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Sample records for bibliography ethical legal

  1. ELSI Bibliography: Ethical legal and social implications of the Human Genome Project

    SciTech Connect

    Yesley, M.S.

    1993-11-01

    This second edition of the ELSI Bibliography provides a current and comprehensive resource for identifying publications on the major topics related to the ethical, legal and social issues (ELSI) of the Human Genome Project. Since the first edition of the ELSI Bibliography was printed last year, new publications and earlier ones identified by additional searching have doubled our computer database of ELSI publications to over 5600 entries. The second edition of the ELSI Bibliography reflects this growth of the underlying computer database. Researchers should note that an extensive collection of publications in the database is available for public use at the General Law Library of Los Alamos National Laboratory (LANL).

  2. ELSI Bibliography: Ethical, legal and social implications of the Human Genome Project. 1994 Supplement

    SciTech Connect

    Yesley, M.S.; Ossorio, P.N.

    1994-09-01

    This report updates and expands the second edition of the ELSI Bibliography, published in 1993. The Bibliography and Supplement provides a comprehensive resource for identifying publications on the major topics related to the ethical, legal and social issues (ELSI) of the Human Genome Project. The Bibliography and Supplement are extracted from a database compiled at Los Alamos National Laboratory with the support of the Office of Energy Research, US Department of Energy. The second edition of the ELSI Bibliography was dated May 1993 but included publications added to the database until fall 1993. This Supplement reflects approximately 1,000 entries added to the database during the past year, bringing the total to approximately 7,000 entries. More than half of the new entries were published in the last year, and the remainder are earlier publications not previously included in the database. Most of the new entries were published in the academic and professional literature. The remainder are press reports from newspapers of record and scientific journals. The topical listing of the second edition has been followed in the Supplement, with a few changes. The topics of Cystic Fibrosis, Huntington`s Disease, and Sickle Cell Anemia have been combined in a single topic, Disorders. Also, all the entries published in the past year are included in a new topic, Publications: September 1993--September 1994, which provides a comprehensive view of recent reporting and commentary on the science and ELSI of genetics.

  3. Ethics: A Selected Bibliography.

    DTIC Science & Technology

    1985-03-01

    Light of American Law. Bloomington: Indiana University Press, 1955. (JF423 C3) 53. Callahan, Daniel , and Bok, Sissela, eds. Ethics Teaching in Higher...Educa- tion. New York: Plenum Press, 1980. (BJ66 E84) 54. Callahan, Daniel , and Engelhardt, H. Tristram, eds. The Roots of Ethics: . Science, Religion...Missouri Press, 1966. (JX1416 C18) -" 56. Caplan, Arthur L., and Callahan, Daniel , eds. Ethics in Hard Times. New York: Plenum Press, 1981. (JA79 E825

  4. The Trouble with Legal Ethics.

    ERIC Educational Resources Information Center

    Simon, William H.

    1991-01-01

    The conceptions of legal ethics or professional responsibility as (1) disciplinary rules or codes; and (2) as the personal moralities of individual lawyers prevail. However, it is the application of general norms to specific circumstances through complex, creative judgment that is the ethical component of the ideal of legal professionalism. (MSE)

  5. Legalism and ethics in healthcare.

    PubMed

    Gallagher, S M

    2000-12-01

    Legalism is the translation of moral problems into legal problems--the repression of moral debate for fear it will be translated into a legal mandate. Some assert that legalism interferes with the serious debate of significant moral issues, while others believe that it elevates moral judgments to moral standards. The purpose of this article is to describe legalism and its impact on ethical decision-making, particularly in the wound care setting.

  6. Legal briefing: Healthcare ethics committees.

    PubMed

    Pope, Thaddeus Mason

    2011-01-01

    This issue's "Legal Briefing" column covers recent legal developments involving institutional healthcare ethics committees. This topic has been the subject of recent articles in JCE. Healthcare ethics committees have also recently been the subject of significant public policy attention. Disturbingly, Bobby Schindler and others have described ethics committees as "death panels." But most of the recent attention has been positive. Over the past several months, legislatures and courts have expanded the use of ethics committees and clarified their roles concerning both end-of-life treatment and other issues. These developments are usefully grouped into the following eight categories: 1. Existence and availability. 2. Membership and composition. 3. Operating procedures. 4. Advisory roles. 5. Decision-making and gate-keeping roles. 6. Confidentiality. 7. Immunity. 8. Litigation and court cases.

  7. Legal Literature Survey: A Bibliography for a Workshop on Unraveling Government and Legal Documents.

    ERIC Educational Resources Information Center

    Shannon, Michael O.

    This bibliography is an attempt to provide an introduction to the literature of law, and a guide for the librarian in the non-legal collection. It is selective, with emphasis on acquisition tools, bibliographies, organization manuals, and legal reference books, including guides to research, dictionaries, directories, and manuals for legal…

  8. Ethical & Legal Issues in School Counseling. Chapter 3: Legal Issues.

    ERIC Educational Resources Information Center

    Remley, Theodore P., Jr.; And Others

    This document contains chapter 3 (7 articles) of a collection of 35 articles primarily from American Association for Counseling and Development (AACD) publications on the most important legal and ethical topics about which all school counselors need to be informed. "The Law and Ethical Practices in Elementary and Middle Schools" (Theodore P.…

  9. Ethical & Legal Issues in School Counseling. Chapter 3: Legal Issues.

    ERIC Educational Resources Information Center

    Remley, Theodore P., Jr.; And Others

    This document contains chapter 3 (7 articles) of a collection of 35 articles primarily from American Association for Counseling and Development (AACD) publications on the most important legal and ethical topics about which all school counselors need to be informed. "The Law and Ethical Practices in Elementary and Middle Schools" (Theodore P.…

  10. [Legal repercussions of Clinical Ethics Committees reports].

    PubMed

    Couceiro V, Azucena; Beca I, Juan Pablo

    2006-04-01

    Clinical Ethics Committees and Research Ethics Committees have their own specific roles. The Clinical Ethics Committee's pronouncements have an advisory function, whereas Research Ethics Committees' decisions are binding. This article analyzes the legal impact of the Clinical Ethics Committees' reports. Legal and medical reasoning share the same practical nature. Both can have several correct answers to the same situation. Clinical Ethics Committees deliberate about these alternatives and analyze the involved values. Their conclusions are non-compulsory recommendations. They do not replace nor diminish the doctor's personal responsibility. Even though the Clinical Ethics Committees' reports are not binding, they constitute a sort of "expert's opinion", expressed by qualified professionals, who assume their own professional responsibility as advisors. The members' behavior is necessarily subject to constitutional and legal regulations. When judges review the Clinical Ethics Committee's reports, they must realize that their nature is advisory, and also consider them an essential element to reduce the gap between the medical and legal fields. In this way, the problem of increasingly transforming medicine into a legal issue can be prevented.

  11. Ethical and Legal Responsibilities of Counselors.

    ERIC Educational Resources Information Center

    Glennen, Robert E.

    In the aftermath of the Watergate scandal, each profession is reviewing its ethical practices. This paper assists in this renewal by citing the code of ethical standards of APGA; reviewing the laws of the State of Nevada regarding privileged communications; and covering the legal aspects which relate to counseling situations. (Author)

  12. Ethics in Oncology: An Annotated Bibliography of Important Literature

    PubMed Central

    Tenner, Laura L.; Helft, Paul R.

    2013-01-01

    The aim of this annotated bibliography about important articles in the field of ethics and oncology is to provide the practicing hematologist/oncologist with a brief overview of some of the important literature in this crucial area. PMID:23942932

  13. Ethical Issues in Social Work. An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Elliott, Martha W., Comp.

    Designed as a practical aid to social work students and practitioners interested in approaching the ethical issues inherent in social work practice, this annotated bibliography lists over 500 books and articles, most of which were published between 1970 and 1983. The bibliography has two main parts, of which the first consists of selections from…

  14. The Legal Ethical Backbone of Conscientious Refusal.

    PubMed

    Munthe, Christian; Nielsen, Morten Ebbe Juul

    2017-01-01

    This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals' conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the notion of a legal right to conscientious refusal for any profession is either fundamentally incompatible with elementary legal ethical requirements, or implausible because it undermines the functioning of a related professional sector (healthcare) or even of society as a whole.

  15. Legal aspects of clinical ethics committees.

    PubMed

    Hendrick, J

    2001-04-01

    In an increasingly litigious society where ritual demands for accountability and "taking responsibility" are now commonplace, it is not surprising that members of clinical ethics committees (CECs) are becoming more aware of their potential legal liability. Yet the vulnerability of committee members to legal action is difficult to assess with any certainty. This is because the CECs which have been set up in the UK are--if the American experience is followed--likely to vary significantly in terms of their functions, procedures, composition, structures and authority. As a consequence it is difficult to generalize about the legal implications. Nevertheless, despite these difficulties this article will outline the broad legal principles governing the potential liability of committee members. It will also consider the relationship between CECs and the courts. It begins, however, with a brief analysis of the relationship between ethics and law in committee deliberations, and in particular of the role of law and legal expertise on CECs.

  16. Ethical Responsibility in Communication: A Selected, Annotated Bibliography. Fourth Edition.

    ERIC Educational Resources Information Center

    Johannesen, Richard L.

    Representing works published between 1970 and 1984, this annotated bibliography identifies a variety of readings that explore fundamental issues of ethics in interpersonal, public, and mass communication, and that examine from an ethical viewpoint how to and whether to employ particular communication tactics or techniques. The bibliography…

  17. Resistance to Reform in Legal Ethics Instruction.

    ERIC Educational Resources Information Center

    Gee, Elizabeth D.

    Perceptions of forces that may restrain the implementation of needed change in legal ethics instruction were investigated in 1984, using a model of resistance to planned change proposed by Goodwin Watson. Based on this model, five barriers to change were assessed: conformity to norms, systemic and cultural coherence, vested interests, the…

  18. Legal and Ethical Aspects of Counseling.

    ERIC Educational Resources Information Center

    Taylor, Jane A.; And Others

    These five mazes, with instruction manual, are designed to facilitate counselors' understanding of potential consequences and their ability to make appropriate legal and ethical decisions as helping professionals. Each maze consists of a problem situation similar to ones that might actually occur in a counseling situation, followed by several…

  19. Resistance to Reform in Legal Ethics Instruction.

    ERIC Educational Resources Information Center

    Gee, Elizabeth D.

    Perceptions of forces that may restrain the implementation of needed change in legal ethics instruction were investigated in 1984, using a model of resistance to planned change proposed by Goodwin Watson. Based on this model, five barriers to change were assessed: conformity to norms, systemic and cultural coherence, vested interests, the…

  20. Ethical and Legal Challenges of Technology.

    ERIC Educational Resources Information Center

    Shaughnessy, Mary Angela

    1995-01-01

    Discusses three ethical and legal challenges of technology: issues of accessibility and equality, the appropriateness of materials available to young people on the Internet, and matters relating to copyright and the licensing of software users. States that educators and parents must make a collaborative effort to address these concerns. (DJM)

  1. Surrogacy: Ethical and Legal Issues

    PubMed Central

    Saxena, Pikee; Mishra, Archana; Malik, Sonia

    2012-01-01

    Surrogacy refers to a contract in which a woman carries a pregnancy “for” another couple. Number of infertile couples from all over the World approach India where commercial surrogacy is legal. Although this arrangement appears to be beneficial for all parties concerned,there are certain delicate issues which need to be addressed through carefully framed laws in order to protect the rights of the surrogate mother and the intended parents. PMID:23293432

  2. Legal and ethical issues in research

    PubMed Central

    Yip, Camille; Han, Nian-Lin Reena; Sng, Ban Leong

    2016-01-01

    Legal and ethical issues form an important component of modern research, related to the subject and researcher. This article seeks to briefly review the various international guidelines and regulations that exist on issues related to informed consent, confidentiality, providing incentives and various forms of research misconduct. Relevant original publications (The Declaration of Helsinki, Belmont Report, Council for International Organisations of Medical Sciences/World Health Organisation International Guidelines for Biomedical Research Involving Human Subjects, World Association of Medical Editors Recommendations on Publication Ethics Policies, International Committee of Medical Journal Editors, CoSE White Paper, International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use-Good Clinical Practice) form the literature that are relevant to the ethical and legal aspects of conducting research that researchers should abide by when conducting translational and clinical research. Researchers should note the major international guidelines and regional differences in legislation. Hence, specific ethical advice should be sought at local Ethics Review Committees. PMID:27729698

  3. A Search for Environmental Ethics: An Initial Bibliography.

    ERIC Educational Resources Information Center

    Anglemyer, Mary, Comp.; And Others

    Presented is an annotated bibliography of publications dealing with the relationship between ethics and the natural environment. Coverage begins with the post-war period (1945). The 446 entries appear alphabetically by author and title, and both a subject index and a name index are provided. Included are writings by scientists, conservationists,…

  4. Ethical Issues in Health Services: A Report and Annotated Bibliography.

    ERIC Educational Resources Information Center

    Carmody, James

    This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…

  5. A Selected Bibliography on Teaching Business Ethics.

    ERIC Educational Resources Information Center

    Cotton, Emily, Comp.

    1991-01-01

    Lists some works dealing with the teaching of business ethics. Consists of articles, surveys, studies, and books. Includes documents concerning suggested teaching methods, moral development, student attitudes, philosophy, and the state of business ethics education at present. (DK)

  6. Dementia in prison: ethical and legal implications.

    PubMed

    Fazel, S; McMillan, J; O'Donnell, I

    2002-06-01

    As the number of elderly prisoners increases in the UK and other Western countries, there will be individuals who develop dementia whilst in custody. We present two case vignettes of men with dementia in English prisons, and explore some of the ethical implications that their continuing detention raises. We find little to support their detention in the various purposes of prison put forward by legal philosophers and penologists, and conclude by raising some of the possible implications of The Human Rights Act 1998.

  7. Medical errors: legal and ethical responses.

    PubMed

    Dickens, B M

    2003-04-01

    Liability to err is a human, often unavoidable, characteristic. Errors can be classified as skill-based, rule-based, knowledge-based and other errors, such as of judgment. In law, a key distinction is between negligent and non-negligent errors. To describe a mistake as an error of clinical judgment is legally ambiguous, since an error that a physician might have made when acting with ordinary care and the professional skill the physician claims, is not deemed negligent in law. If errors prejudice patients' recovery from treatment and/or future care, in physical or psychological ways, it is legally and ethically required that they be informed of them in appropriate time. Senior colleagues, facility administrators and others such as medical licensing authorities should be informed of serious forms of error, so that preventive education and strategies can be designed. Errors for which clinicians may be legally liable may originate in systemically defective institutional administration.

  8. Legal ethical and risk issues in telemedicine.

    PubMed

    Stanberry, B

    2001-03-01

    This paper summarizes the main topics of discussion at a workshop hosted by the Centre for Law Ethics and Risk in Telemedicine at the 2nd International Conference on Advances in the Delivery of Care, held at the Institute of Health Sciences, City University, London from Wednesday 24 to Friday 26 March 1999. The workshop offered a unique opportunity for practitioners in the fields of telemedicine and shared care to discuss the legal, ethical and risk issues arising from the practice of medicine and healthcare from a distance using information and communication technologies ('ICTs') with a panel of experts from the fields of medicine, law, insurance and risk management. There was a broad consensus that many of the legal and ethical issues raised by those who dislike the idea of treating distant patients were not specific to telemedicine but to medicine and healthcare in general. It was agreed, however, that in those areas where telemedicine does create new clinical risks and responsibilities a much more proactive role should be taken by the professional associations and Royal Colleges in providing better education and guidance to their members about the practical and professional issues that will inevitably arise from the evolution of 'Hospitals Without Walls'.

  9. [Is the legally responsible party indeed responsible? An ethical-legal question on the term].

    PubMed

    Fontana-Rosa, Júlio César; Oliveira, Reinaldo Ayer de

    2008-01-01

    The authors discuss the legal and ethical meaning of the expression "Third-Party Consent" by questioning its limits. It is indeed shown that it does not satisfactorily meet what is called third-party consent because this would require legal endorsement by legal codes and norms which, in fact does not occur. As such, the expression "third-party consent", whenever used, may not provide the professional with the normative, ethical and legal support needed for professional performance.

  10. Antiprogestin drugs: ethical, legal and medical issues.

    PubMed

    Cook, R J; Grimes, D A

    1992-01-01

    RU 486 allows women the choice of a medical rather than a surgical abortion, and, for most women, the choice is one of procedure, not of whether to have an abortion. Issues surrounding RU 486 were explored in an American Society of Law and Medicine conference in December 1991 entitled "Antiprogestin Drugs: Ethical, Legal and Medical Issues." An introduction to 14 conference papers provides an overview of the proceedings. Baulieu, the father of RU 486, described updated developments in its use and the medically supervised method of abortion. Bygdeman and Swahn presented their work in Sweden on combining RU 486 with a prostaglandin to make abortion more effective. They suggested that the drug may be an attractive postovulation contraceptive. Greenslad et al. discussed service delivery aspects of the use of RU 486. Holt considered the implications of use of the drug in low-resource settings. A survey of obstetricians and gynecologists, presented by Heilig, indicates that 22% more physicians would perform a medical abortion. Patient perspectives were addressed by David, who stated that measuring acceptability of an abortion technique is difficult; women have historically used whatever method is available. A collaborative research project in India and Cuba on why women chose certain methods was reported by Winikoff et al. (90% of women would choose medical abortion if faced with the choice again). Berer analyzed French data on women's perspectives on medical vs. surgical abortion. The question of adolescent use of the drug was considered by Senderowitz, who lamented the lack of data on the subject and described what is known about adolescent pregnancy. Macklin proposed a framework for ethical analysis and used facts to address ethical questions. Weinstein provided another ethical framework, to analyze whether pharmacists have a right to refuse to provide abortifacient drugs. Buc approached the subject from a legal point of view and concluded that, whereas legal problems

  11. Identifying the Need for Teaching Ethics in Professional Legal Education.

    ERIC Educational Resources Information Center

    Askins, Billy E.; And Others

    This paper describes how the Minimum Continuing Legal Education Board (MCLE) of the Supreme Court of New Mexico used the "MacCrate Report" to start a process of identifying the need for practical training in ethics education for legal professionals. The report, "Legal Education and Professional Development--An Educational…

  12. The living will: legal and ethical perspectives.

    PubMed

    Wold, J L

    1992-02-01

    Problems surrounding issues of dying and death are many. Health professionals, families and individuals all must cope with different aspects of these problems. The living will has been discussed as one way people can alleviate many of the problems associated with the decision to die with dignity. Nurses are in the perfect position to educate people concerning the benefits of having a living will. As patient advocate, it is imperative nurses be apprised of the laws in their states regarding living wills. By initiating a living will, individuals can make their wishes known to both family and the medical establishment. Increased public education concerning state living will legislation and concomitant rights under these laws is needed. Through education, many of the legal and ethical issues that arise from ignorance of the law may be avoided before they become problems.

  13. AIDS and orphans: legal and ethical issues.

    PubMed

    Siamwiza, R

    1998-03-01

    This article explores the ethical and human rights issues surrounding AIDS and those orphaned by the epidemic in Zambia. A major area of controversy is on the rights of parents and children in adoptive or fostering relationships; civil law is unclear, and customary law treats children as the property of parents and selected kin. HIV/AIDS adds to the controversy concerning the following rights for adoptive and foster parents and children: 1) the right of prospective parents to know the health status of the child, and the child to know the prospective parent's status; 2) the rights, responsibilities, and obligations of the foster child's biological family after the placement; 3) the rights of adoptive or foster parents to public welfare assistance, health care, educational grants, particularly if the child has HIV; 4) property rights of adopted or foster children within their new families; and 5) the legal and civil rights of abandoned children. In conclusion, the ethical issues surrounding adoption and fostering require extensive research and public debate, taking into account the impact of broad socioeconomic changes affecting the extended family, as well as the impact of AIDS.

  14. Legal and ethical issues of uterus transplantation.

    PubMed

    Dickens, Bernard M

    2016-04-01

    The clinically detailed report of a successful uterus transplantation and live birth in Sweden, in which a family friend donated her uterus, provides a basis for expanded practice. Family members and friends can serve as living donors without offending legal or ethical prohibitions of paid organ donation, even though family members and friends often engage in reciprocal gift exchanges. Donations from living unrelated sources are more problematic, and there is a need to monitor donors' genuine altruism and motivation. Donation by deceased women-i.e. cadaveric donation-raises issues of uterus suitability for transplantation, and how death is diagnosed. Organs' suitability for donation is often achieved by ventilation to maintain cardiac function for blood circulation, but laws and cultures could deem that a heartbeat indicates donors' live status. Issues could arise concerning ownership and control of organs between recovery from donors and implantation into recipients, and on removal following childbirth, that require legal resolution. Copyright © 2016. Published by Elsevier Ireland Ltd.

  15. Social-Cognitive Development, Ethical and Legal Knowledge, and Ethical Decision Making of Counselor Education Students

    ERIC Educational Resources Information Center

    Lambie, Glenn W.; Hagedorn, W. Bryce; Ieva, Kara P.

    2010-01-01

    Counselors are required to have high levels of social-cognitive development, significant knowledge regarding ethical and legal practice, and sound ethical decision-making processes to provide effective and ethical services to their clients. This study investigated the effect of two counseling ethics courses on 64 master's-level counselor education…

  16. Social-Cognitive Development, Ethical and Legal Knowledge, and Ethical Decision Making of Counselor Education Students

    ERIC Educational Resources Information Center

    Lambie, Glenn W.; Hagedorn, W. Bryce; Ieva, Kara P.

    2010-01-01

    Counselors are required to have high levels of social-cognitive development, significant knowledge regarding ethical and legal practice, and sound ethical decision-making processes to provide effective and ethical services to their clients. This study investigated the effect of two counseling ethics courses on 64 master's-level counselor education…

  17. Bibliographies.

    ERIC Educational Resources Information Center

    Bourdon, Cathleen

    1999-01-01

    Provides "The Librarian's Bookshelf" a selected annotated bibliography of books (mostly published since 1995) to help librarians deal with the issues of providing appropriate service to children and adults. Lists titles alphabetically in several categories of technical services and issues, instruction, information services, legal issues,…

  18. Prolonging life: legal, ethical, and social dilemmas.

    PubMed

    Paulson, Steve; Comfort, Christopher P; Lee, Barbara Coombs; Shemie, Sam; Solomon, Mildred Z

    2014-11-01

    The ability of modern medicine to prolong life has raised a variety of difficult legal, ethical, and social issues on which reasonable minds can differ. Among these are the morality of euthanasia in cases of deep coma or irreversible injury, as well as the Dead Donor Rule with respect to organ harvesting and transplants. As science continues to refine and develop lifesaving technologies, questions remain as to how much medical effort and financial resources should be expended to prolong the lives of patients suspended between life and death. At what point should death be considered irreversible? What criteria should be used to determine when to withhold or withdraw life-prolonging treatments in cases of severe brain damage and terminal illness? To explore these complex dilemmas, Steve Paulson, executive producer and host of To the Best of Our Knowledge, moderated a discussion panel. Pediatrician Sam Shemie, hospice medical director Christopher P. Comfort, bioethicist Mildred Z. Solomon, and attorney Barbara Coombs Lee examined the underlying assumptions and considerations that ultimately shape individual and societal decisions surrounding these issues. The following is an edited transcript of the discussion that occurred November 12, 2013, 7:00-8:30 PM, at the New York Academy of Sciences in New York City. © 2014 New York Academy of Sciences.

  19. The legal ethics of pediatric research.

    PubMed

    Coleman, Doriane Lambelet

    2007-12-01

    Since the mid- to late 1990s, the scientific and medical research community has sought to increase its access to healthy children for research protocols that involve harm or a risk of harm. This move reverses longstanding policy within that community generally to exclude healthy children from such protocols on the grounds that the research as to them is non-therapeutic, that they are particularly vulnerable to research-related abuses, and that they are unable themselves to give informed consent to their participation. The research community's new posture has been supported by prominent pediatric bioethicists who have argued that unless healthy children are included as research subjects in harmful or risky research, the pediatric population will continue to suffer relative to the adult population in the extent to which it benefits from modern advances in science and medicine. In their view, it is possible for the research community to self-administer a rule that strikes a balance between protecting healthy children from research-related abuses and allowing their inclusion in cutting-edge pediatric research. In this scheme, parental consent is central to the research community's claims about child protection. This Article explores the flaws inherent in this ethics of pediatric research. Specifically, it challenges the view from ethics that the law permits parents to consent to their children's inclusion in harmful or risky research to the extent that related invasions would meet legal maltreatment standards. More broadly, it challenges the movement to increase access to healthy children for harmful and risky research on the ground that it risks two important regressions: First, in its willingness to risk harm to individual children in the interests of the group, it threatens the progress the law has made in its development of the concept of the child as an individual worthy of respect in his or her own right, a concept that imagines parents as fiduciaries and that

  20. Ethical and legal aspects in teaching students of medicine.

    PubMed

    Wlasienko, Pawel

    2005-01-01

    Due to the rapid advances in medical technology, medical students are now being faced with increasingly complex and unparalleled ethical and practical dilemmas during their training. The new and future challenges of high-tech medicine demand improvements in current medical education, not only by meeting the needs of students through humanized training programs, but also by involving them in finding solutions to the ethical and legal quandaries they encounter. Today's students of medical universities must acquire knowledge and understanding of the ethical and legal issues relevant to the practice of medicine, and we have to do everything possible to introduce these students to the current discussions on more or less controversial ethical and legal topics. Although final answers may not be found, the very discussion, argumentation, and awakening of students' interest should become an essential part of the core curriculum of every doctor.

  1. Legal and ethical issues regarding social media and pharmacy education.

    PubMed

    Cain, Jeff; Fink, Joseph L

    2010-12-15

    Widespread use of social media applications like Facebook, YouTube, and Twitter has introduced new complexities to the legal and ethical environment of higher education. Social communications have traditionally been considered private; however, now that much of this information is published online to the public, more insight is available to students' attitudes, opinions, and character. Pharmacy educators and administrators may struggle with the myriad of ethical and legal issues pertaining to social media communications and relationships with and among students. This article seeks to clarify some of these issues with a review of the legal facets and pertinent court cases related to social media. In addition, 5 core ethical issues are identified and discussed. The article concludes with recommendations for pharmacy educators with regard to preparing for and addressing potential legal issues pertaining to social media.

  2. Legal and Ethical Issues Regarding Social Media and Pharmacy Education

    PubMed Central

    Fink, Joseph L.

    2010-01-01

    Widespread use of social media applications like Facebook, YouTube, and Twitter has introduced new complexities to the legal and ethical environment of higher education. Social communications have traditionally been considered private; however, now that much of this information is published online to the public, more insight is available to students' attitudes, opinions, and character. Pharmacy educators and administrators may struggle with the myriad of ethical and legal issues pertaining to social media communications and relationships with and among students. This article seeks to clarify some of these issues with a review of the legal facets and pertinent court cases related to social media. In addition, 5 core ethical issues are identified and discussed. The article concludes with recommendations for pharmacy educators with regard to preparing for and addressing potential legal issues pertaining to social media. PMID:21436925

  3. Legal and ethical considerations in the treatment of psychosis.

    PubMed

    Fitzgerald, W L

    1999-01-01

    A variety of legal and ethical issues surround any decision about the treatment of patients with psychosis. These issues have come to the forefront with the introduction of the atypical antipsychotic agents. The law defines the minimum expected level of conduct for a health care professional, and where the law ends, ethics begin. Adverse drug reactions are a leading cause of death in the United States, and medication error is a common reason for liability claims against health care professionals. Patients alleging negligence must prove that the health care professional owed a duty to the patient, that the duty was breached, that the patient was injured, and that the breach of duty was the legal cause of the injury. Professional ethics are governed by various models for ethical decision making. The principles model, which can be readily applied to the patient with mental illness, is based on the ethical principles of beneficence, nonmaleficence, autonomy, utility, and justice.

  4. Ethical and legal issues in e-mail therapy.

    PubMed

    Shapiro, Daniel Edward; Schulman, Charles Eric

    1996-01-01

    Psychologists and psychiatrists recently started using electronic mail (e-mail) to conduct therapy. This article explores relevant ethical and legal issues including, among others, the nature of the professional relationship, boundaries of competence, informed consent, treating minors, confidentiality, and the duty to warn and protect. To illustrate these complex issues, two services currently operating are discussed. To address potential hazards to clients and the profession, a new ethical standard for e-mail therapists is offered.

  5. End of life care pathways: ethical and legal principles.

    PubMed

    Allmark, P; Tod, A

    Myths have developed surrounding the law and ethical principles in end of life care, which can make care provision at the end of life complex and fraught with potential dilemmas. This article examines three of the most common myths related to the provision of palliative care and highlights their inadequacy when set against the ethical and legal principles on which end of life care pathways are based.

  6. [Patenting human genetic material: ethical and legal implications].

    PubMed

    Bergel, S D

    2001-01-01

    If we introduce the subject of patents on human genetic material in a Bioethics Conference we must answer two questions. Firstly, whether the debate can be universalized, bearing in mind the national nature of norms governing intellectual property, and, secondly, whether there are links between patent law and ethics. Using the example of the patenting of biological material, we will see how this impacts on society, which, beyond the technical or legal knowledge required, is voicing its concern on the ethical level.

  7. Business Ethics. Focused Access to Selected Topics (FAST) Bibliography No. 17.

    ERIC Educational Resources Information Center

    Shermis, Michael

    Addressing the needs of students who choose careers in business, this annotated bibliography contains 30 references of articles and papers in the ERIC database dealing with ethics in business. Sources cited in the first section, "Business Instruction," deal with teaching ethics in business communication, business literature, and other areas of the…

  8. Professional Ethics in Vocational Education Research: An Annotated Bibliography of Related Literature.

    ERIC Educational Resources Information Center

    Samuelson, Judith, Comp.

    This 14-item annotated bibliography provides background information on the efforts of several professional groups to define codes of ethics for their members' guidance. It was prepared to aid the members of the American Vocational Education Research Association (AVERA) in their study of ethical principles and guidelines for professional behavior,…

  9. Law and Language: A Selected, Annotated Bibliography on Legal Writing.

    ERIC Educational Resources Information Center

    Collins, Terence; Hattenhauer, Darryl

    1983-01-01

    A survey of literature on legal writing from 1969 through 1980 covers 45 journal articles and ERIC documents on needs for prelaw and law-school curricula and paralegal training. Highly technical materials are included only when they shed light on general issues of legal language. (MSE)

  10. Upholding Legal and Ethical Duties in the Age of Collaboration

    ERIC Educational Resources Information Center

    Shapiro, Elika A.; Morgan, Kara Puklich; Wilde, Laura K.

    2008-01-01

    As public schools across the nation begin to implement the response to intervention (RTI) model of service delivery, school psychologists may find themselves in the difficult position of trying to balance the need to collaborate as part of a problem-solving team with their duty to uphold legal and ethical obligations surrounding informed consent…

  11. Legal and Ethical Issues in Evaluating Abortion Services.

    ERIC Educational Resources Information Center

    Ferris, Lori E.

    2000-01-01

    Focuses on ethical and legal issues that arose in the evaluation of abortion services. Discusses the development of decision rules and tradeoffs in dealing with these issues to reach rational and objective decisions. Places the discussion in the context of balancing usefulness and propriety with respect to informed consent and privacy and makes…

  12. Social Media and Professional School Counselors: Ethical and Legal Considerations

    ERIC Educational Resources Information Center

    Mullen, Patrick R.; Griffith, Catherine; Greene, Jennifer H.; Lambie, Glenn W.

    2014-01-01

    The use of social media continues to expand in prevalence and is a medium of communication for individuals of all ages. Schools are using social media to engage their stakeholders at increasing rates. Therefore, school counselors require the knowledge and appreciation of ethical and legal issues regarding the use of such technology. The purpose of…

  13. Navigating the Legal and Ethical World of Overseas Contracts.

    ERIC Educational Resources Information Center

    Skinner, Karla Jo

    1998-01-01

    Referring to Iowa contract law, reviews ethical and legal aspects of overseas employment contracts signed by educators at recruitment fairs. Iowa Department of Education guidelines state the following aspects of a good contract: it is in writing; it states the salary, pay periods, benefits, and dates of employment; it lists special conditions and…

  14. Upholding Legal and Ethical Duties in the Age of Collaboration

    ERIC Educational Resources Information Center

    Shapiro, Elika A.; Morgan, Kara Puklich; Wilde, Laura K.

    2008-01-01

    As public schools across the nation begin to implement the response to intervention (RTI) model of service delivery, school psychologists may find themselves in the difficult position of trying to balance the need to collaborate as part of a problem-solving team with their duty to uphold legal and ethical obligations surrounding informed consent…

  15. Legal Guardianship in Traumatic Brain Injury Rehabilitation: Ethical Implications.

    ERIC Educational Resources Information Center

    Anderson, Thomas P.; Fearey, Margaret S.

    1989-01-01

    This article examines legal and ethical issues in the rehabilitation of the head-injured client, particularly the use of guardianship. Several models of rehabilitation goal setting are discussed, with a particular emphasis upon an educational model for the relationship between provider and client. Changes in guardianship procedures are suggested.…

  16. Legal Guardianship in Traumatic Brain Injury Rehabilitation: Ethical Implications.

    ERIC Educational Resources Information Center

    Anderson, Thomas P.; Fearey, Margaret S.

    1989-01-01

    This article examines legal and ethical issues in the rehabilitation of the head-injured client, particularly the use of guardianship. Several models of rehabilitation goal setting are discussed, with a particular emphasis upon an educational model for the relationship between provider and client. Changes in guardianship procedures are suggested.…

  17. [Legal and ethical considerations of emergencies in the dental office].

    PubMed

    Zusman, S P; Garfunkel, A; Galili, D; Findler, M; Malamed, S F; Elad, S; Kaufman, E

    2002-01-01

    The dentist has the ethical and legal responsibility to anticipate emergency situations in correlation with the patient's medical status. He has the obligation to do all in his power to prevent emergencies from happening and to be prepared to manage any emergency that might occur. This article also discusses the importance of monitoring and documentation.

  18. Legal and Ethical Issues in Evaluating Abortion Services.

    ERIC Educational Resources Information Center

    Ferris, Lori E.

    2000-01-01

    Focuses on ethical and legal issues that arose in the evaluation of abortion services. Discusses the development of decision rules and tradeoffs in dealing with these issues to reach rational and objective decisions. Places the discussion in the context of balancing usefulness and propriety with respect to informed consent and privacy and makes…

  19. Legal Reasoning, Recipes, Ethics, Values, Educational Administration and Applied Philosophy.

    ERIC Educational Resources Information Center

    Kaminsky, James S.

    1986-01-01

    Constructs a methodology of "bracketed neglect" for redirecting questions of ethics and/or values away from questions pertaining to educational philosophy alone toward the practice of educational administration. Offers examples of this method, which simplifies or neglects selected moral values, related to legal reasoning. Offers an outline of…

  20. The Terri Schiavo case: legal, ethical, and medical perspectives.

    PubMed

    Perry, Joshua E; Churchill, Larry R; Kirshner, Howard S

    2005-11-15

    Although tragic, the plight of Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care. First, the authors review the current medical understanding of persistent vegetative state, including the requirements for patient examination, the differential diagnosis, and the practice guidelines of the American Academy of Neurology regarding artificial nutrition and hydration for patients with this diagnosis. Second, they examine the legal history, including the 2000 trial, the 2002 evidentiary hearing, and the subsequent appeals. The authors argue that the law did not fail Terri Schiavo, but produced the highest-quality evidence and provided the most judicial review of any end-of-life guardianship case in U.S. history. Third, they review alternative ethical frameworks for understanding the Terri Schiavo case and contend that the principle of respect for autonomy is paramount in this case and in similar cases. Far from being unusual, the manner in which Terri Schiavo's case was reviewed and the basis for the decision reflect a broad medical, legal, and ethical consensus. Greater clarity regarding the persistent vegetative state, less apprehension of the presumed mysteries of legal proceedings, and greater appreciation of the ethical principles at work are the chief benefits obtained from studying this provocative case.

  1. Sexual harassment in the medical profession: legal and ethical responsibilities.

    PubMed

    Mathews, Ben; Bismark, Marie M

    2015-08-17

    Sexual harassment of women in medicine has become a subject of national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would be jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession. Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and ethical rights and responsibilities in this context. An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of conduct. An employer may be liable for breaching anti-discrimination legislation, workplace safety laws, duties owed in contract law, and a duty of care owed to the employee. Employers, professional colleges and associations, and regulators should use this national debate as an opportunity to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible.

  2. Ethical Issues of Reproductive Technologies: Legal and Ethical.

    ERIC Educational Resources Information Center

    Kammler, Kim

    Ethical issues which surround the reproductive technologies being used to assist infertile couples include social impact, surrogacy, access to service and confidentiality. The use of reproductive technologies does not appear to cause harm, and often does a lot of good for the family and society. Surrogacy could be a valuable tool for the infertile…

  3. Ethical Issues of Reproductive Technologies: Legal and Ethical.

    ERIC Educational Resources Information Center

    Kammler, Kim

    Ethical issues which surround the reproductive technologies being used to assist infertile couples include social impact, surrogacy, access to service and confidentiality. The use of reproductive technologies does not appear to cause harm, and often does a lot of good for the family and society. Surrogacy could be a valuable tool for the infertile…

  4. Some Ethical Legal Issues in Heart Disease Surgery

    PubMed Central

    Lin, Pyng Jing

    2014-01-01

    Ethical concerns, cultural norms, and legal issues must be carefully considered when treating a patient with heart disease. Although physicians or surgeons must play a role in course of treatment decision making, they should be guided by evidence-based data and the preferences of patients and/or the patient’s parents. However, there is no obligation to provide this type of informed consultation and approval unless these ethical issues become law - which typically occurs through litigation. In this review, we examined common ethical principles that are integral to the regular decisions made by clinicians every day. Some special ethical issues and associated litigation, if any, which might occur perioperatively will also be reviewed. Finally, the final judgments of civil and criminal courts of Taiwan, particularly lawsuits involving physicians associated with coronary artery disease care or aortic aneurysm, will also be introduced. PMID:27122831

  5. Medicine beyond borders: the legal and ethical challenges.

    PubMed

    Kassim, Puteri Nemie J

    2009-09-01

    The ease and affordability of international travel has contributed to the rapid growth of the healthcare industry where people from all around the world are traveling to other countries to obtain medical, dental, and surgical care while at the same time touring, vacationing and fully experiencing the attractions of the countries that they are visiting. A combination of many factors has led to the recent increase in popularity of medical tourism such as exorbitant costs of healthcare in industrialized nations, favorable currency exchange rates in the global economy, rapidly improving technology in many countries of the world and most importantly proven safety of healthcare in selected foreign nations. Nevertheless, the development of medical tourism has certainly awakened many ethical and legal issues, which must be addressed. Issues pertaining to malpractice, consumer protection, organ trafficking, alternative medicine and telemedicine need comprehensive legal regulatory framework to govern them. Ethical issues are also been raised by the promotion of medical tourism in particular those pertaining to doctor and patient relationship. A future, where medical law is subsumed into various legal and ethical dimensions, poses serious challenges for the practice and ethics of medicine.

  6. [Obligatory treatment: ethical, medical and legal issues].

    PubMed

    Archambault, Jean-Claude

    2006-06-01

    Legislation passed on 30 June 1838 created a medico-administrative and legal framework for forced hospitalization. Updated in 1990, this law has been evaluated twice. The last evaluation, in 2005, recommended a 72-hour observation period before deciding whether hospitalization was necessary. The situation of violent patients remains unclear. On the one hand, the psychiatrist has no means of impinging on these patients if they decide to stop their treatment once outside the hospital. On the other hand, for patients who are declared to be irresponsible, it would be wise to consider the possibility of being able to judge them, and adapt their sentences accordingly.

  7. Irrationality: psychological, ethical and legal aspects.

    PubMed

    Dimitrov, A

    1999-01-01

    A definition and a concise classification of irrational mentality and behaviour is proposed in the paper. The basic goal is to reveal the psychological mechanisms of inducing irrational individual and group behaviour by certain social agents. An attempt is made to apply the methodology of self-organization theory to the analysis of psychic equilibrium. The inducing of irrational behaviour is qualified as a crime against the freedom of the individual. In view of its grave social consequences a plea for its serious legal treatment is made.

  8. [Living donors for kidney transplantation: ethical and legal challenges].

    PubMed

    Mamzer-Bruneel, Marie-France; Fournier, Catherine; Legendre, Christophe

    2010-05-01

    Living donor kidney transplantation has developed very heterogeneously worldwide despite excellent results and without taking into account the context of global organ shortage. Such a heterogeneity highlights persistent ethical issues, whereas organ trafficking is emerging as an organized transplant tourism reinforcing the need for strong national legal frameworks. Despite its powerful regulation system, which ensures standardization, transparency and accountability of support for donation, France remains reluctant to enlarge the circle of legal donors, whereas it would be the first step to give a greater role to living organ donation.

  9. Healthy limb amputation: ethical and legal aspects.

    PubMed

    Johnston, Josephine; Elliott, Carl

    2002-01-01

    A surgeon in Scotland has amputated the legs of two consenting, physically healthy patients. Although a handful of medical professionals believe that the desire for healthy limb amputation is symptomatic of a mental disorder that can be treated only by amputation, there is currently no consensus on what causes a person to desire such a disabling intervention. As long as there is no established body of medical opinion as to the diagnosis and treatment of such a condition, performing the surgery may be a criminal act. Given the ethically problematic history of surgery for psychiatric conditions, as well as the absence of sound medical data on this condition, surgeons should exercise great caution before complying with a request to amputate a healthy limb.

  10. Physician Encounters with Human Trafficking: Legal Consequences and Ethical Considerations.

    PubMed

    Todres, Jonathan

    2017-01-01

    There is growing recognition and evidence that health care professionals regularly encounter-though they may not identify-victims of human trafficking in a variety of health care settings. Identifying and responding appropriately to trafficking victims or survivors requires not only training in trauma-informed care but also consideration of the legal and ethical issues that arise when serving this vulnerable population. This essay examines three areas of law that are relevant to this case scenario: criminal law, with a focus on conspiracy; service provider regulations, with a focus on mandatory reporting laws; and human rights law. In addition to imposing a legal mandate, the law can inform ethical considerations about how health care professionals should respond to human trafficking.

  11. Medical confidentiality versus disclosure: Ethical and legal dilemmas.

    PubMed

    Agyapong, V I O; Kirrane, R; Bangaru, R

    2009-02-01

    A case is described of a fifty year old single man who made disclosures about criminal sexual practices during a psychiatric assessment. In common practice with other professional men, a doctor is under a duty not to disclose, without the consent of his patient, information which he has gained in his professional capacity other than in exceptional circumstances. We discuss the ethical and legal considerations surrounding issues of medical confidentiality and the dilemma that sometimes face clinicians, when they feel obliged, in the public interest, to disclose information they have gained in confidence. Breach of confidences can have deleterious consequences; particularly for the doctor-patient relationship, but failure to disclose in some situations could have serious implications for the well-being of the wider society. Doctors should be aware of the basic principles of confidentiality and the ethical and legal framework around which they are built.

  12. Video recording of ophthalmic surgery--ethical and legal considerations.

    PubMed

    Turnbull, Andrew M J; Emsley, Elizabeth S

    2014-01-01

    Video documenting is increasingly used in ophthalmic training and research, with many ophthalmologists routinely recording their surgical cases. Although this modality represents an excellent means of improving technique and advancing knowledge, there are major ethical and legal considerations with its use. Informed consent to record is required in most situations. Patients should be advised of any risk of identification and the purpose of the recording. Systems should be in place to deal with issues such as data storage, withdrawal of consent, and patients requesting copies of their recording. Privacy and security of neither patients nor health care professionals should be compromised. Ownership and distribution of video recordings, the potential for their use in medical litigation, the ethics and legality of editing and the impact on surgeon performance are other factors to consider. Although video recording of ophthalmic surgery is useful and technically simple to accomplish, patient safety and welfare must always remain paramount. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Epigenetics and Child Psychiatry: Ethical and Legal Issues.

    PubMed

    Thomas, Christopher R

    2015-10-01

    Epigenetics has the potential to revolutionize diagnosis and treatment in psychiatry, especially child psychiatry, as it may offer the opportunity for early detection and prevention, as well as development of new treatments. As with the previous introduction of genetic research in psychiatry, there is also the problem of unrealistic expectations and new legal and ethical problems. This article reviews the potential contributions and problems of epigenetic research in child psychiatry. Previous legal and ethical issues in genetic research serve as a guide to those in epigenetic research. Recommendations for safeguards and guidelines on the use of epigenetics with children and adolescents are outlined based on the identified issues. Copyright © 2015 John Wiley & Sons, Ltd.

  14. Plastination: ethical and medico-legal considerations

    PubMed Central

    Conti, Adelaide; Buccelli, Claudio; Addeo, Giuseppe; Capasso, Emanuele; Piras, Mauro

    2016-01-01

    Abstract The international plastination phenomenon has proved to be immensely popular with audiences world-wide. Never before has the human body been exposed to public gaze in such an accessible manner. The exhibitions have perplexed many, included anatomists, some of whom find the display of human bodies unethical. The objective of this study is to review the attention on the use of plastination and exhibition of entire human bodies for non-educational or commercial purposes. The nature of these exhibitions and the uneasy balance between entertainment and education has caused heated debate. The possible legitimacy of the expression of one’s will as far as exhibition purposes isn’t considered sufficient for the indiscriminate use of a corpse despite the ethical necessity of respecting the wishes of individuals based on respect for the deceased. The informed consent of an individual represents only the most basic and minimal prerequisite for the use of the deceased’s body for exhibition purposes, and is absolutely not enough on its own to justify its use in entertainment exhibitions or for the commercialization of the death PMID:28352850

  15. Ethical and legal consideration of prisoner's hunger strike in Serbia.

    PubMed

    Alempijevic, Djordje; Pavlekic, Snezana; Jecmenica, Dragan; Nedeljkov, Aleksandra; Jankovic, Milos

    2011-03-01

    Hunger strike of prisoners and detainees remains a major human rights and ethical issue for medical professionals. We are reporting on a case of a 48-year-old male sentenced prisoner, intravenous heroin user, who went on a hunger strike and died 15 days later. Throughout the fasting period, the prisoner, who was capable of decision making, refused any medical examination. Autopsy findings were not supporting prolonged starvation, while toxicology revealed benzodiazepines and opiates in blood and urine. Cause of death was given as "heroin intoxication" in keeping with detection of 6-MAM. Legal and ethical issues pertinent to medical examination and treatment of prisoners on hunger strike are explored in accordance with legislation and professional ethical standards in Serbia. A recommendation for the best autopsy practice in deaths following hunger strike has been made.

  16. Technological innovations in forensic genetics: social, legal and ethical aspects.

    PubMed

    Wienroth, Matthias; Morling, Niels; Williams, Robin

    2014-01-01

    This paper discusses the nature of four waves of technological innovations in forensic genetics alongside the social, legal and ethical aspect of these innovations. It emphasises the way in which technological advances and their socio-legal frameworks are co-produced, shaping technology expectations, social identities, and legal institutions. It also considers how imagined and actual uses of forensic genetic technologies are entangled with assertions about social order, affirmations of common values and civil rights, and promises about security and justice. Our comments seek to encourage the participation of scientific actors in the development of anticipatory governance deliberations concerning the widening application of forensic genetics in an increasing number of criminal and civil jurisdictions.

  17. Telemedicine: medical, legal and ethical perspectives.

    PubMed

    Clark, Peter A; Capuzzi, Kevin; Harrison, Joseph

    2010-12-01

    Technological innovations in medical care have led to the development of telemedicine programs in both rural and urban environments. The necessity for telemedicine has increased immensely as more cost-effective treatment options have become available for both patients and physicians through the addition of telecommunication technologies to medical practice. The development of telemedicine systems began as a means of providing access to health care resources for individuals living in isolated rural areas, grew into advanced medical intervention techniques for soldiers on the battlefield, and have become prevalent in urban medical centers both as a resource to the underserved populations and as a platform for physicians off-site to conduct patient consults remotely. Urban telemedicine systems, as monitored in the Mercy Health System (Philadelphia, Pennsylvania) and AtlantiCare Regional Medical Center (Atlantic City, New Jersey), display the enormous benefits of telemedicine as a form of preliminary analysis of patients for the treatment of various medical conditions including chronic disease, mental health disorders and stroke. However, the initiation of telemedicine programs requires new protocols and safeguards to be initiated to protect patient confidentiality/privacy, ensure the appropriate licensure of physicians practicing across state borders, and educate patients on the use of new technological systems. Telemedicine represents the progression of medicine in the presence of improving communication technologies and should be instituted in all urban medical centers. This conclusion is based upon the ethical responsibility to treat all persons with dignity and respect, which in this case, mandates the provision of the most cost-effective, beneficial medical care for all populations.

