 years. Almost every participant had witnessed other patients' medical events during HD. Three main themes emerged in analysis of interviews: (1) incomplete knowledge of many aspects of witnessed events and patient absences in the HD center; (2) a process of "filling in the blanks": Participants used their own past events and absences to help process other patients' events and absences and used other patients' events and absences to help process their own future events and absences; and (3) participants' broad support for HD center staff being able to share with other patients basic information about their whereabouts if they themselves are absent from the center. DISCUSSION Witnessed medical events in and patients' absences from the HD center are not only common but are also important to patients, who struggle to process these events and absences due to limited information about what actually happened. Interventions, such as providing patients with more information, could improve patients' experience of witnessed events and fellow patients' absences and potentially impact other patient-centered outcomes.
Collapse
Affiliation(s)
- Sarah J Ramer
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Mark L Unruh
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| |
Collapse
|
29
|
Jones K, Heys S, Thompson R, Ford D, Griffiths L, Johnson R, Lee A, Broadhurst K. Linking pre- and post-adoption records for research in anonymised form in a data safe haven: legal implications and support for a social licence. Int J Popul Data Sci 2020; 5:1370. [PMID: 34007888 PMCID: PMC8110886 DOI: 10.23889/ijpds.v5i3.1370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION The long-term health and wellbeing of adoptees is under-researched. One reason for this has been limited data accessibility regarding the adoption process, and another is a practice common in some UK jurisdictions of changing the National Health Service (NHS) number (or equivalent) at adoption, as part of creating the new identity. The SAIL Databank holds data on child and family court cases from Cafcass Cymru, together with children's social care data, and can link these with routine health and administrative data in anonymised form. However, because the linkage key at SAIL is based on an encryption of the NHS number, working with pre- and post-adoption records for longitudinal research remains a major challenge. We set out to explore the legal implications of, and social support for, linking these records for use in anonymised form for longitudinal research. METHODS We reviewed the main legislation and regulations governing the use of data about adoptees in England and Wales. We gauged support for a social licence in Wales by carrying out interviews with individuals who had been involved in the adoptions process, and by engaging with general public groups for their views. We drew out the main emerging themes and, in combination with the review, propose a way forward. RESULTS The legal review indicated that there are provisions in the Family Procedure Rules (England and Wales) and the General Data Protection Regulation that can be relied upon for the lawful processing of adoption data into anonymised form for research. The main points of concern about linking pre- and post-adoption records were privacy, data security, the need to limit the number of organisations involved in data sharing, and re-identification risk. The over-riding message was favourable with longitudinal research seen as strongly beneficial. CONCLUSION This study has indicated that in Wales, there is no legal impediment, nor major objection from individuals involved in the adoptions process, or members of the general public, for the use of adoption data in anonymised form in a data safe haven. This includes the linkage of pre- and post-adoption records to enable novel longitudinal research to take place. The provisos were that robust safeguards must be in place, and that the research should aim to benefit adoptees and to improve policy and practice. We conclude that it is reasonable to proceed with caution to develop practical ways to link pre- and post-adoption records in a data safe haven.