  18. Legal and Ethical Issues for School Counselors: Supervision as a Safeguard.

    ERIC Educational Resources Information Center

    Barletta, John

    In the past 20 years, counselors have become increasingly aware of the legal and ethical issues related to counseling. This paper addresses the various legal and ethical topics relevant to school counselors. Since counselors need to make informed decisions based on statutes, codes of ethics, professional standards, community expectations, and…

  19. Future issues in transplantation ethics: ethical and legal controversies in xenotransplantation, stem cell, and cloning research.

    PubMed

    Shapiro, Robyn S

    2008-07-01

    With little prospect of developing a sufficient supply of human transplantable organs to meet the large and growing demand, attention has turned to xenotransplantation, as well as stem cell and cloning research, as possible approaches for alleviating this allograft shortage. This article explores ethical and legal issues that surround developments in these fields.

  20. [Ethical and legal issues in late stage of dementia].

    PubMed

    Fernandes, Lia

    2008-01-01

    As we enter the 21st century, growth of the elderly population, the costs of care, and the advances of medical science and technology will continue to have an impact on the patient-physician relationship. Transformation of the health care system will also raise ethical issues inherent to changing roles. The special nature of Alzheimer's patients and the natural course of their disease require special care on the part of physicians to meet the ethical challenges and establish medical goals, in conjunction with their patients and their families. In spite of these rapid advances in biomedical sciences, were not sufficiently developed in the most fitness answers, regarding special moral and ethical attitudes, which must be taken into account, in particular when we try to understand the experience of people with dementia. This article explores emerging issues in relation to awareness in dementia and its impact on legal and ethical matters. The different approaches and principles demonstrated in relation to ethical issues are discussed, with an exploration of the concepts of mental capacity, testamentary capacity, power of attorney, court of protection, advance directives, decision making, participation in research and treatment, informed consent and older people driving. The tensions that exist between the imperatives of doing no harm and of maintaining autonomy in addressing legal and ethical issues are highlighted. The review emphasizes the importance of considering competency and awareness as being multi-faceted, to be understood in the context of social interaction, trying to deal with the challenge of protecting, but not overprotecting, people with dementia. Late stage of dementia is a terminal disease where the goal of the care may not be prolongation of life at all costs, but rather achievement: quality of life, dignity and comfort. In the initial late dementia, quality of life is the target, treating medical problems and psychiatric symptoms. The dignity of

  1. Medical legal and ethical questions in palliative medicine and euthanasia.

    PubMed

    Pribilla, O

    1994-12-16

    The increasing importance of legal and ethical questions in palliative medicine and euthanasia due to the increased technical possibilities for extending life will be considered. In palliative medicine, the choice of the best therapy will be discussed, especially in the case of oncological diseases. Here, consideration of the prospects of success, for example, in chemotherapy, is faced with partly serious side-effects. The requirements of palliative medicine that the patient has to be fully informed of the fatal prognosis of his disease is equally debated as the optimum pain therapy. In this respect, the modification of the Narcotics Act of 1 February 1993 is also under discussion. In the field of euthanasia, the technical development of life extension versus dying has raised considerable legal and ethical problems regarding termination of therapy. Additionally, fiscal considerations are of increasing relevance. The common development of the legal and ethical discussion, for example, with regard to the publicity of the work of the so-called 'Gesellschaft für humanes Sterben', the public discussion leading up to a hearing of the 'Bundestag' regarding active euthanasia leads to a realization of the subject. The proposals for an active termination of life by discontinuing therapy for adults and also for malformed newborns are discussed. A dispute concerning the new legal regulation of active euthanasia in the Netherlands of February 1993 is also discussed. There, around 2% of all deaths per year result from active termination of life and also cases where persons are not able to consent. This also has enormous consequences for the position of the physician.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Organ Transplantation: Legal, Ethical and Islamic Perspective in Nigeria

    PubMed Central

    Bakari, Abubakar A; Abbo Jimeta, Umar S; Abubakar, Mohammed A; Alhassan, Sani U; Nwankwo, Emeka A

    2012-01-01

    Organ transplantation dates back to the ancient times and since then it has become one of the important developments in modern medicine; saving the lives, as well as improving the quality of life of many patients. As the demand for organ transplantation far exceeds the organ availability, the transplant program is often saddled with complex legal and ethical issues. This review article highlights the legal and ethical issues that might arise regarding organ transplantation and appraises the existing legal frame work governing organ transplantation in Nigeria. Information on legal, cultural, religious and medical ethical issues regarding organ transplantation in Nigeria was obtained by searching the PubMed and Google Scholar, conference proceedings, seminar paper presentations, law library and other related publications were collated and analyzed. In decision making for organ transplantation, the bioethical principles like autonomy, beneficence and justice must be employed. It was believed by Catholic theologians that to mutilate one living person to benefit another violates the principle of Totality. Among Muslim scholars and researchers, there are those who throw legal support as to its permissibility while the other group sees it as illegal. Organ/tissues transplantation is considered a medical intervention that touches on the fundamental rights of the donor or the recipient. Where there is an unlawful infringement of the right of such persons in any way may be regarded as against Section 34 of the 1999 Nigerian Constitution dealing with right to dignity of the human person. Worldwide, the researchers and government bodies have agreed on informed consent for organ/tissue donation and for recipient should be obtained without coercion before embarking on such medical treatment Worldwide organ transplantation has become the best medical treatment for patients with end stage organ failure. However, there is no law/legislation backing organ/tissues transplantation in

  3. Ethical and legal aspects of noninvasive prenatal genetic diagnosis.

    PubMed

    Dickens, Bernard M

    2014-02-01

    The new technology that will allow genetic testing of a fetus within the first trimester of pregnancy by isolating cell-free fetal DNA (cffDNA) in the mother's blood raises a range of ethical and legal issues. Considered noninvasive, this test is safe and reliable, and may avoid alternative genetic testing by amniocentesis or chorionic villus sampling, which risks causing spontaneous abortion. Ethical and legal issues of cffDNA testing will become more acute if testing expands to fetal whole-genome sequencing. Critical issues include the state of the science or diagnostic art; the appropriateness of offering the test; the implications of denying the test when it is available and appropriate; disclosure and counseling following test results; and management of patients' choices on acquiring test results. A challenge will be providing patients with appropriate counseling based on up-to-date genetic knowledge, and accommodating informed patients' legal choices. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. The Search for a Legal Ethic: The Adversary System, Liberalism and Beyond

    ERIC Educational Resources Information Center

    Verkuil, Paul R.

    1977-01-01

    The Code of Professional Responsibility of lawyers is examined in terms of ethical responsibility. Two major questions are addressed: to what degree does the profession understand and act consistently with its own ethic; and to what extent should legal ethics relate to larger questions of societal and political ethics? (LBH)

  5. Dispensing with conscience: a legal and ethical assessment.

    PubMed

    Wernow, Jerome R; Grant, Donald G

    2008-11-01

    For over 30 years, pharmacists have exercised the right to dispense medications in accordance with moral convictions based upon a Judeo-Christian ethic. What many of these practitioners see as an apparent shift away from this time-honored ethic has resulted in a challenge to this right. To review and analyze pharmacy practice standards, legal proceedings, and ethical principles behind conflicts of conscientious objection in dispensing drugs used for emergency contraception. We first searched the terms conscience and clause and Plan B and contraception and abortion using Google, Yahoo, and Microsoft Networks (2006-September 26, 2008). Second, we used Medscape to search professional pharmacy and other medical journals, restricting our terms to conscience, Plan B, contraceptives, and abortifacients. Finally, we employed Loislaw, an online legal archiving service, and did a global search on the phrase conscience clause to determine the status of the legal discussion. To date, conflicts in conscientious objection have arisen when a pharmacist believes that dispensing an oral contraceptive violates his or her moral understanding for the promotion of human life. Up to this time, cases in pharmacy have involved only practitioners from orthodox Christian faith communities, primarily devout Roman Catholics. A pharmacist's right to refuse the dispensing of abortifacients for birth control according to moral conscience over against a woman's right to reproductive birth control has created a conflict that has yet to be reconciled by licensing agents, professional standards, or courts of law. Our analysis of prominent conflicts suggests that the underlying worldviews between factions make compromise improbable. Risks and liabilities are dependent upon compliance with evolving state laws, specific disclosure of a pharmacist's moral objections, and professionalism in the handling of volatile situations. Objecting pharmacists and their employers should have clear policies and

  6. Ethical, legal, and social implications (ELSI) of microdose clinical trials.

    PubMed

    Kurihara, Chieko

    2011-06-19

    A "microdose clinical trial" (microdosing) is one kind of early phase exploratory clinical trial, administering the compound at doses estimated to have no pharmacological or toxicological effects, aimed at screening candidates for further clinical development. This article's objective is to clarify the ethical, legal, and social implications (ELSI) of such an exploratory minimum-risk human trial. The definition and non-clinical study requirements for microdosing have been harmonized among the European Union (EU), United States (US), and Japan. Being conducted according to these regulations, microdosing seems to be ethically well justified in terms of respect for persons, beneficence, justice, human dignity, and animal welfare. Three big projects have been demonstrating the predictability of therapeutic dose pharmacokinetics from microdosing. The article offers suggestions as how microdosing can become a more useful and socially accepted strategy.

  7. [Triploid cloned human embryos: ethical, social, and legal aspects].

    PubMed

    Bellver Capella, Vicente

    2012-01-01

    This work attempts to place the experiment within the scientific and social framework of pluripotent-stem-cell research and offer reflections of an ethical and (to a lesser extent) legal nature on the results obtained by this research group. To these ends, the work is divided into two parts. The first part describes the most important aspects of Noggle and Egli's announcement and the biotechnological and media context in which it was made. The second part is concerned with the bioethical issues raised by the experiment. There are basically four issues, which relate to: (1) the nuclear transfer technique, (2) the use of human ovules to carry out the experiment, (3) the destruction of human blastocysts, and (4) the ethical requirements of scientific publications.

  8. Ethical-legal problems of DNA databases in criminal investigation.

    PubMed

    Guillén, M; Lareu, M V; Pestoni, C; Salas, A; Carracedo, A

    2000-08-01

    Advances in DNA technology and the discovery of DNA polymorphisms have permitted the creation of DNA databases of individuals for the purpose of criminal investigation. Many ethical and legal problems arise in the preparation of a DNA database, and these problems are especially important when one analyses the legal regulations on the subject. In this paper three main groups of possibilities, three systems, are analysed in relation to databases. The first system is based on a general analysis of the population; the second one is based on the taking of samples for a particular list of crimes, and a third is based only on the specific analysis of each case. The advantages and disadvantages of each system are compared and controversial issues are then examined. We found the second system to be the best choice for Spain and other European countries with a similar tradition when we weighed the rights of an individual against the public's interest in the prosecution of a crime.

  9. Ethics in the Legal and Business Practices of Radiation Oncology.

    PubMed

    Wall, Terry J

    2017-10-01

    Ethical issues arise when a professional endeavor such as medicine, which seeks to place the well-being of others over the self-interest of the practitioner, meets granular business and legal decisions involved in making a livelihood out of a professional calling. The use of restrictive covenants, involvement in self-referral patterns, and maintaining appropriate comity among physicians while engaged in the marketplace are common challenges in radiation oncology practice. A paradigm of analysis is presented to help navigate these management challenges. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Neuroethics: the ethical, legal, and societal impact of neuroscience.

    PubMed

    Farah, Martha J

    2012-01-01

    Advances in cognitive, affective, and social neuroscience raise a host of new questions concerning the ways in which neuroscience can and should be used. These advances also challenge our intuitions about the nature of humans as moral and spiritual beings. Neuroethics is the new field that grapples with these issues. The present article surveys a number of applications of neuroscience to such diverse arenas as marketing, criminal justice, the military, and worker productivity. The ethical, legal, and societal effects of these applications are discussed. Less practical, but perhaps ultimately more consequential, is the impact of neuroscience on our worldview and our understanding of the human person.

  11. Legal and ethical implications of opt-out HIV testing.

    PubMed

    Hanssens, Catherine

    2007-12-15

    New guidelines from the Centers for Disease Control and Prevention recommend that opt-out screening for human immunodeficiency virus (HIV) without written patient consent be part of routine clinical care and imply that state HIV-associated laws in conflict with this approach should be amended. However, HIV testing and treatment issues are governed by a range of federal and state laws, common law principles, constitutional provisions, and various codes of ethics. Patient testing protocols should satisfy the legal definition of informed consent, to reduce risk of liability for providers (i.e., health care professionals and facilities). Rigid application of the new guidelines may trigger legal claims, especially if there is no link to care for persons with a positive test result, no proof of informed consent, or inadequate counseling. Ensuring confidentiality, better test training for providers, and provider collaboration with HIV service organizations can reduce the risk of patient claims, but state and federal laws, codes of ethics, and concerns about provider liability should temper reflexive wholesale adoption of guidelines that recommend opt-out screening.

  12. Ethical-legal problems of DNA databases in criminal investigation

    PubMed Central

    Guillen, M.; Lareu, M. V.; Pestoni, C.; Salas, A.; Carracedo, A.

    2000-01-01

    Advances in DNA technology and the discovery of DNA polymorphisms have permitted the creation of DNA databases of individuals for the purpose of criminal investigation. Many ethical and legal problems arise in the preparation of a DNA database, and these problems are especially important when one analyses the legal regulations on the subject. In this paper three main groups of possibilities, three systems, are analysed in relation to databases. The first system is based on a general analysis of the population; the second one is based on the taking of samples for a particular list of crimes, and a third is based only on the specific analysis of each case. The advantages and disadvantages of each system are compared and controversial issues are then examined. We found the second system to be the best choice for Spain and other European countries with a similar tradition when we weighed the rights of an individual against the public's interest in the prosecution of a crime. Key Words: DNA databases • forensic genetics • ethics PMID:10951922

  13. Euthanasia of companion animals: a legal and ethical analysis.

    PubMed

    Passantino, Annamaria; Fenga, Carmela; Morciano, Cristina; Morelli, Chiara; Russo, Maria; Di Pietro, Carlotta; Passantino, Michele

    2006-01-01

    In Italy, the conditions under which euthanasia of small pets is justified are only partially regulated by law n. 281/1991, article 2 n. 6 and 9, by the later Ministry Circular n. 9 made on 10/03/1992 and by law n. 189/2004. Law n. 281/1991, besides delegating the job of birth control in cat and dog populations to the regions, has made it statutory that stray dogs may only be euthanised when they are 'seriously or incurably ill or proven to be dangerous'. The Ministry Circular underlines the fact that 'euthanasia of dogs is prohibited except in special justified cases'. On the other hand, due to the legal classification of animals as property, the owner has the right of ownership over his animal so that he can sell it and kill it (ius vitae ac necis). In this view a request for euthanasia is licit, whatever the animal's state of health may be. The authors feel that further legislation to regulate the question more completely would be opportune and thus they analyse the problems of legal-ethics and public health that a veterinarian faces when carrying out euthanasia, also bearing in mind the laws and codes of professional ethics. They suggest possible solutions which could be adopted by the competent authorities.

  14. Ethical and Legal Implications of the Methodological Crisis in Neuroimaging.

    PubMed

    Kellmeyer, Philipp

    2017-10-01

    Currently, many scientific fields such as psychology or biomedicine face a methodological crisis concerning the reproducibility, replicability, and validity of their research. In neuroimaging, similar methodological concerns have taken hold of the field, and researchers are working frantically toward finding solutions for the methodological problems specific to neuroimaging. This article examines some ethical and legal implications of this methodological crisis in neuroimaging. With respect to ethical challenges, the article discusses the impact of flawed methods in neuroimaging research in cognitive and clinical neuroscience, particularly with respect to faulty brain-based models of human cognition, behavior, and personality. Specifically examined is whether such faulty models, when they are applied to neurological or psychiatric diseases, could put patients at risk, and whether this places special obligations on researchers using neuroimaging. In the legal domain, the actual use of neuroimaging as evidence in United States courtrooms is surveyed, followed by an examination of ways that the methodological problems may create challenges for the criminal justice system. Finally, the article reviews and promotes some promising ideas and initiatives from within the neuroimaging community for addressing the methodological problems.

  15. Pediatric neuroenhancement: ethical, legal, social, and neurodevelopmental implications.

    PubMed

    Graf, William D; Nagel, Saskia K; Epstein, Leon G; Miller, Geoffrey; Nass, Ruth; Larriviere, Dan

    2013-03-26

    The use of prescription medication to augment cognitive or affective function in healthy persons-or neuroenhancement-is increasing in adult and pediatric populations. In children and adolescents, neuroenhancement appears to be increasing in parallel to the rising rates of attention-deficit disorder diagnoses and stimulant medication prescriptions, and the opportunities for medication diversion. Pediatric neuroenhancement remains a particularly unsettled and value-laden practice, often without appropriate goals or justification. Pediatric neuroenhancement presents its own ethical, social, legal, and developmental issues, including the fiduciary responsibility of physicians caring for children, the special integrity of the doctor-child-parent relationship, the vulnerability of children to various forms of coercion, distributive justice in school settings, and the moral obligation of physicians to prevent misuse of medication. Neurodevelopmental issues include the importance of evolving personal authenticity during childhood and adolescence, the emergence of individual decision-making capacities, and the process of developing autonomy. This Ethics, Law, and Humanities Committee position paper, endorsed by the American Academy of Neurology, Child Neurology Society, and American Neurological Association, focuses on various implications of pediatric neuroenhancement and outlines discussion points in responding to neuroenhancement requests from parents or adolescents. Based on currently available data and the balance of ethics issues reviewed in this position paper, neuroenhancement in legally and developmentally nonautonomous children and adolescents without a diagnosis of a neurologic disorder is not justifiable. In nearly autonomous adolescents, the fiduciary obligation of the physician may be weaker, but the prescription of neuroenhancements is inadvisable because of numerous social, developmental, and professional integrity issues.

  16. Reflecting on ethical and legal issues in wildlife disease.

    PubMed

    McCallum, Hamish; Hocking, Barbara Ann

    2005-08-01

    Disease in wildlife raises a number of issues that have not been widely considered in the bioethical literature. However, wildlife disease has major implications for human welfare. The majority of emerging human infectious diseases are zoonotic: this is, they occur in humans by cross-species transmissions from animal hosts. Managing these diseases often involves balancing concerns with human health against animal welfare and conservation concerns. Many infectious diseases of domestic animals are shared with wild animals, although it is often unclear whether the infection spills over from wild animals to domestic animals or vice versa. Culling is the standard means of managing such diseases, bringing economic considerations, animal welfare and conservation into conflict. Infectious diseases are also major threatening processes in conservation biology and their appropriate management by culling, vaccination or treatment raises substantial animal ethics issues. One particular issue of great significance in Australia is an ongoing research program to develop genetically modified pathogens to control vertebrate pests including rabbits, foxes and house mice. Release of any self-replicating GMO vertebrate pathogen gives rise to a whole series of ethical questions. We briefly review current Australian legal responses to these problems. Finally, we present two unresolved problems of general importance that are exemplified by wildlife disease. First, to what extent can or should 'bioethics' be broadened beyond direct concerns with human welfare to animal welfare and environmental welfare? Second, how should the irreducible uncertainty of ecological systems be accounted for in ethical decision making?

  17. Safeguarding children's rights in psychopharmacological research: ethical and legal issues.

    PubMed

    Kölch, Michael; Ludolph, Andrea G; Plener, Paul L; Fangerau, Heiner; Vitiello, Benedetto; Fegert, Joerg M

    2010-01-01

    Research on psychopharmacological treatment in children and adolescents is the subject of ongoing ethical discussion, as minors with mental disorders constitute a vulnerable patient group. Considering the important legislative changes in pediatric research over the past decade in both the US and Western Europe, there is a need to review recent developments in this area. Based on a systematic literature review, a hermeneutical analysis focusing the main issues of ethics in child and adolescent psychopharmacology is provided. Legal and regulatory aspects of psychopharmacological research in children are compared between the US and Europe. Relevant issues were informed assent and consent to research participation, minimal risk and burden of research, ethics of pharmacogenetics, research on "me-too" medications, and justice in global research. Additionally, the concern about undue influence of financial interests in research is also addressed. Incentives for the conduct of clinical trials with children comparable to those contained in US legislation are now provided in the EU. Research to develop "me-too" preparations may have no significant benefit for children, but can cause research burden and detract from clinically more important projects by utilizing limited investigator time and patient resources. Thus far, pharmacogenetic studies may bring more individualized treatment approaches into child psychiatry but they remain at present a promise for the future. Finally, the issues of avoiding undue influence from funders and conflicts of interest remain a prominent concern which can be solved by declaring conflicts and publishing all results of studies extensively.

  18. [National Database of Genotypes--ethical and legal issues].

    PubMed

    Franková, Vera; Tesínová, Jolana; Brdicka, Radim

    2011-01-01

    National Database of Genotypes--ethical and legal issues The aim of the project National Database of Genotypes is to outline structure and rules for the database operation collecting information about genotypes of individual persons. The database should be used entirely for health care. Its purpose is to enable physicians to gain quick and easy access to the information about persons requiring specialized care due to their genetic constitution. In the future, another introduction of new genetic tests into the clinical practice can be expected thus the database of genotypes facilitates substantial financial savings by exclusion of duplicates of the expensive genetic testing. Ethical questions connected with the creating and functioning of such database concern mainly privacy protection, confidentiality of personal sensitive data, protection of database from misuse, consent with participation and public interests. Due to necessity of correct interpretation by qualified professional (= clinical geneticist), particular categorization of genetic data within the database is discussed. The function of proposed database has to be governed in concordance with the Czech legislation together with solving ethical problems.

  19. A Qualitative Examination of Ethical and Legal Considerations Regarding Dating Violence

    ERIC Educational Resources Information Center

    Sikes, April; Walley, Cynthia; Hays, Danica G.

    2012-01-01

    Despite the increased attention to dating violence among adolescents and young adults, limited information is available on ethical and legal considerations specific to this population. Therefore, this qualitative study explores 21 trainees' and practitioners' conceptualization of ethical and legal issues pertaining to adolescent dating violence.…

  20. Discussing options between patients and health care professionals in genetic diagnosis: ethical and legal criteria

    PubMed Central

    Nicolás, Pilar

    2007-01-01

    The specific characteristics of genetic data lead to ethical-legal conflicts in the framework of genetic diagnosis. Several international organisations, including UNESCO and the Council of Europe, have enacted rules referring to the use of genetic information. This paper discusses possible legal and ethical criteria that could be used in genetic testing. PMID:19725990

  1. A Qualitative Examination of Ethical and Legal Considerations Regarding Dating Violence

    ERIC Educational Resources Information Center

    Sikes, April; Walley, Cynthia; Hays, Danica G.

    2012-01-01

    Despite the increased attention to dating violence among adolescents and young adults, limited information is available on ethical and legal considerations specific to this population. Therefore, this qualitative study explores 21 trainees' and practitioners' conceptualization of ethical and legal issues pertaining to adolescent dating violence.…

  2. Web-Based Resources for Legal and Ethical Issues in School Counseling.

    ERIC Educational Resources Information Center

    Guillot-Miller, Lynne; Partin, Patricia W.

    2003-01-01

    Identifies major sources of legal and ethical information relevant to school counselors that is available on the World Wide Web. Summaries and Web addresses are provided for major Web sites that address legal and ethical issues in school counseling. (Contains 17 references.) (GCP)

  3. The Ethical and Legal Framework for the Decision Not to Resuscitate

    PubMed Central

    Lee, Melinda A.; Cassel, Christine K.

    1984-01-01

    Practicing physicians are frequently faced with the question of whether or not to institute cardiopulmonary resuscitation in case of cardiac or respiratory arrest in a patient in hospital. Medical training has usually not included any systematic analysis of this issue from either an ethical or a legal standpoint. Many physicians may be unaware that ethical and legal principles, as well as professional guidelines, exist to guide such decision making. In practice, physicians make this decision without the benefit of training in ethical analysis. The problem is especially acute in teaching hospitals when young physicians unacquainted with formal ethics or the law must often make decisions emergently. Studies show some discrepancy between ethical and legal principles and the actual decision making by physicians. For this reason, we recommend an approach that will enable physicians to make and implement decisions not to resuscitate that are consistent with current ethical and legal standards. PMID:6702189

  4. The relationship between medical ethics and the legal system in Italy: food for thought.

    PubMed

    Petrini, Carlo; Ricciardi, Walter

    2016-01-01

    Relations between ethics in general - and medical ethics in particular - and legal systems are complex and have been extensively examined in the literature. The topic is important not only for ethicists and jurists, but also for members of the public, who benefit from the services offered by the professions. While the Italian Institute of Health does not claim to propose new avenues for exploration of the relations between ethics and legal systems, it offers some food for thought in the ongoing debate.

  5. RPA Field Simulations:Dilemma Training for Legal and Ethical Decision Making

    DTIC Science & Technology

    2015-11-07

    RPA Field Simulations: Dilemma -Training for Legal and Ethical Decision-Making Professor Wilbur Scott Dept of...composite scenarios were developed incorporating best features, i.e., “ ethically challenging” moments: wicked dilemmas * cadets were...Impact on Ethics and Law of Armed Conflicts” University of Zurich 6-7 November 2015 BACKGROUND  4th year cadets in Behavioral

  6. Ethical, Legal, Social, and Policy Implications of Behavioral Genetics

    PubMed Central

    Berryessa, Colleen M.; Cho, Mildred K.

    2015-01-01

    The field of behavioral genetics has engendered a host of moral and social concerns virtually since its inception. The policy implications of a genetic basis for behaviors are widespread and extend beyond the clinic to the socially important realms of education, criminal justice, childbearing, and child rearing. The development of new techniques and analytic approaches, including whole-genome sequencing, noninvasive prenatal genetic testing, and optogenetics, has clearly changed the study of behavioral genetics. However, the social context of biomedical research has also changed profoundly over the past few decades, and in ways that are especially relevant to behavioral genetics. The ever-widening scope of behavioral genetics raises ethical, legal, social, and policy issues in the potential new applications to criminal justice, education, the military, and reproduction. These issues are especially critical to address because of their potentially disproportionate effects on vulnerable populations such as children, the unborn, and the incarcerated. PMID:23452225

  7. Ethical, legal, social, and policy implications of behavioral genetics.

    PubMed

    Berryessa, Colleen M; Cho, Mildred K

    2013-01-01

    The field of behavioral genetics has engendered a host of moral and social concerns virtually since its inception. The policy implications of a genetic basis for behaviors are widespread and extend beyond the clinic to the socially important realms of education, criminal justice, childbearing, and child rearing. The development of new techniques and analytic approaches, including whole-genome sequencing, noninvasive prenatal genetic testing, and optogenetics, has clearly changed the study of behavioral genetics. However, the social context of biomedical research has also changed profoundly over the past few decades, and in ways that are especially relevant to behavioral genetics. The ever-widening scope of behavioral genetics raises ethical, legal, social, and policy issues in the potential new applications to criminal justice, education, the military, and reproduction. These issues are especially critical to address because of their potentially disproportionate effects on vulnerable populations such as children, the unborn, and the incarcerated.

  8. Navigating the minefield: legal ethics and healthcare law.

    PubMed

    Goran, Mark H; Fuller, Erin E

    2002-01-01

    Practicing law in the healthcare field is a daunting task due to the highly-regulated nature of the field and the increasing scrutiny of the conduct of industry providers, payors, and vendors. Attorneys must provide difficult opinions regarding matters with civil, criminal, and reimbursement implications and often are asked to represent multiple parties in healthcare-related settings. This article discusses some legal ethics issues for the healthcare practitioner and touches on some of the recent changes to the Model Rules of Professional Conduct, which were adopted by the American Bar Association's House of Delegates at its mid-February 2002 meeting. The authors conduct their analysis by applying the model rules to a number of hypothetical fact situations typical of those encountered in the day-to-day practice of healthcare law.

  9. Ethical and legal responsibilities of the neurosurgeon: selected topics.

    PubMed

    Kaufman, H H; Lewin, J; Munzner, R; Pearson, J; Sullivan, R; Rector, S; Vannoy, D W; Frost, J L; Brisell, D

    1991-06-01

    There are many ethical and legal implications in a variety of activities in the neurosurgeon's day-to-day practice. Awareness of and proper attention to these issues are a professional responsibility that should be attended to, to ensure that the practice of medicine is carried out efficiently and effectively, to maintain public confidence, and to try to avoid micromanagement by third parties. The authors discuss four such subjects of particular interest to them, namely: 1) reporting of certain diseases and conditions to authorities and third parties; 2) acting without the consent of the patient to prevent harm to him or her and/or others; 3) reporting problems with drugs and devices; and 4) the detection and treatment of colleagues impaired by alcohol, drugs, or mental or physical illness.

  10. Physician-assisted suicide: legal and ethical considerations.

    PubMed

    Darr, Kurt

    2007-01-01

    As medicine's technical limits have become increasingly clear, Americans seem more willing to address end-of-life decisionmaking. A major development during the 1990s was physician assistance in dying: physician-assisted suicide in Michigan, Oregon's Death with Dignity Act, and developments in Europe, most notably The Netherlands. This evolution toward recognizing the appropriateness of assistance in dying raises legal and ethical issues for physicians and healthcare institutions such as nursing facilities and acute care hospitals. These issues include the effects on providers' values systems, the trust between patient and provider, and the "slippery slope" that voluntary, active assistance in dying will become involuntary, active assistance. This Article addresses the policy issues that institutions must confront in a changing environment.

  11. [Patient autonomy and informed consent - ethical and legal issues].

    PubMed

    Wolf-Braun, Barbara; Wilke, Hans-Joachim

    2015-03-01

    Informing patients about the benefits and risks of and alternatives to proposed medical or surgical procedures is crucial to the patient-physician relationship. It is a legal and ethical precondition to a patient's informed consent to a course of action. Particularly in cases of serious illness and when there are far reaching implications for a patient's lifestyle, this process entails much more than just imparting information. Indeed, it is a dialogue through which the physician empowers the patient to reach a decision which reflects the patient's life situation and system of values. This process promotes patient autonomy. Studies have shown that this approach builds trust, increases patient satisfaction with health care and results in a higher degree of professional fulfilment for the physician.

  12. Ethical, legal, and social issues: our children's future.

    PubMed

    Gilbert, Steven G

    2005-08-01

    A convergence of issues suggests that protecting child health is not so much a matter of research, but rather a matter of policy and advocacy. First, we have well-articulated views of a vision for child health. Second, we have experience and toxicological research findings demonstrating the adverse health effects of hazardous chemicals on children and recognize that children are more sensitive than adults to chemical exposures. Results from toxicology research have motivated many regulatory and legal actions, and public policy decisions, including the banning of some pesticides, reducing exposures in the workplace, and lowering of acceptable blood lead levels in children. We also know that childhood disabilities from chemical exposure during developmental are often not treatable and therefore must be prevented. Finally, we have an increasingly well-defined framework for discussing social and ethical responsibility to our children. New discoveries in the basic biological and toxicological sciences have challenged our bioethical thinking and societal decision-making. This paper will explore the ethical, legal, and social issues raised by the toxicological sciences first by examining some hard lesson learned about childhood effects of chemicals and then by examining the difficult policy and research decisions that must be made as we address our need for additional information about the health effects of chemicals on adults and children and the impact of having this information. The precautionary principle will be considered as an alternative decision-making approach as well as exploring the concept of the citizen toxicologist (CT). As Garrett Hardin pointed out many years ago, the problems we face often have no technical solutions, but rather require a policy-based approach. This paper will be of interest to the public and health professionals concerned about the broader impact of toxicological research on bioethical and societal decision-making.

  13. BIBLIOGRAPHY.

    ERIC Educational Resources Information Center

    BOURNE, DOROTHY DULLES; BOURNE, JAMES R.

    THIS PARTIALLY ANNOTATED BIBLIOGRAPHY ON SOCIOECONOMIC CHANGE IN PUERTO RICO LISTS WORKS ON PUERTO RICAN COMMUNITIES (MAINLY RURAL), SOCIAL PATTERNS, FAMILY PATTERNS AND PRACTICES, AGRICULTURE, ECONOMICS, EDUCATION, AND MIGRATION. ALTHOUGH THE BIBLIOGRAPHY CONTAINS JOURNAL ARTICLES, IT CONSISTS MAINLY OF BOOK-LENGTH RESEARCH STUDIES. DATES OF…

  14. Bibliography

    ERIC Educational Resources Information Center

    Darinsky, A. V.

    1976-01-01

    The bibliography provides 128 titles of printed materials related to educational development in the USSR, and the publishers' names (many in Russian). The cultural revolution, eradication of illiteracy, adults' general education, contemporary evening schools, textbooks, and statistical reference books, as well as bibliographies and adult education…

  15. The science of stem cells: ethical, legal and social issues.

    PubMed

    Daar, Abdallah S; Sheremeta, Lorraine

    2003-12-01

    Stem cells are exciting to physicians, scientists and patients because of their potential to develop into many different cell types, tissues and perhaps even organs that can possibly be used to treat large numbers of patients with a variety of diseases. Scientific research, while it is still at a very early stage, is developing rapidly and creating enormous challenges for ethicists and policy-makers, especially in relation to embryonic stem cells. An understanding of the scientific facts of stem cell science and technology per se, the embryology and the associated terminology is critically important to making ethically sound policy judgments. The facts, definitions and terminology are confusing and are liable to misuse by those who seek to further a particular position. In this paper we provide a concise overview of the important scientific facts related to embryology and embryonic stem cells and highlight some recent scientific developments that are salient for the purpose of understanding the ethical, legal and social issues that have arisen and will continue to arise and be debated.

  16. Genomic cloud computing: legal and ethical points to consider

    PubMed Central

    Dove, Edward S; Joly, Yann; Tassé, Anne-Marie; Burton, Paul; Chisholm, Rex; Fortier, Isabel; Goodwin, Pat; Harris, Jennifer; Hveem, Kristian; Kaye, Jane; Kent, Alistair; Knoppers, Bartha Maria; Lindpaintner, Klaus; Little, Julian; Riegman, Peter; Ripatti, Samuli; Stolk, Ronald; Bobrow, Martin; Cambon-Thomsen, Anne; Dressler, Lynn; Joly, Yann; Kato, Kazuto; Knoppers, Bartha Maria; Rodriguez, Laura Lyman; McPherson, Treasa; Nicolás, Pilar; Ouellette, Francis; Romeo-Casabona, Carlos; Sarin, Rajiv; Wallace, Susan; Wiesner, Georgia; Wilson, Julia; Zeps, Nikolajs; Simkevitz, Howard; De Rienzo, Assunta; Knoppers, Bartha M

    2015-01-01

    The biggest challenge in twenty-first century data-intensive genomic science, is developing vast computer infrastructure and advanced software tools to perform comprehensive analyses of genomic data sets for biomedical research and clinical practice. Researchers are increasingly turning to cloud computing both as a solution to integrate data from genomics, systems biology and biomedical data mining and as an approach to analyze data to solve biomedical problems. Although cloud computing provides several benefits such as lower costs and greater efficiency, it also raises legal and ethical issues. In this article, we discuss three key ‘points to consider' (data control; data security, confidentiality and transfer; and accountability) based on a preliminary review of several publicly available cloud service providers' Terms of Service. These ‘points to consider' should be borne in mind by genomic research organizations when negotiating legal arrangements to store genomic data on a large commercial cloud service provider's servers. Diligent genomic cloud computing means leveraging security standards and evaluation processes as a means to protect data and entails many of the same good practices that researchers should always consider in securing their local infrastructure. PMID:25248396

  17. Genomic cloud computing: legal and ethical points to consider.

    PubMed

    Dove, Edward S; Joly, Yann; Tassé, Anne-Marie; Knoppers, Bartha M

    2015-10-01

    The biggest challenge in twenty-first century data-intensive genomic science, is developing vast computer infrastructure and advanced software tools to perform comprehensive analyses of genomic data sets for biomedical research and clinical practice. Researchers are increasingly turning to cloud computing both as a solution to integrate data from genomics, systems biology and biomedical data mining and as an approach to analyze data to solve biomedical problems. Although cloud computing provides several benefits such as lower costs and greater efficiency, it also raises legal and ethical issues. In this article, we discuss three key 'points to consider' (data control; data security, confidentiality and transfer; and accountability) based on a preliminary review of several publicly available cloud service providers' Terms of Service. These 'points to consider' should be borne in mind by genomic research organizations when negotiating legal arrangements to store genomic data on a large commercial cloud service provider's servers. Diligent genomic cloud computing means leveraging security standards and evaluation processes as a means to protect data and entails many of the same good practices that researchers should always consider in securing their local infrastructure.

  18. Legal and ethical aspects of organ donation and transplantation

    PubMed Central

    Shroff, Sunil

    2009-01-01

    The legislation called the Transplantation of Human Organ Act (THO) was passed in India in 1994 to streamline organ donation and transplantation activities. Broadly, the act accepted brain death as a form of death and made the sale of organs a punishable offence. With the acceptance of brain death, it became possible to not only undertake kidney transplantations but also start other solid organ transplants like liver, heart, lungs, and pancreas. Despite the THO legislation, organ commerce and kidney scandals are regularly reported in the Indian media. In most instances, the implementation of the law has been flawed and more often than once its provisions have been abused. Parallel to the living related and unrelated donation program, the deceased donation program has slowly evolved in a few states. In approximately one-third of all liver transplants, the organs have come from the deceased donor program as have all the hearts and pancreas transplants. In these states, a few hospitals along with committed NGOs have kept the momentum of the deceased donor program. The MOHAN Foundation (NGO based in Tamil Nadu and Andhra Pradesh) has facilitated 400 of the 1,300 deceased organ transplants performed in the country over the last 14 years. To overcome organ shortage, developed countries are re-looking at the ethics of unrelated programs and there seems to be a move towards making this an acceptable legal alternative. The supply of deceased donors in these countries has peaked and there has been no further increase over the last few years. India is currently having a deceased donation rate of 0.05 to 0.08 per million population. We need to find a solution on how we can utilize the potentially large pool of trauma-related brain deaths for organ donation. This year in the state of Tamil Nadu, the Government has passed seven special orders. These orders are expected to streamline the activity of deceased donors and help increase their numbers. Recently, on July 30, 2008, the

  19. Legal and ethical aspects of organ donation and transplantation.

    PubMed

    Shroff, Sunil

    2009-07-01

    The legislation called the Transplantation of Human Organ Act (THO) was passed in India in 1994 to streamline organ donation and transplantation activities. Broadly, the act accepted brain death as a form of death and made the sale of organs a punishable offence. With the acceptance of brain death, it became possible to not only undertake kidney transplantations but also start other solid organ transplants like liver, heart, lungs, and pancreas. Despite the THO legislation, organ commerce and kidney scandals are regularly reported in the Indian media. In most instances, the implementation of the law has been flawed and more often than once its provisions have been abused. Parallel to the living related and unrelated donation program, the deceased donation program has slowly evolved in a few states. In approximately one-third of all liver transplants, the organs have come from the deceased donor program as have all the hearts and pancreas transplants. In these states, a few hospitals along with committed NGOs have kept the momentum of the deceased donor program. The MOHAN Foundation (NGO based in Tamil Nadu and Andhra Pradesh) has facilitated 400 of the 1,300 deceased organ transplants performed in the country over the last 14 years. To overcome organ shortage, developed countries are re-looking at the ethics of unrelated programs and there seems to be a move towards making this an acceptable legal alternative. The supply of deceased donors in these countries has peaked and there has been no further increase over the last few years. India is currently having a deceased donation rate of 0.05 to 0.08 per million population. We need to find a solution on how we can utilize the potentially large pool of trauma-related brain deaths for organ donation. This year in the state of Tamil Nadu, the Government has passed seven special orders. These orders are expected to streamline the activity of deceased donors and help increase their numbers. Recently, on July 30, 2008, the

  20. [Hunger striking in prisons: ethics and the ethical and legal aspects].

    PubMed

    García-Guerrero, J

    2013-01-01

    Hunger strike is a common form of protest in prisons and is a potential cause of many types of problems, both for the prison administration and the doctors who care for prisoners who participate in one. Issues of conflict of rights and obligations involved, and how to treat people who are subject to the Administration, which in this case takes the position of guarantor, have created major controversies over doctrine. Conscientious objection and the conflict of dual loyalty of doctors working in prisons are also issues closely linked to a prison hunger strike. In this paper we review the solution given to the problem of treatment of a prison hunger strike from three perspectives: ethics, ethical and legal.

  1. Code of Ethics in a Multicultural Company and its Legal Context

    NASA Astrophysics Data System (ADS)

    Odlerová, Eva; Ďurišová, Jaroslava; Šramel, Bystrík

    2012-12-01

    The entry of foreign investors and simultaneous expansion of different national cultures, religions, rules, moral and ethical standards is bringing up problems of cooperation and coexistence of different nationalities, ethnicities and cultures. Working in an international environment therefore requires adaptation to a variety of economic, political, legal, technical, social, cultural and historical conditions. One possible solution is to define a code of ethics, guidelines which find enough common moral principles, which can become the basis for the adoption of general ethical standards, while respecting national, cultural differences and practices. In this article, the authors pay attention not only to the analysis of the common ethical rules in a multicultural company, but also to the legal aspects of codes of ethics. Each code of ethics is a set of standards, which, like the legal norms, regulate the behaviour of individuals. These standards, however, must simultaneously meet certain statutory criteria that define the boundaries of regulation of employee’s behaviour.

  2. Elective surgery and the HIV-positive patient: medical, legal, and ethical issues.

    PubMed

    Clarke, S R; Gonsoulin, T P

    1999-05-01

    The ethical and legal issues surrounding the healthcare provider's obligation to provide care for patients have been a topic of debate since the beginning of modern medicine. The human immunodeficiency virus (HIV)-positive patient requesting cosmetic or elective surgery provides yet another situation in which the physician's ethical and legal responsibilities for the patient become a topic of debate. The risks involved to the physician and patient are first discussed, and then current ethical theory and legal decisions are reviewed. Finally, some conclusions are attempted from the varied opinions in the literature surrounding this controversial topic.

  3. Medical marijuana for HIV-associated sensory neuropathy: legal and ethical issues.

    PubMed

    Larriviere, Daniel G

    2014-10-01

    The number of states legalizing medical marijuana is increasing. Medical marijuana is possibly effective therapy for HIV-associated sensory neuropathy. Despite legalization at the state level, however, the current and contradictory federal drug enforcement policy creates the risk that physicians who recommend medical marijuana to their patients will lose their ability to prescribe medications. The federal-state tension has legal and ethical implications for neurologists who receive a request for medical marijuana from their patients since neurologists must strive to both relieve suffering and obey relevant laws. Recommendation of medical marijuana by neurologists to their patients is ethically permissible but is not ethically mandatory.

  4. Bibliographies.

    ERIC Educational Resources Information Center

    Bourdon, Cathleen

    2001-01-01

    This selective bibliography of books for librarians includes titles regarding academic libraries; administration and personnel; bibliographic instruction; cataloging and classification; children's and young adult services; collection development; copyright; customer service; distance education; electronic libraries; fund raising; government…

  5. Bibliographies.

    ERIC Educational Resources Information Center

    Bourdon, Cathleen

    2001-01-01

    This selective bibliography of books for librarians includes titles regarding academic libraries; administration and personnel; bibliographic instruction; cataloging and classification; children's and young adult services; collection development; copyright; customer service; distance education; electronic libraries; fund raising; government…

  6. E-therapy: practical, ethical, and legal issues.

    PubMed

    Manhal-Baugus, M

    2001-10-01

    E-therapy is a term that has been coined to describe the process of interacting with a therapist online in ongoing conversations over time when the client and counselor are in separate or remote locations and utilize electronic means to communicate with each other. It is a relatively new modality of assisting individuals resolve life and relationship issues. E-therapy utilizes the power and convenience of the internet to allow simultaneous (synchronous) and time-delayed (asynchronous) communication between an individual and a professional. For the purposes of this paper, e-therapy is defined as a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these. It does not include self-help methods such as public bulletin boards or private listservs. E-therapy is not psychotherapy or psychological counseling per se since it does to presume to diagnose or treat mental or medical disorders. However, e-therapy is flexible enough to also address many difficulties which clients present to the online therapist. As in other types of therapy, such as bibliotherapy, occupational therapy, and rehabilitation therapy), e-therapy does assist a person in addressing specific concerns with specific skills. This article examines the following issues of e-therapy. First, the types of e-therapy and related services are described to provide a background for the article. Second, the ethical codes which have been adopted by three major professional organizations (American Counseling Association, National Board for Certified Counselors, and the International Society for Mental Health Online) pertaining to e-therapy are summarized for professional and consumer use. Finally, the practical, ethical, and legal issues of e-therapy services are discussed fully.

  7. Legal and ethical issues in safe blood transfusion

    PubMed Central

    Chandrashekar, Shivaram; Kantharaj, Ambuja

    2014-01-01

    Legal issues play a vital role in providing a framework for the Indian blood transfusion service (BTS), while ethical issues pave the way for quality. Despite licensing of all blood banks, failure to revamp the Drugs and Cosmetic Act (D and C Act) is impeding quality. Newer techniques like chemiluminescence or nucleic acid testing (NAT) find no mention in the D and C Act. Specialised products like pooled platelet concentrates or modified whole blood, therapeutic procedures like erythropheresis, plasma exchange, stem cell collection and processing technologies like leukoreduction and irradiation are not a part of the D and C Act. A highly fragmented BTS comprising of over 2500 blood banks, coupled with a slow and tedious process of dual licensing (state and centre) is a hindrance to smooth functioning of blood banks. Small size of blood banks compromises blood safety. New blood banks are opened in India by hospitals to meet requirements of insurance providers or by medical colleges as this a Medical Council of India (MCI) requirement. Hospital based blood banks opt for replacement donation as they are barred by law from holding camps. Demand for fresh blood, lack of components, and lack of guidelines for safe transfusion leads to continued abuse of blood. Differential pricing of blood components is difficult to explain scientifically or ethically. Accreditation of blood banks along with establishment of regional testing centres could pave the way to blood safety. National Aids Control Organisation (NACO) and National Blood Transfusion Council (NBTC) deserve a more proactive role in the licensing process. The Food and Drug Administration (FDA) needs to clarify that procedures or tests meant for enhancement of blood safety are not illegal. PMID:25535417

  8. End-of-life decisions in Malaysia: Adequacies of ethical codes and developing legal standards.

    PubMed

    Kassim, Puteri Nemie Jahn; Alias, Fadhlina

    2015-06-01

    End-of-life decision-making is an area of medical practice in which ethical dilemmas and legal interventions have become increasingly prevalent. Decisions are no longer confined to clinical assessments; rather, they involve wider considerations such as a patient's religious and cultural beliefs, financial constraints, and the wishes and needs of family members. These decisions affect everyone concerned, including members of the community as a whole. Therefore it is imperative that clear ethical codes and legal standards are developed to help guide the medical profession on the best possible course of action for patients. This article considers the relevant ethical, codes and legal provisions in Malaysia governing certain aspects of end-of-life decision-making. It highlights the lack of judicial decisions in this area as well as the limitations with the Malaysian regulatory system. The article recommends the development of comprehensive ethical codes and legal standards to guide end-of-life decision-making in Malaysia.

  9. Research on embryos in Turkey with ethical and legal aspects

    PubMed Central

    Vatanoğlu-Lutz, Emine Elif

    2012-01-01

    Technically, the term embryo refers to the products of conception after implantation into the wall of the womb, usually nearly two weeks after fertilization, up until the eighth week. Embryos contain stem cells which, according to scientists, could be used to cure a wide range of conditions. Stem cells can be coaxed into growing cells of any other type, which makes them potentially very useful indeed. However, removing stem cells from an embryo will kill the embryo, which some people object to. From the mid 1970s, IVF was being developed and research was carried out on the spare embryos produced. This research helped to improve IVF techniques, as well as to better understand the earliest stages of human development. Research also shed light on a variety of inheritable disorders. In Turkish Law, assisted reproduction treatment (ART) services are regulated with the Regulation of Assisted Reproductive Treatment Centers Act (RAPTCA) The Regulation was issued in 1987, but it has been amended several times since. Also, article 90 of the Turkish Penal Code covers some aspects of research on embryos. At the same time, the Biomedicine Convention (Oviedo Convention), signed by Turkey and which entered into force in 2003, has binding regulations about this issue. Different legal regulations and some ethical guidelines are in conflict with each other, creating much confusion for the researchers. In this paper these conflicts are discussed, giving some practical proposals. PMID:24592037

  10. Psychotropics without borders: ethics and legal implications of internet-based access to psychiatric medications.

    PubMed

    Klein, Carolina A

    2011-01-01

    Medical practitioners are revisiting many of the ethics and the legal implications surrounding the clinical frameworks within which we operate. In today's world, distinguishing between virtual and physical reality continues to be increasingly difficult. The physician may be found grappling with the decision of whether to continue to treat a patient who may be obtaining psychotropic medications through the Internet. This article approaches some of the clinical and legal implications and the ethics regarding the availability of prescription psychotropics over the Internet.

  11. Involuntary Civil Commitment for Substance Use Disorder: Legal Precedents and Ethical Considerations for Social Workers.