Collapse
Affiliation(s)
- Kerina Jones
- Population Data Science, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - Sharon Heys
- Population Data Science, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - Rachel Thompson
- Population Data Science, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - David Ford
- Population Data Science, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - Lucy Griffiths
- Population Data Science, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - Rhodri Johnson
- Population Data Science, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - Alex Lee
- Population Data Science, Swansea University Medical School, Swansea, SA2 8PP, UK
| | - Karen Broadhurst
- Centre for Child & Family Justice Research, Lancaster University, Lancaster, LA1 4YW, UK
| |
Collapse
|
30
|
Pot M, Brehme M, El-Heliebi A, Gschmeidler B, Hofer P, Kroneis T, Schirmer M, Schumann S, Prainsack B. Personalized medicine in Austria: expectations and limitations. Per Med 2020; 17:423-428. [PMID: 33026295 DOI: 10.2217/pme-2020-0061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Mirjam Pot
- Department of Political Science, University of Vienna, Vienna 1010, Austria
| | | | - Amin El-Heliebi
- Medical University of Graz, Gottfried Schatz Research Center, Division of Cell Biology, Histology and Embryology, Graz 8036, Austria.,Center for Biomarker Research in Medicine, Graz 8010, Austria
| | | | - Philipp Hofer
- Medical University of Vienna, Department of Pathology, Vienna 1090, Austria
| | - Thomas Kroneis
- Medical University of Graz, Gottfried Schatz Research Center, Division of Cell Biology, Histology and Embryology, Graz 8036, Austria.,Center for Biomarker Research in Medicine, Graz 8010, Austria
| | - Michael Schirmer
- Department of Internal Medicine, Medical University of Innsbruck, Clinic II, Innsbruck 6020, Austria
| | - Simone Schumann
- Open Science - Life Sciences in Dialogue, Vienna 1030, Austria
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna 1010, Austria.,Department of Global Health & Social Medicine, King's College London, Strand, London WC2R 2LS, United Kingdom
| |
Collapse
|
31
|
Abstract
BACKGROUND Ethical and legal issues are increasingly being reported by health caregivers; however, little is known about the nature of these issues in geriatric care. These issues can improve work and care conditions in healthcare, and consequently, the health and welfare of older people. AIM This literature review aims to identify research focusing on ethical and legal issues in geriatric care, in order to give nurses and other health care workers an overview of existing grievances and possible solutions to take care of old patients in a both ethical and legally correct way. METHODS Using a systematic approach based on Aveyard, a search of the PubMed, CINAHL, and Ethicshare databases was conducted to find out the articles published on ethical and legal issues in geriatric care. ETHICAL CONSIDERATIONS The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria. RESULTS Only 50 articles were included for systematic analysis reporting ethical and legal issues in the geriatric care. The results presented in this article showed that the main ethical issues were related to the older people's autonomy, respect for their needs, wishes and values, and respect for their decision-making. The main legal issues were related to patients' rights, advance directives, elderly rights, treatment nutrition dilemma, and autonomy. CONCLUSION Further education for professional caregivers, elderly people, and their families is needed on following topics: care planning, directive and living wills, and caregiver-family member relationships to guide and support the elderly people within their decision-making processes and during the end-of-life care.
Collapse
Affiliation(s)
- Nertila Podgorica
- UMIT-University for Health Sciences, Austria; 307399FH Gesundheit-Health University of Applied Sciences Tyrol, Austria
| | | | | | - Uwe Siebert
- 31510UMIT-University for Health Sciences, Austria
| | | |
Collapse
|
32
|
Taylor A. Withdrawal of treatment from critically ill children: legal and ethical issues. Nurs Child Young People 2020; 31:20-24. [PMID: 31486596 DOI: 10.7748/ncyp.2019.e1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2019] [Indexed: 11/09/2022]
Abstract
Withdrawal of treatment from critically ill children is a contentious and ethically difficult area. The principle of best interests was central to three recent high-profile legal cases and raised questions about how this is demonstrated in healthcare for children whose treatment may be of no benefit to them. This article discusses the legal and ethical aspects of caring for such children. Nurses are important advocates and should balance their obligation to deliver holistic and family-centred care with that of keeping the child as the central focus, particularly with decision-making. In cases of disagreement between families and clinicians, children's voices are particularly vulnerable to being lost. Pre- and post-registration education, research and a higher profile for nurses in multidisciplinary decision-making are suggested as ways to improve the nursing contribution to this important debate.
Collapse
Affiliation(s)
- Alison Taylor
- School of Health Sciences, University of Brighton, England
| |
Collapse
|
33
|
Kalokairinou L, Borry P, Howard HC. 'It's much more grey than black and white': clinical geneticists' views on the oversight of consumer genomics in Europe. Per Med 2020; 17:129-140. [PMID: 32154757 DOI: 10.2217/pme-2019-0064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Direct-to-consumer (DTC) genetic tests (GT) have created controversy regarding their risks and benefits. In view of recent regulatory developments, this article aims to explore the attitudes of European clinical geneticists toward the oversight of DTC GT. Materials & methods: Fifteen semi-structured interviews were performed with clinical geneticists based in ten European countries. The transcripts were thematically analysized in an iterative process. Results & conclusion: Respondents strongly supported quality standards for DTC GT equal to those applied within the healthcare setting. Despite participants unanimously considering the involvement of healthcare professionals to be important, mandatory medical supervision was controversial. In this regard, promoting education and truth-in-advertising was considered as being key in maintaining a balance between protecting consumers and promoting their autonomy.
Collapse
Affiliation(s)
- Louiza Kalokairinou
- Department of Public Health & Primary Care, Centre for Biomedical Ethics & Law, University of Leuven, Leuven, Belgium
| | - Pascal Borry
- Department of Public Health & Primary Care, Centre for Biomedical Ethics & Law, University of Leuven, Leuven, Belgium
| | - Heidi C Howard
- Centre for Research Ethics & Bioethics, Uppsala University, Uppsala, Sweden
| |
Collapse
|
34
|
|
35
|
Abdalla-Aslan R, Friedlander-Barenboim S, Aframian DJ, Maly A, Nadler C. Ameloblastoma incidentally detected in cone-beam computed tomography sialography: A case report and review of the literature. J Am Dent Assoc 2019; 149:1073-1080. [PMID: 30497576 DOI: 10.1016/j.adaj.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/26/2018] [Accepted: 09/05/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OVERVIEW Cone-beam computerized tomographic (CBCT) imaging is increasingly used in the maxillofacial region for various purposes. The volumetric dataset created by means of CBCT increases the possibility of detecting incidental findings. CASE DESCRIPTION In this case report, the authors describe an otherwise healthy 45-year-old man who was referred from the Sjogren's Syndrome Center in Jerusalem, Israel, for bilateral parotid CBCT sialographic imaging owing to xerostomia lasting for 4 months. CBCT sialographic imaging using iodine contrast material showed normal glandular structure and activity according to the postcannulation panoramic imaging. CBCT sialographic imaging routine volume interpretation revealed a lesion in the mandibular area causing destruction and perforation of the cortical plates, partial disappearance of adjacent lamina dura, and resorption of adjacent teeth, suggesting an aggressive benign tumor. Histopathologic examination confirmed mural cystic ameloblastoma, which was resected with preservation of the mental nerve and the lower mandibular border. The patient received bone graft and implants, with regular follow-ups and no recurrence after 4 years. CONCLUSIONS AND PRACTICAL IMPLICATIONS This case strengthens the need for thorough examination of the whole CBCT imaging volume within and outside the region of interest to detect incidental findings with clinical importance.
Collapse
|
36
|
Staley J, Mazloom R, Lowe P, Newsum CT, Jaberi-Douraki M, Riviere J, Wyckoff GJ. Novel Data Sharing Agreement to Accelerate Big Data Translational Research Projects in the One Health Sphere. Top Companion Anim Med 2019; 37:100367. [PMID: 31837758 DOI: 10.1016/j.tcam.2019.100367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 09/26/2019] [Accepted: 09/26/2019] [Indexed: 01/16/2023]
Abstract
When conducting translational research, the ability to share data generated by researchers and clinicians working with for-profit companies is essential, particularly in cases that involve "one health" data (i.e., data that could come from human, animal, or environmental sources). The 1DATA Project, a collaboration between Kansas State University and the University of Missouri, has examined and overcome some of the barriers to sharing this information for "big data" projects. This article discusses some of the obstacles we encountered, and the ways those obstacles can be surmounted via a novel form of Master Sharing Agreement. Developed in collaboration with industry partners, it is presented here as a template for expediting future one health work.
Collapse
Affiliation(s)
- Joshua Staley
- Veterinary Biomedical Sciences, Kansas State University, Olathe 22201 West Innovation Drive, Olathe, KS, USA
| | - Reza Mazloom
- Institute of Computational Comparative Medicine, Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, USA
| | - Paul Lowe
- Office of the Vice President for Research, Kansas State University, Manhattan, KS, USA
| | - C T Newsum
- Aratana Therapeutics, Inc., 11400 Tomahawk Creek Pkwy #340, Leawood, KS, USA
| | - Majid Jaberi-Douraki
- Institute of Computational Comparative Medicine, Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, USA
| | - Jim Riviere
- Veterinary Biomedical Sciences, Kansas State University, Olathe 22201 West Innovation Drive, Olathe, KS, USA
| | - Gerald J Wyckoff
- Molecular Biology and Biochemistry, University of Missouri - Kansas City School of Biological and Chemical Sciences, Kansas City, MO, USA; Division of Pharmacology and Pharmaceutical Sciences, University of Missouri - Kansas City School of Pharmacy, Kansas City, MO, USA.