    PubMed

    Walton, Matthew T; Hall, Martin T

    2017-01-01

    Although each state in the United States legally authorizes involuntary civil commitment on the grounds of severe mental illness, a considerable number do not have comparable laws to mandate drug addiction treatment. This discrepancy is due, in part, to differing ethical positions regarding whether a substance use disorder diagnosis provides sufficient justification to suspend individual liberty rights. This article chronicles some of the legal and ethical thinking on the subject and applies them to a social work-specific context.

  12. THE GHOST IN OUR GENES: LEGAL AND ETHICAL IMPLICATIONS OF EPIGENETICS

    PubMed Central

    Rothstein, Mark A.; Cai, Yu; Marchant, Gary E.

    2011-01-01

    Epigenetics is one of the most scientifically important, and legally and ethically significant, cutting-edge subjects of scientific discovery. Epigenetics link environmental and genetic influences on the traits and characteristics of an individual, and new discoveries reveal that a large range of environmental, dietary, behavioral, and medical experiences can significantly affect the future development and health of an individual and their offspring. This article describes and analyzes the ethical and legal implications of these new scientific findings. PMID:19459537

  13. Ethical and Legal Issues Regarding Selective Abortion of Fetuses with Down Syndrome.

    ERIC Educational Resources Information Center

    Glover, Noreen M.; Glover, Samuel J.

    1996-01-01

    Selective abortion of fetuses with Down syndrome is discussed in terms of abortion perspectives, genetic testing, legislation, and ethical principles. The ethical principles of autonomy, beneficence, nonmaleficence, fidelity, and justice are offered as guidelines for the examination of legal standards imposed by legislation. (Author/PB)

  14. Bibliography.

    ERIC Educational Resources Information Center

    Naturescope, 1987

    1987-01-01

    Provides a partially annotated bibliography pertaining to the teaching of geology at the elementary school level. Included are general reference books, field guides, children's books, audio-visual materials, booklets, kits, maps, posters, computer courseware, and an index of geology-related articles appearing in past issues of "Ranger Rick"…

  15. Bibliographies.

    ERIC Educational Resources Information Center

    Halsted, Ann L., Comp.

    1983-01-01

    Two annotated bibliographies of books are compiled, one devoted to Roosevelt and the New Deal, the other concerned with Hitler, the Weimar Republic, and the rise of Nazism. Annotations indicate scope of the work and occasionally point out bias or point of view. (CS)

  16. Bibliographies.

    ERIC Educational Resources Information Center

    Halsted, Ann L., Comp.

    1983-01-01

    Two annotated bibliographies of books are compiled, one devoted to Roosevelt and the New Deal, the other concerned with Hitler, the Weimar Republic, and the rise of Nazism. Annotations indicate scope of the work and occasionally point out bias or point of view. (CS)

  17. [Ethical and legal questions regarding the killing of animals to avoid considerable pain and suffering].

    PubMed

    Möbius, G

    1994-09-01

    The ethical and legal problems that are connected with the killing of animals are continuously discussed. Problems with the interpretation of "reasonable reason" and the public criticism of killing to get luxury goods as well as of the methods of killing show the main points. In contrast to the killing of animals in the interest of people the euthanasia of animals to prevention of considerable, not to soothed pain and suffering is appreciated generally as reasonably and ethically justified. The ethical justification confronts with legal problems based on the conflicting position of animals in civil law. These problems are important for a practising veterinarian.

  18. A zygote is not an embryo: ethical and legal considerations.

    PubMed

    Tesarik, Jan; Greco, Ermanno

    2004-07-01

    In spite of several past attempts at defining the point at which conception can be considered completed, resulting in the formation of an embryo, the existing definitions are still contradictory. In the absence of clear terminology, the application of laws aimed at the protection of early human life may have inadequate consequences for the efficacy of the current techniques of human infertility treatment. In this paper biological arguments are revisited, suggesting that the only point at which a clear demarcation line between what is and what is still not an embryo can be drawn is the moment of nuclear syngamy at the outset of the first cleavage division. The term 'zygote' is suggested to denote entities composed of spermatozoon and oocyte components before nuclear syngamy. It is suggested that the current embryo protection laws should not concern the zygote stage: at this stage, the main features that are said, in documents issued by different ethical and legal authorities, to characterize the early human embryo, namely the inseparable union of the male and female contribution, cell division and an autonomous control over cell division, are still not present. This reasoning strictly applies to embryos of biparental (paternal and maternal contribution) origin and cannot be extrapolated to embryos created by cell nuclear transfer (cloning). The application of embryo protection laws from the nuclear syngamy stage onwards can regulate embryo and embryo-derived stem cell research while still preserving the current high standard and efficacy of infertility treatment, which is of immediate interest to millions of infertile couples throughout the world.

  19. Legal, Professional and Ethical Issues: The Use of Computers.

    ERIC Educational Resources Information Center

    Drier, Harry N.

    This monograph deals with normative ethics, or the application of ethical principles in judging the rightness or wrongness of actions. Specifically, the monograph addresses normative ethics in the use of automated systems in the field and practice of counseling and guidance. It is noted that the immense growth planned for computer applications in…

  20. Lethal and Legal The Ethics of Drone Strikes

    DTIC Science & Technology

    2015-12-01

    these domains—most notably the media—are also subject to ongoing debates on eth- ics and legality , focusing on privacy and the need for regulation... legality is necessary. If it is false, greater attention to media and perception man- agement is needed . A further point of legal debate relates to the cir...on the applicable legal regime along with restraints to prevent the further proliferation of drone technology are urgently needed .53 What is also

  1. Ethical and legal framework and regulation for off-label use: European perspective.

    PubMed

    Lenk, Christian; Duttge, Gunnar

    2014-01-01

    For more than 20 years the off-label use of drugs has been an essential part of the ethical and legal considerations regarding the international regulation of drug licensing. Despite a number of regulatory initiatives in the European Union, there seems to remain a largely unsatisfactory situation following a number of critical descriptions and statements from actors in the field. The present article gives an overview of the ethical and legal framework and developments in European countries and identifies existing problems and possible pathways for solutions in this important regulatory area. In addition to the presentation of the ethical and legal foundations, some attention is given to criticisms from medical practitioners to the current handling of off-label drug use. The review also focuses on the situation confronted by patients and physicians when off-label prescriptions are necessary. Through legal descriptions from a number of countries, possible solutions for future discussion of European health care policy are selected and explained.

  2. Can a Law Teacher Avoid Teaching Legal Ethics?

    ERIC Educational Resources Information Center

    Menkel-Meadow, Carrie J.

    1991-01-01

    Because law teachers model lawyering, they need to both expand their own sense of professional responsibility and challenge students' feeling that one course takes care of ethical concerns. A course in professional responsibility is more than just another course about rules. Ethical issues must be integrated into traditional substantive courses.…

  3. Ethical and legal perspectives on the medical practitioners use of social media.

    PubMed

    Kubheka, Brenda

    2017-04-25

    Use of social media has increased exponentially throughout the world. Social media provides a platform for building social and professional relationships that can be used by all, including healthcare professionals. Alongside the benefits of creating networks and spreading information wider and faster than is possible with traditional communication channels, however, it presents ethical and legal challenges. For health professionals, it poses a threat to confidentiality and privacy owed to patients, colleagues and employers. It is vital for health professionals to acknowledge that the same ethical and legal standards apply both online and offline, and that they are accountable to professional bodies and the law for their online activities. This article seeks to explore the ethical and legal pitfalls facing health professionals using social media platforms. Importantly, it seeks to create awareness about the cyberpsychology phenomenon called the 'online disinhibition effect', responsible for lowering restraint during online activities.

  4. Patient Privacy and Conflicting Legal and Ethical Obligations in El Salvador: Reporting of Unlawful Abortions

    PubMed Central

    McNaughton, Heathe Luz; Mitchell, Ellen M.H.; Hernandez, Emilia G.; Padilla, Karen; Blandon, Marta Maria

    2006-01-01

    Postabortion care providers who breach patient confidentiality endanger women’s health and violate ethics. A 1998 abortion ban in El Salvador likely spurred an increase in the number of women investigated, because many women were reported to legal authorities by health care providers. Having analyzed safeguards of confidentiality in laws and ethical guidelines, we obtained information from legal records on women prosecuted from 1998 to 2003 and identified factors that may lead to reporting through a survey of obstetrician-gynecologists (n=110). Although ethical and human rights standards oblige providers to respect patients’ privacy, 80% of obstetrician-gynecologists mistakenly believed reporting was required. Most respondents (86%) knew that women delay seeking care because of fear of prosecution, yet a majority (56%) participated in notification of legal authorities. PMID:16571690

  5. Sharing and Reuse of Sensitive Data and Samples: Supporting Researchers in Identifying Ethical and Legal Requirements.

    PubMed

    Sariyar, Murat; Schluender, Irene; Smee, Carol; Suhr, Stephanie

    2015-08-01

    Availability of and access to data and biosamples are essential in medical and translational research, where their reuse and repurposing by the wider research community can maximize their value and accelerate discovery. However, sharing human-related data or samples is complicated by ethical, legal, and social sensitivities. The specific ethical and legal requirements linked to sensitive data are often unfamiliar to life science researchers who, faced with vast amounts of complex, fragmented, and sometimes even contradictory information, may not feel competent to navigate through it. In this case, the impulse may be not to share the data in order to safeguard against unintentional misuse. Consequently, helping data providers to identify relevant ethical and legal requirements and how they might address them is an essential and frequently neglected step in removing possible hurdles to data and sample sharing in the life sciences. Here, we describe the complex regulatory context and discuss relevant online tools-one which the authors co-developed-targeted at assisting providers of sensitive data or biosamples with ethical and legal questions. The main results are (1) that the different approaches of the tools assume different user needs and prior knowledge of ethical and legal requirements, affecting how a service is designed and its usefulness, (2) that there is much potential for collaboration between tool providers, and (3) that enriched annotations of services (e.g., update status, completeness of information, and disclaimers) would increase their value and facilitate quick assessment by users. Further, there is still work to do with respect to providing researchers using sensitive data or samples with truly 'useful' tools that do not require pre-existing, in-depth knowledge of legal and ethical requirements or time to delve into the details. Ultimately, separate resources, maintained by experts familiar with the respective fields of research, may be needed while

  6. Sharing and Reuse of Sensitive Data and Samples: Supporting Researchers in Identifying Ethical and Legal Requirements

    PubMed Central

    Schluender, Irene; Smee, Carol; Suhr, Stephanie

    2015-01-01

    Availability of and access to data and biosamples are essential in medical and translational research, where their reuse and repurposing by the wider research community can maximize their value and accelerate discovery. However, sharing human-related data or samples is complicated by ethical, legal, and social sensitivities. The specific ethical and legal requirements linked to sensitive data are often unfamiliar to life science researchers who, faced with vast amounts of complex, fragmented, and sometimes even contradictory information, may not feel competent to navigate through it. In this case, the impulse may be not to share the data in order to safeguard against unintentional misuse. Consequently, helping data providers to identify relevant ethical and legal requirements and how they might address them is an essential and frequently neglected step in removing possible hurdles to data and sample sharing in the life sciences. Here, we describe the complex regulatory context and discuss relevant online tools—one which the authors co-developed—targeted at assisting providers of sensitive data or biosamples with ethical and legal questions. The main results are (1) that the different approaches of the tools assume different user needs and prior knowledge of ethical and legal requirements, affecting how a service is designed and its usefulness, (2) that there is much potential for collaboration between tool providers, and (3) that enriched annotations of services (e.g., update status, completeness of information, and disclaimers) would increase their value and facilitate quick assessment by users. Further, there is still work to do with respect to providing researchers using sensitive data or samples with truly ‘useful’ tools that do not require pre-existing, in-depth knowledge of legal and ethical requirements or time to delve into the details. Ultimately, separate resources, maintained by experts familiar with the respective fields of research, may be

  7. [The beginning of human life: ethical and legal perspectives in the context of biotechnological progress].

    PubMed

    Barretto, Vicente de Paulo; Lauxen, Elis Cristina Uhry

    2017-07-13

    Questions concerning the beginning of human life have pervaded society since antiquity. In the post-modern world, scientific and technological advances have fueled discussions on the issue, such that debates previously concentrated on abortion now also focus on biotechnological interventions. The article addresses the latter, reflecting on the extent to which human dignity can be considered a (hermeneutic) reference in establishing ethical and legal parameters for biotechnological advances in the definition of the beginning of human life. The study's method was critical hermeneutic ethics, with ethics at the center of the process of understanding and interpretation, observing the contours of facticity. No consensus was found on the beginning of human life, so it is essential to engage in dialogue with the new reality resulting from biotechnological advances in the process of defining ethical and legal principles for protecting the embryo and human nature, with human dignity as the reference.

  8. Ethical, legal and practical issues of establishing an adipose stem cell bank for research.

    PubMed

    West, C C; Murray, I R; González, Z N; Hindle, P; Hay, D C; Stewart, K J; Péault, B

    2014-06-01

    Access to human tissue is critical to medical research, however the laws and regulations surrounding gaining ethical and legal access to tissue are often poorly understood. Recently, there has been a huge increase in the interest surrounding the therapeutic application of adipose tissue, and adipose-derived stem cells. To facilitate our own research interests and possibly assist our local colleagues and collaborators, we established a Research Tissue Bank (RTB) to collect, store and distribute human adipose tissue derived cells with all the appropriate ethical approval for subsequent downstream research. Here we examine the legal, ethical and practical issues relating to the banking of adipose tissue for research in the UK, and discuss relevant international guidelines and policies. We also share our experiences of establishing an RTB including the necessary infrastructure and the submission of an application to a Research Ethics Committee (REC). Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Tube feeding dilemmas: can artificial nutrition and hydration be legally or ethically withheld or withdrawn?

    PubMed

    Goodhall, L

    1997-02-01

    The incidence of elderly patients receiving long-term artificial nutrition and hydration via a percutaneous endoscopic gastrostomy (PEG) feeding tube is increasing. The wisdom of this practice is debatable when poor quality of life is often the outcome, and this has resulted in a dichotomy of opinions. The legal and ethical implications of withholding or withdrawing life-sustaining nourishment, however, appear to be formidable. This paper examines the judicial trends and the ethical reasoning which influence health care professionals, and attempts to answer the question "can artificial hydration and nutrition be legally or ethically withheld or withdrawn?' The value of advance directives and surrogate decision-making for non autonomous patients is considered, and the quality of life concept is discussed. A bias towards the reductionist male ethos may exist and may be influencing the developing case law. It is recommended that the nursing profession helps to redress the imbalance by becoming more active in ethical decision-making.

  10. The legal and ethical implications of social media in the emergency department.

    PubMed

    Lyons, Rachel; Reinisch, Courtney

    2013-01-01

    Social media is a growing and popular means of communication. It is understandable that health care providers may not share identifying information on patients through these sources. Challenges arise when patients and family members wish to record the care provided in the emergency department. The health care provider may be faced with an ethical and possibly legal dilemma when social media is present in the emergency department. This article seeks to discuss the legal and ethical principles surrounding social media in the emergency department.

  11. [The rules of ethics, legal aspects, and the issue of euthanasia].

    PubMed

    Swiatkowska-Flis, Beata; Pierzchała, Krystyna; Flis, Cezary

    2009-01-01

    The issue of euthanasia is gaining greater momentum in Poland. It is a matter of fact that Poland is a country with an increasing aging population. As a result of this increased awareness, this topic is also becoming increasingly controversial. Does a doctor have the right to decide, on behalf of another person, if they should end their life? What limitations should doctors be bound by in terms of their legal and ethical obligations? The purpose of this study is to investigate the ethical and legal implications associated with euthanasia.

  12. Comparative effectiveness research and big data: balancing potential with legal and ethical considerations.

    PubMed

    Gray, Elizabeth Alexandra; Thorpe, Jane Hyatt

    2015-01-01

    Big data holds big potential for comparative effectiveness research. The ability to quickly synthesize and use vast amounts of health data to compare medical interventions across settings of care, patient populations, payers and time will greatly inform efforts to improve quality, reduce costs and deliver more patient-centered care. However, the use of big data raises significant legal and ethical issues that may present barriers or limitations to the full potential of big data. This paper addresses the scope of some of these legal and ethical issues and how they may be managed effectively to fully realize the potential of big data.

  13. [Ethical and legal points concerning minimally conscious state and permanent vegetative state].

    PubMed

    Tasseau, F

    2005-06-01

    The ethical and legal problems posed by severe outcome of coma are complex and their analysis requires a multi-disciplinary approach. Three aspects have been particularly studied in this paper. The first is a reminder of the medical definitions of the concepts of vegetative state and minimally conscious state. The second focuses on the analysis of the ethical and legal debate of these conditions at an international level. Finally, the third concerns the wealth prospects, proposed, in France, by the circular letter dated May 3, 2002.

  14. The ethics of legally detaining a patient who has tuberculosis.

    PubMed

    Negus, Jennie; Viney, Kerri; Bothamley, Graham

    Patients with infectious diseases can be detained in hospitals under the Public Health (Control of Disease) Act 1984. Jennie Negus and colleagues reflect on a case that illustrates the ethical problems of implementing the current legislation in a hospital.

  15. Bibliography

    NASA Astrophysics Data System (ADS)

    Kopal, Z.; Moutsoulas, M.; Waranius, F. B.

    1983-12-01

    A bibliography of articles entered into the data base at the Lunar and Planetary Institute Library from November 1982 through January 1983 is presented. An abstract of each article is given. The subjects covered by the articles include: the motion of the moon and dynamics of the earth-moon system: shape and gravity field of the moon; the physical structure of the moon, its thermal and stress history; the morphology of the lunar surface, the origin and stratigraphy of lunar formations, and mapping of the moon; the chemical composition of the moon, lunar petrology, mineralogy, and crystallography; electromagnetic properties of the moon; the planets; and other objects, including asteroids, comets, meteorites, and cosmic dust.

  16. Ethical, legal and health economic aspects of neonatal screening.

    PubMed

    Riis, P

    1999-12-01

    The spectrum of the title of this work is wide, but necessarily so, because of the increasing interaction of the three key components--ethics, law and health economy--in all parts of health systems. Although by nature the key components are different, they are still interdependent. Ethics, as the overall term for values, norms and attitudes of democratic societies, is the basic reference for our controlling of our personal lives, our lives with each other, and our lives with society institutions in the broadest sense. Ethics is the cambrium for control with our general behaviour, but is at the same time the cambrium for the control mechanisms of societies, as expressed in national laws. Health economics is often considered a necessary but value-free part of the spectrum, in accordance with money's very material nature. And yet economics and other resource elements (as organs for transplantation or numbers of special experts) have a strong link to ethics via so-called distributional ethics ("we are able to do more than we can afford"). The main theme for this introduction is ethics. In neonatal screening it relates to two different aspects: one linked to the neonate as an individual who can benefit from early diagnosis of treatable diseases, the other to the neonate as a member of a family line, enabling geneticists later to use the results for genetic mapping of a whole family or of large societal groups.

  17. Reneging: A Topic to Promote Engaging Discussions about Law and Ethics in a Business Law or Legal Environment Course

    ERIC Educational Resources Information Center

    Murphy, Tonia Hap

    2009-01-01

    This article is intended for business law and legal environment instructors who want to help students understand how they might react when presented with an ethical conflict, no matter how big or how small. The article discusses not only the compelling ethical issues that may arise in reneging cases, but also legal issues. The article provides…

  18. Reneging: A Topic to Promote Engaging Discussions about Law and Ethics in a Business Law or Legal Environment Course

    ERIC Educational Resources Information Center

    Murphy, Tonia Hap

    2009-01-01

    This article is intended for business law and legal environment instructors who want to help students understand how they might react when presented with an ethical conflict, no matter how big or how small. The article discusses not only the compelling ethical issues that may arise in reneging cases, but also legal issues. The article provides…

  19. HIV vaccine research--South Africa's ethical-legal framework and its ability to promote the welfare of trial participants.

    PubMed

    Strode, Ann; Slack, Catherine; Mushariwa, Muriel

    2005-08-01

    An effective ethical-legal framework for the conduct of research is critical. We describe five essential components of such a system, review the extent to which these components have been realised in South Africa, present brief implications for the ethical conduct of clinical trials of HIV vaccines in South Africa and make recommendations. The components of an effective ethical-legal system that we propose are the existence of scientific ethical and policy-making structures that regulate research; research ethics committees (RECs) that ethically review research; national ethical guidelines and standards; laws protecting research participants; and mechanisms to enforce and monitor legal rights and ethical standards. We conclude that the ethical-legal framework has, for the most part, the necessary institutions, and certain necessary guidelines but does not have many of the laws needed to protect and promote the rights of persons participating in research, including HIV vaccine trials. Recommendations made include advocacy measures to finalise and implement legislation, development of regulations, analysis and comparison of ethical guidelines, and the development of measures to monitor ethical-legal rights at trial sites.

  20. Ethical and legal considerations for internet-based psychotherapy.

    PubMed

    Dever Fitzgerald, Theresa; Hunter, Paulette V; Hadjistavropoulos, Thomas; Koocher, Gerald P

    2010-01-01

    The provision of mental health services over the Internet is becoming increasingly commonplace as new technologies continue to develop. Evidence in support of the efficacy of many such interventions is accumulating. Given the potential global reach of Internet-based psychological services, the authors examine ethical issues relating to this growing area of practice through the lens of the Universal Declaration of Ethical Principles for Psychologists (International Union of Psychological Science, 2008). They also raise issues relating to potential liability risks and offer recommendations intended to guide mental health practitioners who are considering involvement in the provision of Internet-based services.

  1. Lessons Learned from Litigation: Legal and Ethical Consequences of Social Media.

    PubMed

    Brous, Edie; Olsen, Douglas P

    2017-09-01

    Editor's note: To the surprise of many, a Canadian nurse's Facebook post complaining about the medical care a family member had received resulted in disciplinary action by the licensing board. We asked our legal and ethical contributing editors to provide some insight on the issues of this case.

  2. Ethical & Legal Issues in School Counseling. Chapter 4: The School Counselor and Child Abuse.

    ERIC Educational Resources Information Center

    Camblin, Lanthan D., Jr.; And Others

    This document contains chapter 4 (7 articles) of a collection of 35 articles primarily from American Association for Counseling and Development (AACD) publications on the most important legal and ethical topics about which all school counselors need to be informed. "School Counselors and the Reporting of Child Abuse: A Survey of State Laws and…

  3. Higher Education Administration: A Guide to Legal, Ethical, and Practical Issues. The Greenwood Educators' Reference Collection.

    ERIC Educational Resources Information Center

    Goonen, Norma M.; Blechman, Rachel S.

    This book addresses many of the major decisions that academic administrators in higher education face on a daily basis, highlighting the relationship between the academic administrator and faculty members relative to several issues. Eight chapters examine: (1) "A Delicate Balance: Legal, Ethical, and Practical Issues"; (2) "Hiring…

  4. Racist Parenting and the Best Interests of the Child: A Legal and Ethical Analysis

    ERIC Educational Resources Information Center

    Clarke, Paul T.; Heavin, Heather; Walker, Keith

    2010-01-01

    In this article, we use a recent Manitoba child custody case to provide a legal and ethical account of the notion of the best interests of the child. We explore the tension between the best interests of the child and parental rights to expression of a racist nature. We consider how the interests of different actors--the state, parents and…

  5. The Role of the Law School in the Teaching of Legal Ethics and Professional Responsibility.

    ERIC Educational Resources Information Center

    Burger, Warren E.

    1980-01-01

    The Chief Justice of the United States outlines the duty and opportunity, besides relating legal theory to practice, regarding inculcating principles of professional ethics and standards in law students. This duty should permeate the entire educational experience from the first hour. Available from Dennis & Co., 251 Main St., Buffalo, NY…

  6. Confronting the Ubiquity of Electronic Communication and Social Media: Ethical and Legal Considerations for Psychoeducational Practice

    ERIC Educational Resources Information Center

    Demers, Joseph A.; Sullivan, Amanda L.

    2016-01-01

    Most U.S. children and adults use computers and the Internet on a daily basis. The pervasiveness of electronic communication in a variety of contexts, including home and school, raises ethical and legal concerns for school psychologists and those in related fields of practice, because of the risks to privacy and confidentiality, boundaries,…

  7. Medication-Related Practice Roles: An Ethical and Legal Primer for School Psychologists

    ERIC Educational Resources Information Center

    Shahidullah, Jeffrey D.

    2014-01-01

    Given the prevalence of school-age children and adolescents who are prescribed with and are taking psychotropic medications, a critical issue that school psychologists may likely encounter in contemporary practice is providing both quality and continuity of care to these students in the context of relevant legal and ethical parameters. With a…

  8. Doctoral Students' Understanding of Legal and Ethical Obligations in Conducting Education Research

    ERIC Educational Resources Information Center

    Achinewhu-Nworgu, Elizabeth; Nworgu, Queen Chioma; Azaiki, Steve; Dikeh, Charles Nna

    2015-01-01

    Conducting education research requires researchers to observe key legal and ethical obligations and to respect the rights of research participants. Legislation pertaining to data protection, in particular, has important implications for the way in which research data is collected, used, stored and shared. Researchers are also required to conduct…

  9. Psychotropic Medication Consultation in Schools: An Ethical and Legal Dilemma for School Psychologists

    ERIC Educational Resources Information Center

    Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.

    2006-01-01

    Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…

  10. Higher Education Administration: A Guide to Legal, Ethical, and Practical Issues. The Greenwood Educators' Reference Collection.

    ERIC Educational Resources Information Center

    Goonen, Norma M.; Blechman, Rachel S.

    This book addresses many of the major decisions that academic administrators in higher education face on a daily basis, highlighting the relationship between the academic administrator and faculty members relative to several issues. Eight chapters examine: (1) "A Delicate Balance: Legal, Ethical, and Practical Issues"; (2) "Hiring…

  11. Legal and Ethical Issues in the Use of Video in Education Research. Working Paper Series.

    ERIC Educational Resources Information Center

    Arafeh, Sousan; McLaughlin, Mary

    The National Center for Education Statistics (NCES), through the Education Statistics Services Institute, supported the research in this report to help frame future discussions about the use of video research techniques in educational settings. This paper addresses the context of technological, legal, and ethical change facing researchers who use…

  12. [Social perceptions on genomics in four Latin American countries. Ethical-legal implications].

    PubMed

    Rodríguez Yunta, Eduardo; Valdebenito Herrera, Carolina; Misseroni, Adelio; Fernández Milla, Lautaro; Outomuro, Delia; Schiattino Lemus, Irene; Lolas Stepke, Fernando

    2004-01-01

    The authors analyze under an ethical and legal perspective the consequences and anxieties generated by the human genome project in the population of four Latin American countries: Argentine, Chile, México and Perú, through bibliographical analysis and interviews done to biomedical researches, lawyers and legislators, students and lay civilians.

  13. Psychotropic Medication Consultation in Schools: An Ethical and Legal Dilemma for School Psychologists

    ERIC Educational Resources Information Center

    Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.

    2006-01-01

    Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…

  14. Confronting the Ubiquity of Electronic Communication and Social Media: Ethical and Legal Considerations for Psychoeducational Practice

    ERIC Educational Resources Information Center

    Demers, Joseph A.; Sullivan, Amanda L.

    2016-01-01

    Most U.S. children and adults use computers and the Internet on a daily basis. The pervasiveness of electronic communication in a variety of contexts, including home and school, raises ethical and legal concerns for school psychologists and those in related fields of practice, because of the risks to privacy and confidentiality, boundaries,…

  15. Medication-Related Practice Roles: An Ethical and Legal Primer for School Psychologists

    ERIC Educational Resources Information Center

    Shahidullah, Jeffrey D.

    2014-01-01

    Given the prevalence of school-age children and adolescents who are prescribed with and are taking psychotropic medications, a critical issue that school psychologists may likely encounter in contemporary practice is providing both quality and continuity of care to these students in the context of relevant legal and ethical parameters. With a…

  16. Ethical, Legal and Professional Issues in Family Therapy: A Graduate Level Course.

    ERIC Educational Resources Information Center

    Piercy, Fred P.; Sprenkle, Douglas H.

    1983-01-01

    Reports on the curricular components of a 16-week graduate course entitled "Ethical, Legal and Professional Issues in Family Therapy." To aid in replication and assessment, selected teaching strategies are also presented. Course topics include feminism and hedonism, confidentiality, paradox, malpractice, court testimony, job hunting, private…

  17. Ethical & Legal Issues in School Counseling. Chapter 4: The School Counselor and Child Abuse.

    ERIC Educational Resources Information Center

    Camblin, Lanthan D., Jr.; And Others

    This document contains chapter 4 (7 articles) of a collection of 35 articles primarily from American Association for Counseling and Development (AACD) publications on the most important legal and ethical topics about which all school counselors need to be informed. "School Counselors and the Reporting of Child Abuse: A Survey of State Laws and…

  18. The legal and ethical context for knowing and using the latest child welfare research.

    PubMed

    Barsky, Allan E

    2009-01-01

    Many child welfare researchers, policymakers, and practitioners are embracing evidence-based practice as a means of promoting more effective services. This article explores the implications of this movement, including the potential for malpractice liability, limiting the discretion of child welfare professionals, complications with informed consent, and other legal and ethical risks.

  19. ICCE/ICCAI 2000 Full & Short Papers (Policies, Ethics, Standards, and Legal Issues).

    ERIC Educational Resources Information Center

    2000

    This document contains the following full and short papers on policies, ethics, standards, and legal issues from ICCE/ICCAI 2000 (International Conference on Computers in Education/International Conference on Computer-Assisted Instruction): (1) "A Study on the School Information Technology Pilot Scheme: Possibilities of Creative and Lifelong…

  20. Counselors' Role in Preventing Abuse of Older Adults: Clinical, Ethical, and Legal Considerations

    ERIC Educational Resources Information Center

    Forman, Julia M.; McBride, Rebecca G.

    2010-01-01

    Mistreatment of older adults is commonplace. These individuals are subjected to abuse, financial exploitation, and neglect. The authors present an overview of the literature concerning mistreatment, with an emphasis on clinical, ethical, and legal considerations. Methods are proposed for prevention, including counselor education, advocacy, and…

  1. Ethical and legal issues on HIV testing, policy and the practice of dentistry.

    PubMed

    Naidoo, Sudeshni; Vernillo, Anthony

    2012-12-01

    This paper is structured around the following: autonomy and consent, confidentiality, disclosure, knowledge of patient and provider HIV status, the right to choose whom to treat, testing for HIV and the importance of HIV policies in the workplace to guard against discrimination. The emergence of the HIV/AIDS pandemic has challenged traditional ethical values of the health care profession. These include the infectious nature of HIV, the social stigma of the disease and its ethical and legal dilemmas. This paper addresses some of the pertinent questions related to HIV infection and AIDS. The three broad principles of ethics, namely, autonomy, beneficence and justice, provide the basic framework on which this paper is based. Advances in the biotechnology of rapid oral fluid testing particularly in the detection of HIV antibodies from patients in the dental setting have raised additional ethical and legal considerations in the subsequent management of HIV infected patients to include disclosure of test results to the patient and proper referral to physicians or nurse practitioners. The oral health care worker must thus have a solid foundation in the application of bioethical principles. A clinical case scenario related to HIV testing in the dental setting is presented to illustrate how a lack of understanding and the wrongful application of ethical principles may lead to patient harm and legal liability. Given the increasing infection rate of HIV worldwide, polices must be upheld and revised as needed to protect healthcare providers, patients, and society generally against discrimination.

  2. Ethics in a Postmodern Age: Lapsing into Legalism.

    ERIC Educational Resources Information Center

    Haswell, Janis E.

    2003-01-01

    Discusses the publication of "Guidelines for the Ethical Treatment of Students and Student Writing in Composition Studies" in the journal "College Composition and Communication." Notes that the Guidelines were developed as a reaction to the present situation wherein (1) student writing increasingly is the subject of English teachers' publications…

  3. Mobile-centric ambient intelligence in health- and homecare-anticipating ethical and legal challenges.

    PubMed

    Kosta, Eleni; Pitkänen, Olli; Niemelä, Marketta; Kaasinen, Eija

    2010-06-01

    Ambient Intelligence provides the potential for vast and varied applications, bringing with it both promise and peril. The development of Ambient Intelligence applications poses a number of ethical and legal concerns. Mobile devices are increasingly evolving into tools to orientate in and interact with the environment, thus introducing a user-centric approach to Ambient Intelligence. The MINAmI (Micro-Nano integrated platform for transverse Ambient Intelligence applications) FP6 research project aims at creating core technologies for mobile device based Ambient Intelligence services. In this paper we assess five scenarios that demonstrate forthcoming MINAmI-based applications focusing on healthcare, assistive technology, homecare, and everyday life in general. A legal and ethical analysis of the scenarios is conducted, which reveals various conflicting interests. The paper concludes with some thoughts on drafting ethical guidelines for Ambient Intelligence applications.

  4. Ethical and Legal Issues in Biobanking for Genomic Research in Nigeria

    PubMed Central

    Akintola, Simisola. O.

    2013-01-01

    The pursuit of genomic research and biobanking has raised concerns and discussions about the ethical and legal implications. Given the specific challenges that surround such enterprise in low and middle income countries, it is pertinent to examine them in the light of the advent of Biobanking and Genomic research in Nigeria. In this paper I discuss the issues and suggest model solutions derived from advanced jurisdictions. These ethical and legal issues are discussed within the context of the legal system of a typical African country whose jurisprudence derives from that of its erstwhile colonial master, the United Kingdom. This includes issues relating to law and human rights, informed consent, native and customary law. PMID:24353984

  5. [Pneumothorax following dry needling treatment: legal and ethical aspects].

    PubMed

    Ronconi, Gianpaolo; De Giorgio, Fabio; Ricci, Eleonora; Maggi, Loredana; Spagnolo, Antonio G; Ferrara, Paola Emilia

    2016-01-01

    Trigger point "dry needling" is a technique used to treat myofascial pain. It involves using filiform needles which are inserted into muscles to give local pain relief. Few cases of serious adverse events following this treatment have been reported in the literature. In this paper we describe the case of a professional swimmer who developed pneumothorax after dry needling treatment and discuss the medicolegal and ethical aspects related to competencies and responsibilities of medical doctors and physiotherapists performing the procedure.

  6. [Patents and scientific research: an ethical-legal approach].

    PubMed

    Darío Bergel, Salvador

    2014-01-01

    This article aims to review the relationship between patents and scientific research from an ethical point of view. The recent developments in the law of industrial property led in many cases to patent discoveries, contributions of basic science, and laws of nature. This trend, which denies the central principles of the discipline, creates disturbances in scientific activity, which requires the free movement of knowledge in order to develop their potentialities.

  7. The Ethical, Legal, and Social Implications Research Program at the National Human Genome Research Institute.

    PubMed

    Meslin, Eric M; Thomson, Elizabeth J; Boyer, Joy T

    1997-09-01

    Organizers of the Human Genome Project (HGP) understood from the beginning that the scientific activities of mapping and sequencing the human genome would raise ethical, legal, and social issues that would require careful attention by scientists, health care professionals, government officials, and the public. The establishment of the ELSI (ethical, legal, and social implications) programs at the National Human Genome Research Institute (NHGRI) and the Department of Energy (DOE) was thought to be vital to the success of the HGP in the United States. It also provided a novel approach to the simultaneous study of ethical, legal, and social issues and basic scientific issues. Eric Juengst, the first director of the ELSI program, described its origins in a previous issue of the Kennedy Institute of Ethics Journal (Juengst 1991). Now in its seventh year, the ELSI program has accomplished much. This article summarizes the evolution and goals of the ELSI program at NHGRI, outlines the program's current research priorities with examples of activities within each priority area, and provides a look to the future, including the initiation of a strategic planning process.

  8. Resolving legal, ethical, and human rights challenges in HIV vaccine research.

    PubMed

    Patterson, D

    2000-01-01

    In the absence of a cure for AIDS, attention has turned to the possibility of developing a preventive vaccine for HIV infection. Yet many scientific, ethical, legal, and economic obstacles remain. At the current rate, the development and production of an effective vaccine could take 15 to 20 years or longer. If tens of millions more HIV infections and deaths are to be avoided in the coming decades, vaccine research needs to be greatly expedited. Furthermore, it must be undertaken ethically, and the products of this research must benefit people in developing countries. This article, an edited and updated version of a paper presented at "Putting Third First," addresses challenges arising in HIV preventive vaccine research in developing countries. It does not address clinical research in developing countries relating to treatments or therapeutic vaccines. Nor does it address legal and ethical issues relating to HIV vaccine research in industrialized countries, although similar issues arise in both contexts. The article concludes that while ethical codes are silent on the obligation to undertake research and development, international law provides strong legal obligations--particularly with regard to industrialized states--that should be invoked to accelerate HIV vaccine development, and distribution.

  9. German law on circumcision and its debate: how an ethical and legal issue turned political.

    PubMed

    Aurenque, Diana; Wiesing, Urban

    2015-03-01

    The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the 'child as a child' and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany's unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues - as in the case of religious circumcision. © 2013 John Wiley & Sons Ltd.

  10. Ethical and legal framework and regulation for off-label use: European perspective

    PubMed Central

    Lenk, Christian; Duttge, Gunnar

    2014-01-01

    For more than 20 years the off-label use of drugs has been an essential part of the ethical and legal considerations regarding the international regulation of drug licensing. Despite a number of regulatory initiatives in the European Union, there seems to remain a largely unsatisfactory situation following a number of critical descriptions and statements from actors in the field. The present article gives an overview of the ethical and legal framework and developments in European countries and identifies existing problems and possible pathways for solutions in this important regulatory area. In addition to the presentation of the ethical and legal foundations, some attention is given to criticisms from medical practitioners to the current handling of off-label drug use. The review also focuses on the situation confronted by patients and physicians when off-label prescriptions are necessary. Through legal descriptions from a number of countries, possible solutions for future discussion of European health care policy are selected and explained. PMID:25050064

  11. Breakdowns in communication of radiological findings: an ethical and medico-legal conundrum

    PubMed Central

    Murphy, Daniel R.; Singh, Hardeep

    2016-01-01

    Communication problems in diagnostic testing have increased in both number and importance in recent years. The medical and legal impact of failure of communication is dramatic. Over the past decades, the courts have expanded and strengthened the duty imposed on radiologists to timely communicate radiologic abnormalities to referring physicians and perhaps the patients themselves in certain situations. The need to communicate these findings goes beyond strict legal requirements: there is a moral imperative as well. The Code of Medical Ethics of the American Medical Association points out that “Ethical values and legal principles are usually closely related, but ethical obligations typically exceed legal duties.” Thus, from the perspective of the law, radiologists are required to communicate important unexpected findings to referring physicians in a timely fashion, or alternatively to the patients themselves. From a moral perspective, radiologists should want to effect such communications. Practice standards, moral values, and ethical statements from professional medical societies call for full disclosure of medical errors to patients affected by them. Surveys of radiologists and non-radiologic physicians reveal that only few would divulge all aspects of the error to the patient. In order to encourage physicians to disclose errors to patients and assist in protecting them in some manner if malpractice litigation follows, more than 35 states have passed laws that do not allow a physician’s admission of an error and apologetic statements to be revealed in the courtroom. Whether such disclosure increases or decreases the likelihood of a medical malpractice lawsuit is unclear, but ethical and moral considerations enjoin physicians to disclose errors and offer apologies. PMID:27006891

  12. Research subjects with limited English proficiency: ethical and legal issues.

    PubMed

    Resnik, David B; Jones, Caitlin W

    2006-01-01

    In this article, we examine Institutional Review Board (IRB) policies, international guidelines, and federal regulations and guidance for dealing with Limited English Proficiency (LEP) research subjects. We show that federal and international guidance concerning this topic is insufficient, and there is considerable variation in IRB policies. While some IRBs have thorough and useful policies, others do not. Many IRBs do not provide researchers and IRB member with answers to several important questions relating to language barriers in research. We recommend that federal agencies, international organizations, IRBs, and researchers take steps to fill in the gaps in guidance and policy to help insure that LEP populations will receive equitable and ethical treatment in research.

  13. Ethical and legal aspects of global tobacco control

    PubMed Central

    Novotny, T; Carlin, D

    2005-01-01

    On 28 February 2005, the Framework Convention on Tobacco Control came into force as a result of at least 40 countries becoming State Parties through ratification of this first ever health treaty sponsored by the World Health Organization. This article discusses the bioethical, trade, and legal aspects of global tobacco control. Special emphasis is given to globalisation of tobacco use and the challenges it poses to sovereign nations. It also advocates a bioethical basis in the pursuit of global solutions to expanding tobacco use. PMID:16046698

  14. Ethical and legal aspects of global tobacco control.

    PubMed

    Novotny, T E; Carlin, D

    2005-08-01

    On 28 February 2005, the Framework Convention on Tobacco Control came into force as a result of at least 40 countries becoming State Parties through ratification of this first ever health treaty sponsored by the World Health Organization. This article discusses the bioethical, trade, and legal aspects of global tobacco control. Special emphasis is given to globalisation of tobacco use and the challenges it poses to sovereign nations. It also advocates a bioethical basis in the pursuit of global solutions to expanding tobacco use.

  15. Ethical, social, and legal issues surrounding studies of susceptible populations and individuals.

    PubMed Central

    Soskolne, C L

    1997-01-01

    Calls for professional accountability have resulted in the development of ethics guidelines by numerous specialty and subspecialty groups of scientists. Indeed, guidelines among some health professions now address vulnerable and dependent groups: but these are silent on issues related to biomarkers. In parallel, attention has been drawn to human rights concerns associated with attempts to detect hypersusceptible workers, especially in democratic countries. Despite this, concern for vulnerable populations grows as advances in biomarker technology make the identification of genetic predisposition and susceptibility markers of both exposure and outcome more attainable. In this article, the principles derived from the ethical theory of utilitarianism provide the basis for principle-based ethical analysis. In addition, the four principles of biomedical ethics--respect for autonomy, beneficence, nonmaleficence, and social justice--are considered for biomarker studies. The need for a context in which ethical analysis is conducted and from which prevailing social values are shown to drive decisions of an ethical nature is emphasized; these include statutory regulation and law. Because biomarker studies can result in more harm than good, special precautions to inform research participants prior to any involvement in the use of biomarkers are needed. In addition, safeguards to maintain the privacy of data derived from biomarker studies must be developed and implemented prior to the application of these new technologies. Guidelines must be expanded to incorporate ethical, social, and legal considerations surrounding the introduction of new technologies for studying susceptible populations and individuals who may be vulnerable to environmental exposures. PMID:9255569

  16. Bioethics methods in the ethical, legal, and social implications of the human genome project literature.

    PubMed

    Walker, Rebecca L; Morrissey, Clair

    2014-11-01

    While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications (ELSI) of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries (such as social, legal, or political investigations). © 2013 John Wiley & Sons Ltd.

  17. BIOETHICS METHODS IN THE ETHICAL, LEGAL, AND SOCIAL IMPLICATIONS OF THE HUMAN GENOME PROJECT LITERATURE

    PubMed Central

    Walker, Rebecca; Morrissey, Clair

    2013-01-01

    While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications (ELSI) of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample of ELSI publications appearing between 2003-2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries (such as social, legal, or political investigations). PMID:23796275

  18. Legal and ethical considerations in meconium testing for fetal exposure to alcohol.

    PubMed

    Dickens, Bernard M

    2011-01-01

    In Canadian law, pregnant women are held to owe no enforceable duties of care to their children before birth, but healthcare providers may be held accountable once children are born alive for causing injuries prenatally. When children are born in hospitals, recovered meconium may be tested without consent, but there may be an ethical duty to inform mothers. Meconium belongs to the newborns, and mothers may be required to make decisions about its use in their children's best interests. Proposals to test meconium from particular populations raise concern about stigmatization. Meconium, alcohol, fatty acid ethyl esters, ethics, legal duties, pregnancy, fetal alcohol spectrum disorder.

  19. Ethical and legal issues related to the donation and use of nonstandard organs for transplants.

    PubMed

    Cronin, Antonia J

    2013-12-01

    Transplantation of nonstandard or expanded criteria donor organs creates several potential ethical and legal problems in terms of consent and liability, and new challenges for research and service development; it highlights the need for a system of organ donation that responds to an evolving ethical landscape and incorporates scientific innovation to meet the needs of recipients, but which also safeguards the interests and autonomy of the donor. In this article, the use of deceased donor organs for transplants that fail to meet standard donor criteria and the legitimacy of interventions and research aimed at optimizing their successful donation are discussed.

  20. Confidentiality of employee health records: ethical and legal dilemmas for occupational health nurses.

    PubMed

    McHugh, Janice

    2003-09-01

    Health professionals must be familiar with regulations and statutes addressing privacy and confidentiality issues. The occupational health nurse must also be aware of specific limitations and exceptions to confidentiality. Occupational health nurses must become proactive in governmental affairs to lobby for changes to include workplace health records in future legislation. To ensure employee trust, occupational health nurses must maintain their ethical and legal responsibility to act morally when making decisions related to confidentiality. The AAOHN Code of Ethics and Interpretive Statements and the AAOHN Position Statement on Confidentiality of Health Information can be used as frameworks to guide occupational health nursing practice.

  1. Ethics and Medico Legal Aspects of “Not for Resuscitation”

    PubMed Central

    Salins, Naveen Sulakshan; Pai, Sachin Gopalakrishna; Vidyasagar, MS; Sobhana, Manikkath

    2010-01-01

    Not for resuscitation in India still remains an abstract concept with no clear guidelines or legal frame work. Cardiopulmonary resuscitation is a complex medical intervention which is often used inappropriately in hospitalized patients and usually guided by medical decision making rather than patient-directed choices. Patient autonomy still remains a weak concept and relatives are expected to make this big decision in a short time and at a time of great emotional distress. This article outlines concepts around ethics and medico legal aspects of not for resuscitation, especially in Indian setting. PMID:21811350

  2. Legal Issues in Higher Education, 1969-1970; A Selected Annotated Bibliography.

    ERIC Educational Resources Information Center

    Roberts, Dayton Y., Ed.

    The selected annotations in this bibliography were compiled from articles in college and university law reviews and journals, other specialized law journals and from educational journals and periodicals. Topics covered include student discipline, academic freedom, faculty tenure, political speakers, collective bargaining, student rights, financial…

  3. Ethical, Legal and Social Issues related to the health data-warehouses: re-using health data in the research and public health research.

    PubMed

    Lamas, Eugenia; Barh, Anne; Brown, Dario; Jaulent, Marie-Christine

    2015-01-01

    Research derived from the application of information and communication technologies in medicine operates in a context involving the globalization of collecting, sharing, storage, transfer and re-use of personal health data. Health data computerization within Clinical Information Systems (as Electronic Healthcare Records) should allow the re-use of health data for clinical research and public health purposes. One of the objects allowing the integration of healthcare and research information systems is the health data-warehouse (DWH). However, ethical-legal frameworks in force are not adapted to these DWHs because they were not conceived for re-using data in a different context than the one of their acquisition. For that matter, access modalities to data-warehouses must ensure the respect of patients' rights: information to the patient, as well as confidentiality and security. Through a bibliography research, some Ethical, legal and Social Issues (ELSI) have been identified: Patients' rights Modalities of implementation of the DWs; Solidarity and common good; Transparency and Trust. Comparative analysis between the Directive 95/46/CE and the "Proposal for regulation on protection of individuals with regard to the processing of personal data" shows that this regulation pretends allowing the re-use of key-coded data when aimed at a scientific purpose. However, since this new regulation does not align with the ethical and legal requirements at an operational level, a Code of practice on secondary use of Medical Data in scientific Research Projects has been developed at the European Level. This Code provides guidance for Innovative Medicine Initiative (IMI) and will help to propose practical solutions to overcome the issue of the re-use of data for research purposes.

  4. A four-part working bibliography of neuroethics: Part 4 - Ethical issues in clinical and social applications of neuroscience.

    PubMed

    Becker, Kira; Shook, John R; Darragh, Martina; Giordano, James

    2017-05-31

    As a discipline, neuroethics addresses a range of questions and issues generated by basic neuroscientific research (inclusive of studies of putative neurobiological processes involved in moral and ethical cognition and behavior), and its use and meanings in the clinical and social spheres. Here, we present Part 4 of a four-part bibliography of the neuroethics literature focusing on clinical and social applications of neuroscience, to include: the treatment-enhancement discourse; issues arising in neurology, psychiatry, and pain care; neuroethics education and training; neuroethics and the law; neuroethics and policy and political issues; international neuroethics; and discourses addressing "trans-" and "post-" humanity. To complete a systematic survey of the literature, 19 databases and 4 individual open-access journals were employed. Searches were conducted using the indexing language of the U.S. National Library of Medicine (NLM). A Python code was used to eliminate duplications in the final bibliography. When taken with Parts 1-3, this bibliography aims to provide a listing of international peerreviewed papers, books, and book chapters published from 2002 through 2016. While seeking to be as comprehensive as possible, it may be that some works were inadvertently and unintentionally not included. We therefore invite commentary from the field to afford completeness and contribute to this bibliography as a participatory work-in-progress.