| |
Collapse
|
37
|
Bourne L. Respecting the ethical principle of autonomy in end of life care decisions. Nurs Stand 2019:e11335. [PMID: 31565902 DOI: 10.7748/ns.2019.e11335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2019] [Indexed: 06/10/2023]
Abstract
There is a range of ethical, legal and professional issues associated with end of life care and the decisions made by healthcare professionals. The complexity of such decisions may lead healthcare professionals to question whether they have fulfilled their ethical, legal and professional duties towards the patients they care for. Respect for the ethical principle of autonomy and an understanding of the law may assist in mitigating any doubts that healthcare professionals have about fulfilling these duties. This article examines the ethical principle of autonomy and how it relates to advance decisions to refuse treatment, do not attempt cardiopulmonary resuscitation orders and the doctrine of double effect. It also outlines the relevant legal guidance regarding autonomy and end of life care decisions. Lisbeth Bourne at the time of writing was co-programme leader, Children and Young People and Mental Health Nursing, School of Health and Society, University of Salford, Salford, England.
Collapse
Affiliation(s)
- Lisbeth Bourne
- Children and Young People and Mental Health Nursing, School of Health and Society, University of Salford, Salford, England
| |
Collapse
|
38
|
Kafka JM, Moracco KE, Barrington C, Mortazavi AL. Judging Domestic Violence From the Bench: A Narrative Analysis of Judicial Anecdotes About Domestic Violence Protective Order Cases. Qual Health Res 2019; 29:1132-1144. [PMID: 30608215 DOI: 10.1177/1049732318821691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Interview participants sometimes share anecdotes (stories about past events), to illustrate a point or discuss their perspectives. When sharing these stories, participants may imbue the events with their own personal meaning-making, selective memory, and biases. We conducted a narrative analysis of anecdotes shared by judges ( n = 20) who preside over Domestic Violence Protective Order (DVPO) hearings to examine how biases and misperceptions shape decisions in DVPO cases. We found that judges rely on biases to sort cases as "true domestic violence" compared with "frivolous cases." In the anecdotes they shared, judges often used gendered stereotypes to depict litigants, and many judges felt that DVPOs had limited efficacy in preventing violence. We argue that important cognitive insights are revealed by interview participants during the spontaneous act of storytelling. In the case of judges, their biases could lead to DVPOs being denied in situations when they are warranted.
Collapse
Affiliation(s)
- Julie M Kafka
- 1 UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Kathryn E Moracco
- 1 UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Clare Barrington
- 1 UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Afsaneh L Mortazavi
- 1 UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| |
Collapse
|
39
|
Abstract
DNA barcoding is now a common tool in parasitology and epidemiology, which require good methods for identification not only of parasites and pathogens but vectors and reservoirs. This special issue presents some advances and challenges in barcoding of microbes, parasites, and their vectors and reservoirs. DNA barcoding found new applications in disease ecology, conservation parasitology, environmental parasitology and in paleoparasitology. New technologies such as next-generation sequencing and matrix-assisted laser desorption-ionization time-of-flight have made it now possible to investigate large samples of specimens. By allowing the investigation of parasites at the interface between environment, biodiversity, animal and human health, barcoding and biobanking have important policy outcomes as well as ethics and legal implications. The special issue 'Advances and challenges in the barcoding of parasites, vectors and reservoirs' illustrates some recent advances and proposes new avenues for research in barcoding in parasitology.
Collapse
|
40
|
Sivakumar PT, Mukku SSR, Antony S, Harbishettar V, Kumar CN, Math SB. Implications of Mental Healthcare Act 2017 for geriatric mental health care delivery: A critical appraisal. Indian J Psychiatry 2019; 61:S763-S767. [PMID: 31040470 PMCID: PMC6482673 DOI: 10.4103/psychiatry.indianjpsychiatry_100_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The prevalence of mental health problems in older adults is increasing globally as well as in India due to population ageing. Mental Healthcare Act (MHCA) 2017 has a rights-based approach and came into force in India in May 2018. Its provisions have significant implications for promoting mental health care and protecting the rights of persons with mental illness (PMI). Older adults with mental health problems such as dementia have a high risk for loss of mental capacity, abuse, violation of their rights, and institutionalization. This act advocates the development of specialized clinical services for the older adults in mental health care institutions. It also recognizes the rights of PMI to access a range of services required, including rehabilitation services. Several provisions of the act, such as those related to mental capacity, advance directive, nominated representative, and responsibilities of other agencies, have specific challenges related to older adults with mental illness. In this article, we present a critical appraisal of the implications of MHCA 2017 in the context of the care of the older adults with mental illness.
Collapse
Affiliation(s)
- Palanimuthu Thangaraju Sivakumar
- Department of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Shiva Shanker Reddy Mukku
- Department of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sojan Antony
- Department of Psychiatric Social Work, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vijaykumar Harbishettar
- Department of Psychiatry, Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Department of Psychiatry, Forensic Psychiatry Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, Forensic Psychiatry Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| |
Collapse
|
41
|
Armando RG, Mengual Gomez DL, Maggio J, Sanmartin MC, Gomez DE. Telomeropathies: Etiology, diagnosis, treatment and follow-up. Ethical and legal considerations. Clin Genet 2019; 96:3-16. [PMID: 30820928 DOI: 10.1111/cge.13526] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/12/2019] [Accepted: 02/26/2019] [Indexed: 12/13/2022]
Abstract
Telomeropathies involve a wide variety of infrequent genetic diseases caused by mutations in the telomerase maintenance mechanism or the DNA damage response (DDR) system. They are considered a family of rare diseases that often share causes, molecular mechanisms and symptoms. Generally, these diseases are not diagnosed until the symptoms are advanced, diminishing the survival time of patients. Although several related syndromes may still be unrecognized this work describes those that are known, highlighting that because they are rare diseases, physicians should be trained in their early diagnosis. The etiology and diagnosis are discussed for each telomeropathy and the treatments when available, along with a new classification of this group of diseases. Ethical and legal issues related to this group of diseases are also considered.
Collapse
Affiliation(s)
- Romina G Armando
- Laboratory of Molecular Oncology, Universidad Nacional de Quilmes, Buenos Aires, Argentina
| | - Diego L Mengual Gomez
- Laboratory of Molecular Oncology, Universidad Nacional de Quilmes, Buenos Aires, Argentina
| | - Julián Maggio
- Laboratory of Molecular Oncology, Universidad Nacional de Quilmes, Buenos Aires, Argentina
| | - María C Sanmartin
- Laboratory of Molecular Oncology, Universidad Nacional de Quilmes, Buenos Aires, Argentina
| | - Daniel E Gomez
- Laboratory of Molecular Oncology, Universidad Nacional de Quilmes, Buenos Aires, Argentina
| |
Collapse
|
42
|
Abstract
BACKGROUND Little is understood about the different ways patients complete advance directives (ADs), which is most commonly through lawyers and increasingly using websites. OBJECTIVE To understand patients' perspectives on different approaches to facilitating AD completion, the value of legal regulation of ADs, and the use of a web-based platform to create an AD. DESIGN Semi-structured interviews with patients. SETTING/PARTICIPANTS We purposively sampled 25 patients at least 70 years of age or with a chronic disease from 2 internal medicine clinics. MEASUREMENTS Interviews focused on experiences and perspectives creating ADs, including facilitation by lawyers, health-care professionals, and websites. Feedback on a website prototype was also obtained. Responses were analyzed with modified grounded theory until thematic saturation was achieved. RESULTS Although a majority of participants with ADs had used lawyers, participants were ambivalent about the benefits of lawyer facilitation. Most valued both the medical perspective of a health-care professional and a lawyer's attention to legal requirements for AD validity. Participants had positive impressions of the web platform, but some were concerned about privacy with online storage. Trust emerged as an overarching theme, and participants valued legal regulation of ADs to ensure document authenticity and delivery of preference-concordant care. CONCLUSION Efforts to improve documentation of care planning need to address the disparate methods by which participants complete ADs. Creating options that combine the perceived benefits of a legal approach with greater health professional involvement could appeal to participants. Privacy concerns may limit web use by some patients.