  5. Position of the academy of nutrition and dietetics: ethical and legal issues in feeding and hydration.

    PubMed

    O'Sullivan Maillet, Julie; Baird Schwartz, Denise; Posthauer, Mary Ellen

    2013-06-01

    It is the position of the Academy of Nutrition and Dietetics that individuals have the right to request or refuse nutrition and hydration as medical treatment. Registered dietitians (RDs) should work collaboratively as part of the interprofessional team to make recommendations on providing, withdrawing, or withholding nutrition and hydration in individual cases and serve as active members of institutional ethics committees. RDs have an active role in determining the nutrition and hydration requirements for individuals throughout the life span. When individuals choose to forgo any type of nutrition and hydration (natural or artificial), or when individuals lack decision-making capacity and others must decide whether or not to provide artificial nutrition and hydration, RDs have a professional role in the ethical deliberation around those decisions. Across the life span, there are multiple instances when nutrition and hydration issues create ethical dilemmas. There is strong clinical, ethical, and legal support both for and against the administration of food and water when issues arise regarding what is or is not wanted by the individual and what is or is not warranted by empirical clinical evidence. When a conflict arises, the decision requires ethical deliberation. RDs' understanding of nutrition and hydration within the context of nutritional requirements and cultural, social, psychological, and spiritual needs provide an essential basis for ethical deliberation. RDs, as health care team members, have the responsibility to promote use of advanced directives. RDs promote the rights of the individual and help the health care team implement appropriate therapy. This paper supports the "Practice Paper of the Academy of Nutrition and Dietetics: Ethical and Legal Issues of Feeding and Hydration" published on the Academy website at: www.eatright.org/positions. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  6. Ethical, Legal and Social Issues Surrounding Research on Genetic Contributions to Anti-Social Behavior

    PubMed Central

    Berryessa, Colleen M.; Martinez-Martin, Nicole A.; Allyse, Megan A.

    2013-01-01

    Scientific study of genetic contributions to chronic antisocial behavior has stemmed from many lines of research in recent years. Genetic research involving twin, family, and adoption studies have traditionally been used to compare the health and behavior outcomes of individuals who share the same environment or hereditary lineage; several of these studies have concluded that heredity plays some role in the formation of chronic antisocial behavior, including various forms of aggression and chronic norm-defiance. However, the ethical, social, and legal environment surrounding research on the biological contributions to antisocial behavior in the United States is contentious. Although there has been some discussion in the last few decades regarding the ethical, social, and legal concerns around this type of research within academic and policy circles, analysis and discussion of these concerns rarely appear together. This paper explores the main themes that interact to form the basis of much of the resistance to positing biological contributions to antisocial behavior. PMID:24319343

  7. Allow-natural-death (AND) orders: legal, ethical, and practical considerations.

    PubMed

    Schlairet, Maura C; Cohen, Richard W

    2013-06-01

    Conversations with patients and families about the allow-natural-death (AND) order, along with the standard do-not-resuscitate (DNR) order during end-of-life (EOL) decision-making, may create engagement and understanding while promoting care that can be defended using enduring notions of autonomy, beneficence, and professional duty. Ethical, legal, and pragmatic issues surrounding EOL care decision-making seem to suggest discussion of AND orders as one strategy clinicians could consider at the individual practice level and at institutional levels. A discussion of AND orders, along with traditional DNR orders is presented. This is followed by argument and counter-argument focused on ethical, legal, and practical issues germane to EOL care decision-making associated with use of AND orders.

  8. [Crispr-Cas9 Gene Editing Revolution and the Its Ethical and Legal Challenges].

    PubMed

    Bellver Capella, Vicente

    2016-01-01

    After discovering the CRISPR-Cas9 as an extraordinary method for Gene editing it is necessary to reflect on the ethical, political and legal impact of this technology. This work pretends to offer a preliminary consideration of these problems. I do not pay attention to the potential of CRISPR-Cas9 in the fields of health or environment, nor to all the ethical, legal and political challenges it involves. I principally focus the attention on the possibility of using CRISPR-Cas9 to alter the human germ line. There are some rulings on this topic delivered by intergovernmental organizations. There also are some statements from the scientific community on the matter. They are important in order to know the reasons why they propose a moratorium on the use of CRISPR-Cas9 for human germ line editing. I begin the paper with a short explanation on how CRISPR-Cas9 works.

  9. Exercising restraint: clinical, legal and ethical considerations for the patient with Alzheimer's disease.

    PubMed

    McBrien, Barry

    2007-04-01

    The number of older people using emergency care is increasing steadily and older people account for over half of all emergency admissions. In the emergency setting, nurses caring for older people with Alzheimer's disease can be faced with many complex ethical and legal challenges. Moreover, challenges such as the use of physical restraint can precipitate conflict when the nurse is placed in the precarious position of doing good, respecting autonomy and avoiding paternalism. Although, there is no complete set of "rules" that can provide nurses with an answer to each dilemma, it is of significant value for nurses to have sound knowledge of ethical and legal positions in order to analyse the many complex situations that they may encounter.

  10. Ethical and legal issues in the clinical practice of primary health care.

    PubMed

    Maestro, Francisco Javier; Martinez-Romero, Marcos; Vazquez-Naya, Jose Manuel; Pereira, Javier; Pazos, Alejandro

    2013-01-01

    Since it was conceived, the notion of primary care has been a crucial concept in health services. Most health care is provided at this level and primary care clinicians have an essential role, both in terms of disease prevention and disease management. During the last decades, primary health care has evolved from a traditional paternalistic model, in which patients played the role of passive recipient of care, towards a situation in which patients are partners involved in the decision making-process. This new context opened a considerable number of new ethical and legal aspects, which need to be comprehensively analyzed and discussed in order to preserve the quality of primary health care all around the world. This work reviews the most important ethical and legal issues in primary health care. Legislation issues are explained in the context of the Spanish Health Services.

  11. A legal-ethical analysis of reproductive endocrinologists' right to refuse ovulation induction to patients with diminished ovarian reserve.

    PubMed

    Karipcin, Fethiye Sinem; Hossain, Amjad; Phelps, John Y

    2011-11-01

    Review of the legal and ethical basis for reproductive endocrinologists to refuse ovulation induction to patients with diminished ovarian reserve. The Lexis-Nexis search engine was used to perform a legal review pertaining to refusal of treatment. Ethical opinions of medical organizations were also reviewed. Federal antidiscrimination laws provide legal recourse for patients with diminished ovarian reserve who are denied ovulation induction. However, the same laws also permit refusal of care when there is bona fide medical justification to decline services. In addition, the codes of ethics for relevant professional organizations support physicians' decisions to refuse treatment when treatment is futile. Although it is ethically and legally permissible to deny ovulation induction to patients with diminished ovarian reserve when medically justified, refusal may invite retaliatory litigation. Counseling remains a cornerstone in directing these patients to options with more potential for success, such as donor eggs and adoption.

  12. Nurse drug diversion and nursing leader's responsibilities: legal, regulatory, ethical, humanistic, and practical considerations.

    PubMed

    Tanga, Hazel Y

    2011-01-01

    Nurses who divert drugs pose significant threats to patient safety, but also become a liability to healthcare organizations and the nursing department where the diversion occurred. Healthcare and nursing leaders have a responsibility to ensure that security systems are in place to prevent diversion and protect patients if nursing impairment is suspected as a result of drug diversion. Nursing leaders must consider legal, regulatory, ethical, humanistic, and practical considerations in resolving this issue.

  13. Application of legal principles and medical ethics: multifetal pregnancy and fetal reduction

    PubMed Central

    Cheong, May Anne; Tay, Catherine Swee Kian

    2014-01-01

    In the management of complex medical cases such as a multifetal pregnancy, knowledge of the ethical and legal implications is important, alongside having competent medical skills. This article reviews these principles and applies them to scenarios of multifetal pregnancy and fetal reduction. Such a discussion is not solely theoretical, but is also relevant to clinical practice. The importance of topics such as bioethical principles and informed consent are also herein addressed. PMID:25017403

  14. Legal and ethical implications of health care provider insurance risk assumption.

    PubMed

    Cox, Thomas

    2010-01-01

    From bedside to boardroom, nurses deal with the consequences of health care provider insurance risk assumption. Professional caregiver insurance risk refers to insurance risks assumed through contracts with third parties, federal and state Medicare and Medicaid program mandates, and the diagnosis-related groups and Prospective Payment Systems. This article analyzes the financial, legal, and ethical implications of provider insurance risk assumption by focusing on the degree to which patient benefits are reduced.

  15. Ethical and legal issues raised by cord blood banking - the challenges of the new bioeconomy.

    PubMed

    Stewart, Cameron L; Aparicio, Lorena C; Kerridge, Ian H

    2013-08-19

    • Cord blood banking raises ethical and legal issues which highlight the need for careful regulatory approaches to the emerging bioeconomy. • Consent processes for both private and public banking should be inclusive and representative of the different familial interests in the cord blood. • Property law is a potentially useful way of understanding the mechanisms for donation to both public and private banks. • Increasing tensions between public and private models of banking may require the adoption of hybrid forms of banking.

  16. Child protection: legal and ethical obligation regarding the report of child abuse in four different countries.

    PubMed

    Cukovic-Bagic, Ivana; Welbury, Richard R; Flander, Gordana Buljan; Hatibovic-Kofman, Sahza; Nuzzolese, Emilio

    2013-12-01

    Child protection is the duty of every single member of the society. Health professionals who work with children, such as members of dental team, are in the unique position to recognize signs of physical, sexual and emotional abuse as well as (dental) neglect. They should report any suspected case where a child is or may be in need of welfare. The professional responsibility is regulated by legal and ethical obligations. In this preliminary work the authors investigate the legal and ethical Acts, and the similarities vs. differences in obligations regarding reporting child abuse and neglect (CAN) cases in four countries: Croatia, United Kingdom, Italy and Canada. In all four countries all health professionals have a duty to report their suspicion if a child is in a harmful situation. All of them who fail to report, or even neglect or delay to report a suspicion, are liable on conviction to a pecuniary fine which varies from country to country. Depending on the country, if a professional has reasonable grounds to suspect that a child is or may be in need of protection, must report to: CAS (children's aid society), to CSS (center for social services), to police, to a Juvenile Court, or to the ombudsman. In all four countries, dentists are not asked to diagnose 'child maltreatment', but simply report the suspicion with supportive evidence. Ethical obligation comes from medical and dental ethical codes regulated by the Chamber or Council of Dentists. In all four countries legal and ethical obligations in reporting CAN are similar. Differences are related mostly to fines for nonreporting or a delay in reporting. Expanded investigation through other European countries and standard operational procedures is needed, in order to harmonize policies and guidelines for reporting CAN and maximize children protection.

  17. Legal, Ethical, and Financial Dilemmas in Electronic Health Record Adoption and Use

    PubMed Central

    Singh, Hardeep

    2011-01-01

    Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and mechanisms for clinicians to publically report potential EHR safety issues. Ethical dilemmas that need additional discussion relate to opt-out provisions that exclude patients from electronic record storage, sale of deidentified patient data by EHR vendors, adolescent control of access to their data, and use of electronic data repositories to redesign the nation's health care delivery and payment mechanisms on the basis of statistical analyses. Finally, one overwhelming financial question is who should pay for EHR implementation because most users and current owners of these systems will not receive the majority of benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These actions can help identify and prioritize solutions to the key legal, ethical, and financial dilemmas discussed, so that widespread, safe, effective, interoperable EHRs can help transform health care. PMID:21422090

  18. Legal, ethical, and financial dilemmas in electronic health record adoption and use.

    PubMed

    Sittig, Dean F; Singh, Hardeep

    2011-04-01

    Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and mechanisms for clinicians to publically report potential EHR safety issues. Ethical dilemmas that need additional discussion relate to opt-out provisions that exclude patients from electronic record storage, sale of deidentified patient data by EHR vendors, adolescent control of access to their data, and use of electronic data repositories to redesign the nation's health care delivery and payment mechanisms on the basis of statistical analyses. Finally, one overwhelming financial question is who should pay for EHR implementation because most users and current owners of these systems will not receive the majority of benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These actions can help identify and prioritize solutions to the key legal, ethical, and financial dilemmas discussed, so that widespread, safe, effective, interoperable EHRs can help transform health care.

  19. Embryonic stem cells research in Israel: a legal and ethical inquiry.

    PubMed

    Siegal, Gil

    2004-01-01

    Embryonic stem cell research (ESCR) holds great promise for future remedies, coupled with gainful venture opportunities. However, the possibility to benefit to the full extent from this modality is contingent to the resolution of significant ethical and legal difficulties. Currently, a myriad of international laws and regulation precludes a systematic, singular point of view, necessitating a nation-by-nation analysis. This article focuses on the legal and ethical framework of ESCR in Israel, where significant scientific and entrepreneurship activities are taking place. The article highlights the current legislation and regulation, and presents the prevailing guidelines developed by national advisory committees in authorizing stem cell research. The main issues presented include the status of pre-embryos, rights of gamete donors and the breadth of informed consent required, the concept of benefit-sharing and limitation on oocyte retrieval, critical in this arena. Such description is meant to enable the understanding of current trends in legal and ethical research scrutiny in Israel, illuminate the duties and restraints of researchers and their financing companies, thereby fostering a more rationalized prospective of biotechnology endeavors.

  20. Treating war detainees and terror suspects: legal and ethical responsibilities of military physicians.

    PubMed

    Singh, Jerome Amir

    2007-12-01

    Several international legal instruments and ethical guidelines bestow rights and impose duties on detainees and military physicians, respectively. Ideological totalism, moral disengagement, and victim blame can facilitate the abuse of detainees, and this mindset must be avoided by military physicians. Physicians should report suspected violations of detainee rights to the U.N. Special Rapporteur on Torture or organizations such as the International Committee of the Red Cross, Médecins Sans Frontières, Amnesty International, Physicians for Human Rights, or Human Rights Watch. To discourage victimization of physician whistleblowers on detainee abuse, domestic medical associations should pressure their respective governments to explicitly endorse their codes of ethics. Domestic medical communities should regard it as their ethical duty to pressure their respective governments to accede to the Optional Protocol to the Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment, if their governments have not already done so. They should also regard it as their ethical duty to pressure their governments to afford "prisoner of war" status to persons they detain. If faced with a conflict between following national policies and following universally accepted, multilateral principles of international law and ethics, military physicians should consider themselves ethically bound to follow the latter. The duty of care must supercede any blanket notion of loyalty, obligation, allegiance, or patriotism that the physician may feel is owed to his or her station. This is the true ethos of service to humankind.

  1. Advanced patient records: some ethical and legal considerations touching medical information space.

    PubMed

    Kluge, E H

    1993-04-01

    The application of advanced computer-based information technology to patient records presents an opportunity for expanding the informational resource base that is available to health-care providers at all levels. Consequently, it has the potential for fundamentally restructuring the ethics of the physician/patient relationship and the ethos of contemporary health-care delivery. At the same time, the technology raises several important ethical problems. This paper explores some of these implications. It suggests that the fundamental ethical issue at stake in these developments is the status of the electronic record which functions as the analog of the health-care consumer in health-care decision making. Matters such as control and patient dignity are implicated. Other important ethical issues requiring solution include data ownership, data liability, informed consent to use and retrieval, security and access. The paper suggests that the ethical problems that arise cannot be solved in piecemeal fashion and on a purely national basis. They should be addressed in a coordinated international fashion and receive appropriate legal expression in the relevant countries and be incorporated into appropriate codes of ethics.

  2. Ethical and legal issue raised by DNA fingerprinting in France.

    PubMed

    Mangin, P

    1996-01-01

    As soon as DNA identification tests have been introduced as a new powerful tool in criminalistics and in paternity testing, this new technology has immediately aroused a mixture of ethical concerns, suspicion and interest among scientists and non-scientists. The major concerns about the so called 'DNA fingerprints' were related first to the possible constitution of data based by the police agencies for the purpose of identifying and investigating individuals as potential criminal suspects, and secondly to the risk of a widespread use without safeguards for private investigation as establishing paternity or the typing of a person for insurance companies. In this context, and in order to preserve civil liberties and the respect of individual privacy, the national Consultative Bioethics Committee advised, as early as 1989, the French government that DNA identification should be strictly limited to judicial use and performed by accredited laboratories. After a long debate, this recommendation has finally been adopted in July, 1994 by the French Parliament. As a result, France is presently the only member state of the European Union with such restricted legislation. This is not without raising difficulties in the implementation of the law, especially in the field of paternity testing where the demand is growing and can be satisfied in any other neighbour country.

  3. [Consent and confidentiality in occupational health practice: balance between legal requirements and ethical values].

    PubMed

    Mora, Erika; Franco, G

    2010-01-01

    The recently introduced Italian law on the protection of workers' health states that the occupational health physician (competent physician) is required to act according to the Code of Ethics of the International Commission on Occupational Health (ICOH). This paper aims at examining the articles of legislative decree 81/2008 dealing with informed consent and confidentiality compared with the corresponding points of the ICOH Ethics Code. Analysis of the relationship between articles 25 and 39 (informed consent) and 18, 20 and 39 (confidentiality) of the decree shows that there are some points of disagreement between the legal requirements and the Code of Ethics, in particular concerning prescribed health surveillance, consent based on appropriate information (points 8, 10 and 12 of the Code) and some aspects of confidentiality (points 10, 20, 21, 22 and 23 of the Code). Although the competent physician is required to act according to the law, the decisional process could lead to a violation of workers' autonomy.

  4. Ethical and legal analyses of policy prohibiting tobacco smoking in enclosed public spaces.

    PubMed

    Oriola, Taiwo A

    2009-01-01

    A spate of legislations prohibiting cigarette smoking in enclosed public spaces, mainly on grounds of public health protection, recently swept across cities around the world. This is in tandem with a raft of increasingly restrictive national laws that emerged on the back of the ratification of the WHO Framework for Tobacco Control by more than one 168 countries in 2005. The central debate on the increasingly restrictive tobacco laws revolves on the extent to which public health interests justification should ground political intervention in a private right as basic as tobacco smoking, which interestingly is often lumped in the food and beverage category. The pertinent legal and ethical questions therefore are the following: Is or should there be a general unrestricted right to tobacco smoking? If there were such a right, should public health or ethical considerations trump private right to smoke in enclosed public spaces? And if public health interests were so paramount, should they go farther and ground tobacco smoking proscription in all private and public spheres? Using ethical principles and rights-based arguments, the paper critically examines the legal and ethical ramifications of public health justification for tobacco smoking proscription in enclosed public spaces.

  5. Growing families in a shrinking world: legal and ethical challenges in cross-border surrogacy.

    PubMed

    Crockin, Susan L

    2013-12-01

    Crossing national borders to have children is a rapidly growing phenomenon, fuelled by restrictions on access and technologies in some countries and for some patients, by high costs in others, and all generating a burgeoning multibillion dollar international industry. Cross-border gestational surrogacy is one form of family building that challenges legal, policy and ethical norms between countries and puts both intended parents and gestational surrogates at risk, and can leave the offspring of these arrangements vulnerable in a variety of ways, including parent-child, immigration and citizenship status. The widely varying political, religious and legal views amongst countries make line drawing and rule making challenging. This article reviews recent court decisions about and explores the legal dimensions of cross-border surrogacy. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  6. European survey on ethical and legal framework of clinical trials in paediatrics: results and perspectives.

    PubMed

    Altavilla, Annagrazia; Giaquinto, Carlo; Ceci, Adriana

    2008-09-01

    This article constitutes a synthesis and analysis of the results of the "Survey on the ethical and legal frameworks existing in Europe for paediatric clinical trials" carried out by the European network TEDDY. TEDDY is a "Network of Excellence" funded by the Sixth EU Framework Programme (FP6). It began its activities in June 2005 and it is scheduled to run until 2010. It involves 19 partners in 11 countries. The overall goal of TEDDY is to promote the availability of safe and effective medicines to children in Europe by integrating existing expertise and the good practices. In the domain of ethics, the main aim of TEDDY is raise the awareness of the public and researchers concerning issues linked to biomedical research in paediatrics, by contributing to developing the debate on the ethical and legal stakes, as well as the potential deviations, in order to ensure the best possible protection of children participating in clinical trials. This study, with twenty-seven participating countries (23 EU Member States and 4 countries associated to the Fifth and Sixth EU Framework Programme), proposes to highlight the existing differences in the legislation of European countries concerning the procedure of consent, as well as the guarantee of the paediatric expertise within the Ethics Committees which are in charge of evaluating research protocols. The study shows that, even though the Directive 2001/20/EC has been transposed, the value attributed to the consent of minors who participate in clinical trials is different depending on the European state. Despite the general rule of having the written consent of the legal representative of the minor, over a certain age (different in relation to each state) and under certain conditions, to give the consent alone to participate in biomedical research. Furthermore, there is an Ethics Committee for minors in only four countries. In addition, we illustrate the lack of information and in-depth debate in Europe concerning the ethical

  7. [Terminal medical interventions: psychosocial, medical, ethical and legal aspects].

    PubMed

    Englert, M; Ronson, A; Lossignol, D; Body, J J

    2001-04-01

    We give an overview of the available medical solutions to help a patient with refractory symptoms at the end of his life. Patient "competence" must first be evaluated and, even if their diagnosis is difficult, organic mental disorders and depression must be diagnosed and adequately treated to allow a real, personal and honest dialog. Administration of high doses of morphine is frequently used at the end of life not only to fully relieve pain but also to accelerate death, even if this is not clearly stated. This technique is not devoid of hypocrisy and high doses of morphine can have quite unpleasant side effects. Treatment withdrawal or withholding is generally not sufficient to allow a correct end of life. The arrest of ventilation, dialysis, artificial nutrition and even more hydration must often be coupled with techniques inducing unconsciousness, which makes imprecise the limits between such a "passive" ending of life and "active" euthanasia. The technique of terminal sedation, frequently based on the use of midazolam, has been more recently introduced in some palliative care units. Such a "controlled sedation" is supposed to allow a "natural" death by inducing a profound sleep. In opposition with active euthanasia, which allows a quiet and rapid death at a moment chosen by the patient himself, this technique of "sedation" has an undetermined duration, has legal implications which could be viewed as quite similar as the ones of euthanasia, and, moreover, this prolonged agony can be extremely stressful and distressing for the family. Medical-assisted suicide is allowed in The Netherlands under the same conditions as euthanasia. Death is generally obtained after a few hours but the technique is not always successful and the process of death can sometimes be prolonged and uncomfortable. This technique can nevertheless be preferred by some physicians and patients. As compared to active euthanasia, the proportion of medically-assisted suicides (1/6) is low in The

  8. Ethical, legal and social issues of genetic studies with African immigrants as research subjects.

    PubMed

    Gong, Gordon; Kosoko-Lasaki, Sade; Haynatzki, Gleb; Cook, Cynthia; O'Brien, Richard L; Houtz, Lynne E

    2008-09-01

    There is growing interest in exploring gene-environment interactions in the etiology of diseases in immigrants from sub-Saharan Africa. Our experience working with the Sudanese immigrant population in Omaha, NE, makes clear the pressing need for geneticists and federal and local funding agencies to address the ethical, legal and social implications of genetic research with such vulnerable populations. Our work raises several questions. How does one design research with African immigrant participants to assure it is ethical? Many immigrants may not understand the purposes, risks and benefits involved in research because of low literacy rates, one of the results of civil wars, or concepts of biologic science foreign to their cultures. Is it possible to obtain truly informed consent? Do African immigrants perceive genetic research using them as subjects as racist? Is genetic research on minorities "biopiracy" or "bio-colonialism?" In our experience, some Sudanese immigrants have challenged the legality and ethics of genetic studies with profit-making as an end. We have concluded that it is essential to educate African immigrant or any other non-English-speaking immigrant participants in research using lay language and graphic illustrations before obtaining consent. Cultural proficiency is important in gaining the trust of African immigrants; profit-sharing may encourage their participation in genetic research to benefit all; involvement of African immigrant community leaders in planning, delivery and evaluation using the community-based participatory research approach will facilitate healthcare promotion, health literacy education, as well as genetic research. It is crucial to address the ethical, legal and social implications of genetic studies with African immigrants as research subjects.

  9. Ethical principles and legal requirements for pediatric research in the EU: an analysis of the European normative and legal framework surrounding pediatric clinical trials.

    PubMed

    Pinxten, Wim; Dierickx, Kris; Nys, Herman

    2009-10-01

    The involvement of minors in clinical research is inevitable to catch up with the lack of drugs labeled for pediatric use. To encourage the responsible conduct of pediatric clinical trials in the EU, an extensive legal framework has been developed over the past decade in which the practical, ethical, legal, social, and commercial issues in pediatric research are addressed. In this article, the European legal framework surrounding pediatric clinical trials is analyzed from the perspective of the major ethical concerns in pediatric research. The four principles of biomedical ethics will be used as a conceptual framework (1) to map the ethical issues addressed in the European legal framework, (2) to study how these issues are commonly handled in competent adults, (3) to detect workability problems of these paradigmatic approaches in the specific setting of pediatric research, and (4) to illustrate the strong urge to differentiate, specify, or adjust these paradigmatic approaches to guarantee their successful operation in pediatric research. In addition, a concise comparative analysis of the European regulation will be made. To conclude our analysis, we integrate our findings in the existing ethical discussions on issues specific to pediatric clinical research.

  10. Care of critically ill newborns in India. Legal and ethical issues.

    PubMed

    Subramanian, K N; Paul, V K

    1995-06-01

    The nature of neonatal care in India is changing. While the quality of care will most likely improve as the economy grows, the eventual scope of change remains to be seen. Attitudinal and behavioral changes, in addition to better economic conditions, are needed to realize more appropriate interventions in neonatal care. Economic, cultural, religious, social, political, and other considerations may limit or affect neonatal care, especially for ELBW infants or infants with congenital malformations or brain injury. Various protections for critically ill newborns exist under Indian law and the Constitution of India. New laws are being enacted to enhance the level of protection conferred, including laws which ban amniocentesis for sex determination and define brain death in connection with the use of human organs for therapeutic purposes. The applicability of consumer protection laws to medical care is also being addressed. It is noted, however, that India lacks a multidisciplinary bioethics committee. An effort should be made to discuss the legal and ethical issues regarding the care of critically ill newborns, with discussions considering religious, cultural, traditional, and family values. Legal and ethical guidelines should be developed by institutions, medical councils, and society specific to newborn care, and medical, nursing, and other paramedical schools should include these issues as part of the required coursework. Physicians, nurses, philosophers, and attorneys with expertise in law and ethics should develop and teach these courses. Such measures over the long term will ensure that future health care providers are exposed to these issues, ideally with a view toward enhancing patient care.

  11. When is differential treatment discriminatory? Legal, ethical, and professional considerations for psychology trainees with disabilities.

    PubMed

    Taube, Daniel O; Olkin, Rhoda

    2011-11-01

    A supervisor may tell graduate trainees with obvious disabilities to disclose the disability to potential clients. Legal and ethical guidelines only partially address whether this requirement is permissible. Here we examine such disclosures from several vantage points. Professional judgments guide supervisors in deciding whether to request that a trainee disclose a disability. The law provides little guidance to supervisors in making this decision. Instead, professional ethics and beliefs about disability drive decisions, and these beliefs may be prejudicial. In this article, we examine whether it is good practice for a supervisor in a practicum or internship to require a trainee with an obvious disability to disclose the disability to potential clients before the first meeting so that the client has freedom to request a different therapist. We use this situation to examine the pertinent legal standards; ethical guidelines; and clinical, professional, and social justice issues. The requirement of disclosure may not be in the best interests of the client and has deleterious repercussions for trainees with disabilities, their peers, and the profession. Unless addressed without prejudice, differential treatment becomes discriminatory and is an obstacle to successful completion of professional education by trainees with obvious disabilities.

  12. [Ethical and legal implications of the determination of blood alcohol content in the emergency department].

    PubMed

    Real de Asúa, Diego; González-Cajal, Jesús

    2012-01-01

    Alcohol is the most widely consumed toxic in Spain. Excessive alcohol intake is responsible for a significant number of visits to emergency departments (EDs), and what occurs may not only have severe medical consequences, but also serious legal implications. Most Spanish EDs lack specific protocols concerning the correct determination of blood alcohol content (BAC). The present work aims to review the technical, ethical and legal problems surrounding this test. Since ethanol is metabolized in peripheral blood, blood extraction should be standardized in order to preserve the proper chain of custody. An emergency test for BAC should be performed in two scenarios: patients with an altered level of consciousness of unknown origin (when health-care professionals act for the good of the patient), and situations which may be penalized by law (when health-care professionals act for the good of the community). The latter would include traffic controls and traffic accidents, job-related accidents, criminal activities or harmful domestic behaviour. Health-care professionals are responsible for treating patients' clinical information with due respect and confidentiality. However, professional secrecy may be overridden by legal imperative in certain situations. It is necessary to promote conscious ethical decision-taking by the health-care professional, so that this responsibility does not solely depend on the juridical context.

  13. Ethical, legal and social issues to consider when designing a surrogacy law.

    PubMed

    Ekberg, Merryn Elizabeth

    2014-03-01

    The aim of this article is to address the ethical, legal and social issues that arise when a woman becomes pregnant and gives birth to a child with the intention of surrendering this child to another woman or couple. The secondary aim is to offer some recommendations that will be beneficial for the lawmakers, policymakers and regulators who design and enforce the rules and regulations that govern surrogacy arrangements. The article considers both commercial and altruistic surrogacy and highlights some of the similarities and differences between the two. Beginning with the initial question of whether surrogacy should be legal, the controversial questions raised relate to the time before conception, during the pregnancy and after the birth of the child. The article concludes that surrogacy arrangements are ethical and should be legal because they enable the medically and socially infertile, including singles and same-sex couples, the opportunity to become parents and to enjoy the lifelong pleasures of parenthood. For many, this will be the strongest argument for the legalisation of surrogacy and the greatest benefit to arise from surrogacy arrangements.

  14. The legal and ethical status of children in health care in the UK.

    PubMed

    Baxter, R; Long, A; Sines, D

    1998-05-01

    Ethical issues about children's rights in respect of matters concerning resource allocation or treatment opportunities are now a matter for public consumption and concern. Alongside this exists a long-frustrated desire by children's nurses to promote children's health. Long-held assumptions about the legal and moral status of children within the health care system in this country are now rightly scrutinized and challenged. Those of us who claim to represent children now possess an opportunity to exploit public attention for the benefit of these children. This article will explore selected major relevant legal and moral concepts that relate to children with the aim of making transparent some of the important and often confusing information available. It is anticipated that debates about the legal and ethical status of children may be stimulated and fuelled from the following discussion. It is strongly recommended that entering into dialogue with families and children about their perceived needs will go a long way towards advancing thoughtful nursing care of individual children, their families and the general population.

  15. Ethical and legal controversies in cloning for biomedical research--a South African perspective.

    PubMed

    Dhai, A; Moodley, J; McQuoid-Mason, D J; Rodeck, C

    2004-11-01

    Therapeutic embryonic stem cell research raises a number of ethical and legal issues. The promised benefits are new and important knowledge of human embryological development, gene action, and the production of transplantable tissue and organs that could be effective in reversing or curing currently irreversible disease processes. However, this research involves the deliberate production, use, and ultimate destruction of cloned embryos, hence re-awakening the debate on the moral status of the embryo. Other moral anxieties include the possibility that women (as donors of ova) would be exploited, that this research would land on the slippery slope of reproductive cloning, and that promises made too early could lead to false hope among sick patients. It also raises the question of intellectual and actual property rights in human cell lines and the techniques by which they are produced. Review of legal systems internationally reveals that there is no global consensus on therapeutic embryonic stem cell research. Legal considerations are very much influenced by ethical deliberations on the moral status of the embryo. The South African parliament is promulgating legislation permitting therapeutic cloning, thereby demonstrating a commitment by the state to act in the best interests of patients and of regenerative medicine.

  16. Ethics, privacy and the legal framework governing medical data: opportunities or threats for biomedical and public health research?

    PubMed

    Coppieters, Yves; Levêque, Alain

    2013-06-21

    Privacy is an important concern in any research programme that deals with personal medical data. In recent years, ethics and privacy have become key considerations when conducting any form of scientific research that involves personal data. These issues are now addressed in healthcare professional training programmes. Indeed, ethics, legal frameworks and privacy are often the subject of much confusion in discussions among healthcare professionals. They tend to group these different concepts under the same heading and delegate responsibility for "ethical" approval of their research programmes to ethics committees. Public health researchers therefore need to ask questions about how changes to legal frameworks and ethical codes governing privacy in the use of personal medical data are to be applied in practice. What types of data do these laws and codes cover? Who is involved? What restrictions and requirements apply to any research programme that involves medical data?

  17. Implications of the ethical-legal framework for adolescent HIV vaccine trials--report of a consultative forum.

    PubMed

    Slack, Catherine; Strode, Ann; Grant, Catherine; Milford, Cecilia

    2005-09-01

    The ethical-legal framework in South Africa is in a period of transition, with a number of new developments changing the substantive principles and procedures for health research in the country. Some of the changing dynamics include both law reform and the review of ethical guidelines. This changing environment poses many complexities for researchers, research ethics committees and participating communities involved in planning, implementing and reviewing research with child participants, including HIV vaccine trials. This paper presents the major themes and outcomes of a consultative meeting convened by the HIV AIDS Vaccines Ethics Group in July 2004 for key stakeholder groups. At this forum participants discussed the complexities posed by a transitional and sometimes contradictory ethical-legal framework and how the framework could be improved to simultaneously promote critical research and the welfare of child participants.

  18. Legal and Ethical Considerations in Allowing Parental Exemptions From Newborn Critical Congenital Heart Disease (CCHD) Screening.

    PubMed

    Hom, Lisa A; Silber, Tomas J; Ennis-Durstine, Kathleen; Hilliard, Mary Anne; Martin, Gerard R

    2016-01-01

    Critical congenital heart disease (CCHD) screening is rapidly becoming the standard of care in the United States after being added to the Recommended Uniform Screening Panel (RUSP) in 2011. Newborn screens typically do not require affirmative parental consent. In fact, most states allow parents to exempt their baby from receiving the required screen on the basis of religious or personally held beliefs. There are many ethical considerations implicated with allowing parents to exempt their child from newborn screening for CCHD. Considerations include the treatment of religious exemptions in our current legal system, as well as medical and ethical principles in relation to the rights of infants. Although there are significant benefits to screening newborns for CCHD, when a parent refuses for religious or personal beliefs, in the case of CCHD screening, the parental decision should stand.

  19. Sallekhana: the ethicality and legality of religious suicide by starvation in the Jain religious community.

    PubMed

    Braun, Whitny

    2008-12-01

    This article examines Sallekhana, the Jain religious ritual of fasting to death, from the American and Indian legal and ethical perspectives. Two cases are presented. The first involves a woman in her twenties who starved herself to escape a voice in her head. The second case involves a woman with terminal cancer who chose to starve to death rather than accept palliative care. Both are analyzed with attention paid to the Jain theological rationale behind the practice and the social circumstances that predicate this vow. I argue that within Jain communities the moral presumption should be that Sallekhana is a valid religious ritual and should therefore be legally protected if it is freely chosen by an informed person free from coercion.

  20. Legal, financial, and ethical ambiguities for Mexican American families: caring for children with chronic conditions.

    PubMed

    Rehm, Roberta S

    2003-05-01

    The author reports findings from a study about experiences of 17 Mexican American families caring for children with serious chronic conditions. Legal, financial, and ethical ambiguities arose when parents' desire to provide necessary care for their children and providers' professional commitment to offer this care conflicted with United States laws, including welfare reform initiatives, requiring providers to determine eligibility before providing care to immigrants and to report undocumented care seekers to authorities. Families frequently felt intimidated because health care systems are complex, and legal residency status often varied among family members. Findings imply that official policy and education of family members should aim to assure that children with chronic conditions receive needed services without relying on providers to enforce immigration laws.

  1. Biobanks for research. Ethical and legal aspects in human biological samples collections in France.

    PubMed

    Noiville, Christine

    2012-06-01

    Because they gather huge quantities of human biological samples and information allowing for better understanding of diseases, biobanks appear as a very powerful tool for boosting both medical research and public health as a whole. Although France does not really appear as a leader in biobanking compared to China or UK, biobanks and other samples collections abound in our country and have then been regulated, even though french law does not use the term biobank as such. The present article gives an overview of the current legal framework and explores the remaining ethical and legal issues, concerning particularly the protection of donors, the sharing of biobanks content and the sharing of biobanks benefits. The article explains how these universal questions arise in this country and what answers (sometimes specific) they get or could get in the following years.

  2. Bibliographie (Bibliography).

    ERIC Educational Resources Information Center

    Francais dans le Monde, 1981

    1981-01-01

    Presents a selective bibliography of dictionaries, books, and articles. References are grouped under three sections: I. Lexicology, II. Dictionaries and III. Didactics. Each item is followed by a concise critical note. The compilation is by the "Centre d'Etudes du Lexique" (CELEX, Paris-Villetaneuse). (MES)

  3. Ethical and legal challenges for health telematics in a global world: telehealth and the technological imperative.

    PubMed

    Kluge, Eike-Henner W

    2011-02-01

    Telehealth is one of the more recent applications of ICT to health care. It promises to be both cost-effective and efficient. However, there lies a danger that focusing mainly on pragmatic considerations will ignore fundamental ethical issues with legal implications that could undermine its success. Implicated here are, among others, changes in the nature of the health care professional patient relationship and informed consent, etc. The position of health informatics professionals as well as hard- and software providers is also affected. A further complicating factor is outsourcing. This paper identifies relevant issues and outlines some of their implications. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Ethical, legal and social implications of incorporating personalized medicine into healthcare

    PubMed Central

    Brothers, Kyle B; Rothstein, Mark A

    2015-01-01

    As research focused on personalized medicine has developed over the past decade, bioethics scholars have contemplated the ethical, legal and social implications of this type of research. In the next decade, there will be a need to broaden the focus of this work as personalized medicine moves into clinical settings. We consider two broad issues that will grow in importance and urgency. First, we analyze the consequences of the significant increase in health information that will be brought about by personalized medicine. Second, we raise concerns about the potential of personalized medicine to exacerbate existing disparities in healthcare. PMID:25601880

  5. Ethical, legal and social implications of incorporating personalized medicine into healthcare.

    PubMed

    Brothers, Kyle B; Rothstein, Mark A

    As research focused on personalized medicine has developed over the past decade, bioethics scholars have contemplated the ethical, legal and social implications of this type of research. In the next decade, there will be a need to broaden the focus of this work as personalized medicine moves into clinical settings. We consider two broad issues that will grow in importance and urgency. First, we analyze the consequences of the significant increase in health information that will be brought about by personalized medicine. Second, we raise concerns about the potential of personalized medicine to exacerbate existing disparities in healthcare.

  6. Legal and ethical issues in microbicides research and development in Canada.

    PubMed

    Alexandrova, Anna

    2004-08-01

    The Canadian AIDS Society (CAS) recently completed a report entitled Microbicides Development and Delivery in Canada: Legal, Ethical and Human Rights Issues. The report builds on Canadian and international experience and was written in consultation with Canadian community and international experts. It is available on the CAS website (www.cdnaids.ca) and from the Canadian HIV/AIDS Information Centre (www.aidssida.cpha.ca) as of September 2004. In this article the report's author, Anna Alexandrova, argues that Canada needs to develop a microbicides development and delivery strategy that addresses research and development issues, outlines possible roles for meaningful community participation, and provides guidelines on funding, promotion, licensing, and distribution.

  7. Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations.

    PubMed

    Davis, Karen D; Flor, Herta; Greely, Henry T; Iannetti, Gian Domenico; Mackey, Sean; Ploner, Markus; Pustilnik, Amanda; Tracey, Irene; Treede, Rolf-Detlef; Wager, Tor D

    2017-10-01

    Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. Brain imaging (for example, functional MRI, PET, EEG and magnetoencephalography) is widely considered to have potential for diagnosis, prognostication, and prediction of treatment outcome in patients with chronic pain. In this Consensus Statement, a presidential task force of the International Association for the Study of Pain examines the capabilities of brain imaging in the diagnosis of chronic pain, and the ethical and legal implications of its use in this way. The task force emphasizes that the use of brain imaging in this context is in a discovery phase, but has the potential to increase our understanding of the neural underpinnings of chronic pain, inform the development of therapeutic agents, and predict treatment outcomes for use in personalized pain management. The task force proposes standards of evidence that must be satisfied before any brain imaging measure can be considered suitable for clinical or legal purposes. The admissibility of such evidence in legal cases also strongly depends on laws that vary between jurisdictions. For these reasons, the task force concludes that the use of brain imaging findings to support or dispute a claim of chronic pain - effectively as a pain lie detector - is not warranted, but that imaging should be used to further our understanding of the mechanisms underlying pain.

  8. When courts intervene: public health, legal and ethical issues surrounding HIV, pregnant women, and newborn infants.

    PubMed

    Tessmer-Tuck, Jennifer A; Poku, Joseph K; Burkle, Christopher M

    2014-11-01

    Ninety-three percent of pediatric AIDS cases are the result of perinatal HIV transmission, a disease that is almost entirely preventable with early intervention, which reduces the risk of perinatal HIV infection from 25% to <2%. The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics both recommend routine HIV testing of all pregnant women and at-risk newborn infants. When pregnant women decline HIV testing and/or treatment, public health, legal, and ethical dilemmas can result. Federal courts consistently uphold a woman's right to refuse medical testing and treatment, even though it may benefit her fetus/newborn infant. Federal courts also reliably respect the rights of parents to make health care decisions for their newborn infants, which may include declining medical testing and treatment. Confusing the issue of HIV testing and treatment, however, is the fact that there is no definitive United States Supreme Court ruling on the issue. State laws and standards vary widely and serve as guiding principles for practicing clinicians, who must be vigilant of ongoing legal challenges and changes in the states in which they practice. We present a case of an HIV-positive pregnant woman who declined treatment and then testing or treatment of her newborn infant. Ultimately, the legal system intervened. Given the rarity of such cases, we use this as a primer for the practicing clinician to highlight the public health, legal, and ethical issues surrounding prenatal and newborn infant HIV testing and treatment in the United States, including summarizing key state-to-state regulatory differences.

  9. Protected health information on social networking sites: ethical and legal considerations.

    PubMed

    Thompson, Lindsay A; Black, Erik; Duff, W Patrick; Paradise Black, Nicole; Saliba, Heidi; Dawson, Kara

    2011-01-19

    setting of medical mission trips. Trainees need to learn to equate standards of patient privacy in all medical contexts using both legal and ethical arguments to maintain the highest professional principles. We propose three practical guidelines. First, there should be a legal resource for physicians traveling on medical mission trips such as an online list of local laws, or a telephone legal contact. Second, institutions that organize medical mission trips should plan an ethics seminar prior the departure on any trip since the legal and ethical implications may not be intuitive. Finally, at minimum, traveling physicians should apply the strictest legal precedent to any situation.

  10. Protected Health Information on Social Networking Sites: Ethical and Legal Considerations

    PubMed Central

    2011-01-01

    privacy, they only seem to make this lapse in the setting of medical mission trips. Trainees need to learn to equate standards of patient privacy in all medical contexts using both legal and ethical arguments to maintain the highest professional principles. We propose three practical guidelines. First, there should be a legal resource for physicians traveling on medical mission trips such as an online list of local laws, or a telephone legal contact. Second, institutions that organize medical mission trips should plan an ethics seminar prior the departure on any trip since the legal and ethical implications may not be intuitive. Finally, at minimum, traveling physicians should apply the strictest legal precedent to any situation. PMID:21247862

  11. [Ethical and legal aspects of animal experiments on non-human primates].

    PubMed

    Luy, J

    2007-03-01

    Animal experiments on non-human primates give cause for ethical concerns for three reasons (1) the inclusion of "ethical animal protection" in the German Constitution (Article 20a of the "Grundgesetz" GG, 2002) has led to real consequences for the application process with respect to the use of primates for fundamental research; (2) the legal requirements in Europe to ensure animal welfare are currently being tightened and (3) the global problem of the protection of species, especially with respect to the capturing and subsequent sale of primates is still unsolved. As a result of the way humans interpret the term justice (the principle of equality) it was to be expected that great apes, being the animals that most closely resemble humans, would play a key role in the establishment of animal protection laws. In 1997,Great Britain and Ireland made it illegal to conduct experiments on great apes. In 1999, New Zealand went even further and created a kind of basic rights for great apes. In 2003,The Netherlands forbade animal experiments using great apes as did Sweden, which also included gibbons in this ban (which is in line with current taxonomy, which considers gibbons to belong to the family Hominidae). In 2006 Austria forbade experiments carried out on chimpanzees, bonobos, gorillas, orang-utans, and gibbons. Only recently, a state commission on ethics in Switzerland demanded that the Swiss government do the same. And the summer of 2006 saw a debate in Spain on the inclusion of the protection of great apes in the primary goals of the state. Due to the principle of equality, a further extension (both geographically and systemically) of the exclusion of great apes from animal experiments is to be expected. Since Article 20a GG on "ethical animal protection" came into effect on August 1,2002, the regulatory authorities in Germany have the right to independently check and control animal experiments as to their ethical tenability (Administrative Court Giessen, confirmed

  12. Ethical, legal, social, and policy issues in the use of genomic technology by the U.S. Military

    PubMed Central

    Mehlman, Maxwell J.; Li, Tracy Yeheng

    2014-01-01

    Advances in genomic science are attracting the interest of the U.S. military for their potential to improve medical care for members of the military and to aid in military recruitment, training, specialization, and mission accomplishment. While researchers have explored the ethical, legal, and social issues raised by the use of genomic science in a wide variety of contexts, there has been virtually no examination of these issues in connection with the use of genomics by the military. This article identifies potential uses of genomic science by the military, proposes an applicable ethical and legal framework, and applies the framework to provide ethical and legal guidance for military decision-makers. PMID:25937933

  13. Clinical genetic research 3: Genetics ELSI (Ethical, Legal, and Social Issues) research.

    PubMed

    Pullman, Daryl; Etchegary, Holly

    2015-01-01

    ELSI (Ethical, Legal, and Social Issues) is a widely used acronym in the bioethics literature that encompasses a broad range of research areas involved in examining the various impacts of science and technology on society. In Canada, GE3LS (Genetics, Ethical, Economic, Environmental, Legal, Social issues) is the term used to describe ELSI studies. It is intentionally more expansive in that GE3LS explicitly brings economic and environmental issues under its purview. ELSI/GE3LS research has become increasingly important in recent years as there has been a greater emphasis on "translational research" that moves genomics from the bench to the clinic. The purpose of this chapter is to outline a range of ELSI-related work that might be conducted as part of a large scale genetics or genomics research project, and to provide some practical insights on how a scientific research team might incorporate a strong and effective ELSI program within its broader research mandate. We begin by describing the historical context of ELSI research and the development of GE3LS research in the Canadian context. We then illustrate how some ELSI research might unfold by outlining a variety of research questions and the various methodologies that might be employed in addressing them in an area of ELSI research that is encompassed under the term "public engagement." We conclude with some practical pointers about how to build an effective ELSI/GE3LS team and focus within a broader scientific research program.

  14. Ethical and legal issues in non-heart-beating organ donation.

    PubMed

    Bos, Michael A

    2005-05-15

    Procurement of kidneys and livers from non-heart-beating donors (NHBD) raises ethical and legal issues that need to be considered before wider use of these donors is undertaken. Although NHBDs were used in kidney transplantation as early as the 1960s, retrieval of these organs is not universally accepted today. From a medical point of view, these organs were considered "marginal" because the majority showed delayed or impaired function early after implantation. Legal problems relate to determination of death on cardiopulmonary criteria, the issue of valid consent, and the use of preservation measures. Among ethical issues involved are observance of the dead-donor rule, decisions with respect to resuscitation and withdrawal of life-sustaining treatment, respect for the dying patient and the dead body, and proper guidance of the family. In The Netherlands NHB donation was pioneered by the Maastricht Centre as early as 1981. Today, all seven transplant centers procure and transplant these organs, and NHBDs have become an important source of transplantable kidneys and livers. Recent legislation in The Netherlands also supports NHB donation by allowing the use of organ-preserving measures, even in the absence of family consent. As a result, one of every three kidneys transplanted in The Netherlands in 2004 derives from a NHBD. This article explores Dutch NHBD practice, protocols, and results and compares these data internationally.

  15. The Ethical and Legal Dilemma in Terminating the Physician-Patient Relationship.

    PubMed

    Senderovitch, Helen

    2016-05-01

    A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.

  16. Strikes and the National Health Service: Some legal and ethical issues

    PubMed Central

    Dworkin, Gerald

    1977-01-01

    This paper is sadly opportune. The general public is angry and bewildered if not hurt by the variety of strikes which are brought more or less forcibly to their attention. People used to understand what lay behind a strike - a demand for more pay, better conditions - but today a political element often intrudes, and it is this that worries those who ask themselves whether this or that dispute is either lawful or morally acceptable. Professor Dworkin, a lawyer, first sets out the legal issues surrounding strikes and then advances the ethical arguments, closely relating them to the legal framework. The most interesting part of the paper, however, may well be that devoted to the moral obligation of example, in particular the example to be set by members of the medical profession and by all those caring for the sick. As public attitudes to industrial disputes `become dulled and quiescent' it is absolutely necessary that there should be a reappraisal of the moral standards of the past which coincide with a respect for the law. In the last century the term `anomie' was used to describe a `society which has shaken off its former restraints such as religion, respect for law and order and a definite moral code as to what is right and wrong'. We are living in that sort of society today, and one need not be a professional `ethicist' to recognize the signs, and hopefully, to work for the return of `ethical' values. PMID:874982

  17. Legal and ethical implications of medically enforced feeding of detained asylum seekers on hunger strike.

    PubMed

    Kenny, Mary A; Silove, Derrick M; Steel, Zachary

    2004-03-01

    The current practice of non-consensual medical treatment of hunger-striking asylum seekers in detention needs closer inquiry. An Australian Government regulation empowers the Department of Immigration and Multicultural and Indigenous Affairs (DIMIA) to authorise non-consensual medical treatment for a person in immigration detention if they are at risk of physical harm, but there are doubts about whether the regulation would withstand legal challenge. Authorisation by DIMIA does not compel medical practitioners to enforce treatment if such action is contrary to their "ethical, moral or religious convictions". The World Medical Association has established guidelines for doctors involved in managing people on hunger strikes. The Declaration of Tokyo (1975) and the Declaration of Malta (1991) both prohibit the use of non-consensual force-feeding of hunger strikers who are mentally competent. If called upon to treat hunger strikers, medical practitioners should be aware of their ethical and legal responsibilities, and that they should act independently of government or institutional interests.

  18. Ethical and legal aspects of stem cell practices in Turkey: where are we?

    PubMed

    Ozturk Turkmen, H; Arda, B

    2008-12-01

    Advances in medical technology and information have facilitated clinical practices that favourably affect the success rates of treatment for diseases. Regenerative medicine has been the focus of the recent medical agenda, to the extent of fundamentally changing treatment paradigms. Stem cell practices, their efficacy, and associated ethical concerns have been debated intensively in many countries. Stem cell research is carried out along with the treatment of patients. Thus, various groups affected by the practices inevitably participate in the discussions. In addition to discussions based on avoiding any harm, providing benefits and respecting personal autonomy and justice, problems arise owing to the lack of legal regulations for stem cell research and practice. The dimensions of the problems vary in the developing countries, with widespread use of advanced medical technology but with lack of sources allocated for healthcare, dominance of paternalistic physician-patient relationships and failure to achieve a sufficient level of awareness of patients' rights. This article discusses the current situation of stem cell practices within the context of regenerative medicine in Turkey and ethical concerns about some of the legal regulations, such as the Regulation for Umblical Cord Blood Banking and Guidelines for Non-embryonic Stem Cell Study for Non-clinical Purposes directing the research on this issue.

  19. Cyberdermatoethics I: ethical, legal, technologic, and clinical aspects of patient-physician e-mail.

    PubMed

    Luo, John; Logan, Christopher; Long, Thomas P; Bercovitch, Lionel

    2009-01-01

    As Internet access has become ubiquitous, electronic mail (e-mail) is becoming more widely used as a means of communication between patient and dermatologist. Dealing with the ethical, legal, and clinical consequences has lagged behind the technology. Privacy of e-mail cannot exist without security, and as a foundation for understanding e-mail security, the elements of e-mail technology are reviewed. One of the greatest risks of e-mail is compromise of privacy. Although self-documenting and convenient, e-mail lacks the emotional cues of face-to-face encounters, is asynchronous and not always read in timely fashion, and is not suitable for certain clinical concerns such as urgent matters and cancer diagnoses. Legal issues relating to federal privacy regulations, ethical issues such as autonomy and justice, and guidelines for the use of e-mail in clinical practice are reviewed. Case scenarios are used to present the pitfalls in clinical e-mail encounters, including establishment of the doctor-patient relationship, diagnosis and treatment over the Internet, and curbside consultations.

  20. Personalized Medicine in a New Genomic Era: Ethical and Legal Aspects.

    PubMed

    Shoaib, Maria; Rameez, Mansoor Ali Merchant; Hussain, Syed Ather; Madadin, Mohammed; Menezes, Ritesh G

    2016-11-28

    The genome of two completely unrelated individuals is quite similar apart from minor variations called single nucleotide polymorphisms which contribute to the uniqueness of each and every person. These single nucleotide polymorphisms are of great interest clinically as they are useful in figuring out the susceptibility of certain individuals to particular diseases and for recognizing varied responses to pharmacological interventions. This gives rise to the idea of 'personalized medicine' as an exciting new therapeutic science in this genomic era. Personalized medicine suggests a unique treatment strategy based on an individual's genetic make-up. Its key principles revolve around applied pharmaco-genomics, pharmaco-kinetics and pharmaco-proteomics. Herein, the ethical and legal aspects of personalized medicine in a new genomic era are briefly addressed. The ultimate goal is to comprehensively recognize all relevant forms of genetic variation in each individual and be able to interpret this information in a clinically meaningful manner within the ambit of ethical and legal considerations. The authors of this article firmly believe that personalized medicine has the potential to revolutionize the current landscape of medicine as it makes its way into clinical practice.

  1. Screening for Psychopathology Versus Selecting for Suitability: Ethical and Legal Considerations

    NASA Technical Reports Server (NTRS)

    Holland, Albert W.; Galarza, Laura; Arvey, Richard; Hysong, Sylvia; Sackett, Paul; Cascio, Wayne

    2000-01-01

    The current system for psychological selection of U.S. astronauts is divided into two phases: The select-out phase and the select-in phase. The select-out phase screens candidates for psychopathology; candidates who do not meet the baseline psychiatric requirements are immediately disqualified. The select-in phase assesses candidates for suitability to fly short- and long-duration missions. Suitability ratings are given for ten factors found to be critical for short and long-duration space missions. There are qualitative differences in the purpose of the two phases (select-in vs. select-out) and in the nature of the information collected in each phase. Furthermore, there are different logistic, ethical, and legal issues related to a medical or psychiatric (select-out) screening versus a suitability (select-in) psychological screening process . The purpose of this presentation is to contrast the ethical and legal environment surrounding the select-out and select-in phases of the psychological selection system. Issues such as data collection, data storage and management, the federal statutory environment, and personnel training will be discussed. Further, a summary of the new standards for psychological testing is presented, along with their implications for astronaut selection.

  2. Should commercial organ donation be legalized in Germany? An ethical discourse.

    PubMed

    Keller, F; Winkler, U; Mayer, J; Stracke, S

    2007-03-01

    We evaluated the arguments pro and con concerning kidney sales from a German perspective. At present, we see social, medical, and ethical reasons why organ selling should not be legalized in Germany. Legalization of organ selling would weaken the principle of solidarity within the German health system. Conversely, profit making will undermine the principle of social justice. Within the present social system in Germany, there is no economic pressure to sell an organ to save life, and there is no medical need to buy a kidney. Also, there exists the risk that opening the market for organ sales will de-motivate potential directed organ donors. Relatives would have more doubts about giving their consent to donate organs of their deceased. Moreover, the historical experience with the "action T4" of the Nazi regime sensitized German society for the categorical imperative set forth by Immanuel Kant (1724-1804), namely that man is not a means, but an end to himself. By selling one's kidney, the donor uses himself as a means and as an instrument for the end result of gaining money. With directed organ donation, the welfare of the recipient is the end result. The pending reform of the German health system needs a more communitarian sense, which will be eroded should organs be sold and no longer donated as gifts. Germany's special historical experience and a deeply embedded consent toward ethical values give reason for the prohibition of organ selling in Germany.

  3. Regulating Gamete Donation in the U.S.: Ethical, Legal and Social Implications.

    PubMed

    Sabatello, Maya

    2015-09-01

    This article explores the practice of gamete donation in the U.S. having in mind the larger question of what do we as a society owe children born as a result (donor-conceived children). Do recipient-parents have a duty to tell their donor-conceived child about his/her genetic origins? Should the identity of the donor be disclosed or remain anonymous? Does the child have a right to know her conception story and to receive information, including identifying information, about the donor? Furthermore, if a donor-conceived child has a right to know, who has the duty to tell her/him about it? The Article underscores the ethical, legal and social dilemmas that arise, comparing and contrasting with international developments in this arena. It highlights the market-based and more specific medical justifications for regulating this field, explores the emerging so-called right of the child to know his/her genetic origins ("the right to know"), and considers the challenges such a right evokes to existing legal culture and principles of medical ethics in the U.S. as well as other broader societal implications of such a right.

  4. Management of the Jehovah's Witness in Obstetrics and Gynecology: A Comprehensive Medical, Ethical, and Legal Approach.

    PubMed

    Zeybek, Burak; Childress, Andrew M; Kilic, Gokhan S; Phelps, John Y; Pacheco, Luis D; Carter, Michele A; Borahay, Mostafa A

    2016-08-01

    Obstetricians and gynecologists frequently deal with hemorrhage so they should be familiar with management of patients who refuse blood transfusion. Although there are some reports in the literature about management of Jehovah's Witness patients in obstetrics and gynecology, most of them are case reports, and a comprehensive review about these patients including ethicolegal perspective is lacking. This review outlines the medical, ethical, and legal implications of management of Jehovah's Witness patients in obstetrical and gynecological settings. A search of published literature using PubMed, Ovid Medline, EMBASE, and Cochrane databases was conducted about physiology of oxygen delivery and response to tissue hypoxia, mortality rates at certain hemoglobin levels, medical management options for anemic patients who refuse blood transfusion, and ethical/legal considerations in Jehovah's Witness patients. Early diagnosis of anemia and immediate initiation of therapy are essential in patients who refuse blood transfusion. Medical management options include iron supplementation and erythropoietin. There are also some promising therapies that are in development such as antihepcidin antibodies and hemoglobin-based oxygen carriers. Options to decrease blood loss include antifibrinolytics, desmopressin, recombinant factor VII, and factor concentrates. When surgery is the only option, every effort should be made to pursue minimally invasive approaches. All obstetricians and gynecologists should be familiar with alternatives and "less invasive" options for patients who refuse blood transfusions.

  5. Property and privacy paradigms of "marketable spit": an ethical and legal counterpart to blood?

    PubMed

    Vernillo, Anthony Thomas; Wolpe, Paul Root

    2010-01-01

    Major advances in the testing of oral fluid (e.g., saliva) may lead to the diagnosis and treatment of previously undiagnosed conditions and may enable dentists to manage oral disease more effectively. Such use of another body fluid, blood, is already well established. Blood is a complex tissue that has been extensively researched and is now used for a wide variety of diagnostic tests. It is also regarded as a form of property with ethical and legal dimensions. If saliva is to fulfill a similar role, it should perhaps be granted those same protections. This paper advances the concept that saliva should be considered a form of property, possibly within personal biological materials law. The emerging potential for the development of marketable products from oral fluids raises the issue of protecting the research participant's ethical and legal rights. In particular, violation of privacy and genetic discrimination may arise from the testing of salivary DNA. Respect for autonomy requires that the clinician inform a patient or research participant about his or her rights to property and privacy as these may pertain to oral fluid.

  6. Regulating Gamete Donation in the U.S.: Ethical, Legal and Social Implications

    PubMed Central

    Sabatello, Maya

    2015-01-01

    This article explores the practice of gamete donation in the U.S. having in mind the larger question of what do we as a society owe children born as a result (donor-conceived children). Do recipient-parents have a duty to tell their donor-conceived child about his/her genetic origins? Should the identity of the donor be disclosed or remain anonymous? Does the child have a right to know her conception story and to receive information, including identifying information, about the donor? Furthermore, if a donor-conceived child has a right to know, who has the duty to tell her/him about it? The Article underscores the ethical, legal and social dilemmas that arise, comparing and contrasting with international developments in this arena. It highlights the market-based and more specific medical justifications for regulating this field, explores the emerging so-called right of the child to know his/her genetic origins (“the right to know”), and considers the challenges such a right evokes to existing legal culture and principles of medical ethics in the U.S. as well as other broader societal implications of such a right. PMID:26388996

  7. Biomedical research involving patients with disorders of consciousness: ethical and legal dimensions.

    PubMed

    Farisco, Michele; Evers, Kathinka; Petrini, Carlo

    2014-01-01

    THE DIRECTIVE 2001/20/UE AND THE RESEARCH INVOLVING PATIENTS WITH DOCS: Research involving patients with disorders of consciousness (DOCs) deserves special ethical and legal attention because of its Janus-faced nature. On the one hand, it raises concerns about the risk to expose the involved subjects to disproportionate risks not respecting their individual dignity, particularly their right to be cared for; on the other hand, research is an essential tool in order to improve the clinical condition of patients with DOCs. The present paper concerns the ethical and legal dimensions of biomedical research involving patients with disorders of consciousness. In particular, it focuses on informed consent to experimental treatments, which is a challenging issue both from an ethical and legal point of view. The first part reads the Directive 2001/20/EU in the light of the experimentation of patients with DOCs, and suggests a revision in order to better assess the issue of informed consent. THE PARTICULAR CASE OF INFORMED CONSENT FOR OBSERVATIONAL STUDIES OF NON-COMMUNICATIVE PATIENTS: The second part presents an informed consent form for studies through video-recording of patients unable to communicate their own consent. This form has been elaborated by the bioethics unit of the project "Review of the nosography of vegetative states: application of methods of behavioral analysis to individuals in coma or vegetative state" developed at the Italian National Institute of Health. RELEVANCE OF THE SUGGESTED FORM: The paper describes the conceptual framework of the form for informed consent to studies through video-recoding, which is a relevant example of what issues should be included in an informed consent for any type of studies through video-recording of patients unable to express their own consent. The article has been sent on November the 7th 2013, before the adoption of the Regulation (EU) no. 536/2014 (and consequent abrogation of the Directive 2001/20/EU) and the release

  8. Legal and ethical issues in neuroimaging research: human subjects protection, medical privacy, and the public communication of research results.

    PubMed

    Kulynych, Jennifer

    2002-12-01

    Humans subjects research entails significant legal and ethical obligations. Neuroimaging researchers must be familiar with the requirements of human subjects protection, including evolving standards for the protection of privacy and the disclosure of risk in "non-therapeutic" research. Techniques for creating veridical surface renderings from volumetric anatomical imaging data raise new privacy concerns, particularly under the federal medical privacy regulation. Additionally, neuroimaging researchers must consider their obligation to communicate research results responsibly. The emerging field of neuroethics should strive to raise awareness of these issues and to involve neuroimaging researchers in the legal, ethical, and policy debates that currently surround human subjects research.

  9. Should DBS for Psychiatric Disorders be Considered a Form of Psychosurgery? Ethical and Legal Considerations.

    PubMed

    Stahl, Devan; Cabrera, Laura; Gibb, Tyler

    2017-06-26

    Deep brain stimulation (DBS), a surgical procedure involving the implantation of electrodes in the brain, has rekindled the medical community's interest in psychosurgery. Whereas many researchers argue DBS is substantially different from psychosurgery, we argue psychiatric DBS-though a much more precise and refined treatment than its predecessors-is nevertheless a form of psychosurgery, which raises both old and new ethical and legal concerns that have not been given proper attention. Learning from the ethical and regulatory failures of older forms of psychosurgery can help shed light on how to address the regulatory gaps that exist currently in DBS research. To show why it is important to address the current regulatory gaps within psychiatric DBS, we draw on the motivations underlying the regulation of earlier forms of psychosurgery in the US. We begin by providing a brief history of psychosurgery and electrical brain stimulation in the US. Against this backdrop, we introduce psychiatric DBS, exploring current research and ongoing clinical trials. We then draw out the ethical and regulatory similarities between earlier forms of psychosurgery and psychiatric DBS. As we will show, the factors that motivated strict regulation of earlier psychosurgical procedures mirror concerns with psychiatric DBS today. We offer three recommendations for psychiatric DBS regulation, which echo earlier motivations for regulating psychosurgery, along with new considerations that reflect the novel technologies used in DBS.

  10. Ethical and legal issues regarding consent in research with adult stroke patients: case study in the ethics of mental health research.

    PubMed

    Pope, Anne

    2012-03-01

    This case study describes research into interventions to enhance stroke patients' ability to communicate. Because patients' cognitive abilities are compromised, it is argued that they may lack the capacity to consent and that surrogate consent should be required. In South Africa, this would make conducting the research difficult because only court-appointed curators are "legally appropriate" substitutes for research enrolment. Here, the research ethics committee must balance legal requirements and ethical concerns. It must also balance protection and respect for autonomy, even for cognitively compromised participants. First, incapacity should not simply be assumed but should be individually assessed. However, stroke patients present a further complication for capacity assessment because they may retain the capacity to reason but have lost the ability to communicate effectively. Second, the research ethics committee must decide whether recruitment should be restricted or whether incapacitated participants may be enrolled. Given the low risk of harm, incapacitated persons could be enrolled by proxies.

  11. A Selected Annotated Bibliography on Speech Ghostwriting: Its Principles, Practices and Ethics.

    ERIC Educational Resources Information Center

    Starr, Douglas P.

    The author presents a fully annotated bibliography of 80 items relating to the subject of ghostwriting of public addresses and other forms of persuasive communication. Most of the items deal with ghostwriting in the areas of political persuasion and public relations, although some general entries are included. Topics of the material range from…

  12. [Involuntary treatment of mental patients in the community: legal and ethical dilemmas].

    PubMed

    Mitrossili, M

    2014-01-01

    continues to divide the psychiatric and legal word for it causes intense questioning from a legal, ethical, deontological and clinical aspect, as it offends fundamental rights of the individual. In a legal civilization, in which the principle of informed consent or refusal constitutes a basic rule of the lawfulness of the medical and psychiatric act, any divergence from this rule has consequences for the patients and affects a well-tempered therapeutic treatment. The above mentioned measure could be counterbalanced by the legal regulation of advance directives and the provision for the appointment of a proxy person by the mental patient.

  13. Keeping Kids Safe from a Design Perspective: Ethical and Legal Guidelines for Designing a Video-Based App for Children

    ERIC Educational Resources Information Center

    Zydney, Janet Mannheimer; Hooper, Simon

    2015-01-01

    Educators can use video to gain invaluable information about their students. A concern is that collecting videos online can create an increased security risk for children. The purpose of this article is to provide ethical and legal guidelines for designing video-based apps for mobile devices and the web. By reviewing the literature, law, and code…

  14. Keeping Kids Safe from a Design Perspective: Ethical and Legal Guidelines for Designing a Video-Based App for Children

    ERIC Educational Resources Information Center

    Zydney, Janet Mannheimer; Hooper, Simon

    2015-01-01

    Educators can use video to gain invaluable information about their students. A concern is that collecting videos online can create an increased security risk for children. The purpose of this article is to provide ethical and legal guidelines for designing video-based apps for mobile devices and the web. By reviewing the literature, law, and code…

  15. Prison Field Trips: Can White-Collar Criminals Positively Affect the Ethical and Legal Behavior of Marketing and MBA Students?

    ERIC Educational Resources Information Center

    Castleberry, Stephen B.

    2007-01-01

    Marketing educators bear some responsibility for teaching ethics and legal issues to their students. Visits to white-collar criminals in a federal prison camp are one method of achieving this task. This article develops and empirically assesses ten objectives for such a visit by MBA and undergraduate marketing classes. Undergraduates rated the…

  16. Prison Field Trips: Can White-Collar Criminals Positively Affect the Ethical and Legal Behavior of Marketing and MBA Students?

    ERIC Educational Resources Information Center

    Castleberry, Stephen B.

    2007-01-01

    Marketing educators bear some responsibility for teaching ethics and legal issues to their students. Visits to white-collar criminals in a federal prison camp are one method of achieving this task. This article develops and empirically assesses ten objectives for such a visit by MBA and undergraduate marketing classes. Undergraduates rated the…

  17. Using Critical Literacy to Explore Genetics and Its Ethical, Legal, and Social Issues with In-Service Secondary Teachers

    ERIC Educational Resources Information Center

    Gleason, Michael L.; Melancon, Megan E.; Kleine, Karynne L. M.

    2010-01-01

    The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by…

  18. Using Critical Literacy to Explore Genetics and Its Ethical, Legal, and Social Issues with In-Service Secondary Teachers

    ERIC Educational Resources Information Center

    Gleason, Michael L.; Melancon, Megan E.; Kleine, Karynne L. M.

    2010-01-01

    The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by…

  19. Points to Consider: Ethical, Legal, and Psychosocial Implications of Genetic Testing in Children and Adolescents

    PubMed Central

    Botkin, Jeffrey R.; Belmont, John W.; Berg, Jonathan S.; Berkman, Benjamin E.; Bombard, Yvonne; Holm, Ingrid A.; Levy, Howard P.; Ormond, Kelly E.; Saal, Howard M.; Spinner, Nancy B.; Wilfond, Benjamin S.; McInerney, Joseph D.

    2015-01-01

    In 1995, the American Society of Human Genetics (ASHG) and American College of Medical Genetics and Genomics (ACMG) jointly published a statement on genetic testing in children and adolescents. In the past 20 years, much has changed in the field of genetics, including the development of powerful new technologies, new data from genetic research on children and adolescents, and substantial clinical experience. This statement represents current opinion by the ASHG on the ethical, legal, and social issues concerning genetic testing in children. These recommendations are relevant to families, clinicians, and investigators. After a brief review of the 1995 statement and major changes in genetic technologies in recent years, this statement offers points to consider on a broad range of test technologies and their applications in clinical medicine and research. Recommendations are also made for record and communication issues in this domain and for professional education. PMID:26140447

  20. Legal and ethical issues in the use of anonymous images in pathology teaching and research.

    PubMed

    Tranberg, H A; Rous, B A; Rashbass, J

    2003-02-01

    The privacy of patients' health information is of paramount importance. However, it is equally important that medical staff and students have access to photographs and video recordings of real patients for training purposes. Where the patient can be identified from such images, his or her consent is clearly required to both obtain the image and to use it in this way. However, the need for consent, both legally and ethically, is much less convincing where the patient cannot, by the very nature of the image, be identified from it. This is the case for many images used in the teaching of clinical medicine, such as videos taken of laparoscopies, images of internal organs and unlabelled X-rays.

  1. Denial of pregnancy – a literature review and discussion of ethical and legal issues

    PubMed Central

    Jenkins, Angela; Millar, Simon; Robins, James

    2011-01-01

    Denial of pregnancy is an important condition that is more common than expected, with an incidence at 20 weeks gestation of approximately 1 in 475. The proportion of cases persisting until delivery is about 1 in 2500, a rate similar to that of eclampsia. Denial of pregnancy poses adverse consequences including psychological distress, unassisted delivery and neonaticide. It is difficult to predict which women will develop denial of pregnancy. There are a number of forms of denial of pregnancy, including psychotic and non-psychotic variants. Denial of pregnancy is a ‘red flag’ that should trigger referral for psychiatric assessment. A national registry may help to provide more information about this condition and implement appropriate care. This condition poses challenging legal and ethical issues including assessment of maternal capacity, evaluation of maternal (and possibly fetal) best interests and the possibility of detention in hospital. PMID:21725094

  2. Teaching spiritual care in a public institution: legal implications, standards of practice, and ethical obligations.

    PubMed

    Lantz, Cheryl M

    2007-01-01

    This article reviews the status of teaching spiritual care in a public institution of higher education. The resurgence of interest in spiritual care across the United States has spurred interest and expanded theories of spirituality within the nursing profession. Nursing education rose to the challenge of teaching spiritual care theories and interventions to students, despite the absence of policy to guide educators. However, differences between public and private educational institutions have led to variations in the teaching of spiritual care. In addition to the legal implications stemming from the need for separation of church and state, nurses must also be aware of their ethical obligations in order to teach spiritual care concepts appropriately. The accrediting agencies for nursing education programs and hospitals, as well as state licensure boards, foster high expectations for nurses to provide spiritual care. A call for research and policy development to guide nurse educators is also addressed in this article.

  3. Vaccinating Health Care Workers Against Influenza: The Ethical and Legal Rationale for a Mandate

    PubMed Central

    Wu, Joel T.; Poland, Gregory A.; Jacobson, Robert M.; Koenig, Barbara A.; Tilburt, Jon C.

    2011-01-01

    Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza vaccination rates for health care workers have remained unacceptably low for more than three decades, adversely affecting patient safety. When public health is jeopardized, and a safe, low-cost, and effective method to achieve patient safety exists, health care organizations and public health authorities have a responsibility to take action and change the status quo. Mandatory influenza vaccination for health care workers is supported not only by scientific data but also by ethical principles and legal precedent. The recent influenza pandemic provides an opportunity for policymakers to reconsider the benefits of mandating influenza vaccination for health care workers, including building public trust, enhancing patient safety, and strengthening the health care workforce. PMID:21228284

  4. The complex legal and ethical issues related to generic medications. Viral hepatitis: a case study.

    PubMed

    Danta, M; Ghinea, N

    2017-04-01

    The economic impact of medications is significant, with many countries unable to afford the essential medicines listed by the WHO. Generic medications are one strategy to address this issue. Generic medications are similar to but not the same as originator medications. They have a significant cost advantage because they do not require the background research and development studies to support registration. Consequently, they are gaining increased market share in both the developed and developing world. Many new medications are now licensed to generic manufacturers in the developing world. As a result, it is possible for patients to bypass regulatory and cost barriers by importing medications directly from generic producers. Importation of the novel hepatitis C direct-acting antiviral therapy into Australia before it was registered in the country is an illustrative case study. This review will characterise generic medications and some of the legal and ethical issues around their utilisation, focusing on the relevant players, including pharma, government, patients and doctors.

  5. Immunization for prevention and treatment of cocaine abuse: legal and ethical implications.

    PubMed

    Cohen, P J

    1997-12-15

    A cocaine vaccine, currently under investigation by several laboratories, would be an innovative and exciting means of treating and preventing cocaine addiction. However, an approved vaccine will raise at least two major areas of concern. (1) Loss of privacy: cocaine antibodies might be used as a marker to identify, penalize, and stigmatize vaccinated individuals. (2) Selection for vaccination: should immunization be voluntary or compelled: should immunization be restricted to addicts, to those at risk of addiction, or should it be universal; should immunization be used in children? I propose to analogize cocaine addiction to an infectious disease which poses a major public health problem. This approach can provide an ethical and legal foundation on which we may begin to formulate a societal approach to the use of the cocaine vaccine.

  6. Post-traumatic stress disorder: ethical and legal relevance to the criminal justice system.

    PubMed

    Soltis, Kathryn; Acierno, Ron; Gros, Daniel F; Yoder, Matthew; Tuerk, Peter W

    2014-01-01

    Post-Traumatic Stress Disorder is a major public health concern in both civilian and military populations, across race, age, gender, and socio-economic status. While PTSD has been around for centuries by some name or another, its definition and description also continue to evolve. Within the last few years, the American Psychological Association has published the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, which includes some major changes in the diagnostic criteria for PTSD. Recent data on epidemiology, etiological theories, and empirically supported methods of treatment, as well as implications for legal processes and criminal justice system personnel, are discussed. © 2014 American Society of Law, Medicine & Ethics, Inc.

  7. Legal consequences and ethical dilemmas of pain perception in persistent vegetative states.

    PubMed

    Rifkinson-Mann, Stephanie

    2003-01-01

    "Persistent vegetative state" (PVS) describes brain-damaged patients who survive their injuries in a sleeplike, insensible state, with periodic awakenings. Due to technological advances, such individuals can sustain biological existence for prolonged periods of time. Their existence results in a dichotomy between the legal and medical interpretations of persistent vegetative states, giving rise to ethical conflicts. The author reviews the limitations in our understanding of what PVS signifies for the afflicted individual, and explores the conflicts arising from such limitations that may impact an individual's right to live or die. The author concludes that the medical community has yet to adopt consistent clinical criteria to diagnose PVS and that a universal standard for PVS is needed to avoid the abuse of vegetative individuals' rights.

  8. Denial of pregnancy: a literature review and discussion of ethical and legal issues.

    PubMed

    Jenkins, Angela; Millar, Simon; Robins, James

    2011-07-01

    Denial of pregnancy is an important condition that is more common than expected, with an incidence at 20 weeks gestation of approximately 1 in 475. The proportion of cases persisting until delivery is about 1 in 2500, a rate similar to that of eclampsia. Denial of pregnancy poses adverse consequences including psychological distress, unassisted delivery and neonaticide. It is difficult to predict which women will develop denial of pregnancy. There are a number of forms of denial of pregnancy, including psychotic and non-psychotic variants. Denial of pregnancy is a 'red flag' that should trigger referral for psychiatric assessment. A national registry may help to provide more information about this condition and implement appropriate care. This condition poses challenging legal and ethical issues including assessment of maternal capacity, evaluation of maternal (and possibly fetal) best interests and the possibility of detention in hospital.

  9. Legal, ethical, and human rights considerations for physicians treating children with atypical or ambiguous genitalia.

    PubMed

    Greenberg, Julie A

    2017-06-01

    Some governments, human rights organizations, intersex organizations, and doctors have called for a moratorium on genital and gonadal surgeries for infants born with atypical or ambiguous genitalia. Moratorium supporters believe that the surgeries carry physical and emotional risks, the psychosocial benefits of these procedures have not been proven, and the surgeries violate the patients׳ fundamental human rights if they are performed before these patients can provide informed consent. Given these calls for a moratorium, treatment teams must determine how to treat their patients and how to counsel their patients׳ parents. This article examines the treatment teams׳ ethical and legal responsibilities and provides advice for treatment teams to follow that will protect their patients and their practices. Copyright © 2017. Published by Elsevier Inc.

  10. Developing and implementing clinical practice tools: the legal and ethical implications.

    PubMed

    Keogh, S J; Courtney, M

    2001-12-01

    The complexity of health care is ever increasing, as is the volume of research and literature available. In response there has been a corresponding emphasis on basing clinical decisions on the best available research evidence. The development and implementation of clinical practice tools is cited as a means of ensuring research utilisation as well as moderating variations in clinical practice. It is important that nurses contribute to the development of these clinical tools in order to actively shape their own practice. Nurses therefore need to have an understanding of the terminology and processes involved, and the implications for practice. This paper outlines definitions of the various clinical tools, the development process, and the legal and ethical implications of clinical practice tools.

  11. Practical legal and ethical considerations for the provision of acute disaster mental health services.

    PubMed

    Call, John A; Pfefferbaum, Betty; Jenuwine, Michael J; Flynn, Brian W

    2012-01-01

    Mental health professionals who provide emergency psychosocial assistance in the immediate aftermath of disasters do so in the midst of crisis and chaos. Common roles undertaken by disaster mental health professionals include treating existing conditions of disaster survivors and providing psychosocial support to front line responders and those acutely affected. Other roles include participating in multidisciplinary health care teams as well as monitoring and supporting team members' mental health. When, in the immediate aftermath of a disaster, mental health professionals provide such assistance, they may take on legal and ethical responsibilities that they are not fully aware of or do not fully comprehend. Unfortunately, not much has been written about these obligations, and professional organizations have provided little guidance. Thus, the purpose of the present article is to outline and discuss an analysis framework and suggest recommendations that mental health professionals can use to help guide their actions during the chaos immediate post disaster.

  12. Ethical, legal, and social implications of incorporating genomic information into electronic health records

    PubMed Central

    Hazin, Ribhi; Brothers, Kyle B.; Malin, Bradley A.; Koenig, Barbara A.; Sanderson, Saskia C.; Rothstein, Mark A.; Williams, Marc S.; Clayton, Ellen W.; Kullo, Iftikhar J.

    2014-01-01

    The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk. PMID:24030434

  13. Ethical, legal, and social implications of incorporating genomic information into electronic health records.

    PubMed

    Hazin, Ribhi; Brothers, Kyle B; Malin, Bradley A; Koenig, Barbara A; Sanderson, Saskia C; Rothstein, Mark A; Williams, Marc S; Clayton, Ellen W; Kullo, Iftikhar J

    2013-10-01

    The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk.

  14. Ethical, Legal, and Administrative Considerations for Preparticipation Evaluation for Wilderness Sports and Adventures.

    PubMed

    Young, Craig C; Campbell, Aaron D; Lemery, Jay; Young, David S

    2015-12-01

    Preparticipation evaluations (PPEs) are common in team, organized, or traditional sports but not common in wilderness sports or adventures. Regarding ethical, legal, and administrative considerations, the same principles can be used as in traditional sports. Clinicians should be trained to perform such a PPE to avoid missing essential components and to maximize the quality of the PPE. In general, participants' privacy should be observed; office-based settings may be best for professional and billing purposes, and adequate documentation of a complete evaluation, including clearance issues, should be essential components. Additional environmental and personal health issues relative to the wilderness activity should be documented, and referral for further screening should be made as deemed necessary, if unable to be performed by the primary clinician. Travel medicine principles should be incorporated, and recommendations for travel or adventure insurance should be made.

  15. Ethical, Legal, and Administrative Considerations for Preparticipation Evaluation for Wilderness Sports and Adventures.

    PubMed

    Young, Craig C; Campbell, Aaron D; Lemery, Jay; Young, David S

    2015-09-01

    Preparticipation evaluations (PPEs) are common in team, organized, or traditional sports but not common in wilderness sports or adventures. Regarding ethical, legal, and administrative considerations, the same principles can be used as in traditional sports. Clinicians should be trained to perform such a PPE to avoid missing essential components and to maximize the quality of the PPE. In general, participants' privacy should be observed; office-based settings may be best for professional and billing purposes, and adequate documentation of a complete evaluation, including clearance issues, should be essential components. Additional environmental and personal health issues relative to the wilderness activity should be documented, and referral for further screening should be made as deemed necessary, if unable to be performed by the primary clinician. Travel medicine principles should be incorporated, and recommendations for travel or adventure insurance should be made.

  16. Scientific, legal, and ethical challenges of end-of-life organ procurement in emergency medicine.

    PubMed

    Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan L

    2010-09-01

    We review (1) scientific evidence questioning the validity of declaring death and procuring organs in heart-beating (i.e., neurological standard of death) and non-heart-beating (i.e., circulatory-respiratory standard of death) donation; (2) consequences of collaborative programs realigning hospital policies to maximize access of procurement coordinators to critically and terminally ill patients as potential donors on arrival in emergency departments; and (3) ethical and legal ramifications of current practices of organ procurement on patients and their families. Relevant publications in peer-reviewed journals and government websites. Scientific evidence undermines the biological criteria of death that underpin the definition of death in heart-beating (i.e., neurological standard) and non-heart-beating (i.e., circulatory-respiratory standard) donation. Philosophical reinterpretation of the neurological and circulatory-respiratory standards in the death statute, to avoid the appearance of organ procurement as an active life-ending intervention, lacks public and medical consensus. Collaborative programs bundle procurement coordinators together with hospital staff for a team-huddle and implement a quality improvement tool for a Rapid Assessment of Hospital Procurement Barriers in Donation. Procurement coordinators have access to critically ill patients during the course of medical treatment with no donation consent and with family or surrogates unaware of their roles. How these programs affect the medical care of these patients has not been studied. Policies enforcing end-of-life organ procurement can have unintended consequences: (1) erosion of care in the patient's best interests, (2) lack of transparency, and (3) ethical and legal ramifications of flawed standards of declaring death. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  17. Ethical and legal duty of anesthesiologists regarding Jehovah's Witness patient: care protocol.

    PubMed

    Takaschima, Augusto Key Karazawa; Sakae, Thiago Mamôru; Takaschima, Alexandre Karazawa; Takaschima, Renata Dos Santos Teodoro; Lima, Breno José Santiago Bezerra de; Benedetti, Roberto Henrique

    Jehovah's Witnesses patients refuse blood transfusions for religious reasons. Anesthesiologists must master specific legal knowledge to provide care to these patients. Understanding how the Law and the Federal Council of Medicine treat this issue is critical to know how to act in this context. The aim of this paper was to establish a treatment protocol for the Jehovah's Witness patient with emphasis on ethical and legal duty of the anesthesiologist. The article analyzes the Constitution, Criminal Code, resolutions of the Federal Council of Medicine, opinions, and jurisprudence to understand the limits of the conflict between the autonomy of will of Jehovah's Witnesses to refuse transfusion and the physician's duty to provide the transfusion. Based on this evidence, a care protocol is suggested. The Federal Council of Medicine resolution 1021/1980, the penal code Article 135, which classifies denial of care as a crime and the Supreme Court decision on the HC 268,459/SP process imposes on the physician the obligation of blood transfusion when life is threatened. The patient's or guardian's consent is not necessary, as the autonomy of will manifestation of the Jehovah's Witness patient refusing blood transfusion for himself and relatives, even in emergencies, is no not forbidden. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  18. Ethical, legal and social issues for personal health records and applications.

    PubMed

    Cushman, Reid; Froomkin, A Michael; Cava, Anita; Abril, Patricia; Goodman, Kenneth W

    2010-10-01

    Robert Wood Johnson Foundation's Project HealthDesign included funding of an ethical, legal and social issues (ELSI) team, to serve in an advisory capacity to the nine design projects. In that capacity, the authors had the opportunity to analyze the personal health record (PHR) and personal health application (PHA) implementations for recurring themes. PHRs and PHAs invert the long-standing paradigm of health care institutions as the authoritative data-holders and data-processors in the system. With PHRs and PHAs, the individual is the center of his or her own health data universe, a position that brings new benefits but also entails new responsibilities for patients and other parties in the health information infrastructure. Implications for law, policy and practice follow from this shift. This article summarizes the issues raised by the first phase of Project HealthDesign projects, categorizing them into four topics: privacy and confidentiality, data security, decision support, and HIPAA and related legal-regulatory requirements. Discussion and resolution of these issues will be critical to successful PHR/PHA implementations in the years to come.

  19. [Ethical and legal duty of anesthesiologists regarding Jehovah's Witness patient: care protocol].

    PubMed

    Takaschima, Augusto Key Karazawa; Sakae, Thiago Mamôru; Takaschima, Alexandre Karazawa; Takaschima, Renata Dos Santos Teodoro; de Lima, Breno José Santiago Bezerra; Benedetti, Roberto Henrique

    Jehovah's Witnesses patients refuse blood transfusions for religious reasons. Anesthesiologists must master specific legal knowledge to provide care to these patients. Understanding how the Law and the Federal Council of Medicine treat this issue is critical to know how to act in this context. The aim of this paper was to establish a treatment protocol for the Jehovah's Witness patient with emphasis on ethical and legal duty of the anesthesiologist. The article analyzes the Constitution, Criminal Code, resolutions of the Federal Council of Medicine (FCM), opinions, and jurisprudence to understand the limits of the conflict between the autonomy of will of Jehovah's Witnesses to refuse transfusion and the physician's duty to provide the transfusion. Based on this evidence, a care protocol is suggested. The FCM resolution 1021/1980, the penal code Article 135, which classifies denial of care as a crime and the Supreme Court decision on the HC 268,459/SP process imposes on the physician the obligation of blood transfusion when life is threatened. The patient's or guardian's consent is not necessary, as the autonomy of will manifestation of the Jehovah's Witness patient refusing blood transfusion for himself and relatives, even in emergencies, is no not forbidden. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. Ethical, legal, and social aspects of farm animal cloning in the 6th Framework Programme for Research.

    PubMed

    Claxton, John; Sachez, Elena; Matthiessen-Guyader, Line

    2004-01-01

    Cloned livestock have potential importance in the provision of improved medicine as well as in the development of livestock production. The public is, however, increasingly concerned about the social and ethical consequences of these advances in knowledge and techniques. There is unevenness throughout Europe in different Member States' attitudes to research into livestock cloning. Although there is EU legislation controlling the use of animals for research purposes, there is no legislation specifically governing cloning in livestock production. The main EU reference is the 9th Opinion of the European Group on Ethics, which states "Cloning of farm animals may prove to be of medical and agricultural as well as economic benefit. It is acceptable only when the aims and methods are ethically justified and when carried out under ethical conditions." The ethical justification includes the avoidance of suffering, the use of the 3Rs principle and a lack of better alternatives. The Commission addresses these issues in the 6th Framework Programme by promoting the integration of ethical, legal and social aspects in all proposals where they are relevant, by fostering ethical awareness and foresight in the proposals, by encouraging public dialogue, and by supporting specific actions to promote the debate. Research must respect fundamental ethical principles, including animal welfare requirements.

  1. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program

    PubMed Central

    Meagher, Karen M.

    2016-01-01

    Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation—deliberative public bioethics—into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice. PMID:26843669

  2. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program.

    PubMed

    Meagher, Karen M; Lee, Lisa M

    2016-01-01

    Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation--deliberative public bioethics--into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice.

  3. Legal and ethical issues in genetic testing and counseling for susceptibility to breast, ovarian and colon cancer.

    PubMed Central

    Dickens, B M; Pei, N; Taylor, K M

    1996-01-01

    The prediction of susceptibility to heritable breast, ovarian and colon cancer raises important legal and ethical concerns. Health care professionals have a duty to disclose sufficient information to enable patients to make informed decisions. They must also safeguard the confidentiality of patient data. These duties may come into conflict if a positive finding in one patient implies that family members are also at risk. A legal distinction is made between a breach of confidentiality and the legitimate sharing of information in a patient's interest or to prevent harm to a third party. Physicians also have a fiduciary duty to warn. Other issues concern the legal liability assumed by genetic counsellors, whose disclosures may influence decisions about childbearing, for example, and the risk of socioeconomic discrimination faced by people with a known genetic susceptibility. Traditional ethical orientations and principals may be applied to these and other questions, but feminist ethics will likely have particular importance in the development of an ethical stance toward testing and counseling for heritable breast and ovarian cancer. PMID:8634959

  4. Sharing the air, the legal and ethical considerations of extending tobacco legislation to include multiunit dwellings in Alberta.

    PubMed

    Stooke, Victoria D

    2014-01-01

    This study explores the legal and ethical considerations of extending tobacco legislation to include multiunit dwellings (MUDs) in Alberta and the implications for public health nursing practice. The tobacco legislation in Canada currently protects individuals in public places and not private dwellings. In Alberta, there are over 1 million individuals living in MUDs who are exposed to environmental tobacco smoke. Children are particularly vulnerable to the negative health effects. As well, many apartment fires in Alberta are related to smoking which makes expanding tobacco legislation to include MUDs an important public health issue. There are many potential barriers to the adoption of this tobacco legislation including legal, ethical, and civil rights concerns, and the bureaucracy of the political process. This study articulates the position that it is both legal and ethical to expand provincial tobacco legislation to include MUDs after the consideration of individual civil rights and using the Canadian Nurses Association Code of Ethics for Registered Nurses (2008) as a guide for practice. Public health nurses must advocate for a change in the current legislation by becoming politically active and building community capacity to demonstrate accountability and promote social justice. © 2013 Wiley Periodicals, Inc.

  5. Trafficking in Human Beings for the Purpose of Organ Removal and the Ethical and Legal Obligations of Healthcare Providers.

    PubMed

    Caulfield, Timothy; Duijst, Wilma; Bos, Mike; Chassis, Iris; Codreanu, Igor; Danovitch, Gabriel; Gill, John; Ivanovski, Ninoslav; Shin, Milbert

    2016-02-01

    Physicians and other health care professionals seem well placed to play a role in the monitoring and, perhaps, in the curtailment of the trafficking in human beings for the purpose of organ removal. They serve as important sources of information for patients and may have access to information that can be used to gain a greater understanding of organ trafficking networks. However, well-established legal and ethical obligations owed to their patients can create challenging policy tensions that can make it difficult to implement policy action at the level of the physician/patient. In this article, we explore the role-and legal and ethical obligations-of physicians at 3 key stages of patient interaction: the information phase, the pretransplant phase, and the posttransplant phase. Although policy challenges remain, physicians can still play a vital role by, for example, providing patients with a frank disclosure of the relevant risks and harms associated with the illegal organ trade and an honest account of the physician's own moral objections. They can also report colleagues involved in the illegal trade to an appropriate regulatory authority. Existing legal and ethical obligations likely prohibit physicians from reporting patients who have received an illegal organ. However, given the potential benefits that may accrue from the collection of more information about the illegal transactions, this is an area where legal reform should be considered.

  6. Trafficking in Human Beings for the Purpose of Organ Removal and the Ethical and Legal Obligations of Healthcare Providers

    PubMed Central

    Caulfield, Timothy; Duijst, Wilma; Bos, Mike; Chassis, Iris; Codreanu, Igor; Danovitch, Gabriel; Gill, John; Ivanovski, Ninoslav; Shin, Milbert

    2016-01-01

    Abstract Physicians and other health care professionals seem well placed to play a role in the monitoring and, perhaps, in the curtailment of the trafficking in human beings for the purpose of organ removal. They serve as important sources of information for patients and may have access to information that can be used to gain a greater understanding of organ trafficking networks. However, well-established legal and ethical obligations owed to their patients can create challenging policy tensions that can make it difficult to implement policy action at the level of the physician/patient. In this article, we explore the role—and legal and ethical obligations—of physicians at 3 key stages of patient interaction: the information phase, the pretransplant phase, and the posttransplant phase. Although policy challenges remain, physicians can still play a vital role by, for example, providing patients with a frank disclosure of the relevant risks and harms associated with the illegal organ trade and an honest account of the physician's own moral objections. They can also report colleagues involved in the illegal trade to an appropriate regulatory authority. Existing legal and ethical obligations likely prohibit physicians from reporting patients who have received an illegal organ. However, given the potential benefits that may accrue from the collection of more information about the illegal transactions, this is an area where legal reform should be considered. PMID:27500253

  7. Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology.

    PubMed

    Kunde, Lauren; McMeniman, Erin; Parker, Malcolm

    2013-08-01

    Clinical photography has long been an important aspect in the management of dermatological pathology and has many applications in contemporary dermatology practice. With the continuous evolution of digital and smartphone technology, clinicians must maintain ethical and medico-legal standards. This article reviews how dermatology trainees are utilising this technology in their clinical practice and what procedures they follow when taking photos of patients. We review the ethical and legal considerations of clinical photography in dermatology and present a hypothetical medico-legal scenario. Dermatology registrars were surveyed on their use of personal smartphones and digital equipment for photographing patients in their clinical practice. Numerous medico-legal providers were approached to provide medico-legal advice about a hypothetical scenario. We found that the use of these technologies is prevalent among dermatology registrars and all respondents reported regular use. Clinicians should routinely obtain and document adequate patient consent in relation to clinical photography, utilise strict privacy settings on smartphones and other digital devices and ensure that the images are stored on these devices for minimal periods. Express consent documentation in the clinical file puts the clinician in a more defensible position if a complaint is made to the medical board or privacy commissioner. © 2013 The Authors. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.

  8. Resolving the "egg supply problem" in human embryonic stem cell derivation through technical means--a legal and ethical analysis.

    PubMed

    Hammond, Natasha; Holm, Søren

    2008-03-01

    This paper seeks to briefly discuss the legal and ethical problems connected to scientific developments in the field of human embryonic stem cell derivation aimed at solving the "egg supply problem" in stem cell research. The legal situation is discussed in respect of the UK's current regulatory regime, proposed reform and the Oviedo Convention. The scientific developments which are examined are chimeric embryos, in vitro maturation of oocytes, derivation of stem cell lines in connection with pre-implantation genetic diagnosis and the derivation of oocytes from existing stem cell lines.

  9. Aid-in-dying practice in Europe and the United States: Legal and ethical perspectives for pharmacy.

    PubMed

    Varadarajan, Ranjani; Freeman, Robert A; Parmar, Jayesh R

    This article briefly reviews 'aid-in-dying' options such as euthanasia and physician-assisted suicide in Europe and the US Physician-assisted suicide is now legal in four US States. Current practices, medications used and statistics relating to prescription frequency and death rates from the participating States are briefly discussed. This paper also examines the role of pharmacists in assisted suicides; legal, ethical and professional challenges that they face, and future implications on pharmacist education to enable them to make an educated decision about their involvement in aid-in-dying practices. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Ethical, legal and social issues in newborn screening in the United States.