Collapse
Affiliation(s)
- Joshua A Rolnick
- 1 Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,2 National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA, USA.,3 Palliative and Advanced Illness Research Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Judy A Shea
- 1 Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Joanna L Hart
- 3 Palliative and Advanced Illness Research Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,4 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Scott D Halpern
- 3 Palliative and Advanced Illness Research Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,4 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
43
|
Spencer A, Patel S. Applying the Data Protection Act 2018 and General Data Protection Regulation principles in healthcare settings. Nurs Manag (Harrow) 2019; 26:34-40. [PMID: 31468753 DOI: 10.7748/nm.2019.e1806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 10/27/2022]
Abstract
The Data Protection Act (DPA) of 1998 was radically updated in 2018 and since then there has been much media coverage about the General Data Protection Regulation (GDPR). Recent headlines have featured well known organisations that have been fined under the DPA 1998. This article describes the recent changes in data protection law, including the principles behind the DPA and GDPR, highlights patients' rights and how nurses can advocate for the protection of patients' personal data, and outlines nurses' role in ensuring that the principles of data protection are implemented fully as part of patient care delivery.
Collapse
|
44
|
Brown A. Legal implications of pressure injuries: experience of a tissue viability nurse expert. Nurs Stand 2019; 34:e11301. [PMID: 31468931 DOI: 10.7748/ns.2019.e11301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2018] [Indexed: 06/10/2023]
Abstract
NHS Resolution manages the Clinical Negligence Scheme for Trusts, and aims to reduce the cost of litigation in terms of clinical negligence claims. To achieve this, potential clinical negligence claims are screened to assess whether to defend the claim or to provide an out-of-court settlement. Nurse experts from all nursing specialties are engaged to review all documentation and patient records to offer an opinion on the viability of a claim. This article describes the processes involved in assessing tissue viability clinical negligence claims, providing examples of evidence that guided decisions and advice on how nurses can protect their organisation from costly litigation.
Collapse
Affiliation(s)
- Annemarie Brown
- School of Health and Social Care, University of Essex, Essex, England
| |
Collapse
|
45
|
McKenzie KC, Bauer J, Reynolds PP. Asylum Seekers in a Time of Record Forced Global Displacement: the Role of Physicians. J Gen Intern Med 2019; 34:137-143. [PMID: 29907914 PMCID: PMC6318190 DOI: 10.1007/s11606-018-4524-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 01/23/2018] [Accepted: 05/11/2018] [Indexed: 10/28/2022]
Abstract
In 2016, over 65 million individuals were displaced from their homes due to human rights abuses, and 262,000 people applied for asylum in the USA. Individuals who have experienced persecution are present in many primary and specialty clinics. A medical forensic evaluation can increase the likelihood of a successful asylum case. This paper reviews the legal framework for asylum and the contribution forensic evaluations can make to this vulnerable population. Physicians without asylum expertise can help these patients by recognizing their legal right to residential protection and referring them to lawyers and physicians with expert skills. Performing forensic examinations of asylum seekers offers physicians the opportunity to collaborate with attorneys, immigration officials, and human rights experts. Clinicians who do this work find it personally and professionally rewarding, especially when they impart their expert knowledge and skills to future clinicians by involving trainees in these evaluations. Physicians who encounter refugees or asylum seekers in their roles as providers or as preceptors should have familiarity with the field of asylum medicine to enhance the comprehensive care they deliver.