    PubMed

    Therrell, Bradford L

    2003-01-01

    Four million babies are born annually in the US. There are 51 separate laws mandating universal screening and each has its own restrictions. Forty-nine programs allow the parents to "opt out" of testing (dissent), and 2 programs allow the parents to "opt in" (consent). The extent to which these decisions are "informed" varies and in most cases, no information exists as to whether the parents knew or understood what the newborn screening program entailed. Most programs have educational material available describing the state program but whether this information is the information needed (in terms of literacy level and content) to provide a sufficient understanding of the program is not generally known. In most programs, testing is automatic and the program information is contained in the hospital materials given to the mother upon entry or exit from the birthing facility. All newborn screening programs are administered by the state public health agency and ultimately the state legislatures are responsible for creating the laws governing newborn screening. Financing mechanisms are complex with fees varying from $0 - $60 and not directly related to the number of disorders screened, although system components such as education, methods of sample collection, sample submission, laboratory testing, follow-up, confirmation, diagnosis, treatment, outcome and quality assurance are considered in most fee setting processes. The standards for programs have developed over the years at least partly as a result of medical-legal confrontations. During the past several years there has been a notable increase in program expansions including expanded biochemical testing and screening for hearing loss. In 1999, the Maternal and Child Health Bureau funded a newborn screening task force to review the issues facing state newborn screening systems and to make recommendations for improvements and/or changes in these systems. Two primary issues of ethical, legal and social consequence were

  11. The autism "epidemic": Ethical, legal, and social issues in a developmental spectrum disorder.

    PubMed

    Graf, William D; Miller, Geoffrey; Epstein, Leon G; Rapin, Isabelle

    2017-04-04

    Classic autism has gradually evolved into the concept of a larger "spectrum disorder." The rising prevalence of autism and autism spectrum disorder (autism/ASD) diagnoses can be largely attributed to broader diagnostic criteria, adoption of dimensional assessment strategies, increased awareness, linking of services to diagnosis, and the inclusion of milder neurodevelopmental differences bordering on normality. The spectrum disorder diagnosis raises numerous bioethical issues for individuals and society. Three groups of caregivers have important ethical, legal, and social obligations to individuals with autism/ASD: (1) families and advocates of individuals with autism/ASD; (2) health care and other professionals; and (3) governments. Each group may have different views of autism/ASD diagnostic criteria, screening, testing, and the effectiveness of various interventions. All see timely diagnosis as desirable, but earlier diagnosis may not be better, morally or practically. The growing practice of genetic testing in milder ASD raises ethical questions because of its uncertain scientific validity and limited clinical utility. Individuals with autism/ASD have various kinds of needs but all want acceptance and most deserve better accommodations. Governments struggle to provide a fair allocation of appropriate special education and supportive services. This article examines the evolving dimensions of the autism/ASD diagnosis, outlines certain bioethics principles related to its evaluation and management, reviews relevant laws and disability rights, and emphasizes the societal obligation to recognize neurodevelopmental variation and human neurodiversity. Future directions in the evaluation and care of autism/ASD should attempt to integrate the roles and responsibilities of all agents caring for each unique autistic individual.

  12. Ethical, Legal, and Clinical Considerations when Disclosing a High-Risk Syndrome for Psychosis.

    PubMed

    Mittal, Vijay A; Dean, Derek J; Mittal, Jyoti; Saks, Elyn R

    2015-10-01

    There are complex considerations when planning to disclose an attenuated psychosis syndrome (APS) diagnosis. In this review, we evaluate ethical, legal, and clinical perspectives as well as caveats related to full, non- and partial disclosure strategies, discuss societal implications, and provide clinical suggestions. Each of the disclosure strategies is associated with benefits as well as costs/considerations. Full disclosure promotes autonomy, allows for the clearest psychoeducation about additional risk factors, helps to clarify and/or correct previous diagnoses/treatments, facilitates early intervention and bolsters communication between providers but there are important considerations involving heritability, comorbidity, culture, and stigma. Non-disclosure advances nonmaleficence by limiting stigma and stress (which may inadvertently exacerbate the condition), and confusion (related to the rapidly evolving diagnosis) in a sensitive developmental period but is complicated by varying patient preferences and the possibility that, as new treatments without adverse effects become available, the risk with false positives no longer justifies the accompanying loss of autonomy. Partial disclosure balances ethical considerations by focusing on symptoms instead of labels, but evidence that laypersons may interpret this information as a pseudo-diagnosis and that symptoms alone also contribute to stigma limits the efficacy of this approach. In addition, there are notable societal considerations relating to disclosure involving conservatorship, the reach of insurance companies, and discrimination. We advocate a hybrid approach to disclosure and recommend future research aimed at understanding the effects of stigma on clinical course and a renewed focus on those help-seeking cases that do not transition but remain clinically relevant. © 2015 John Wiley & Sons Ltd.

  13. Treatment for gender dysphoria in children: the new legal, ethical and clinical landscape.

    PubMed

    Smith, Malcolm K; Mathews, Ben

    2015-02-02

    Gender dysphoria is a condition in which a child's subjectively felt identity and gender are not congruent with her or his biological sex. Because of this, the child suffers clinically significant distress or impairment in social functioning. The Family Court of Australia has recently received an increasing number of applications seeking authorisation for the provision of hormones to treat gender dysphoria in children. Some medical procedures and interventions performed on children are of such a grave nature that court authorisation must be obtained to render them lawful. These procedures are referred to as special medical procedures. Hormonal therapy for the treatment of gender dysphoria in children is provided in two stages occurring years apart. Until recently, both stages of treatment were regarded by courts as special medical treatments, meaning court authorisation had to be provided for both stages. In a significant recent development, courts have drawn a distinction between the two stages of treatment, permitting parents to consent to the first stage. In addition, it has been held that a child who is determined by a court to be Gillick competent can consent to stage 2 treatment. The new legal developments concerning treatment for gender dysphoria are of ethical, clinical and practical importance to children and their families, and to medical practitioners treating children with gender dysphoria. Medical practitioners should benefit from an understanding of the recent developments in legal principles. This will ensure that they have up-to-date information about the circumstances under which treatment may be conducted with parental consent, and those in which they must seek court authorisation.

  14. Practice paper of the Academy of Nutrition and Dietetics abstract: ethical and legal issues of feeding and hydration.

    PubMed

    Schwartz, Denise Baird; Posthauer, Mary Ellen; O'Sullivan Maillet, Julie

    2013-07-01

    It is the position of the Academy of Nutrition and Dietetics that individuals have the right to request or refuse nutrition and hydration as medical treatment. Registered dietitians should work collaboratively as part of an interprofessional team to make recommendations on providing, withdrawing, or withholding nutrition and hydration in individual cases and serve as active members of institutional ethics committees. This practice paper provides a proactive, integrated, systematic process to implement the Academy's position. The position and practice papers should be used together to address the history and supporting information of ethical and legal issues of feeding and hydration identified by the Academy. Elements of collaborative ethical deliberation are provided for pediatrics and adults and in different conditions. The process of ethical deliberation is presented with the roles and responsibilities of the registered dietitian and the dietetic technician, registered. Understanding the importance and applying concepts dealing with cultural values and religious diversity is necessary to integrate clinical ethics into nutrition care. Incorporating screening for quality-of-life goals is essential before implementing the Nutrition Care Process and improving health literacy with individual interactions. Developing institution-specific policies and procedures is necessary to accelerate the practice change with artificial nutrition, clinical ethics, and quality improvement projects to determine best practice. This paper supports the "Position of the Academy of Nutrition and Dietetics: Ethical and Legal Issues of Feeding and Hydration" published in the June 2013 issue of the Journal of the Academy of Nutrition and Dietetics. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  15. A review of the legal and ethical issues for the conduct of HIV-related research in prisons.

    PubMed

    Lazzarini, Z; Altice, F L

    2000-01-01

    This article sets the stage for future discussions of expanding prisoners' access to clinical trials in an effort to move from commentary and recommendations to changes in practice. It describes barriers to access to clinical trials, the demographics of HIV/AIDS in prisons, the unique situation posed by the potential for HIV-related research in prisons, and examines briefly the history of prisoner research in the U.S. The article considers both ethical and legal responses to clinical trials in prisons, noting the potential for and limitations of legal actions. Finally, it makes recommendations for conditions necessary to conduct ethical research in prisons and calls for more cooperation between prison systems and HIV/AIDS clinical trials researchers to make expanded access to clinical trials a reality.

  16. Willingness of the local health department workforce to respond to infectious disease events: empirical, ethical, and legal considerations.

    PubMed

    Taylor, Holly A; Rutkow, Lainie; Barnett, Daniel J

    2014-01-01

    According to the Institute of Medicine, the local health department workforce is at the hub of the public health emergency preparedness system. A growing body of research has pointed to troubling attitudinal gaps among local health department workers, a vital response cohort, regarding willingness to respond to emergent infectious disease threats, ranging from naturally occurring pandemics to bioterrorism events. A summary of relevant literature on the empirical evidence, ethical norms, and legal standards applicable to the willingness of public health professionals to respond to an infectious disease emergency is presented. Recommendations are proposed for future work to be done to bring the relevant empirical, ethical, and legal considerations together to develop practical guidance for the local response to infectious disease emergencies.

  17. The Ethical, Legal, and Social Implications Program of the National Human Genome Research Institute: reflections on an ongoing experiment.

    PubMed

    McEwen, Jean E; Boyer, Joy T; Sun, Kathie Y; Rothenberg, Karen H; Lockhart, Nicole C; Guyer, Mark S

    2014-01-01

    For more than 20 years, the Ethical, Legal, and Social Implications (ELSI) Program of the National Human Genome Research Institute has supported empirical and conceptual research to anticipate and address the ethical, legal, and social implications of genomics. As a component of the agency that funds much of the underlying science, the program has always been an experiment. The ever-expanding number of issues the program addresses and the relatively low level of commitment on the part of other funding agencies to support such research make setting priorities especially challenging. Program-supported studies have had a significant impact on the conduct of genomics research, the implementation of genomic medicine, and broader public policies. The program's influence is likely to grow as ELSI research, genomics research, and policy development activities become increasingly integrated. Achieving the benefits of increased integration while preserving the autonomy, objectivity, and intellectual independence of ELSI investigators presents ongoing challenges and new opportunities.

  18. Monitoring the worker and the community for chemical exposure and disease: legal and ethical considerations in the US.

    PubMed

    Ashford, N A

    1994-07-01

    Biomonitoring of workers and communities raises important legal and ethical concerns, but the two contexts are different. Monitoring workers is usually done by, or at the instigation of, the employer who, in law, is responsible for their health and safety. Whenever worker monitoring leads to the removal of workers, difficult issues emerge affecting labor-management relations, labor law, and discrimination law. Resulting legal and ethical questions are usually framed with the context of the employment contract or labor relationship. In contrast, public health or environmental officials may be the driving force behind biomonitoring of the community. No employer-employee relationship exists, and the doctor-patient relationship may be tenuous. The community may often request biomonitoring, but the situation is no less contentious. On the basis of an historical view of monitoring events within the US, mechanisms are suggested to promote positive interactions between employers and workers and among agencies, individuals, and groups in the monitoring of chemically contaminated communities.

  19. Patients as consumers of health care in South Africa: the ethical and legal implications.

    PubMed

    Rowe, Kirsten; Moodley, Keymanthri

    2013-03-21

    South Africa currently has a pluralistic health care system with separate public and private sectors. It is, however, moving towards a socialised model with the introduction of National Health Insurance. The South African legislative environment has changed recently with the promulgation of the Consumer Protection Act and proposed amendments to the National Health Act. Patients can now be viewed as consumers from a legal perspective. This has various implications for health care systems, health care providers and the doctor-patient relationship. Calling a recipient of health care a 'consumer' as opposed to a 'patient' has distinct connotations and may result in differential behaviour. Labels reflect the ideals of the context in which they are used. Various models of the doctor-patient relationship exist and different metaphors have been used to describe it. Increasingly there are third parties involved within the doctor-patient relationship making it more difficult for the doctor to play the fiduciary role. In certain parts of the world, there has been a shift from a traditional paternalistic model to a consumerist model. The ethical implications of the commodification of health care are complex. As health care becomes a 'product' supplied by the health care 'provider', there is the risk that doctors will replace professional ethics with those of the marketplace. Health care is a universal human need and cannot be considered a mere commodity. In modern medical ethics, great emphasis is placed on the principle of respect for patient autonomy. Patients are now the ultimate decision-makers. The new Consumer Protection Act in South Africa applies to consumers and patients alike. It enforces strict liability for harm caused by goods and services. Everyone in the supply chain, including the doctor, can be held jointly and severally liable. This may lead to enormous challenges in health care delivery. Viewing patients as consumers may be detrimental to the doctor

  20. Patients as consumers of health care in South Africa: the ethical and legal implications

    PubMed Central

    2013-01-01

    Background South Africa currently has a pluralistic health care system with separate public and private sectors. It is, however, moving towards a socialised model with the introduction of National Health Insurance. The South African legislative environment has changed recently with the promulgation of the Consumer Protection Act and proposed amendments to the National Health Act. Patients can now be viewed as consumers from a legal perspective. This has various implications for health care systems, health care providers and the doctor-patient relationship. Discussion Calling a recipient of health care a ‘consumer’ as opposed to a ‘patient’ has distinct connotations and may result in differential behaviour. Labels reflect the ideals of the context in which they are used. Various models of the doctor-patient relationship exist and different metaphors have been used to describe it. Increasingly there are third parties involved within the doctor-patient relationship making it more difficult for the doctor to play the fiduciary role. In certain parts of the world, there has been a shift from a traditional paternalistic model to a consumerist model. The ethical implications of the commodification of health care are complex. As health care becomes a ‘product’ supplied by the health care ‘provider’, there is the risk that doctors will replace professional ethics with those of the marketplace. Health care is a universal human need and cannot be considered a mere commodity. In modern medical ethics, great emphasis is placed on the principle of respect for patient autonomy. Patients are now the ultimate decision-makers. The new Consumer Protection Act in South Africa applies to consumers and patients alike. It enforces strict liability for harm caused by goods and services. Everyone in the supply chain, including the doctor, can be held jointly and severally liable. This may lead to enormous challenges in health care delivery. Summary Viewing patients as

  1. Strategies for Acing the Fundamentals and Mitigating Legal and Ethical Consequences of Poor Physician-Patient Communication.

    PubMed

    Brueck, MaryKatherine; Salib, Angelique M

    2017-03-01

    This article explores how the absence of effective verbal and nonverbal communication in the physician-patient encounter can lead to poor outcomes for patients and physicians alike. The article discusses legal and ethical topics physicians should consider during a medical encounter and provides educational and practical suggestions for improving effective communication between physicians and their patients. © 2017 American Medical Association. All Rights Reserved.

  2. PR Bibliography, 1994.

    ERIC Educational Resources Information Center

    Walker, Albert, Ed.

    1994-01-01

    Based on searches of databases and over 140 periodicals, this annotated bibliography presents a representative collection of books and journal articles related to the knowledge and practice of public relations published in 1993. The annotated bibliography is subdivided into 35 different categories, including business credibility and ethics;…

  3. PR Bibliography, 1993.

    ERIC Educational Resources Information Center

    Walker, Albert, Ed.

    1993-01-01

    Based on searches of over 200 periodicals, this annotated bibliography of books and journal articles presents material related to the knowledge and practice of public relations published in 1992. The annotated bibliography is subdivided into more than 30 different categories ranging from business ethics to writing techniques. The largest…

  4. PR Bibliography, 1994.

    ERIC Educational Resources Information Center

    Walker, Albert, Ed.

    1994-01-01

    Based on searches of databases and over 140 periodicals, this annotated bibliography presents a representative collection of books and journal articles related to the knowledge and practice of public relations published in 1993. The annotated bibliography is subdivided into 35 different categories, including business credibility and ethics;…

  5. PR Bibliography, 1993.

    ERIC Educational Resources Information Center

    Walker, Albert, Ed.

    1993-01-01

    Based on searches of over 200 periodicals, this annotated bibliography of books and journal articles presents material related to the knowledge and practice of public relations published in 1992. The annotated bibliography is subdivided into more than 30 different categories ranging from business ethics to writing techniques. The largest…

  6. The Translational Potential of Research on the Ethical, Legal and Social Implications of Genomics

    PubMed Central

    Burke, Wylie; Appelbaum, Paul; Dame, Lauren; Marshall, Patricia; Press, Nancy; Pyeritz, Reed; Sharp, Richard; Juengst, Eric

    2014-01-01

    Federally funded research on the ethical, legal and social implications of genomics (“ELSI” research) includes a programmatic charge to consider policy-relevant questions and to communicate findings in venues that help inform the policy-making process. In addressing this goal, investigators must consider the range of policies that are relevant to human genetics, how foundational research in bioethics, law, and the social sciences might inform those policies, and the potential professional issues that this translational imperative raises for ELSI investigators. We review these questions in the light of experiences from a consortium of federally funded Centers of Excellence in ELSI Research, and offer a set of policy recommendations for program design and evaluation of ELSI research. We conclude that it would be a mistake to require that ELSI research programs demonstrate a direct impact on science or health policy; however, ELSI researchers can take steps to increase the relevance of their work to policy makers. Similarly, funders of ELSI research concerned to facilitate policy development can help by building cross-disciplinary translational research capacities, and universities can take steps to make policy-relevant research more rewarding for scholars in the humanities, social sciences, and law. PMID:24946153

  7. The legal and ethical concerns that arise from using complex predictive analytics in health care.

    PubMed

    Cohen, I Glenn; Amarasingham, Ruben; Shah, Anand; Xie, Bin; Lo, Bernard

    2014-07-01

    Predictive analytics, or the use of electronic algorithms to forecast future events in real time, makes it possible to harness the power of big data to improve the health of patients and lower the cost of health care. However, this opportunity raises policy, ethical, and legal challenges. In this article we analyze the major challenges to implementing predictive analytics in health care settings and make broad recommendations for overcoming challenges raised in the four phases of the life cycle of a predictive analytics model: acquiring data to build the model, building and validating it, testing it in real-world settings, and disseminating and using it more broadly. For instance, we recommend that model developers implement governance structures that include patients and other stakeholders starting in the earliest phases of development. In addition, developers should be allowed to use already collected patient data without explicit consent, provided that they comply with federal regulations regarding research on human subjects and the privacy of health information. Project HOPE—The People-to-People Health Foundation, Inc.

  8. [Withdrawal of artificial nutrition and hydration in severe stroke: medical, legal and ethical considerations].

    PubMed

    Tannier, C; Crozier, S; Zuber, M; Constantinides, Y; Delezie, E; Gisquet, E; Grignoli, N; Lamy, C; Louvet, F; Pinel, J-F

    2015-02-01

    In the majority of cases, severe stroke is accompanied by difficulty in swallowing and an altered state of consciousness requiring artificial nutrition and hydration. Because of their artificial nature, nutrition and hydration are considered by law as treatment rather basic care. Withdrawal of these treatments is dictated by the refusal of unreasonable obstinacy enshrined in law and is justified by the risk of severe disability and very poor quality of life. It is usually the last among other withholding and withdrawal decisions which have already been made during the long course of the disease. Reaching a collegial consensus on a controversial decision such as artificial nutrition and hydration withdrawal is a difficult and complex process. The reluctance for such decisions is mainly due to the symbolic value of food and hydration, to the fear of "dying badly" while suffering from hunger and thirst, and to the difficult distinction between this medical act and euthanasia. The only way to overcome such reluctance is to ensure flawless accompaniment, associating sedation and appropriate comfort care with a clear explanation (with relatives but also caregivers) of the rationale and implications of this type of decision. All teams dealing with this type of situation must have thoroughly thought through the medical, legal and ethical considerations involved in making this difficult decision.

  9. Illicit drugs, testing, prevention and work in France: ethical and legal issues.

    PubMed

    Fantoni-Quinton, Sophie; Bossu, Bernard; Morgenroth, Thomas; Frimat, Paul

    2010-09-01

    The use of illicit drugs in the workplace raises issues pertaining to prevention and safety and the responsibility of the various members of staff. It also brings into question the interface between work and private life. If employees are in theory responsible for their own safety and risk heavy penalties in the event of the consumption of illicit drugs in the workplace, such behaviour has to be proved. In reality, the worker can only be partially and marginally held liable, given the fact that the employer is prohibited from infringing on their rights and liberties (restrictions on the searching of their personal belongings and lockers as well as on the carrying out of breath testing and saliva testing under restrictive conditions). Employers have for their part a broader range of responsibilities and, above all, an absolute obligation to achieve specific goals in terms of health and safety resulting in the need to take action. In accordance with the International Labour Organization recommendations, European and national legislation, the employer has to implement a suitable preventive policy. However, where is the balance between prevention and repression? Very few studies have raised these issues and our aim is to precisely situate the place of drug testing in the employer's repressive arsenal in France and to try to answer the legal and ethical issues raised. Thus, for example, repression can only be acceptable when it deals with moderate and non-addicted users, or it could be tantamount to discrimination.

  10. Implantable nano-neurotechnological devices: consideration of ethical, legal, and social issues and implications.

    PubMed

    Giordano, James; Akhouri, Rohan; McBride, Dennis

    2009-01-01

    Over the past decades, there has been considerable progress in the capability and application(s) of technology in the neurosciences. The tools of neurotechnology conjoin advances made in other disciplines, including nanoscience, to offer somewhat unique properties and capabilities that affect multiple dimensions of neural systems via implantable devices that afford articulation and manipulation at the subcellular scale. However, while striving for good, it is equally important to regard potential to generate major ethical, legal, and social issues (ELSI) that arise in, and from the study and applications of implantable nano-neurotechnologies. This paper discusses specific properties and uses of various nano-neurotechnologies, and addresses proximate and distal ELSI. We argue that the fusion of nano- and neuroscience and technologies give rise to unique risks and burdens, but posit that a frank precautionary principle might be unrealistic given the demiurge of progress. Rather, we call for a dialectical approach that balances technological incentives with responsibility for inquiry, application, and consequences, and advocate that potential ELSI must be appreciated early and throughout the research and development process.

  11. 'Biologizing' Psychopathy: Ethical, Legal, and Research Implications at the Interface of Epigenetics and Chronic Antisocial Conduct.

    PubMed

    Tamatea, Armon J

    2015-10-01

    Epigenetics, a field that links genetics and environmental influences on the expression of phenotypic traits, offers to increase our understanding of the development and trajectory of disease and psychological disorders beyond that thought of traditional genetic research and behavioural measures. By extension, this new perspective has implications for risk and risk management of antisocial behaviour where there is a biological component, such as psychopathy. Psychopathy is a personality disorder associated with repeat displays of antisocial behaviour, and is associated with the disproportionate imposition of harm on communities. Despite advances in our knowledge of psychopathic individuals, the construct remains complex and is hampered by a lack of integration across a range of fundamental domains. The clinical and forensic research on psychopathy is brought into conversation with the emerging field of epigenetics to highlight critical issues of (1) clinical definition and diagnosis, (2) assessment, (3) aetiology of psychopathic phenotypes, and (4) treatment and rehabilitation approaches. Broader ethical and legal questions of the role of epigenetic mechanisms in the management of psychopathy beyond the criminal justice arena are also outlined. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Ethical and legal issues in cross-system practice in India: Past, present and future.

    PubMed

    Math, Suresh Bada; Moirangthem, Sydney; Kumar, Naveen C; Nirmala, Maria Christine

    2015-01-01

    Recent changes in policies allowing practitioners of Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) to integrate into the mainstream of healthcare and also allowing practitioners of Ayurveda and Homoeopathy to perform medical termination of pregnancy (MTP) under the proposed amendment to the MTP bill have brought crosssystem practice into the limelight. We evaluate cross-system practice from its legal and ethical perspectives. Across judgments, the judiciary has held that cross-system practice is a form of medical negligence; however, it is permitted only in those states where the concerned governments have authorized it by a general or special order. Further, though a state government may authorize an alternative medicine doctor to prescribe allopathic medicines (or vice versa), it does not condone the prescription of wrong medicines or wrong diagnosis. Courts have also stated that prescribing allopathic medicines and misrepresenting these as traditional medicines is an unfair trade practice and not explaining the side-effects of a prescribed allopathic medicine amounts to medical negligence. Finally, the Supreme Court has cautioned that employing traditional medical practitioners who do not possess the required skill and competence to give allopathic treatment in hospitals and to let an emergency patient be treated by them is gross negligence. In the event of an unwanted outcome, the responsibility is completely on the hospital authorities. Therefore, there is an urgent need to abolish cross-system practice, invest in healthcare, and bring radical changes in health legislations to make right to healthcare a reality. Copyright 2015, NMJI.

  13. Launching the Greek forensic DNA database. The legal framework and arising ethical issues.

    PubMed

    Voultsos, Polychronis; Njau, Samuel; Tairis, Nikolaos; Psaroulis, Dimitrios; Kovatsi, Leda

    2011-11-01

    Since the creation of the first national DNA database in Europe in 1995, many European countries have legislated laws for initiating and regulating their own databases. The Greek government legislated a law in 2008, by which the National DNA Database of Greece was founded and regulated. According to this law, only DNA profiles from convicted criminals were recorded. Nevertheless, a year later, in 2009, the law was amended to permit the creation of an expanded database including innocent people and children. Unfortunately, the new law is very vague in many aspects and does not respect the principle of proportionality. Therefore, according to our opinion, it will soon need to be re-amended. Furthermore, prior to legislating the new law, there was no debate with the community itself in order to clarify what system would best suit Greece and what the citizens would be willing to accept. We present the current legal framework in Greece, we highlight issues that need to be clarified and we discuss possible ethical issues that may arise.

  14. Legal, ethical, and methodological considerations in the Internet-based study of child pornography offenders.

    PubMed

    Ray, James V; Kimonis, Eva R; Donoghue, Christine

    2010-01-01

    With its ever-growing penetration of remote regions of the world, the Internet provides great opportunity for conducting research. Beyond clear advantages such as increased cost-effectiveness and efficiency in collecting large samples, Internet-based research has proven particularly useful in reaching hidden or marginalized populations who engage in illegal or deviant behaviors. However, this new medium for research raises important and complex legal, ethical, and methodological/technological issues that researchers must address, particularly when studying undetected criminal behaviors. The current paper chronicles various issues that were encountered in the implementation of an active Internet-based pilot research study of child pornography (CP) users. Moreover, this study was undertaken to address a critical gap in the existing research on CP offending, which has to date primarily focused on incarcerated or convicted samples. The Internet provides the optimal medium for studying community populations of CP users, given that it has become the primary market for CP distribution. This paper is designed to serve as a guide for researchers interested in conducting Internet-based research studies on criminal and sexually deviant populations, particularly CP offenders. Several recommendations are offered based on our own experiences in the implementation of this study.

  15. Points to consider: Ethical, legal, and psychosocial implications of genetic testing in children and adolescents

    SciTech Connect

    1995-11-01

    Rapid developments in genetic knowledge and technologies increase the ability to test asymptomatic children for late-onset diseases, disease susceptibilities, and carrier status. These developments raise ethical and legal issues that focus on the interests of children and their parents. Although parents are presumed to promote the well-being of their children, a request for a genetic test may have negative implications for children, and the health-care provider must be prepared to acknowledge and discuss such issues with families. This report is grounded in several social concepts: First, the primary goal of genetic testing should be to promote the well-being of the child. Second, the recognition that children are part of a network of family relationships supports an approach to potential conflicts that is not adversarial but, rather, emphasizes a deliberative process that seeks to promote the child`s well-being within this context. Third, as children grow through successive stages of cognitive and moral development, parents and professionals should be attentive to the child`s increasing interest and ability to participate in decisions about his or her own welfare. 46 refs., 1 tab.

  16. Open disclosure: ethical, professional and legal obligations, and the way forward for regulation.

    PubMed

    Finlay, Angus J F; Stewart, Cameron L; Parker, Malcolm

    2013-05-06

    Open disclosure (OD) after adverse health care events is the subject of a national standard that has been implemented in state health policy documents, and is included in the Medical Board of Australia's code of conduct for doctors. Nevertheless, doctors have been slow to embrace the practice of OD. There is a strong ethical case for implementing OD in the primary interests of patients, and additionally from a medicolegal risk management point of view. There are no statutory requirements in relation to OD, but common law judgments have imposed a duty of OD in tort and contract. There are a number of barriers to the better uptake and implementation of OD, including perceptions of legal risk, lack of education and training, reluctance to admit error, uncertainty concerning what and how much to disclose, and the variations in state and territory "apology laws". The implementation of OD could be improved by making apology laws consistent across jurisdictions, including providing "blanket" cover for admissions of fault; by preventing insurers voiding contracts when apologies are made, either through self-regulation or legislation; and by inserting OD obligations into different structures within the health system.

  17. The translational potential of research on the ethical, legal, and social implications of genomics.

    PubMed

    Burke, Wylie; Appelbaum, Paul; Dame, Lauren; Marshall, Patricia; Press, Nancy; Pyeritz, Reed; Sharp, Richard; Juengst, Eric

    2015-01-01

    Federally funded research on the ethical, legal, and social implications (ELSI) of genomics includes a programmatic charge to consider policy-relevant questions and to communicate findings in venues that help inform the policy-making process. In addressing this goal, investigators must consider the range of policies that are relevant to human genetics; how foundational research in bioethics, law, and the social sciences might inform those policies; and the potential professional issues that this translational imperative raises for ELSI investigators. We review these questions in light of experiences from a consortium of federally funded Centers of Excellence in ELSI Research, and offer a set of policy recommendations for program design and evaluation of ELSI research. We conclude that it would be a mistake to require that ELSI research programs demonstrate a direct impact on science or health policy; however, ELSI researchers can take steps to increase the relevance of their work to policy makers. Similarly, funders of ELSI research who are concerned with facilitating policy development can help by building cross-disciplinary translational research capacities, and universities can take steps to make policy-relevant research more rewarding for scholars in the humanities, social sciences, and law.

  18. Consumers on the Internet: ethical and legal aspects of commercialization of personalized nutrition.

    PubMed

    Ahlgren, Jennie; Nordgren, Anders; Perrudin, Maud; Ronteltap, Amber; Savigny, Jean; van Trijp, Hans; Nordström, Karin; Görman, Ulf

    2013-07-01

    Consumers often have a positive attitude to the option of receiving personalized nutrition advice based upon genetic testing, since the prospect of enhancing or maintaining one's health can be perceived as empowering. Current direct-to-consumer services over the Internet, however, suffer from a questionable level of truthfulness and consumer protection, in addition to an imbalance between far-reaching promises and contrasting disclaimers. Psychological and behavioral studies indicate that consumer acceptance of a new technology is primarily explained by the end user's rational and emotional interpretation as well as moral beliefs. Results from such studies indicate that personalized nutrition must create true value for the consumer. Also, the freedom to choose is crucial for consumer acceptance. From an ethical point of view, consumer protection is crucial, and caution must be exercised when putting nutrigenomic-based tests and advice services on the market. Current Internet offerings appear to reveal a need to further guaranty legal certainty by ensuring privacy, consumer protection and safety. Personalized nutrition services are on the borderline between nutrition and medicine. Current regulation of this area is incomplete and undergoing development. This situation entails the necessity for carefully assessing and developing existing rules that safeguard fundamental rights and data protection while taking into account the sensitivity of data, the risks posed by each step in their processing, and sufficient guarantees for consumers against potential misuse.

  19. Psychiatric Genetics in Child Custody Proceedings: Ethical, Legal, and Social Issues

    PubMed Central

    Sabatello, Maya; Appelbaum, S.

    2016-01-01

    This paper considers the ethical, legal, and social issues raised by the prospect of increasing use of psychiatric genetic data in child custody litigation. Although genetic tests cannot currently confirm a parent or child's psychiatric diagnosis, it is likely that as relevant findings emerge, they will be introduced in family courts to challenge parental capacity. Here, we draw on three projected, but plausible, scenarios for obtaining psychiatric data about parents -- imposed genetic testing, access to medical records, and genetic theft -- then consider the use of psychiatric genetic data of children, to highlight the issues that judges, child custody evaluators, and clinicians who may provide treatment for parents or children with mental health issues will need to consider. These include: genetic privacy, stigma, genetic surveillance, and judicial and health professionals' bias. We argue that the unchecked introduction of psychiatric genetic data may have a detrimental effect on the administration of justice. In particular, the article highlights the risk that the (mis)use of psychiatric genetic data in custody disputes would 1) exacerbate stigma and treatment-avoidance among parents and incentivize privacy violations to pressure parents to relinquish parental rights; 2) disproportionately affect poor parents and single mothers of color involved with Child Protective Services; and 3) detract attention from social and environmental factors impacting mental health to the detriment of the families involved. Awareness of these issues and an understanding of the meaning of genomic data by judges and custody evaluators will be pivotal in ensuring that justice is served. PMID:27695660

  20. Checklist to meet ethical and legal obligations to critically ill patients at the end of life.

    PubMed

    Sibbald, Robert W; Chidwick, Paula; Handelman, Mark; Cooper, Andrew B

    2011-01-01

    Despite improvements in communication, errors in end-of-life care continue to be made. For example, healthcare professionals may take direction from the wrong substitute decision-maker, or from family members when the patient is capable; permit families to propose treatment plans; conflate values and beliefs with prior expressed wishes or fail to inquire about prior expressed wishes. Sometimes healthcare professionals know what prior expressed wishes are but do not respect them; others do not believe they have enough time to have an end-of-life discussion or lack the confidence, willingness and skills to manage one. As has been shown in initiatives to improve in surgical safety, the use of a checklist presents opportunities to potentially minimize common mistakes and errors. When engaging in end-of-life care, a checklist can help focus on what needs to be communicated rather than how it needs to be communicated. We propose a checklist to support healthcare professionals in meeting their ethical and legal obligations to patients at the end of life. The checklist should minimize common mistakes, and in situations where irreconcilable conflict is unavoidable, it will ensure that both healthcare teams and family members are informed and prepared.

  1. Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands.

    PubMed

    Bollen, Jan; Ten Hoopen, Rankie; Ysebaert, Dirk; van Mook, Walther; van Heurn, Ernst

    2016-08-01

    Organ donation after euthanasia has been performed more than 40 times in Belgium and the Netherlands together. Preliminary results of procedures that have been performed until now demonstrate that this leads to good medical results in the recipient of the organs. Several legal aspects could be changed to further facilitate the combination of organ donation and euthanasia. On the ethical side, several controversies remain, giving rise to an ongoing, but necessary and useful debate. Further experiences will clarify whether both procedures should be strictly separated and whether the dead donor rule should be strictly applied. Opinions still differ on whether the patient's physician should address the possibility of organ donation after euthanasia, which laws should be adapted and which preparatory acts should be performed. These and other procedural issues potentially conflict with the patient's request for organ donation or the circumstances in which euthanasia (without subsequent organ donation) traditionally occurs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Living kidney donation in Europe: legal and ethical perspectives--the EUROTOLD Project.

    PubMed

    Price, D

    1994-01-01

    The demand for organ replacement by transplantation continues to outstrip supply, leading to unnecessary morbidity and health care costs. "Space capacity" (i. e. cadaver organs not currently harvested for transplant) has been tackled within Western Europe in particular by many strategies--medical, social, educational and legal--but with varying degrees of success. Despite this, the use of living donors has not been fully exploided in many European countries to fill this gap. The total picture is, however, one of marked differences between countries and between centres within countries. In Turkey and Greece, living donors generally account for 60-90% of all renal donors. Countries within Scandinavia also have a high rate of living donor use, especially Norway. By contrast the percentage is far more modest, for example in Spain, Ireland, France and Germany. In the United Kingdom the rate is only 6% with a range of between 0 and 20%. Sources of living donors also show substantial variations between countries, notably the extent to which non-genetically related donors are used. A European Commission sponsored study has been established to acquire a broad understanding of the interaction of ethical values, cultural traditions and social customs on willingness to donate. It will also aim to assess the effect of national laws on professional attitudes to living donor transplantation. This is a collaborative project between the University Department of Surgery, Leicester General Hospital, the Department of Law, De Montfort University and the Department of Mathematics, Newcastle University. Transplant units throughout Europe, including France, Germany, Switzerland, Norway, The Netherlands, Eire and Turkey are collaborating to exchange information and views on living donor transplantation.

  3. The medical-legal quandary of healthcare in capital punishment: an ethical dilemma for the anesthesia provider.

    PubMed

    Johnson, Kevin W

    2008-12-01

    The case of Brase v Rees was presented before the US Supreme Court to consider the constitutionality of death by lethal injection as practiced in the state of Kentucky. The 3-drug combination of sodium thiopental, pancuronium bromide, and potassium chloride is a key aspect in question. Capital punishment conflicts with medical and nursing code of ethics preventing providers who are skilled at difficult intravenous (IV) access, assessment of appropriate sedation, and involvement without fear of disciplinary action. Therefore, untrained or undertrained personnel from the prison have been delegated these duties. Cases in which failure to establish or maintain IV access has led to executions lasting up to 90 minutes before the execution was complete. Participation by skilled medical personnel has been a debate between the medical and legal communities since the inception of lethal injection. Healthcare should reevaluate the ethical and moral principle of beneficence as the legal system attempts to evaluate the constitutionality of lethal injection. Can a nurse or doctor step out of the role of medical professional, use knowledge and skill to make death by lethal injection more humane, and not violate the ethical principle of "do no harm"?

  4. Legal, Social, Ethical, and Medical Perspectives on the Care of the Statutory Rape Adolescent in the Emergency Department.

    PubMed

    Tsai, Shiu-Lin; Acosta, Elvira; Cardenas, Toni; Sigall, Jeremy K; Van Geem, Kevin

    2017-07-01

    Rapes involving adolescents who present to the emergency department (ED) are fraught with ethical and legal complexities and are often emotionally turbulent for patients, their families, and medical providers. Management requires a thoughtful approach from multiple standpoints, including legal, psychosocial, ethical, and medical ones. However, there is no standardized sexual assault education for emergency medicine residents, and management practices vary widely.(1,2) We present a hypothetical statutory rape case based on real cases that occurred in New York City and bring together the perspectives of an attorney on the legal parameters, two social workers on the psychosocial issues, an ethicist on the moral considerations, and a pediatric emergency physician-who is also a sexual assault forensic examiner-on the medical treatments. We aim to provide a framework for physicians to navigate issues of patient-physician privilege involving minors, privacy rules, and mandatory reporting laws. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  5. The Adoption of Cloud Computing in the Field of Genomics Research: The Influence of Ethical and Legal Issues

    PubMed Central

    Charlebois, Kathleen; Palmour, Nicole; Knoppers, Bartha Maria

    2016-01-01

    This study aims to understand the influence of the ethical and legal issues on cloud computing adoption in the field of genomics research. To do so, we adapted Diffusion of Innovation (DoI) theory to enable understanding of how key stakeholders manage the various ethical and legal issues they encounter when adopting cloud computing. Twenty semi-structured interviews were conducted with genomics researchers, patient advocates and cloud service providers. Thematic analysis generated five major themes: 1) Getting comfortable with cloud computing; 2) Weighing the advantages and the risks of cloud computing; 3) Reconciling cloud computing with data privacy; 4) Maintaining trust and 5) Anticipating the cloud by creating the conditions for cloud adoption. Our analysis highlights the tendency among genomics researchers to gradually adopt cloud technology. Efforts made by cloud service providers to promote cloud computing adoption are confronted by researchers’ perpetual cost and security concerns, along with a lack of familiarity with the technology. Further underlying those fears are researchers’ legal responsibility with respect to the data that is stored on the cloud. Alternative consent mechanisms aimed at increasing patients’ control over the use of their data also provide a means to circumvent various institutional and jurisdictional hurdles that restrict access by creating siloed databases. However, the risk of creating new, cloud-based silos may run counter to the goal in genomics research to increase data sharing on a global scale. PMID:27755563

  6. Ethical, legal and societal considerations on Zika virus epidemics complications in scaling-up prevention and control strategies.

    PubMed

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Olalubi, Oluwasogo A; Chengho, Chryseis F; Khater, Emad I M

    2017-08-25

    Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.

  7. The Adoption of Cloud Computing in the Field of Genomics Research: The Influence of Ethical and Legal Issues.

    PubMed

    Charlebois, Kathleen; Palmour, Nicole; Knoppers, Bartha Maria

    2016-01-01

    This study aims to understand the influence of the ethical and legal issues on cloud computing adoption in the field of genomics research. To do so, we adapted Diffusion of Innovation (DoI) theory to enable understanding of how key stakeholders manage the various ethical and legal issues they encounter when adopting cloud computing. Twenty semi-structured interviews were conducted with genomics researchers, patient advocates and cloud service providers. Thematic analysis generated five major themes: 1) Getting comfortable with cloud computing; 2) Weighing the advantages and the risks of cloud computing; 3) Reconciling cloud computing with data privacy; 4) Maintaining trust and 5) Anticipating the cloud by creating the conditions for cloud adoption. Our analysis highlights the tendency among genomics researchers to gradually adopt cloud technology. Efforts made by cloud service providers to promote cloud computing adoption are confronted by researchers' perpetual cost and security concerns, along with a lack of familiarity with the technology. Further underlying those fears are researchers' legal responsibility with respect to the data that is stored on the cloud. Alternative consent mechanisms aimed at increasing patients' control over the use of their data also provide a means to circumvent various institutional and jurisdictional hurdles that restrict access by creating siloed databases. However, the risk of creating new, cloud-based silos may run counter to the goal in genomics research to increase data sharing on a global scale.

  8. Standard Operating Procedures, ethical and legal regulations in BTB (Brain/Tissue/Bio) banking: what is still missing?

    PubMed

    Ravid, Rivka

    2008-06-01

    The use of human biological specimens in scientific research is the focus of current international public and professional concern and a major issue in bioethics in general. Brain/Tissue/Bio banks (BTB-banks) are a rapid developing sector; each of these banks acts locally as a steering unit for the establishment of the local Standard Operating Procedures (SOPs) and the legal regulations and ethical guidelines to be followed in the procurement and dissemination of research specimens. An appropriat Code of Conduct is crucial to a successful operation of the banks and the research application they handle. What are we still missing ? (1) Adequate funding for research BTB-banks. (2) Standard evaluation protocls for audit of BTB-bank performance. (3) Internationally accepted SOP's which will facilitate exchange and sharing of specimens and data with the scientific community. (4) Internationally accepted Code of Conduct. In the present paper we review the most pressing organizational, methodological, medico-legal and ethical issues involved in BTB-banking; funding, auditing, procurement, management/handling, dissemination and sharing of specimens, confidentiality and data protection, genetic testing, "financial gain" and safety measures. Taking into consideration the huge variety of the specimens stored in different repositories and the enormous differences in medico-legal systems and ethics regulations in different countries it is strongly recommend that the health-care systems and institutions who host BTB-Banks will put more efforts in getting adequate funding for the infrastructure and daily activities. The BTB-banks should define evaluation protocols, SOPs and their Code of Conduct. This in turn will enable the banks to share the collected specimens and data with the largest possible number of researchers and aim at a maximal scientific spin-off and advance in public health research.

  9. Standard Operating Procedures, ethical and legal regulations in BTB (Brain/Tissue/Bio) banking: what is still missing?

    PubMed

    Ravid, Rivka

    2008-09-01

    The use of human biological specimens in scientific research is the focus of current international public and professional concern and a major issue in bioethics in general. Brain/Tissue/Bio banks (BTB-banks) are a rapid developing sector; each of these banks acts locally as a steering unit for the establishment of the local Standard Operating Procedures (SOPs) and the legal regulations and ethical guidelines to be followed in the procurement and dissemination of research specimens. An appropriat Code of Conduct is crucial to a successful operation of the banks and the research application they handle. What are we still missing ? (1) Adequate funding for research BTB-banks. (2) Standard evaluation protocls for audit of BTB-bank performance. (3) Internationally accepted SOP's which will facilitate exchange and sharing of specimens and data with the scientific community. (4) Internationally accepted Code of Conduct. In the present paper we review the most pressing organizational, methodological, medico-legal and ethical issues involved in BTB-banking; funding, auditing, procurement, management/handling, dissemination and sharing of specimens, confidentiality and data protection, genetic testing, "financial gain" and safety measures. Taking into consideration the huge variety of the specimens stored in different repositories and the enormous differences in medico-legal systems and ethics regulations in different countries it is strongly recommend that the health-care systems and institutions who host BTB-Banks will put more efforts in getting adequate funding for the infrastructure and daily activities. The BTB-banks should define evaluation protocols, SOPs and their Code of Conduct. This in turn will enable the banks to share the collected specimens and data with the largest possible number of researchers and aim at a maximal scientific spin-off and advance in public health research.

  10. Ethical, legal, and social issues of the Human Genome Project: what to do with what we know.

    PubMed

    Pellerin, C

    1994-01-01

    Since fiscal year 1991, the U.S. Human Genome Project has spent $170.6 million in federal funds to help isolate genes associated with Huntington's disease, amyotrophic lateral sclerosis, neurofibromatosis types 1 and 2, myotonic dystrophy, and fragile X syndrome and to localize genes that predispose people to breast cancer, colon cancer, hypertension, diabetes, and Alzheimer's disease. Now comes the hard part. Biology's 21st century megaproject starts to look relatively manageable compared to another challenge facing the enterprise: sorting out ethical, legal, and social issues associated with using this information. "The Human Genome Project," wrote Senior Editor Barbara Jasny in the October 1 Science editorial, stretches "the limits of the technology and the limits of our ability to ethically and rationally apply genetic information to our lives."

  11. Spheres of influence: Ethical, legal, and social issues of the Human Genome Project: What to do with what we know

    SciTech Connect

    Pellerin, C. )

    1994-01-01

    Since fiscal year 1991, the U.S. Human Genome Project has spent $170.6 million in federal funds to help isolate genes associated with Huntington's disease, amyotrophic lateral sclerosis, neurofibromatosis types 1 and 2, myotonic dystrophy, and fragile X syndrome and to localize genes that predispose people to breast cancer, colon cancer, hypertension, diabetes, and Alzheimer's disease. Now come the hard part. Biology's 21st century megaproject starts to look relatively manageable compared to another challenge facing the enterprise: sorting out ethical, legal, and social issues associated with using this information. [open quotes]The Human Genome Project,[close quotes] wrote Senior Editor Barbara Jasny in the October 1 Science editorial, stretches [open quotes]the limits of the technology and the limits of our ability to ethically and rationally apply genetic information to our lives.[close quotes

  12. Confidentiality and fitness to drive: Professional, ethical, and legal duties in the case of the diabetic bus driver.

    PubMed

    Wareham, Christopher

    2017-07-28

    Patients who pose a risk of serious accidents present a difficult ethical problem for medical practitioners. The duty to maintain confidentiality is an ancient and weighty obligation and has many beneficial consequences for patients and society generally. Similarly, the duty of care towards a patient militates against disclosing details that could remove his or her source of income and imperil physical and mental wellbeing. However, in cases where maintaining confidentiality can result in severe harm to the patient and the public, the benefits of confidential practice may be outweighed. While many publications on this topic provide clinical criteria for determining the unfitness of a diabetic patient to drive, the focus in this article is on ethical, professional, and legal responsibilities after a practitioner has decided that a driver poses a significant danger.

  13. Ethical and legal considerations regarding the ownership and commercial use of human biological materials and their derivatives

    PubMed Central

    Petrini, Carlo

    2012-01-01

    This article considers some of the ethical and legal issues relating to the ownership and use – including for commercial purposes – of biological material and products derived from humans. The discussion is divided into three parts: after first examining the general notion of ownership, it moves to the particular case of possible commercial use, and finally reflects on the case in point in the light of the preceding considerations. Units of cord blood donated altruistically for transplantation and which are found unsuitable for storage and transplantation, or which become unsuitable while stored in biobanks, are taken as an example. These cord-blood units can be discarded together with other biological waste, or they can be used for research or the development of blood-derived products such as platelet gel. Several ethical questions (eg, informed consent, property, distribution of profits, and others) arise from these circumstances. In this regard, some criteria and limits to use are proposed. PMID:22977316

  14. Outstanding ethical-legal issues on biobanks. An overview on the regulations of the Member States of the Eurobiobank project.

    PubMed

    Martín Uranga, Amelia; Martín Arribas, M Concepción; Jaeger, Cécile; Posadas, Manuel

    2005-01-01

    EuroBiobank (EBB) was created in 2001. This is a network of European biological banks made up by 7 member States. The purpose of the network is to ease the access to the biological resources of the human being in patients who suffer uncommon diseases. This study deals mainly with the ethical-legal debate that has arisen in those States, as well as the existing legal regulation and the proposed recommendations for its possible solution. Likewise, there is a special mention about the informed consent, the possible use in the future of the samples in relation to its commercial use as industrial property rights and to Directive 2004/03 that was adopted by the European Parliament 31 March, 2004.

  15. Sexual exploitation and trafficking of the young and vulnerable: reflections on a legal, ethical, and human rights disgrace.

    PubMed

    English, Abigail

    2011-08-01

    Sexual exploitation and trafficking of the young and vulnerable has devastating consequences for their physical and emotional development, health, and well-being. The horrific treatment they suffer bears the hallmarks of evil made manifest. Governments have enacted laws pursuant to international treaties, conventions, and protocols. Nonprofit and nongovernmental organizations (NGOs) are working to prevent young people from being exploited and trafficked, to identify victims, and to provide services to survivors. Progress in addressing the problem is haltingly slow in relation to its magnitude. The prevalence and persistence of this phenomenon is an ethical, legal, and human rights disgrace.

  16. Withdrawal of ventilation at the patient's request in MND: a retrospective exploration of the ethical and legal issues that have arisen for doctors in the UK

    PubMed Central

    Phelps, Kay; Regen, Emma; Oliver, David; McDermott, Chris; Faull, Christina

    2017-01-01

    Background Ventilatory support has benefits including prolonging survival for respiratory failure in motor neurone disease (MND). At some point some patients may wish to stop the intervention. The National Institute of Health and Care Excellence (NICE) guidance recommends research is needed on ventilation withdrawal. There is little literature focusing on the issues doctors encounter when withdrawing ventilation at the request of a patient. Aim To identify and explore with doctors the ethical and legal issues that they had encountered in the withdrawal of ventilation at the request of a patient with MND. Method A retrospective thematic analysis of interviews of 24 doctors (including palliative care, respiratory, neurology and general practice) regarding their experiences with withdrawal of ventilation support from patients with MND. Results Respondents found withdrawal of ventilation at the request of patients with MND to pose legal, ethical and moral challenges in five themes: ethical and legal rights to withdrawal from treatment; discussions with family; discussions with colleagues; experiences of legal advice; issues contributing to ethical complexity. Though clear about the legality of withdrawal of treatment in theory, the practice led to ethical and moral uncertainty and mixed feelings. Many respondents had experienced negative reactions from other healthcare professionals when these colleagues were unclear of the distinction between palliation of symptoms, withdrawal of treatment and assisted death. Conclusions Legal, ethical and practical guidance is needed for professionals who support a patient with MND who wishes to withdraw from ventilation. Open discussion of the ethical challenges is needed as well as education and support for professionals. PMID:26362794

  17. Personal genome testing: test characteristics to clarify the discourse on ethical, legal and societal issues.

    PubMed

    Bunnik, Eline M; Schermer, Maartje H N; Janssens, A Cecile J W

    2011-06-14

    As genetics technology proceeds, practices of genetic testing have become more heterogeneous: many different types of tests are finding their way to the public in different settings and for a variety of purposes. This diversification is relevant to the discourse on ethical, legal and societal issues (ELSI) surrounding genetic testing, which must evolve to encompass these differences. One important development is the rise of personal genome testing on the basis of genetic profiling: the testing of multiple genetic variants simultaneously for the prediction of common multifactorial diseases. Currently, an increasing number of companies are offering personal genome tests directly to consumers and are spurring ELSI-discussions, which stand in need of clarification. This paper presents a systematic approach to the ELSI-evaluation of personal genome testing for multifactorial diseases along the lines of its test characteristics. This paper addresses four test characteristics of personal genome testing: its being a non-targeted type of testing, its high analytical validity, low clinical validity and problematic clinical utility. These characteristics raise their own specific ELSI, for example: non-targeted genetic profiling poses serious problems for information provision and informed consent. Questions about the quantity and quality of the necessary information, as well as about moral responsibilities with regard to the provision of information are therefore becoming central themes within ELSI-discussions of personal genome testing. Further, the current low level of clinical validity of genetic profiles raises questions concerning societal risks and regulatory requirements, whereas simultaneously it causes traditional ELSI-issues of clinical genetics, such as psychological and health risks, discrimination, and stigmatization, to lose part of their relevance. Also, classic notions of clinical utility are challenged by the newer notion of 'personal utility.' Consideration

  18. Personal genome testing: Test characteristics to clarify the discourse on ethical, legal and societal issues

    PubMed Central

    2011-01-01

    Background As genetics technology proceeds, practices of genetic testing have become more heterogeneous: many different types of tests are finding their way to the public in different settings and for a variety of purposes. This diversification is relevant to the discourse on ethical, legal and societal issues (ELSI) surrounding genetic testing, which must evolve to encompass these differences. One important development is the rise of personal genome testing on the basis of genetic profiling: the testing of multiple genetic variants simultaneously for the prediction of common multifactorial diseases. Currently, an increasing number of companies are offering personal genome tests directly to consumers and are spurring ELSI-discussions, which stand in need of clarification. This paper presents a systematic approach to the ELSI-evaluation of personal genome testing for multifactorial diseases along the lines of its test characteristics. Discussion This paper addresses four test characteristics of personal genome testing: its being a non-targeted type of testing, its high analytical validity, low clinical validity and problematic clinical utility. These characteristics raise their own specific ELSI, for example: non-targeted genetic profiling poses serious problems for information provision and informed consent. Questions about the quantity and quality of the necessary information, as well as about moral responsibilities with regard to the provision of information are therefore becoming central themes within ELSI-discussions of personal genome testing. Further, the current low level of clinical validity of genetic profiles raises questions concerning societal risks and regulatory requirements, whereas simultaneously it causes traditional ELSI-issues of clinical genetics, such as psychological and health risks, discrimination, and stigmatization, to lose part of their relevance. Also, classic notions of clinical utility are challenged by the newer notion of 'personal

  19. Legal and Ethical Issues Related to the Management of Cultural Heritage in Space

    NASA Astrophysics Data System (ADS)

    Walsh, Justin

    in space. The United Nations Outer Space Treaty of 1967 -the primary document governing how nations act in outer space -is now hopelessly out-of-date. There is no mention in the treaty of cultural heritage (the UNESCO convention that concerns international protection of cultural heritage on Earth was not completed until 1970), nor was there any recognition of the role private groups and individuals might play in space exploration. This paper will outline key legal and ethical issues related to cultural heritage management and protection. It will also suggest some ways in which culturally significant sites in space can be protected for future study and even touristic appreciation.

  20. [Man and animal from the ethical view

    PubMed

    Teutsch, Gotthard M.

    1997-01-01

    This review over the books, articles in Journals and newspapers in 1996 and 1997 reports about the development in the field of man-animal- and man-nature-relations. The review considers the following themes: development, trends and perspectives, philosophy, theology, eco-ethics, legal questions, animal experimentation, freedom of research, teaching and conscience, farm animals, hunting and fishing, zoo and circus, bio-technology, violence, killing, vegetarism and dignity of creatures. The review includes a bibliography with about 300 quatoations.

  1. Managers Confront Competing Practical, Legal, and Ethical Claims: A Comprehensive Teaching Case

    ERIC Educational Resources Information Center

    McAdams, Tony

    2009-01-01

    Law classes help reveal the successes of the American legal system. Students observe that the law is honorable, workable, and effective. At the same time, law classes offer the opportunity to look at those situations where the legal system sometimes struggles to achieve its justice goals. Students certainly need to learn that lesson, but they also…

  2. Managers Confront Competing Practical, Legal, and Ethical Claims: A Comprehensive Teaching Case

    ERIC Educational Resources Information Center

    McAdams, Tony

    2009-01-01

    Law classes help reveal the successes of the American legal system. Students observe that the law is honorable, workable, and effective. At the same time, law classes offer the opportunity to look at those situations where the legal system sometimes struggles to achieve its justice goals. Students certainly need to learn that lesson, but they also…

  3. The Messiha and Schiavo cases: third-party ethical and legal [corrected] interventions in futile care disputes.

    PubMed

    Faunce, Thomas A; Stewart, Cameron

    2005-09-05

    Relatives may increasingly demand that an incompetent patient's treatment be continued indefinitely, despite clinical advice that it is technically "futile" (offering no reasonable prospect of return to a meaningful quality of life). Third-party interventions may become a more frequent part of attempts to resolve such disputes where there is no formal advance directive. In the Messiha case, the Supreme Court of New South Wales upheld clinical judgement regarding the patient's best interests as most important. In the Schiavo case in the United States, clinicians' decisions on futility of treatment had received unwavering judicial support in more than 20 proceedings. Political differences between the US and Australia make it unlikely clinicians in this country will face Schiavo-type legislative challenges to individual clinical decisions and the judicial rulings upholding them. Consulting a clinical ethics committee in such scenarios is both legally recommended and clinically warranted as an important device for diffusing tensions between relatives and clinicians, as well as clarifying their respective ethical and legal responsibilities. In protracted or apparently irresolvable disputes with relatives, applying for a judicial declaration on futility of treatment has become a practical option for intensivists in Australia and should be a recognised part of their training.

  4. The state of ethical-legal oaths in UK medical practice today: Is it time to look at standardising?

    PubMed

    Atenstaedt, R L

    2016-12-01

    The taking of an ethical-legal oath is a "rite of passage" for many medical practitioners. A 1997 paper noted that half of medical schools in the UK administer an oath. I performed a survey of UK medical schools to see whether these are still used today. An electronic survey was sent to 31 UK medical schools, asking them whether the Hippocratic Oath (in any version) was taken by their medical students; non-respondents were followed up by telephone. Information was obtained from 21 UK medical schools, giving a response rate of 68% (21/31). A total of 18 (86%) institutions use an oath. Ethical-legal oaths are therefore taken in the vast majority of UK medical schools today. However, a great variety are used, and there are advantages in standardisation. My recommendation is that the Standard Medical Oath of the UK (SMOUK) is adopted by all medical schools, and that this is also taken regularly by doctors as part of revalidation.

  5. Neuroscience, ethics and legal responsibility: the problem of the insanity defense. Commentary on "The ethics of neuroscience and the neuroscience of ethics: a phenomenological-existential approach".

    PubMed

    Smith, Steven R

    2012-09-01

    The insanity defense presents many difficult questions for the legal system. It attracts attention beyond its practical significance (it is seldom used successfully) because it goes to the heart of the concept of legal responsibility. "Not guilty by reason of insanity" generally requires that as a result of mental illness the defendant was unable to distinguish right from wrong at the time of the crime. The many difficult and complex questions presented by the insanity defense have led some in the legal community to hope that neuroscience might help resolve some of these problems, but that hope is not likely to be realized.

  6. Managing the public health risk of a 'sex worker' with hepatitis B infection: legal and ethical considerations.

    PubMed

    Poll, Ray

    2011-10-01

    This paper examines the ethical issues faced by health workers managing a fictional case of a female sex worker who is hepatitis B positive with a high level of virus but is asymptomatic. According to guidelines she does not require treatment herself, but is potentially highly infectious to others. Recent legal cases in the UK show it can be criminal to pass on HIV or hepatitis B infection sexually if the risk is known and the partner has not been informed. However, there is no statute or case law showing that health workers are required to intervene to prevent such a potential 'crime', particularly when the partners are unknown, as in this case. The health workers could respond in various ways. They could do nothing, thus making further infection probable. They could advise the sex worker to use condoms and to inform her clients. They could treat the sex worker to reduce her level of infectivity, although there is no benefit to her. They could disclose the sex worker's status, although breaking confidentiality is a serious matter ethically and may be of no benefit to the unknown client group. Regulating prostitution might help; but sex workers with infection may work off licence. This paper discusses the clinical, moral and ethical issues associated with such a scenario and concludes that the most beneficial course is to target clients, through health education, to recognise the potential risks of infection from a sex worker and to take suitable precautions including immunisation against hepatitis B.

  7. Occupational health practice and exposure to nanoparticles: reconciling scientific evidence, ethical aspects, and legal requirements.

    PubMed

    Franco, Giuliano

    2011-01-01

    The paper aims at focusing the relationship between scientific evidence and ethical values' issues of occupational health practice according to the new Italian law 81/2008 stating that the occupational health physician (OHP) is required to act according to the Code of Ethics of the International Commission on Occupational Health. The code itself emphasizes that (i) the practice should be relevant, knowledge-based, sound, and appropriate to the occupational risks and (ii) the objectives and methods of health surveillance must be clearly defined. Because exposure to nanoparticles involves several uncertainties about health effects and may limit the effectiveness of workers' health surveillance, OHPs face a several ethical dilemmas, involving different stakeholders. The dilemmas arising from the practice should be dealt with according to the ethical principles of beneficence, autonomy, and justice in order to take a decision.

  8. The use of pornographic materials by adolescent male cancer patients when banking sperm in the UK: legal and ethical dilemmas.

    PubMed

    Crawshaw, Marilyn A; Glaser, Adam W; Pacey, Allan A

    2007-09-01

    Increased awareness of the importance of fertility concerns to teenage cancer survivors is leading to growing numbers of male teenagers being offered sperm banking at the time of diagnosis. This is now extending to males diagnosed with other conditions where gonadotoxic agents are used in treatment. The storage of sperm in these circumstances is a challenging aspect of health care, given the complex issues and timescale involved. UK law has been enacted to protect legal minors from the potentially harmful effects of exposure to pornographic materials, yet there is reason to suppose that their use in this context could have therapeutic benefit in aiding successful masturbation. This paper uses material gained through consultation with the eleven largest UK sperm banks and 94 male teenage cancer survivors, to discuss the associated legal and ethical dilemmas, including those around the role of parents/carers. Findings suggest that there is variable practice in sperm banks, that almost a quarter of teenage males wanted access to soft porn when banking sperm, and half wanted to bring in their own materials. It concludes that there is an urgent need for any legal barriers to the therapeutic use of pornographic materials to be understood and examined.

  9. Brain death in the pediatric patient: historical, sociological, medical, religious, cultural, legal, and ethical considerations.

    PubMed

    Farrell, M M; Levin, D L

    1993-12-01

    transplanted liver, a reversed coagulation system, a blocked immune system, and a paralyzed musculoskeletal system. A human being is a man, woman, or child who is a composite of two intricately related but conceptually distinguishable components: the biological entity and the person. Therefore, human beings can suffer more than one death: a biological death and decay, and another death. Biological death is a cessation of processes of biological synthesis and replication, and is an irreversible loss of integration of the biological units. The reasons for having criteria for death are to diagnose death and pronounce a person dead. Society can then begin to engage in grief, religious rites, funerals, and burials, and accept biological death. Wills can be read, property distributed, insurance claimed, individuals can remarry, succession can take place, and legal proceedings can begin. Also, organ donation can take place, which entails difficult ethical decisions. The Harvard criteria of 1968 were devised to set forth brain-death criteria with whole brain death in mind. Currently, there are several controversies regarding these criteria: a) whether they apply to infants and children; b) whether ancillary tests are necessary; c) what the intervals of observation and testing are; and d) are there exceptions to the whole brain death criteria. Concerning the use of the adult criteria for infants and children, most researchers now agree that the adult criteria apply to infants and children who are full term and > 7 days of age. Concerning ancillary tests, there has been, in our machine- and technology-oriented profession, a great deal of emphasis on the different tests and their ability to fulfill the criteria of whole brain death. However, clinical examination and the apnea test are usually sufficient to fulfill the criteria. Ancillary tests may be desired in some cases, and a variety of these tests is available. (ABSTRACT TR

  10. Ethics: A Selected Bibliography

    DTIC Science & Technology

    2010-06-01

    organizational decision making and behavior. http://josephsoninstitute.org Kant , Immanuel . The Critique of Pure Reason, translated by J.M.D. Meiklejohn. The...Meredith. Vol. 42 of Great Books of the Western World. Chicago: Encyclopaedia Britannica, 1955. 613pp. (AC1 .G7 v.42) Kant , Immanuel . The Philosophy of... Kant : Immanuel Kant’s Moral and Political Writing. Edited by Carl J. Friedrich. New York: Modern Library, 1993. 525pp. (B2758 .F7 1993) Kidder

  11. Gag rules and trade secrets in managed care contracts. Ethical and legal concerns.

    PubMed

    Brody, H; Bonham, V L

    1997-10-13

    Gag rules-clauses in managed care contracts that prevent physicians from disclosing information that the plan may find disparaging, but that could relate directly to the patient's health-have recently been the subject of ethical condemnation and legislative prohibition. Another serious problem in managed care contracts, trade secrets, or guidelines and quality assurance mechanisms that are imposed on physicians while their origins are shrouded in proprietary secrecy, have by contrast received little attention. Responses to these ethical challenges to the physician's integrity must involve individual physicians, managed care organizations, professional organizations, and public policymakers.

  12. Rethinking ethical and legal issues at the end of life in the U.K. and Brazil: a role for solidarity?

    PubMed

    Ventura, Carla A Arena; Gallagher, Ann; Jago, Robert; Mendes, Isabel Amélia Costa

    2013-12-01

    There are currently high profile debates about legal and ethical aspects of end of life care and treatment in the U.K. and Brazil. Unlike some other jurisdictions, neither country has legalised assisted dying or euthanasia. We argue that it is timely to consider the issues from the perspectives of an evolving concept in bioethics, that of solidarity.

  13. Case Study of a Coffee War: Using the "Starbucks v. Charbucks" Dispute to Teach Trademark Dilution, Business Ethics, and the Strategic Value of Legal Acumen

    ERIC Educational Resources Information Center

    Melvin, Sean P.

    2012-01-01

    A Harvard Business School-style teaching case can be a powerful pedagogical tool to teach law and ethics to business students because instructors can combine a traditional business case study with Socratic-style dialogue and legal analysis from a managerial perspective. This teaching note includes suggestions for several methods of using the case,…

  14. Case Study of a Coffee War: Using the "Starbucks v. Charbucks" Dispute to Teach Trademark Dilution, Business Ethics, and the Strategic Value of Legal Acumen

    ERIC Educational Resources Information Center

    Melvin, Sean P.

    2012-01-01

    A Harvard Business School-style teaching case can be a powerful pedagogical tool to teach law and ethics to business students because instructors can combine a traditional business case study with Socratic-style dialogue and legal analysis from a managerial perspective. This teaching note includes suggestions for several methods of using the case,…

  15. The ethical and legal implications of deactivating an implantable cardioverter‐defibrillator in a patient with terminal cancer

    PubMed Central

    England, Ruth; England, Tim; Coggon, John

    2007-01-01

    In this paper, the ethical and legal issues raised by the deactivation of implantable cardioverter‐defibrillators (ICDs) in patients with terminal cancer is considered. It is argued that the ICD cannot be well described either as a treatment or as a non‐treatment option, and thus raises complex questions regarding how rules governing deactivation should be framed. A new category called “integral devices” is proposed. Integral devices require their own special rules, reflecting their position as a “halfway house” between a form of treatment and a part of the body. The practical problems faced by doctors working in palliative medicine with regard to the deactivation of ICDs are also considered. PMID:17761824

  16. Health-related biotechnologies for infectious disease control in Africa: Ethical, Legal and Social Implications (ELSI) of transfer and development.

    PubMed

    Sommerfeld, J; Oduola, A M J

    2007-01-01

    The African continent is disproportionately affected by infectious diseases. Malaria, HIV/AIDS, tuberculosis, and more "neglected" diseases including African trypanosomiasis, Buruli ulcer, leishmaniasis, onchocerciasis and trachoma continue to dramatically impact social and economic development on the continent. Health biotechnologies provide potential to develop effective strategies for the fight against the vicious circle of poverty and infections by helping in the development and improvement of novel affordable drugs, diagnostics and vaccines against these diseases. As the prospects of this emerging biotechnology research and deployment of its products become a reality in Africa, there is a need to consider the ethical, legal and social implications of both the scientific and technological advances and their use in the communities. The article provides a short overview of the potential values of biotechnology, issues involved in its transfer and presents the rationale, design and recommendations of the international workshop/symposium held in April 2005 at the International Institute for Tropical Agriculture (IITA) in Ibadan, Nigeria.

  17. [Analysis of barriers and legal-ethical opportunities for disclosure and apology for medical errors in Spain].

    PubMed

    Giraldo, Priscila; Corbella, Josep; Rodrigo, Carmen; Comas, Mercè; Sala, Maria; Castells, Xavier

    2016-01-01

    To identify opportunities for disclosing information on medical errors in Spain and issuing an apology, as well as legal-ethical barriers. A cross-sectional study was conducted through a questionnaire sent to health law and bioethics experts (n=46). A total of 39 experts (84.7%) responded that health providers should always disclose adverse events and 38 experts (82.6%) were in favour of issuing an apology. Thirty experts (65.2%) reported that disclosure of errors would not lead to professional liability. The main opportunity for increasing disclosure was by enhancing trust in the physician-patient relationship and the main barrier was fear of the outcomes of disclosing medical errors. There is a broad agreement on the lack of liability following disclosure/apology on adverse events and the need to develop a strategy for disclosure among support for physicians. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Does the Shoe Fit? Ethical, Legal, and Policy Considerations of Global Positioning System Shoes for Individuals with Alzheimer's Disease.

    PubMed

    Yang, Y Tony; Kels, Charles G

    2016-08-01

    As the overall incidence of Alzheimer's disease rises, the burden on caregivers and law enforcement institutions will increase to find individuals who wander. As such, technological innovations that could reduce this burden will become increasingly important. One such innovation is the GPS Shoe. As with any innovation involving the transfer of personal data to third parties, potential pitfalls with respect to loss of privacy and inadequate consent counterbalance the substantial promise of GPS shoes. To some extent, advance planning can mitigate these concerns, wherein individuals willingly elect to be monitored before their impairments progress to a stage that makes such authorization impractical. Nonetheless, tension may arise between the peace of mind of caregivers and family members and other important considerations at the intersection of autonomy, privacy, dignity, and consent. Ultimately, confronting ethical, legal, and policy considerations at the front end of product development and deployment will help ensure that new technologies are used wisely and that their lifesaving potential is realized.

  19. Legal and ethical issues in the regulation and development of engineering achievements in medical technology. I.

    PubMed

    Bronzino, J D; Flannery, E J; Wade, M

    1990-01-01

    The statutory and regulatory requirements governing medical device development and approval are reviewed. Some of the procedures that the US Food and Drug Administration has implemented to loosen the strictures that impede development and approval of new medical devices are discussed. Some of the ethical issues associated with these procedures are examined.

  20. Legal, ethical and human-rights issues related to the storage of oral history interviews in archives.

    PubMed

    Thurgood, Graham

    2002-01-01

    This paper provides some personal reflections that explore the legal, ethical and human rights issues of conducting oral history interviews with elderly retired nurses. The interviews are part of a research study into the history of nursing in the West Yorkshire towns of Halifax and Huddersfield, UK, between 1870-1960. The merit of this research is that it provides a unique account of the development of nursing and can enrich our understanding of the implications for present-day practice within the fast changing world of the 21st century. A literature review identified a 'gap in knowledge' of how and why local nursing developed. This study proposes to bridge this gap and provide an investigative account of the important issues for local nursing. The two methodological approaches are analysis of the primary and secondary documentary archival sources, and oral history interviewing of retired nurses. 'Word of mouth' or snowball sampling identified over 300 potential interviewees ranging from 65-97 years old. A final sample of 21 representative of location, age and career experience was selected to ensure a strategic purposive sample. The resultant audiotapes and transcripts will be stored in the university's archives. The main focus of the paper will be the legal, ethical and human rights issues of storing interviewees tapes/transcripts in archives. Reflections on these problems and attempts to overcome them have been provided. These are centred on the issue of whether to edit the tapes and/or transcripts. Arguments are provided for and against editing and potential practical solutions to some of the practical issues are identified. The main aim is to identify methods that will enable the protection of those who may be harmed in anyway by the tapes or transcripts been open to public access.

  1. The ethical and legal aspects of palliative sedation in severely brain-injured patients: a French perspective.

    PubMed

    Baumann, Antoine; Claudot, Frédérique; Audibert, Gérard; Mertes, Paul-Michel; Puybasset, Louis

    2011-02-08

    To fulfill their crucial duty of relieving suffering in their patients, physicians may have to administer palliative sedation when they implement treatment-limitation decisions such as the withdrawal of life-supporting interventions in patients with poor prognosis chronic severe brain injury. The issue of palliative sedation deserves particular attention in adults with serious brain injuries and in neonates with severe and irreversible brain lesions, who are unable to express pain or to state their wishes. In France, treatment limitation decisions for these patients are left to the physicians. Treatment-limitation decisions are made collegially, based on the presence of irreversible brain lesions responsible for chronic severe disorders of consciousness. Before these decisions are implemented, they are communicated to the relatives. Because the presence and severity of pain cannot be assessed in these patients, palliative analgesia and/or sedation should be administered. However, palliative sedation is a complex strategy that requires safeguards to prevent a drift toward hastening death or performing covert euthanasia. In addition to the law on patients' rights at the end of life passed in France on April 22, 2005, a recent revision of Article 37 of the French code of medical ethics both acknowledges that treatment-limitation decisions and palliative sedation may be required in patients with severe brain injuries and provides legal and ethical safeguards against a shift towards euthanasia. This legislation may hold value as a model for other countries where euthanasia is illegal and for countries such as Belgium and Netherlands where euthanasia is legal but not allowed in patients incapable of asking for euthanasia but in whom a treatment limitation decision has been made.

  2. The ethical and legal aspects of palliative sedation in severely brain-injured patients: a French perspective

    PubMed Central

    2011-01-01

    To fulfill their crucial duty of relieving suffering in their patients, physicians may have to administer palliative sedation when they implement treatment-limitation decisions such as the withdrawal of life-supporting interventions in patients with poor prognosis chronic severe brain injury. The issue of palliative sedation deserves particular attention in adults with serious brain injuries and in neonates with severe and irreversible brain lesions, who are unable to express pain or to state their wishes. In France, treatment limitation decisions for these patients are left to the physicians. Treatment-limitation decisions are made collegially, based on the presence of irreversible brain lesions responsible for chronic severe disorders of consciousness. Before these decisions are implemented, they are communicated to the relatives. Because the presence and severity of pain cannot be assessed in these patients, palliative analgesia and/or sedation should be administered. However, palliative sedation is a complex strategy that requires safeguards to prevent a drift toward hastening death or performing covert euthanasia. In addition to the law on patients' rights at the end of life passed in France on April 22, 2005, a recent revision of Article 37 of the French code of medical ethics both acknowledges that treatment-limitation decisions and palliative sedation may be required in patients with severe brain injuries and provides legal and ethical safeguards against a shift towards euthanasia. This legislation may hold value as a model for other countries where euthanasia is illegal and for countries such as Belgium and Netherlands where euthanasia is legal but not allowed in patients incapable of asking for euthanasia but in whom a treatment limitation decision has been made. PMID:21303504

  3. Reuse of single use medical devices in Canada: clinical and economic outcomes, legal and ethical issues, and current hospital practice.

    PubMed

    Hailey, David; Jacobs, Philip D; Ries, Nola M; Polisena, Julie

    2008-01-01

    The aim of this study was to assess the evidence that reuse of medical devices marketed for single use only (SUDs) is safe, effective and cost-effective, and to consider the use and health services impact of this practice in Canada. A systematic review was performed of studies that reported clinical or economic outcomes following reuse of SUDs in humans. Direct costs of adverse health events associated with SUD reuse and indications of budget impact were obtained using data for devices for laparoscopic cholecystectomy and coronary angioplasty. Legal and ethical issues were reviewed, drawing on material relevant to Canada. Data on current reuse of SUDs were obtained through a survey of Canadian acute care hospitals. Studies of variable quality suggested that SUD reuse could be safe and effective, and would give cost savings, if there were no adverse events. Eliminating reuse of SUDs for laparoscopic cholecystectomy and coronary angioplasty would add less than 0.1 percent to costs of the procedures over 1 year. Adverse health events associated with device reuse create liability risks; patients should be informed of any known or foreseeable risks of reuse. Most of the 28 percent (111/398) of acute hospitals that reprocess SUDs do so in-house. Some do not have a written policy or an incident reporting mechanism. There is insufficient evidence to establish the safety, efficacy and cost-effectiveness of reusing SUDs. Legal and ethical issues require attention to minimize liability and maintain patient safety and trust. Some hospitals that reprocess SUDs do not have adequate documentation. These findings do not support the reuse of SUDs in Canadian hospitals.

  4. Group Counseling in the Schools: Legal, Ethical, and Treatment Issues in School Practice

    ERIC Educational Resources Information Center

    Crespi, Tony D.

    2009-01-01

    School psychologists are interested in providing effective and efficient direct services to children. With a wide spectrum of psychological problems impacting children, group counseling represents one viable and valuable intervention. Given the complexity of group counseling, many schools and school psychologists are interested in legal and…

  5. The Human Genome Project: ethical and legal considerations for neuroscience nurses.

    PubMed

    Tazbir, J

    2001-08-01

    The Human Genome Project has nearly completed the identification of the human genome. The medical, social, and legal implications are numerous. Neuroscience nurses have the unique opportunity to be an integral part of the genetics age because of the many genetic-based neuroscience diseases.

  6. Legal and Ethical Implications of Working with Minors in Alabama: Consent and Confidentiality

    ERIC Educational Resources Information Center

    Keim, Michael A.; Cobia, Debra

    2010-01-01

    Until recently, there has been little guidance in the professional literature with respect to counseling minors outside of the school setting. Although most authors suggest referring to state statutes for legal limits of counseling practice, little research exists describing these requirements in Alabama. The purpose of this literature and…

  7. Problems in deceptive medical procedures: an ethical and legal analysis of the administration of placebos

    PubMed Central

    Simmons, Beth

    1978-01-01

    The use of placebos in therapy or research poses ethical questions. What are the benefits and the costs in ethical terms of condoning deception of the patient or subject? What does the deception mean for the patient's or subject's right to give informed consent to his treatment? Doctors are rightly expected to disclose to their patient facts which would in their judgement best enable him to give informed consent to treatment. On occasion, the degree of this disclosure may be limited by the need to avoid hazarding the success of treatment of an unstable patient whose condition threatens his life, but doctors should have no right to withhold information just to prevent a patient refusing consent to therapy. No such limitation should apply in experiments where full disclosure must operate to enable the subject to give his informed consent. The potential medical benefits for the patient of placebo therapy have to be weighed against all the ethical costs of the deception and dishonesty involved, including the longer term repercussions on doctor/patient trust: similar ethical costs may arise in experiments involving the use of placebos without disclosure of this as a possibility to the subject. Deception is ethically degrading to both parties not only being a breach of trust, but denying the moral autonomy of the patient or subject to make his own choice. The writer concludes that placebos should be used only with full disclosure and consent whether in therapy or in research, and that this need not impede the success of either. PMID:739513

  8. Geneletter: An Internet-based newsletter on the ethical, legal, and social implications of genetics. Final report to the Department of Energy [Final report

    SciTech Connect

    Reilly, Philip; Wertz, Dorothy C.

    2001-05-01

    The GeneLetter (http://www.geneletter.org) is an Internet newsletter on ethical, legal, and social issues in genetics, designed for a wide and varied audience, some of whom may not be familiar with genetic science. It appears every two months, with a variety of long and short feature articles on ethics and on genetic disorders, a section on new federal and state legislation, an international section, a student corner, book and video reviews, a summary of genetics in the news, and a list of upcoming conferences. Feature articles have ventured into an area of wide general concern, behavioral genetics. The newsletter also has an interactive chatbox and the opportunity of more private communications with the editors via email. The purpose of the GeneLetter is to help fill a communication and knowledge gap on ethical, legal and social issues surrounding genetics.

  9. Implementing risk-stratified screening for common cancers: a review of potential ethical, legal and social issues.

    PubMed

    Hall, A E; Chowdhury, S; Hallowell, N; Pashayan, N; Dent, T; Pharoah, P; Burton, H

    2014-06-01

    The identification of common genetic variants associated with common cancers including breast, prostate and ovarian cancers would allow population stratification by genotype to effectively target screening and treatment. As scientific, clinical and economic evidence mounts there will be increasing pressure for risk-stratified screening programmes to be implemented. This paper reviews some of the main ethical, legal and social issues (ELSI) raised by the introduction of genotyping into risk-stratified screening programmes, in terms of Beauchamp and Childress's four principles of biomedical ethics--respect for autonomy, non-maleficence, beneficence and justice. Two alternative approaches to data collection, storage, communication and consent are used to exemplify the ELSI issues that are likely to be raised. Ultimately, the provision of risk-stratified screening using genotyping raises fundamental questions about respective roles of individuals, healthcare providers and the state in organizing or mandating such programmes, and the principles, which underpin their provision, particularly the requirement for distributive justice. The scope and breadth of these issues suggest that ELSI relating to risk-stratified screening will become increasingly important for policy-makers, healthcare professionals and a wide diversity of stakeholders. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

  10. Notifying patients exposed to blood products associated with Creutzfeldt-Jakob disease: integrating science, legal duties and ethical mandates

    PubMed Central

    Caulfield, T; Dossetor, J; Boshkov, L; Hannon, J; Sawyer, D; Robertson, G

    1997-01-01

    The issue of notifying people who have been exposed to blood products that have been associated with Creutzfeldt-Jakob disease (CJD) has arisen at a time when the Canadian blood system is under intense scrutiny. As a result, the Canadian Red Cross Society issued a recommendation to health care institutions that recipients of CJD-associated blood products be identified, notified and counselled. Although Canadian jurisprudence in the realm of informed consent may support a policy of individual notification, a review of the scientific evidence and the applicable ethical principles arguably favours a policy of a more general public notification. Indeed, situations such as this require a unique approach to the formation of legal and ethical duties, one that effectively integrates all relevant factors. As such, the authors argue that individual notification is currently not justified. Nevertheless, if a system of general notification is implemented (e.g., through a series of public health announcements), it should provide, for people who wish to know, the opportunity to find out whether they were given CJD-associated products. PMID:9371070

  11. Ethical, legal and social issues in the context of the planning stages of the Southern African Human Genome Programme.

    PubMed

    de Vries, Jantina; Slabbert, Melodie; Pepper, Michael S

    2012-03-01

    As the focus on the origin of modern man appears to be moving from eastern to southern Africa, it is recognised that indigenous populations in southern Africa may be the most genetically diverse on the planet and hence a valuable resource for human genetic diversity studies. In order to build regional capacity for the generation, analysis and application of genomic data, the Southern African Human Genome Programme was recently launched with the aid of seed funding from the national Department of Science and Technology in South Africa. The purpose of the article is to investigate pertinent ethical, legal and social issues that have emerged during the planning stages of the Southern African Human Genome Programme. A careful consideration of key issues such as public perception of genomic research, issues relating to genetic and genomic discrimination and stigmatisation, informed consent, privacy and data protection, and the concept of genomic sovereignty, is of paramount importance in the early stages of the Programme. This article will also consider the present legal framework governing genomic research in South Africa and will conclude with proposals regarding such a framework for the future.

  12. Hunger strikers: ethical and legal dimensions of medical complicity in torture at Guantanamo Bay.

    PubMed

    Dougherty, Sarah M; Leaning, Jennifer; Greenough, P Gregg; Burkle, Frederick M

    2013-12-01

    Physicians and other licensed health professionals are involved in force-feeding prisoners on hunger strike at the US Naval Base at Guantanamo Bay (GTMO), Cuba, the detention center established to hold individuals captured and suspected of being terrorists in the wake of September 11, 2001. The force-feeding of competent hunger strikers violates medical ethics and constitutes medical complicity in torture. Given the failure of civilian and military law to end the practice, the medical profession must exert policy and regulatory pressure to bring the policy and operations of the US Department of Defense into compliance with established ethical standards. Physicians, other health professionals, and organized medicine must appeal to civilian state oversight bodies and federal regulators of medical science to revoke the licenses of health professionals who have committed prisoner abuses at GTMO.

  13. Choosing between possible lives: legal and ethical issues in preimplantation genetic diagnosis.

    PubMed

    Scott, Rosamund

    2006-01-01

    This article critically appraises the current legal scope of the principal applications of preimplantation genetic diagnosis (PGD). This relatively new technique, which is available to some parents undergoing in vitro fertilization (IVF) treatment, aims to ensure that a child is not born with a seemingly undesirable genetic condition. The question addressed here is whether there should be serious reasons to test for genetic conditions in embryos in order to be able to select between them. The Human Fertilisation and Embryology Authority and the Human Genetics Commission have decided that there should be such reasons by broadly aligning the criteria for PGD with those for selective abortion. This stance is critically explored, as are its implications for the possible use of PGD to select either against or for marginal features or for significant traits. The government is currently reviewing the legal scope and regulation of PGD.

  14. [Ethical-legal aspects of the civil responsibility of physicians in professional practice].

    PubMed

    Fortes, P A

    1990-12-01

    The ethical-juridical concepts related to the civil responsibility of medical activity in liberal practice are brought up to date. To this end, the arguments which guide the shaping up of the contractual relationship between the physician and the client are analysed, as also are the foundations on which the notion of guilt--an essential component of civil responsibility, whether relating to technical acts of to those within the field of medical humanism--are grounded. The answers presented for the solution of this question by European juridical systems are given.

  15. DNA banking and DNA databanking: Legal, ethical, and public policy issues

    SciTech Connect

    Reilly, P.R.; McEwen, J.E.; Lawyer, J.D.; Small, D.

    1997-04-30

    The purpose of this research was to provide support to enable the authors to: (1) perform legal and empirical research and critically analyze DNA banking and DNA databanking as those activities are conducted by state forensic laboratories, the military, academic researchers, and commercial enterprises; and (2) develop a broadcast quality educational videotape for viewing by the general public about DNA technology and the privacy and related issues that it raises. The grant thus had both a research and analysis component and a public education component. This report outlines the work completed under the project.

  16. Legal and ethical issues in the regulation and development of engineering achievements in medical technology. II.

    PubMed

    Bronzino, J D; Flannery, E J; Wade, M

    1990-01-01

    For pt.I see ibid., vol.9, no.2, p.79-81 (1990). The ethical issues raised by the fact that patients/subjects are less protected in non-investigational-device-exemption (non-IDE) use of unapproved medical devices than in IDE use are examined. Practice, research, and nonvalidated practice, an intervention that falls into the region between pure practice and pure research, are defined and examined with respect to non-IDE use of unapproved medical devices. Two types of non-IDE use are considered: that which would be permitted under the feasibility studies mechanism, and emergency use. Ethical issues in both cases are discussed. It is concluded that the Food and Drug Administration (FDA) must not only expand the freedom of scientific investigators to develop new medical devices, allowing flexibility in defined non-IDE contexts that will not jeopardize the safety or welfare of patients, but also clearly and concisely define the procedures which outline this expanded freedom.

  17. [An approach to the legal and ethical problem of surrogate motherhood].

    PubMed

    López Guzmán, José; Aparisi Miralles, Angela

    2012-01-01

    Surrogate motherhood is an issue which currently gives rise to considerable complexity. Some consider that it is a justifiable practice which should be permitted by law. However, western legal systems have traditionally understood that whereas objects can be traded freely, persons, including the human body, its organs and most essential functions, cannot be the object of commerce. This means that the freedom of the individual to make contracts for mutual benefit is limited. Regarding the child, legalization of surrogate motherhood means converting the parent-child relationship into a commercial relationship, since in the last instance this would depend on a financial transaction. Moreover, experience has shown that the child is left in a very vulnerable position, since his or her situation depends on the clauses set forth in the contract, which in no sense guarantees that his or her interests and rights will be protected. For all these reasons, we must conclude that the wish on the part of infertile couples should be taken seriously by society. However, not all desires that adults have should be regarded as rights, particularly if this is detrimental to the dignity and rights of other subjects involved, particularly those of vulnerable women and their children.

  18. [End of life non-therapeutic intensive care for organ preservation and donation: legal and ethical issues].

    PubMed

    Baumann, Antoine; Ducrocq, Xavier; Audibert, Gérard; Coudane, Henry; Mertes, Paul-Michel; Claudot, Frédérique

    2012-10-01

    Stroke is presently the first cause of brain death in France. In this context, the question of elective non-therapeutic ventilation and resuscitation arises, aiming at enabling the patients for whom a decision to stop all the therapeutics has been made to evolve towards brain death and organ donation. In 2010, the French society of intensive care has released guidelines regarding stroke management including strategy on this topic. The question has also been referred to the Ethics Committee of Nancy university hospital by a chief-nurse of our hospital and we report here its conclusions and propositions. A workgroup was appointed and has tackled the major issues: the justification, the risks for the patient and the society, the expression of the patient's consent, the legality of this care benefiting only a third party, and the practical details. Elective intensive care following decision to stop any treatment after severe stroke seems to be justified with regard to public health as well as individual or collective ethics, providing the patient has expressed his/her consent or his/her non-opposition before stroke occurrence. In France there is no legal frame regulating this practice, no information of the general public, and a public debate has yet to be initiated. Regarding the practical details, a priori agreement of the organ procurement organisation, patient's consent, and approval of the consultant required by the law of April 22, 2005 relating to Patients' rights and to the end of life to rule out any conflict of interest, have to be checked before referring the patient to ICU. Advance directives drafting must be developed and their scope extended to organ donation and elective resuscitation. Therefore, fair information of the general public and clarity and transparency of the procedures are needed. The prolongation of the French moratorium on Maastricht III type non-heart beating organ donation - grounded on fears of possible conflicts on interest - seems

  19. Ethical, legal and social issues in restoring genetic identity after forced disappearance and suppression of identity in Argentina.

    PubMed

    Penchaszadeh, Victor B

    2015-07-01

    Human genetic identification has been increasingly associated with the preservation, defence and reparation of human rights, in particular the right to genetic identity. The Argentinian military dictatorship of 1976-1983 engaged in a savage repression and egregious violations of human rights, including forced disappearance, torture, assassination and appropriation of children of the disappeared with suppression of their identity. The ethical, legal and social nuances in the use of forensic genetics to support the right to identity in Argentina included issues such as the best interest of children being raised by criminals, the right to learn the truth of one's origin and identity, rights of their biological families, the issue of voluntary versus compulsory testing of victims, as well as the duty of the state to investigate crimes against humanity, punish perpetrators and provide justice and reparation to the victims. In the 30 years following the return to democracy in 1984, the search, localization and DNA testing of disappeared children and young adults has led, so far, to the genetic identification of 116 persons who had been abducted as babies. The high value placed on DNA testing to identify victims of identity suppression did not conflict with the social consensus that personal identity is a complex and dynamic concept, attained by the interaction of genetics with historical, social, emotional, educational, cultural and other important environmental factors. The use of genetic identification as a tool to redress and repair human rights violations is a novel application of human genetics within a developing set of ethical and political circumstances.

  20. Implementing a One Health approach to emerging infectious disease: reflections on the socio-political, ethical and legal dimensions.

    PubMed

    Degeling, Chris; Johnson, Jane; Kerridge, Ian; Wilson, Andrew; Ward, Michael; Stewart, Cameron; Gilbert, Gwendolyn

    2015-12-29

    'One Health' represents a call for health researchers and practitioners at the human, animal and environmental interfaces to work together to mitigate the risks of emerging and re-emerging infectious diseases (EIDs). A One Health approach emphasizing inter-disciplinary co-operation is increasingly seen as necessary for effective EID control and prevention. There are, however, socio-political, ethical and legal challenges, which must be met by such a One Health approach. Based on the philosophical review and critical analysis of scholarship around the theory and practice of One Health it is clear that EID events are not simply about pathogens jumping species barriers; they are comprised of complex and contingent sets of relations that involve socioeconomic and socio-political drivers and consequences with the latter extending beyond the impact of the disease. Therefore, the effectiveness of policies based on One Health depends on their implementation and alignment with or modification of public values. Despite its strong motivating rationale, implementing a One Health approach in an integrated and considered manner can be challenging, especially in the face of a perceived crisis. The effective control and prevention of EIDs therefore requires: (i) social science research to improve understanding of how EID threats and responses play out; (ii) the development of an analytic framework that catalogues case experiences with EIDs, reflects their dynamic nature and promotes inter-sectoral collaboration and knowledge synthesis; (iii) genuine public engagement processes that promote transparency, education and capture people's preferences; (iv) a set of practical principles and values that integrate ethics into decision-making procedures, against which policies and public health responses can be assessed; (v) integration of the analytic framework and the statement of principles and values outlined above; and (vi) a focus on genuine reform rather than rhetoric.

  1. Withholding differential risk information on legal consumer nicotine/tobacco products: The public health ethics of health information quarantines.

    PubMed

    Kozlowski, Lynn T; Sweanor, David

    2016-06-01

    The United States provides an example of a country with (a) legal tobacco/nicotine products (e.g., snus, other smokeless tobacco, cigarettes) differing greatly in risks to health and (b) respected health information websites that continue to omit or provide incorrect differential risk information. Concern for the principles of individual rights, health literacy, and personal autonomy (making decisions for oneself), which are key principles of public health ethics, has been countered by utilitarian arguments for the use of misleading or limited information to protect public health overall. We argue that omitting key health relevant information for current or prospective consumers represents a kind of quarantine of health-relevant information. As with disease quarantines, the coercive effects of quarantining information on differential risks need to be justified, not merely by fears of net negative public health effects, but by convincing evidence that such measures are actually warranted, that public health overall is in imminent danger and that the danger is sufficient to override principles of individual autonomy. Omitting such health-relevant information for consumers of such products effectively blindfolds them and impairs their making informed personal choices. Moral psychological issues that treat all tobacco/nicotine products similarly may also be influencing the reluctance to inform on differential risks. In countries where tobacco/nicotine products are legally sold and also differ greatly in disease risks compared to cigarettes (e.g., smokeless tobacco and vape), science-based, comprehensible, and actionable health information (consistent with health literacy principles) on differential risks should be available and only reconsidered if it is established that this information is causing losses to population health overall.

  2. Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

    PubMed Central

    Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

    2013-01-01

    In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation – ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and

  3. Public Perceptions of Ethical, Legal and Social Implications of Pre-implantation Genetic Diagnosis (PGD) in Malaysia.

    PubMed

    Olesen, Angelina P; Mohd Nor, Siti Nurani; Amin, Latifah; Che Ngah, Anisah

    2016-12-19

    Pre-implantation genetic diagnosis (PGD) became well known in Malaysia after the birth of the first Malaysian 'designer baby', Yau Tak in 2004. Two years later, the Malaysian Medical Council implemented the first and only regulation on the use of Pre-implantation Genetic Diagnosis in this country. The birth of Yau Tak triggered a public outcry because PGD was used for non-medical sex selection thus, raising concerns about PGD and its implications for the society. This study aims to explore participants' perceptions of the future implications of PGD for the Malaysian society. We conducted in-depth interviews with 21 participants over a period of one year, using a semi-structured questionnaire. Findings reveal that responses varied substantially among the participants; there was a broad acceptance as well as rejection of PGD. Contentious ethical, legal and social issues of PGD were raised during the discussions, including intolerance to and discrimination against people with genetic disabilities; societal pressure and the 'slippery slope' of PGD were raised during the discussions. This study also highlights participants' legal standpoint, and major issues regarding PGD in relation to the accuracy of diagnosis. At the social policy level, considerations are given to access as well as the impact of this technology on families, women and physicians. Given these different perceptions of the use of PGD, and its implications and conflicts, policies and regulations of the use of PGD have to be dealt with on a case-by-case basis while taking into consideration of the risk-benefit balance, since its application will impact the lives of so many people in the society.

  4. The therapeutic partnership: legal and ethical aspects of consumer health information.

    PubMed

    Gann, R

    1995-06-01

    Patients' rights to information in the UK are based on a mixture of statute (including legislation on access to medical records) and case law (principally revolving around the issue of informed consent). These rights are set out in the Patient's Charter, which is itself a mixture of rights based on legislation and those enforced by management practice. Failure to provide adequate information to a patient could expose a medical practitioner to action for negligence or battery. Negligent information-giving could also expose consumer health information services to damages, for which the best defence is a high standard of professional competence and adequate professional indemnity insurance. Sharing information about the risks and benefits of treatment to enable truly informed decision making and consent by the patient is a key element of an ethical relationship between care giver and consumer--the therapeutic partnership.

  5. Ethical and legal issues in cases of withdrawing treatment from an incompetent patient in Italy.

    PubMed

    Veshi, Denard

    2013-12-01

    The traditional approach towards end-of-life decision-making in Italy has changed. Whilst article 32 of the Italian Constitution recognizes the 'right to health' that grants patients to withhold or withdraw medical treatment, the Italian Medical Ethics Code neglects any kind of assistance during death or euthanasia. Although norms seem clear, ethicists and lawyers continue to discuss if withdrawing treatment from an incompetent patient should be classified as immoral and/or illegal. This is the result of acceptance of concepts such as patient's autonomy and the "right to die". On one hand, ethicist and lawyers, valuing the patient's autonomy, believe that letting die cannot be punished. On the other hand, however, some conservative ethicists and lawyers argue that the right to life is absolute and imperative and therefore a physician must do everything possible to protect one's life.

  6. Canine leishmaniosis and euthanasia in Italy: a critical legal-ethical analysis.

    PubMed

    Passantino, A; Russo, M; Coluccio, P

    2010-12-01

    The increasing awareness that control of zoonotic visceral leishmaniosis (ZVL) depends on effective control of canine leishmaniosis has promoted research into leishmanial infection in dogs, but has also encouraged the indiscriminate elimination of seropositive dogs. Public health campaigns in various parts of the world (e.g. in Brazil and China) are designed to reduce the incidence of human ZVL by targeting/killing dogs. However, not all situations are the same; in Italy, for example, there would be little support for this type of control measure because attitudes towards animals are different. Moreover, research has suggested that the destruction of seropositive dogs is a relatively ineffective control measure. In this context, the authors reflect on some epidemiological, ethical and juridical aspects, aiming to contribute to the discussion and to find more feasible solutions.

  7. Parents' perceptions of HIV counselling and testing in schools: ethical, legal and social implications.

    PubMed

    Gwandure, Ruth; Ross, Eleanor; Dhai, Ames; Gardner, Jillian

    2013-07-29

    In view of the high prevalence of HIV and AIDS in South Africa, particularly among adolescents, the Departments of Health and Education have proposed a school-based HIV counselling and testing (HCT) campaign to reduce HIV infections and sexual risk behaviour. Through the use of semi-structured interviews, our qualitative study explored perceptions of parents regarding the ethico-legal and social implications of the proposed campaign. Despite some concerns, parents were generally in favour of the HCT campaign. However, they were not aware of their parental limitations in terms of the Children's Act. Their views suggest that the HCT campaign has the potential to make a positive contribution to the fight against HIV and AIDS, but needs to be well planned. To ensure the campaign's success, there is a need to enhance awareness of the programme. All stakeholders, including parents, need to engage in the programme as equal partners. 