Collapse
Affiliation(s)
- Katherine C McKenzie
- Yale Center for Asylum Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
| | - Jon Bauer
- Asylum and Human Rights Clinic, University of Connecticut School of Law, Hartford, CT, USA
| | - P Preston Reynolds
- Division of General Medicine, Hospitalist Medicine, Geriatrics and Palliative Care, University of Virginia School of Medicine, Charlottesville, VA, USA
| |
Collapse
|
46
|
Abstract
Nurses and the environment in which they work have an important role in patient safety and quality of care. Evidence demonstrates a link between lower nurse staffing levels and higher nurse workloads on hospital wards with adverse patient outcomes such as increased mortality, infections, falls and hospital stay, as well as adverse effects on staff well-being. Therefore, ensuring adequate numbers of nurses are on duty and available to care for patients safely has become a crucial task for nurses and hospital managers. In March 2016, Wales became the first country in Europe and one of only a small number of countries globally to legislate on nurse staffing levels. In April 2018, the Nurse Staffing Levels (Wales) Act 2016 was fully implemented in acute medical and surgical hospital wards. This article outlines the background to, and development of, nurse staffing approaches in Wales that preceded the introduction of this legislation. It aims to provide nurses with an understanding of the journey towards introducing legislation for nurse staffing levels and workforce planning in Wales, which will be relevant to those affected by the implementation of any legislation in this important area of healthcare. This article also provides information about how the nurse staffing legislation evolved as a result of important work and collaboration that was already undertaken throughout NHS Wales.
Collapse
Affiliation(s)
- Aled Jones
- School of Healthcare Sciences, Cardiff University, Cardiff, Wales
| | - Helen Whyley
- Royal College of Nursing Wales, Ty Maeth, Cardiff, Wales
| | | | - Lesley Bevan
- Cwm Taf University Health Board, Merthyr Tydfil, Wales
| |
Collapse
|
47
|
Abstract
Duty of care is a fundamental aspect of nursing, and many nurses consider this to be an important part of their professional duties as a nurse. However, the legal underpinnings of duty of care are often overlooked, and, as such, nurses may be unsure about when to act if they encounter emergency situations or serious incidents, especially when they are off duty. This article examines the legal, ethical and professional aspects of duty of care, what these mean for nurses in practice, and how duty of care is intrinsically linked with standards of care and negligence.
Collapse
Affiliation(s)
- Iwan Dowie
- Healthcare law, University of South Wales, Pontypridd, Wales
| |
Collapse
|
48
|
Abstract
Nurses, midwives and nursing students are legally responsible for their actions. This article discusses the legal standard of care required in relation to nursing and midwifery practice and nurses' professional standards and code of conduct. It examines how courts in the UK determine if nurses have met their duty of care and how nurses must ensure they maintain competence to provide safe care. It examines why organisational knowing - understanding the organisation in which one is employed; its people, values and how it works - is important for all nurses, regardless of their level in the organisation. It also discusses workplace incivility and its adverse effects on nurses, patient care and healthcare organisations. The article explains that if nurses are uncertain why they are doing something, they should investigate this further, because the law expects nurses to be able to justify their actions, or failure to act.
Collapse
Affiliation(s)
- Louise Terry
- School of Health and Social Care, London South Bank University, London, England
| | - Graham Carr
- School of Health and Social Care, London South Bank University, London, England
| | - Yvonne Halpin
- School of Health and Social Care, London South Bank University, London, England
| |
Collapse
|
49
|
Abstract
One of the most critical junctures for community support of breastfeeding is the mother's return to work. When breastfeeding workers have access to both time and space for expressing breast milk, they are more likely to breastfeed for the recommended term, yet many mothers still struggle to access these simple accommodations in their workplace. Healthcare providers can and should aid nursing mothers in accessing these accommodations. One tangible way to offer support for continued breastfeeding upon return to work is to provide notes for lactation accommodation in the workplace.
Collapse
Affiliation(s)
- Jessica Lee
- Staff Attorney, Center for WorkLife Law , UC Hastings College of the Law, San Francisco, California
| |
Collapse
|
50
|
Abstract
This article outlines how care home staff can support safe sexual and intimate expression among older people. Older people may continue to engage in sexual and intimate acts in a residential setting; however, because of the stigma associated with sexual and intimate expression among older people, many care homes prohibit such intimacy. It is essential that care home staff adopt a person-centred approach to care that recognises the importance of maintaining the dignity and autonomy of residents while considering the potential for harm associated with sexual and intimate expression. This article discusses the issues associated with managing sexual and intimate expression among older people in care homes and uses a case study example to assist care homes in developing sexual health policies.
Collapse
Affiliation(s)
- Maggie Syme
- Center on Aging, Kansas State University, Manhattan, United States
| |
Collapse
|