  8. Handling ethical, legal and social issues in birth cohort studies involving genetic research: responses from studies in six countries

    PubMed Central

    2010-01-01

    Background Research involving minors has been the subject of much ethical debate. The growing number of longitudinal, pediatric studies that involve genetic research present even more complex challenges to ensure appropriate protection of children and families as research participants. Long-term studies with a genetic component involve collection, retention and use of biological samples and personal information over many years. Cohort studies may be established to study specific conditions (e.g. autism, asthma) or may have a broad aim to research a range of factors that influence the health and development of children. Studies are increasingly intended to serve as research platforms by providing access to data and biological samples to researchers over many years. This study examines how six birth cohort studies in North America and Europe that involve genetic research handle key ethical, legal and social (ELS) issues: recruitment, especially parental authority to include a child in research; initial parental consent and subsequent assent and/or consent from the maturing child; withdrawal; confidentiality and sample/data protection; handling sensitive information; and disclosure of results. Methods Semi-structured telephone interviews were carried out in 2008/09 with investigators involved in six birth cohort studies in Canada, Denmark, England, France, the Netherlands and the United States. Interviewees self-identified as being knowledgeable about ELS aspects of the study. Interviews were conducted in English. Results The studies vary in breadth of initial consent, but none adopt a blanket consent for future use of samples/data. Ethics review of new studies is a common requirement. Studies that follow children past early childhood recognise a need to seek assent/consent as the child matures. All studies limit access to identifiable data and advise participants of the right to withdraw. The clearest differences among studies concern handling of sensitive

  9. Handling ethical, legal and social issues in birth cohort studies involving genetic research: responses from studies in six countries.

    PubMed

    Ries, Nola M; LeGrandeur, Jane; Caulfield, Timothy

    2010-03-23

    Research involving minors has been the subject of much ethical debate. The growing number of longitudinal, pediatric studies that involve genetic research present even more complex challenges to ensure appropriate protection of children and families as research participants. Long-term studies with a genetic component involve collection, retention and use of biological samples and personal information over many years. Cohort studies may be established to study specific conditions (e.g. autism, asthma) or may have a broad aim to research a range of factors that influence the health and development of children. Studies are increasingly intended to serve as research platforms by providing access to data and biological samples to researchers over many years.This study examines how six birth cohort studies in North America and Europe that involve genetic research handle key ethical, legal and social (ELS) issues: recruitment, especially parental authority to include a child in research; initial parental consent and subsequent assent and/or consent from the maturing child; withdrawal; confidentiality and sample/data protection; handling sensitive information; and disclosure of results. Semi-structured telephone interviews were carried out in 2008/09 with investigators involved in six birth cohort studies in Canada, Denmark, England, France, the Netherlands and the United States. Interviewees self-identified as being knowledgeable about ELS aspects of the study. Interviews were conducted in English. The studies vary in breadth of initial consent, but none adopt a blanket consent for future use of samples/data. Ethics review of new studies is a common requirement. Studies that follow children past early childhood recognise a need to seek assent/consent as the child matures. All studies limit access to identifiable data and advise participants of the right to withdraw. The clearest differences among studies concern handling of sensitive information and return of results. In

  10. Incidental findings found in “healthy” volunteers during imaging performed for research: current legal and ethical implications

    PubMed Central

    Booth, T C; Jackson, A; Wardlaw, J M; Taylor, S A; Waldman, A D

    2010-01-01

    Incidental findings found in “healthy” volunteers during research imaging are common and have important implications for study design and performance, particularly in the areas of informed consent, subjects' rights, clinical image analysis and disclosure. In this study, we aimed to determine current practice and regulations concerning information that should be given to research subjects when obtaining consent, reporting of research images, who should be informed about any incidental findings and the method of disclosure. We reviewed all UK, European and international humanitarian, legal and ethical agencies' guidance. We found that the guidance on what constitutes incidental pathology, how to recognise it and what to do about it is inconsistent between agencies, difficult to find and less complete in the UK than elsewhere. Where given, guidance states that volunteers should be informed during the consent process about how research images will be managed, whether a mechanism exists for identifying incidental findings, arrangements for their disclosure, the potential benefit or harm and therapeutic options. The effects of incidentally discovered pathology on the individual can be complex and far-reaching. Radiologist involvement in analysis of research images varies widely; many incidental findings might therefore go unrecognised. In conclusion, guidance on the management of research imaging is inconsistent, limited and does not address the interests of volunteers. Improved standards to guide management of research images and incidental findings are urgently required. PMID:20335427

  11. [Alcohol and work: ethical-deontological and medico-legal remark upon the recent set of rules].

    PubMed

    Chiaravalli, M; Guzzetti, Laura; Tavani, M

    2007-01-01

    The Disposition of the Permanent Conference for the relation among the State, the Regions and the Autonomous Provinces of Trento and Bolzano, published in Gazzetta Ufficiale n. 75 on the 30th March 2006 the list of high-risk occupations under the influence of alcohol, activating de facto a previous law (Legge n. 125, 3017 march 2001, "Legge quadro in materia di alcol e di problemi alcolcorrelati"). We here present some ethical-deontological and medical-juridical profiles on the contents of this law and some consideration about its application. Particular attention is dedicated to deontological aspects about industrial safety rules and to medico-legal aspects about occupation under the influence of alcohol, with references to complex relations among worker's discretion right, employer's right to the protection of his own interests and qualified doctor's (or someone to him comparable) right to the respect for the deontological code, with regard to benefit recipient information before the medical treatment. Authors'purpose is to evidence critical points and interpretative ambiguities of a regulation lacking in its practical applications, to provide further proposals of consideration, available to revalue a thematic rich in questions and with a significant social impact.

  12. Using critical literacy to explore genetics and its ethical, legal, and social issues with in-service secondary teachers.

    PubMed

    Gleason, Michael L; Melançon, Megan E; Kleine, Karynne L M

    2010-01-01

    The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by applying a critical literacy approach that allows people develop cognitive skills such that they are able to "read the world" (Wink, 2004). The approach is one that permits readers to go beyond the literal text to examine what is present as well as what is missing as it relates to issues of equity and fairness. Becoming critically literate enabled these teacher-participants to challenge the subtle attitudes, values, and beliefs conveyed by a range of written and oral texts. The teacher-participants in this course improved their critical literacy skills by actively reading, critically writing about, and using evidence to support their conclusions about issues arising from advances in human genetics. A biologist, a linguist, and an educator collaboratively designed and taught the course. The personalized focus on the integration of thoughtful reading and writing in this class enhanced the teacher-participants' (n = 16) professional and intellectual development and will potentially improve learning in their biology and English classrooms in the future.

  13. The evolution of a high-fidelity patient simulation learning experience to teach legal and ethical issues.

    PubMed

    Smith, Katharine V; Klaassen, JoAnn; Zimmerman, Christine; Cheng, An-Lin

    2013-01-01

    A transformative learning activity, in which students participated in a high-fidelity patient simulation (HFPS) scenario, was initiated to help students learn the importance of legal and ethical content in their clinical practice. The authors used the continuous quality improvement process to guide their HFPS implementation strategies from year to year. The plan, do, check, and act model served as the framework by which 3 consecutive years of HFPS evaluations were conducted and findings subsequently implemented. Evaluation data indicated that the HFPS was most effective at the end of the semester to review and apply previous content and that neither the role fulfilled by students in the scenario nor the actual participation in the scenario (vs. observation and participation in the debriefing) made a significant difference in students' pre- and posttest scores, student or faculty evaluations, or student perceptions of the HFPS experience. These findings ensured a quality learning experience for students and helped faculty address the logistics of accommodating an increasing number of students in the HFPS scenarios each year.

  14. Using Critical Literacy to Explore Genetics and its Ethical, Legal, and Social Issues with In-Service Secondary Teachers

    PubMed Central

    Melançon, Megan E.; Kleine, Karynne L. M.

    2010-01-01

    The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by applying a critical literacy approach that allows people develop cognitive skills such that they are able to “read the world” (Wink, 2004). The approach is one that permits readers to go beyond the literal text to examine what is present as well as what is missing as it relates to issues of equity and fairness. Becoming critically literate enabled these teacher-participants to challenge the subtle attitudes, values, and beliefs conveyed by a range of written and oral texts. The teacher-participants in this course improved their critical literacy skills by actively reading, critically writing about, and using evidence to support their conclusions about issues arising from advances in human genetics. A biologist, a linguist, and an educator collaboratively designed and taught the course. The personalized focus on the integration of thoughtful reading and writing in this class enhanced the teacher-participants' (n = 16) professional and intellectual development and will potentially improve learning in their biology and English classrooms in the future. PMID:21123688

  15. Ethical, legal and social issues in nutrigenomics: the challenges of regulating service delivery and building health professional capacity.

    PubMed

    Castle, David; Ries, Nola M

    2007-09-01

    Nutrigenomics, the conjunction of molecular nutrition with human genomics, is among the first publicly available applications of the human genome project. Nutrigenomics raises ethical, legal and social issues particularly with respect to how the public may access nutrigenetic tests and associated nutritional and lifestyle advice. Current regulatory controversy focuses on potential harms associated with direct-to-consumer (DTC) marketing of nutrigenetic tests and especially the need to protect consumers from unreliable tests, false claims and unproven dietary supplements. Nutrigenomics does, however, offer the potential of important health benefits for some individuals. The regulation of nutrigenomic services is slowly evolving, but there is little indication of increased professional capacity to support service delivery. Primary care physicians have minimal training in nutrition and genetics, and medical geneticists are in high demand and short supply. Dietetic practitioners are experts in nutrition science and interest in nutrigenomics is growing among members of this professional group. However, as with physicians, dietetics practitioners would require considerable training to bring nutrigenomics into their practice capacity. A downside of regulatory restrictions on direct consumer access to nutrigenomics companies is that responsible businesses may be hindered in meeting emergent public demand while health care professional groups have not yet developed capacity to provide nutrigenomics services.

  16. Owning the tooth: exploring the ethical and legal issues relating to the use of extracted human teeth in dental education in Australia.

    PubMed

    Holden, Acl; Dracopoulos, S A

    2016-11-23

    Extracted human teeth have been used to practice operative techniques for a very long time. As a natural surrogate for a live tooth in vivo, their use has traditionally been very important for the development of skills in trainee dentists, as well as their qualified colleagues who wish to practise existing or new skills. As synthetic alternatives develop greater authenticity, alongside a society in which many retain their natural dentition well into old age, the current paradigm relating to how extracted teeth in dental education are used needs to be revisited. An ethical and legal dilemma that must be addressed within dental education relates to where and how teeth may be sourced. This article will seek to question whether there is a legal or ethical requirement to gain consent for the use of extracted teeth from patients, as well as exploring the status of whether extracted dental tissue can be considered to be the property of either patient or surgeon. Whilst synthetic alternatives are being utilized more frequently in education, it is unlikely that they will completely replace extracted natural teeth in the immediate future. It is therefore imperative that their use complies with legal doctrine and contemporary ethical thought.

  17. [Terms of informed consent for users of dental clinics in Brazil: legal and ethical issues].

    PubMed

    Sales-Peres, Sílvia Helena de Carvalho; Sales-Peres, Arsênio; Eleutério, Adriana Silveira de Lima; de Oliveira, José Luiz Góes; Gigliotti, Mariana Pracucio

    2011-01-01

    The consent of patient before the beginning of any procedure has to be a respected condition, without any exception. It is necessary the patients to be aware of their health status, their specific needs, the intention of each treatment, the alternatives plans (including no treatment), to know their prognostic, risks, consequences, limitations, and to be aware of their responsibilities and those of your dentist, resulting in the success of the treatment. The Informed Consent (TCLE) aims to fortify and to clarify the position of the patient, being established the rights and duties of both parts - patient and professional. The integral knowledge of the treatment will minimize the anxiety of the patient and treatment complications, and promote greater quality of dental services and improve the satisfaction of both dentist and patient. However, there are few articles in Brazil about this, but there are some ethics problems involving dental clinics regarding this document of information for the patient. Therefore, the aim of this work is to carry through a critical revision on the subject demonstrating the importance of the TCLE in the Brazilian dental clinics.

  18. Protecting Ideas: Ethical and Legal Considerations When a Grant's Principal Investigator Changes.

    PubMed

    Koniaris, Leonidas G; Coombs, Mary I; Meslin, Eric M; Zimmers, Teresa A

    2016-08-01

    Ethical issues related the responsible conduct of research involve questions concerning the rights and obligations of investigators to propose, design, implement, and publish research. When a principal investigator (PI) transfers institutions during a grant cycle, financial and recognition issues need to be addressed to preserve all parties' obligations and best interests in a mutually beneficial way. Although grants often transfer with the PI, sometimes they do not. Maintaining a grant at an institution after the PI leaves does not negate the grantee institution's obligation to recognize the PI's original ideas, contributions, and potential rights to some forms of expression and compensation. Issues include maintaining a role for the PI in determining how to take credit for, share and publish results that involve his or her original ideas. Ascribing proper credit can become a thorny issue. This paper provides a framework for addressing situations and disagreements that may occur when a new PI continues the work after the original PI transfers. Included are suggestions for proactively developing institutional mechanisms that address such issues. Considerations include how to develop solutions that comply with the responsible conduct of research, equitably resolve claims regarding reporting of results, and avoid the possibility of plagiarism.

  19. The historical, ethical, and legal background of human-subjects research.

    PubMed

    Rice, Todd W

    2008-10-01

    The current system of human-subject-research oversight and protections has developed over the last 5 decades. The principles of conducting human research were first developed as the Nuremberg code to try Nazi war criminals. The 3 basic elements of the Nuremberg Code (voluntary informed consent, favorable risk/benefit analysis, and right to withdraw without repercussions) became the foundation for subsequent ethical codes and research regulations. In 1964 the World Medical Association released the Declaration of Helsinki, which built on the principles of the Nuremberg Code. Numerous research improprieties between 1950 and 1974 in the United States prompted Congressional deliberations about human-subject-research oversight. Congress's first legislation to protect the rights and welfare of human subjects was the National Research Act of 1974, which created the National Commission for Protection of Human Subjects of Biomedical and Behavioral Research, which issued the Belmont Report. The Belmont Report stated 3 fundamental principles for conducting human-subjects research: respect for persons, beneficence, and justice. The Office of Human Research Protections oversees Title 45, Part 46 of the Code for Federal Regulations, which pertains to human-subjects research. That office indirectly oversees human-subjects research through local institutional review boards (IRB). Since their inception, the principles of conducting human research, IRBs, and the Code for Federal Regulations have all advanced substantially. This paper describes the history and current status of human-subjects-research regulations.

  20. Reprioritizing Research Activity for the Post-Antibiotic Era: Ethical, Legal, and Social Considerations.

    PubMed

    Hey, Spencer Phillips; Kesselheim, Aaron S

    2017-03-01

    Many hold that the so-called golden era of antibiotic discovery has passed, leaving only a limited clinical pipeline for new antibiotics. A logical conclusion of such arguments is that we need to reform the current system of antibiotic drug research-including clinical trials and regulatory requirements-to spur activity in discovery and development. The United States Congress in the past few years has debated a number of bills to address this crisis, including the 2012 Generating Antibiotic Incentives Now Act and the 2016 21st Century Cures Act. Experts have also sought to advance antibiotic development by encouraging greater use of trials with noninferiority hypotheses, which are thought to be easier to conduct. The goal underlying these proposals is to stave off the post-antibiotic era by expanding the pharmaceutical armamentarium as quickly as possible. But although new antibiotic agents are necessary to combat the long-term threat of drug-resistant disease, we argue that these research policies, which effectively lower the bar for antibiotic approval, are ethically problematic. Rather, given broader public health considerations related to the full lifecycle of antibiotic use-including development of resistance-we should reject an overly permissive approach to new antibiotic approval and instead set the bar for regulatory approval at a point that will naturally direct research resources toward the most transformative chemical or social interventions.

  1. Navigating the legal and ethical foundations of informed consent and confidentiality in integrated primary care.

    PubMed

    Hudgins, Cathy; Rose, Sandra; Fifield, Peter Y; Arnault, Steve

    2013-03-01

    This article describes findings from ongoing research and analysis of current literature in addition to discussions with leaders in the field, communications with lawyers and administrators of advocacy and government agencies pertaining to integrated primary care (IPC). Standards of care are established based on a myriad of factors, including professional codes of ethics, case law, state and federal laws, professional standards, existing best practices, current professional guidelines, administrative rules and regulations, and licensing board regulations. Regulations may differ for behavioral health and medical providers, posing challenges in IPC settings. This article provides a review of these regulations, particularly 42CFR Part 2, a federal law governing confidentiality for substance abuse programs, Health Insurance Portability and Accountability Act (HIPAA), and state laws relevant to patient care in IPC settings. On the basis of findings from the study, the authors make recommendations related to patient care practices concerning informed consent and release of information procedures, treatment and warm hand-off protocols, documentation and electronic record keeping, agreements with other providers, and billing.

  2. [The case of Inmaculada Echevarría: ethical and legal implications].

    PubMed

    Simón-Lorda, P; Barrio-Cantalejo, I M

    2008-12-01

    Inmaculada Echevarría was a woman with Progressive Muscular Dystrophy who was totally dependent on mechanical ventilation. In October 2006, she publicly asked to be disconnected of the ventilator. The clinical and biographical data of the case are presented in the first part of the work. The paper goes on to explain the decisions of the two committees that evaluated her request, that is the Regional Ethics Committee and the Consultative Council of Andalusia. Finally, the outcome of the case is presented. The second part analyzes the background of the debate on end-of-life decision making in Spain in cases such as those of Ramon Sampedro, Jorge Leon or Madeleine Z. It then presents four different settings of end-of-life decision making that have been clarified over these last years: euthanasia and assisted suicide, limitation of life-prolonging treatment, treatment refusal and palliative sedation. The article concludes that the latter three can be considered as sufficiently clarified after the case of Inmaculada Echevarría. However, the first one, that is euthanasia and assisted suicide, must be confronted by the Spanish society in forthcoming years.

  3. Knowledge management and electronic care records: Incorporating social, legal and ethical issues.

    PubMed

    Bassinder, James; Bali, Rajeev K; Naguib, Raouf

    2006-01-01

    Many challenges face developers of secure computer-based clinical systems but the technical problems are overshadowed by many obstacles, key amongst them being social and ethical issues. A sound Knowledge Management (KM) structure within clinical environments can recognise the responsibility of healthcare professionals to keep patient clinical data (for example, electronic care record (ECR) systems) secure. An arrangement is proposed that gives the most senior clinician in a healthcare facility the ultimate responsibility for security of clinical data held in the organisation. Ideally, the senior clinician would possess training and experience in information systems and their security. Contracts should be developed between healthcare facilities and their patients, defining the limits to the use and disclosure of clinical health data. However, we are observing increasing confusion about the term 'Knowledge Management' which may be limited both its efficacy and effectiveness. Health organisations are referring to the term in various contexts and health informatics articles frequently use the term and interpret it in diverse ways. Given the divergence of views, this paper will attempt to establish KM's efficacy for the implementation of electronic care record systems.

  4. Ethical and legal obligation to avoid long-term tunneled catheter access.

    PubMed

    Rehman, Raheela; Schmidt, Rebecca J; Moss, Alvin H

    2009-02-01

    Despite recent national initiatives promoting the arteriovenous fistula as the initial, primary, and sole vascular access to be used by hemodialysis patients and recommending a decrease in the prevalence of tunneled cuffed catheters to less than 10%, the prevalence of tunneled cuffed catheters as hemodialysis access is increasing. This study describes the risks of tunneled cuffed catheters, explores the reasons why they remain prevalent, and presents the stance that nephrologists have an obligation to offer tunneled cuffed catheters only for temporary use and not as an acceptable alternative for long-term vascular access to patients for whom a properly functioning arteriovenous fistula or graft is possible. Recommendations for tunneled cuffed catheter use were based on dialysis clinical practice guidelines and the medical evidence regarding outcomes of use of arteriovenous fistulas and tunneled cuffed catheters. The authors found that compared with dialysis with arteriovenous fistulas, long-term dialysis with tunneled cuffed catheters is associated with (1) two to threefold increased risk of death, (2) a five to 10-fold increased risk of serious infection, (3) increased hospitalization, (4) a decreased likelihood of adequate dialysis, and (5) an increased number of vascular access procedures. To adequately inform patients about access options, nephrologists are ethically obligated to systematically explain to patients the harms of tunneled cuffed catheters. If catheters must be used to initiate dialysis, nephrologists should present catheters only as "temporary" measures and "unsafe for long-term use."

  5. Pharmacogenetics and pharmacogenomics: recent developments, their clinical relevance and some ethical, social, and legal implications.

    PubMed

    Norbert, Paul W; Roses, Allen D

    2003-03-01

    In recent debates on novel procedures of molecular medicine pharmacogenomics is attracting more and more attention as a genotype-based approach for improving safety and efficacy of the use of therapeutic substances. Promoted by basic knowledge generated in the field of medical genomics, facilitated by novel technological tools for mapping genetic variation in individuals, and supported by results of initial clinical studies linking specific genotypes to metabolic characteristics of individuals important for assessing drug response, procedures of pharmacogenetics and pharmacogenomics now are starting to impact significantly on clinical research and development and medical practice. In this situation assessing the goals, risk, and benefits of pharmacogenetics and pharmacogenomics is essential for the medically successful, ethically justifiable, and socially acceptable implementation of genotype-based diagnosis and pharmacotherapy. We discuss the current state of the art in pharmacogenetics and pharmacogenomics and introduce a model for evidence based assessment of its goals, risk, and benefits. We differentiate here between pragmatic and normative issues in the development of pharmacogenomics in order to contrast prevailing, insufficiently interest-based modes of public technology assessment with the evidence-based mode that can be established as part of clinical study design. Finally, we provide a framework for the analysis of social accountability that can be used for technology development and technology assessment with regard to pharmacogenomics in particular and molecular medicine in general.

  6. Substance abuse and control in the United States: ethical and legal issues.

    PubMed

    Newcomb, M D

    1992-08-01

    In 1986, the United States began to wage its most recent War on Drugs. This has involved establishing various policies and making investments to implement these policies and approaches. In general, the U.S. has taken a tough-guy stand to drug abuse and control that emphasizes punishment, restriction, and 'social warfare', as opposed to a public health oriented position. Current policy reflects a 'quick fix' solution to a complex problem, which may partially explain its failure and why we appear to be losing the War on Drugs. In this review I summarize the current debates and controversies surrounding drug abuse in the U.S. regarding the extent of the drug problem, the need for drug control, prevention efforts, legalization controversy, workplace strategies, treatment dilemmas, and maternal drug abuse. I argue that a radically different approach must be taken that is grounded in public health methods and an appreciation of the larger social context in which drug abuse occurs. We must look for a long-term solution to this complex problem that is integrated into society, and which is certainly resistant to the current quick fix approaches.

  7. A moment in human development: legal protection, ethical standards and social policy on the selective non-treatment of handicapped neonates.

    PubMed

    Gostin, L

    1985-01-01

    Selective non-treatment decisions involving severely handicapped neonates have recently come under renewed judicial and legislative scrutiny. In this Article, the Author examines the legal, ethical and social considerations attendant to the non-treatment decision. In Part II of this Article the Author discusses the predominant ethical viewpoints relating to this issue and proposes a new moral standard based on personal interests. Part III presents a survey of the jurisprudence relating to selective non-treatment decisions. Parts IV and V of this Article provide a critical examination of the recently enacted Child Abuse Amendments of 1984, a federal legislative initiative designed to regulate treatment decisions relating to handicapped infants. The Author suggests that the ethical standards and treatment criteria proposed in this Article may prove useful to courts seeking to balance the handicapped neonate's constitutional right to privacy with the requirements of the new federal law.

  8. Ethical and legal issues in the use of related donors for therapeutic insemination.

    PubMed

    Marshall, Lorna A

    2002-11-01

    . Financial incentives, including direct and indirect payment and inheritance, should not be so substantial that they become inducements that may lead the prospective donor to discount the emotional risk associated with the procedure. Legal counsel should be strongly encouraged to clarify issues of disclosure, rights, and duties, as well as the donor's relationship to the resulting offspring. Any possible changes in these issues in the event of divorce or death of requesting individuals should be addressed. In certain cases, requests should be immediately denied. Gametes from consanguineous relationships should never be used to initiate a pregnancy. Because of potential parental conflicts of interest, programs should not allow minors under the age of 18 years to donate sperm. The use of a family member may not be appropriate when sperm donation is chosen to prevent genetic diseases. Careful genetic counseling should be done before intrafamilial sperm donation is allowed in this situation. If, after careful consideration of the proposed arrangement, the physician chooses to facilitate the relationship, then all precautions should be taken to prevent medical, psychologic, and legal harm to the requesting couple or individual, the potential donor, and the prospective child. Programs that offer these arrangements should make every effort to obtain long-term follow up on the outcomes of these relationships, so that programs can provide more accurate information to families considering these relationships in the future. The physician or program should not feel obligated to agree to every request for intrafamilial sperm donation. When the assessment reveals consistent concerns about coercion of the prospective donor or about unhealthy family dynamics, the physician should feel free to deny these procedures. The physician should advise the requesting couple or individual to seek alternative methods, such as anonymous sperm donation, to conceive.

  9. Implementation of minimal invasive gynaecological surgery certification will challenge gynaecologists with new legal and ethical issues

    PubMed Central

    Tanos, V; Socolov, R; Demetriou, P; Kyprianou, M; Watrelot, A; Van Belle, Y; Campo, R

    2016-01-01

    Abstract The introduction of a certification / diploma program in Minimal Invasive Surgery (MIS) is expected to improve surgical performance, patient’s safety and outcome. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA) and the ESHRE Certification for Reproductive Endoscopic Surgery (ECRES) provides a structured learning path, recognising different pillars of competence. In order to achieve a high level of competence a two steps validation is necessary: (a) the individual should be certified of having the appropriate theoretical knowledge and (b) the endoscopic psychomotor skills before entering in the diploma programme reflecting the surgical competence. The influence of such an educational and credentialing path could improve safety and offer financial benefits to the hospitals, physicians and healthcare authorities. Moreover the medicolegal consequences can be important when a significant amount of surgeons possess the different diplomas. As the programs are becoming universally accessible, recognised as the best scientific standard, included in the continuous medical education (CME) and continuous professional development (CPD), it is expected that a significant number of surgeons will soon accomplish the diploma path. The co-existence and practice of both non-certified and certified surgeons with different degrees of experience is unavoidable. However, it is expected that national health systems (NHS), hospitals and insurance companies will demand and hire doctors with high and specific proficiency to endoscopic surgery. When medico-legal cases are under investigation, the experts should be aware of the limitations that individual experience provides. The court first of all examines and then judges if there is negligence and decides accordingly. However, lack of certification may be considered as negligence by a surgeon operating a case that eventual faces litigation problems. Patients’ safety and objective preoperative

  10. Implementation of minimal invasive gynaecological surgery certification will challenge gynaecologists with new legal and ethical issues.

    PubMed

    Tanos, V; Socolov, R; Demetriou, P; Kyprianou, M; Watrelot, A; Van Belle, Y; Campo, R

    2016-06-27

    The introduction of a certification / diploma program in Minimal Invasive Surgery (MIS) is expected to improve surgical performance, patient's safety and outcome. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA) and the ESHRE Certification for Reproductive Endoscopic Surgery (ECRES) provides a structured learning path, recognising different pillars of competence. In order to achieve a high level of competence a two steps validation is necessary: (a) the individual should be certified of having the appropriate theoretical knowledge and (b) the endoscopic psychomotor skills before entering in the diploma programme reflecting the surgical competence. The influence of such an educational and credentialing path could improve safety and offer financial benefits to the hospitals, physicians and healthcare authorities. Moreover the medicolegal consequences can be important when a significant amount of surgeons possess the different diplomas. As the programs are becoming universally accessible, recognised as the best scientific standard, included in the continuous medical education (CME) and continuous professional development (CPD), it is expected that a significant number of surgeons will soon accomplish the diploma path. The co-existence and practice of both non-certified and certified surgeons with different degrees of experience is unavoidable. However, it is expected that national health systems (NHS), hospitals and insurance companies will demand and hire doctors with high and specific proficiency to endoscopic surgery. When medico-legal cases are under investigation, the experts should be aware of the limitations that individual experience provides. The court first of all examines and then judges if there is negligence and decides accordingly. However, lack of certification may be considered as negligence by a surgeon operating a case that eventual faces litigation problems. Patients' safety and objective preoperative counselling are

  11. Can autonomy be limited--an ethical and legal perspective in a South African context?

    PubMed

    Engelbrecht, Sidney F

    2014-11-30

    The principle of autonomy acknowledges the positive duty on a health care practitioner to respect the decisions of a patient. The principle of respect for autonomy is codified in the International Bill of Rights, the African Charter, The South African Constitution (108 of 1996) and the Patients' Right Charter. The common notion is to protect a person's liberty, privacy and integrity. Health care practitioners should honour the rights of patients to self-determination or to make their own informed choices. Patients have the right to live their lives by their own beliefs, values and preferences. This implies that a healthcare practitioner should respect the wishes of a patient when a patient makes an autonomous decision. The principle of respect for autonomy takes into consideration a patient's choice based on informed consent and the protection of confidentiality of the patient. Informed consent is a process whereby information is shared with a patient to enable an informed decision. It is therefore important for a patient to be well informed to give effect to the notion of making an informed decision. The relationship between the healthcare practitioner and the patient is based on trust and communication. Full disclosure to a patient will empower a patient to make a true informed decision. It is of particular importance for a health care practitioner to acknowledge and respect the decisions and choice made by a patient so as not to violate a patient's autonomy. Can autonomy be limited? It can, if legally required and duly justified. Section 36 of the South African Constitution (Act 108 of 1996) limits rights in the Bill of Rights by application of a general law.

  12. Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines.

    PubMed

    Antal, A; Alekseichuk, I; Bikson, M; Brockmöller, J; Brunoni, A R; Chen, R; Cohen, L G; Dowthwaite, G; Ellrich, J; Flöel, A; Fregni, F; George, M S; Hamilton, R; Haueisen, J; Herrmann, C S; Hummel, F C; Lefaucheur, J P; Liebetanz, D; Loo, C K; McCaig, C D; Miniussi, C; Miranda, P C; Moliadze, V; Nitsche, M A; Nowak, R; Padberg, F; Pascual-Leone, A; Poppendieck, W; Priori, A; Rossi, S; Rossini, P M; Rothwell, J; Rueger, M A; Ruffini, G; Schellhorn, K; Siebner, H R; Ugawa, Y; Wexler, A; Ziemann, U; Hallett, M; Paulus, W

    2017-09-01

    by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6-7, 2016 and were refined thereafter by email correspondence. Copyright © 2017 International Federation of Clinical Neurophysiology. All rights reserved.

  13. Ethical and legal implications of whole genome and whole exome sequencing in African populations.

    PubMed

    Wright, Galen E B; Koornhof, Pieter G J; Adeyemo, Adebowale A; Tiffin, Nicki

    2013-05-28

    Rapid advances in high throughput genomic technologies and next generation sequencing are making medical genomic research more readily accessible and affordable, including the sequencing of patient and control whole genomes and exomes in order to elucidate genetic factors underlying disease. Over the next five years, the Human Heredity and Health in Africa (H3Africa) Initiative, funded by the Wellcome Trust (United Kingdom) and the National Institutes of Health (United States of America), will contribute greatly towards sequencing of numerous African samples for biomedical research. Funding agencies and journals often require submission of genomic data from research participants to databases that allow open or controlled data access for all investigators. Access to such genotype-phenotype and pedigree data, however, needs careful control in order to prevent identification of individuals or families. This is particularly the case in Africa, where many researchers and their patients are inexperienced in the ethical issues accompanying whole genome and exome research; and where an historical unidirectional flow of samples and data out of Africa has created a sense of exploitation and distrust. In the current study, we analysed the implications of the anticipated surge of next generation sequencing data in Africa and the subsequent data sharing concepts on the protection of privacy of research subjects. We performed a retrospective analysis of the informed consent process for the continent and the rest-of-the-world and examined relevant legislation, both current and proposed. We investigated the following issues: (i) informed consent, including guidelines for performing culturally-sensitive next generation sequencing research in Africa and availability of suitable informed consent documents; (ii) data security and subject privacy whilst practicing data sharing; (iii) conveying the implications of such concepts to research participants in resource limited settings. We

  14. Ethical and legal implications of whole genome and whole exome sequencing in African populations

    PubMed Central

    2013-01-01

    Background Rapid advances in high throughput genomic technologies and next generation sequencing are making medical genomic research more readily accessible and affordable, including the sequencing of patient and control whole genomes and exomes in order to elucidate genetic factors underlying disease. Over the next five years, the Human Heredity and Health in Africa (H3Africa) Initiative, funded by the Wellcome Trust (United Kingdom) and the National Institutes of Health (United States of America), will contribute greatly towards sequencing of numerous African samples for biomedical research. Discussion Funding agencies and journals often require submission of genomic data from research participants to databases that allow open or controlled data access for all investigators. Access to such genotype-phenotype and pedigree data, however, needs careful control in order to prevent identification of individuals or families. This is particularly the case in Africa, where many researchers and their patients are inexperienced in the ethical issues accompanying whole genome and exome research; and where an historical unidirectional flow of samples and data out of Africa has created a sense of exploitation and distrust. In the current study, we analysed the implications of the anticipated surge of next generation sequencing data in Africa and the subsequent data sharing concepts on the protection of privacy of research subjects. We performed a retrospective analysis of the informed consent process for the continent and the rest-of-the-world and examined relevant legislation, both current and proposed. We investigated the following issues: (i) informed consent, including guidelines for performing culturally-sensitive next generation sequencing research in Africa and availability of suitable informed consent documents; (ii) data security and subject privacy whilst practicing data sharing; (iii) conveying the implications of such concepts to research participants in resource

  15. [Ethical, Legal, and Social Issues (ELSI) in Gambling Disorder and Its Treatment].

    PubMed

    Moriyama, Nariakira

    2016-10-01

    Recently, the Ministry of Health, Labor and Welfare estimated the prevalence rate of gambling disorder to be 4.8 percent of the population. This rate is outstandingly higher than other countries with prevalence rates between 0.25 and 2.0 percent. It is also estimated that no fewer than 5 million Japanese suffer from the disease. In the last two years, 100 new patients visited the author's clinic. On an average, they started gambling at the age of 19.7 years, and incurring debt at the age of 25.8 years. They first visited the clinic at an average age of 38.2 years, and the average amount they had spent on gambling up to that point was 13 million yen. Twenty percent of them had taken some legal measures to reduce their burden from debts before seeking treatment. Sixty percent of pathological gamblers exclusively played pachinko and slot machine games. Patients who did not play on such machines accounted for no less than 2 percent of cases. This is not surprising, considering the fact that Japan has nearly 4.6 million pachinko and slot machines, which account for two thirds of the total electric gaming machines in the world. Japanese legislation does not regard pachinko and slot machines as gambling, but merely as gaming. Therefore, pachinko companies have no restrictions as such to promote their market. They can advertise freely in newspapers and TV commercials. Pachinko halls are filled with lighting, sounds, and visual effects to stimulate and excite gamblers. The harmful effects of gambling disorder include depression, loss of employment and friends, marital discord, fraud, embezzlement, theft in the family, and theft from non-family members. The most helpful therapy involves attending self-help group sessions at least once a week. One of the best-known self-help groups is Gamblers Anonymous (GA); there are 162 GA groups in Japan. The author believes there should be one GA group for every city across the nation. Unfortunately, psychiatrists, who should be taking

  16. Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy.

    PubMed

    Harper, Joyce; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo J; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

    2014-08-01

    How has the interface between genetics and assisted reproduction technology (ART) evolved since 2005? The interface between ART and genetics has become more entwined as we increase our understanding about the genetics of infertility and we are able to perform more comprehensive genetic testing. In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and ART and published an extended background paper, recommendations and two Editorials. An interdisciplinary workshop was held, involving representatives of both professional societies and experts from the European Union Eurogentest2 Coordination Action Project. In March 2012, a group of experts from the European Society of Human Genetics, the European Society of Human Reproduction and Embryology and the EuroGentest2 Coordination Action Project met to discuss developments at the interface between clinical genetics and ART. As more genetic causes of reproductive failure are now recognized and an increasing number of patients undergo testing of their genome prior to conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and PGD may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from RCTs to substantiate that the technique is both effective and efficient. Whole genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving, but still remains very

  17. Ethical and legal dilemmas around termination of pregnancy for severe fetal anomalies: A review of two African neonates presenting with ventriculomegaly and holoprosencephaly.

    PubMed

    Chima, S C; Mamdoo, F

    2015-12-01

    Termination of pregnancy (TOP) or feticide for severe fetal anomalies is ethically and morally challenging and maybe considered illegal in countries with restrictive abortion laws. While diagnostic modalities such as fetal ultrasound, magnetic resonance imaging, and genetic screening have improved prenatal diagnosis, these technologies remain scarce in many African countries making diagnosis and counseling regarding TOP difficult. Ethical dilemmas such as women's autonomy rights may conflict with fetus' right to personhood, and doctor's moral obligations to society. In liberal jurisdictions, previable fetuses may not have legal rights of personhood; therefore, appropriate action would be to respect pregnant women's decisions regarding TOP. However, in countries with restrictive abortion laws the fetus maybe imbued with the right of personhood at conception, making TOP illegal and exposing doctors and patients to potential criminal prosecution. Birth of a severely disabled baby with independent legal rights creates further conflicts between parents and clinicians complicating healthcare decision-making. Irrespective of the maternal decision to accept or refuse TOP, the psychological and emotional impact of an impaired fetus or neonate, often lead to moral distress and posttraumatic stress reactions in parents. Doctors have legal and ethical obligations to provide an accurate antenatal diagnosis with full disclosure to enable informed decision making. Failure to provide timely or accurate diagnosis may lead to allegations of negligence with potential liability for "wrongful birth" or "wrongful life" following birth of severely disabled babies. Mismanagement of such cases also causes misuse of scarce healthcare resources in resource-poor countries. This paper describes ethical challenges in clinical management of two neonates born following declined and failed feticide for severe central nervous system anomalies with a critical appraisal of the relevant literature.

  18. Legal, ethical, and procedural bases for the use of aseptic techniques to implant electronic devices

    USGS Publications Warehouse

    Mulcahy, Daniel M.

    2013-01-01

    animals often mask the signs of infection to avoid attracting predators (Wobeser 2006). Guidance specific to sterilization of electronic devices for implantation is limited in the wildlife record (Burger et al. 1994; Mulcahy 2003). Few biologists have been formally trained in aseptic technique, but most biologists know that electronic devices should be treated in some way to reduce the chance for infection of the host animal by bacteria, viruses, parasites, and fungi. Most biologists (73%) who implant devices into fishes believe aseptic techniques are important (Wagner and Cooke 2005). However, I maintain that many biologists find it difficult to place the concept of asepsis into practice in their work because of confusion about what constitutes aseptic technique, a lack of surgical knowledge and training, the perception of increased costs, or the belief that aseptic surgeries are impractical or unnecessary for their application. Some have even argued that, while compromising surgical techniques in the field might result in complications or mortalities, the money saved would allow for a compensatory increase in sample size (Anderson and Talcott 2006). In this paper I define aseptic surgical techniques, document the legal and professional guidance for performing aseptic surgeries on wild animals, and present options for sterilizing electronic devices and surgical instruments for field use.

  19. The Precision Medicine Initiative's All of Us Research Program: an agenda for research on its ethical, legal, and social issues.

    PubMed

    Sankar, Pamela L; Parker, Lisa S

    2016-12-08

    The Precision Medicine Initiative (PMI) is an innovative approach to developing a new model of health care that takes into account individual differences in people's genes, environments, and lifestyles. A cornerstone of the initiative is the PMI All of Us Research Program (formerly known as PMI-Cohort Program) which will create a cohort of 1 million volunteers who will contribute their health data and biospecimens to a centralized national database to support precision medicine research. The PMI All of US Research Program is the largest longitudinal study in the history of the United States. The designers of the Program anticipated and addressed some of the ethical, legal, and social issues (ELSI) associated with the initiative. To date, however, there is no plan to call for research regarding ELSI associated with the Program-PMI All of Us program. Based on analysis of National Institutes of Health (NIH) funding announcements for the PMI All of Us program, we have identified three ELSI themes: cohort diversity and health disparities, participant engagement, and privacy and security. We review All of Us Research Program plans to address these issues and then identify additional ELSI within each domain that warrant ongoing investigation as the All of Us Research Program develops. We conclude that PMI's All of Us Research Program represents a significant opportunity and obligation to identify, analyze, and respond to ELSI, and we call on the PMI to initiate a research program capable of taking on these challenges.Genet Med advance online publication 01 December 2016Genetics in Medicine (2016); doi:10.1038/gim.2016.183.

  20. Some legal, social, and ethical issues related to the genetic testing revolution, as exemplified in the long QT syndrome.

    PubMed

    Liebman, J

    2001-01-01

    Molecular Biology is revolutionizing medicine. There are a number of conditions, particularly exemplified by the long QT syndrome, where there is no structural abnormality but where a subset of patients is prone to sudden death. The issues of appropriate care are very complex, because there is tremendous overlap between patients with prolongation of the QT who remain asymptomatic and those with prolongation who are very symptomatic. Furthermore, even those who are prone to have one of the abnormal genes, may be asymptomatic. A large literature has developed, from both legal and ethical aspects, related to the fact that in genetic disease per se, not only is the person at risk, but so are many members of his or her family. A large literature has also developed as to which should be prime, the patient's privacy or the responsibility to make sure the entire family is knowledgeable and perhaps tested. At the present moment our care is based upon the fact that the precise identification of the gene is not yet available on a routine basis. This of course, may soon change. But we will still have difficult decisions to make. Obviously, we have a responsibility as physicians to be as precise as our discipline allows, but we have a responsibility to be flexible. Relief of anxiety, as an example, has to be a prime issue. This is certainly the case now when any information related to infants with potential sudden death is still incomplete. We must not approach the care of the patient in such a way that protection of the physician may interfere with appropriate care. The discussion necessarily includes a variety of aspects.

  1. Neuroscience in forensic psychiatry: From responsibility to dangerousness. Ethical and legal implications of using neuroscience for dangerousness assessments.

    PubMed

    Gkotsi, Georgia Martha; Gasser, Jacques

    2016-01-01

    Neuroscientific evidence is increasingly being used in criminal trials as part of psychiatric testimony. Up to now, "neurolaw" literature remained focused on the use of neuroscience for assessments of criminal responsibility. However, in the field of forensic psychiatry, responsibility assessments are progressively being weakened, whereas dangerousness and risk assessment gain increasing importance. In this paper, we argue that the introduction of neuroscientific data by forensic experts in criminal trials will be mostly be used in the future as a means to evaluate or as an indication of an offender's dangerousness, rather than their responsibility. Judges confronted with the pressure to ensure public security may tend to interpret neuroscientific knowledge and data as an objective and reliable way of evaluating one's risk of reoffending. First, we aim to show how the current socio-legal context has reshaped the task of the forensic psychiatrist, with dangerousness assessments prevailing. In the second part, we examine from a critical point of view the promise of neuroscience to serve a better criminal justice system by offering new tools for risk assessment. Then we aim to explain why neuroscientific evidence is likely to be used as evidence of dangerousness of the defendants. On a theoretical level, the current tendency in criminal policies to focus on prognostics of dangerousness seems to be "justified" by a utilitarian approach to punishment, supposedly revealed by new neuroscientific discoveries that challenge the notions of free will and responsibility. Although often promoted as progressive and humane, we believe that this approach could lead to an instrumentalization of neuroscience in the interest of public safety and give rise to interventions which could entail ethical caveats and run counter to the interests of the offenders. The last part of this paper deals with some of these issues-the danger of stigmatization for brain damaged offenders because of

  2. Adoption Bibliography and Multi-Ethnic Sourcebook.

    ERIC Educational Resources Information Center

    Van Why, Elizabeth Wharton, Comp.

    Designed for parents who have adopted or who contemplate adoption, and for educational, legal, medical, social, and theological professionals, this bibliography and source book contains over 1250 citations relating to adoption. The book is divided into two parts. The first section is a bibliography of articles, personal narratives, dissertations,…

  3. Reporting of gunshot wounds by doctors in emergency departments: a duty or a right? Some legal and ethical issues surrounding breaking patient confidentiality.

    PubMed

    Frampton, A

    2005-02-01

    Recent guidelines have been produced advising doctors working in emergency departments that they should report all gunshot injuries to the police (albeit with consent in all but very limited circumstances). This article will discuss some of the legal and ethical issues that surround breaking patient confidentiality in relation to gunshot wounds and other potentially dangerous patients; and looks at some cases from the UK and the USA where such issues have been ruled on. Finally, the issue of whether physicians do, or should, have a duty to warn when they feel that their patient may be dangerous will be discussed.

  4. Managing Legal Affairs.

    ERIC Educational Resources Information Center

    Weeks, Richard H.

    2001-01-01

    Discusses school administrators' legal-affairs management responsibilities regarding legal advice, law versus ethics, and sources of law. Suggests strategies for retaining and managing legal counsel and avoiding situations involving litigation, torts, and conflict resolution. Explains general counsel services; outlines education,…

  5. Managing Legal Affairs.

    ERIC Educational Resources Information Center

    Weeks, Richard H.

    2001-01-01

    Discusses school administrators' legal-affairs management responsibilities regarding legal advice, law versus ethics, and sources of law. Suggests strategies for retaining and managing legal counsel and avoiding situations involving litigation, torts, and conflict resolution. Explains general counsel services; outlines education,…

  6. Ethics.

    PubMed

    Pellegrino, Edmund D

    In this brief annual review of ethical issues in medicine, Pellegrino focuses on two issues, AIDS and surrogate mothers. The AIDS epidemic has generated debate over public health needs vs. individual rights, modification of sexual practices, screening programs to detect infected persons, confidentiality of test results, experimental therapies, and the duty of physicians to care for AIDS patients. Surrogate motherhood arrangements have become one of the more controversial of the new reproductive technologies. The publicity that accompanied the custody battle over New Jersey's "Baby M" intensified debate over the commercialization of childbearing and the regulation of reproduction. Pellegrino concludes that physicians, along with ethicists and policymakers, have an obligation to "lead society in careful and judicious deliberation" of the ethical issues raised by AIDS and by reproductive technologies.

  7. Student Strip Searches: The Legal and Ethical Implications of "Safford Unified School District v. Redding" for School Leaders

    ERIC Educational Resources Information Center

    Torres, Mario S.; Brady, Kevin P.; Stefkovich, Jacqueline A.

    2011-01-01

    The legal freedom from unreasonable searches and seizures is guaranteed to all adult citizens under the Fourth Amendment of the U.S. Constitution. These same legal protections from unreasonable searches and seizures are not guaranteed to today's k-12 student population. School officials are not subject to the same warrant and probable cause…

  8. Student Strip Searches: The Legal and Ethical Implications of "Safford Unified School District v. Redding" for School Leaders

    ERIC Educational Resources Information Center

    Torres, Mario S.; Brady, Kevin P.; Stefkovich, Jacqueline A.

    2011-01-01

    The legal freedom from unreasonable searches and seizures is guaranteed to all adult citizens under the Fourth Amendment of the U.S. Constitution. These same legal protections from unreasonable searches and seizures are not guaranteed to today's k-12 student population. School officials are not subject to the same warrant and probable cause…

  9. Genetic testing and genomic analysis: a debate on ethical, social and legal issues in the Arab world with a focus on Qatar.

    PubMed

    El Shanti, Hatem; Chouchane, Lotfi; Badii, Ramin; Gallouzi, Imed Eddine; Gasparini, Paolo

    2015-11-14

    In 2013 both Saudi Arabia and Qatar launched genome projects with the aim of providing information for better diagnosis, treatment and prevention of diseases and, ultimately to realize personalized medicine by sequencing hundred thousands samples. These population based genome activities raise a series of relevant ethical, legal and social issues general, related to the specific population structure as well as to the Islamic perspective on genomic analysis and genetic testing. To contribute to the debate, the Authors after reviewing the existing literature and taking advantage of their professional experience in the field and in the geographic area, discuss and provide their opinions. In particular, the Authors focus on the impact of consanguinity on population structure and disease frequency in the Arab world, on genetic testing and genomic analysis (i.e. technical aspects, impact, etc.) and on their regulations. A comparison between the Islamic perspective and the ethical, social and legal issues raised in other population contexts is also carried. In conclusion, this opinion article with an up-to-date contribution to the discussion on the relevance and impact of genomic analysis and genetic testing in the Arab world, might help in producing specific national guidelines on genetic testing and genomic analysis and help accelerate the implementation and roll out of genome projects in Muslim countries and more specifically in Qatar, and other countries of the Gulf.

  10. The use of personal data from medical records and biological materials: ethical perspectives and the basis for legal restrictions in health research.

    PubMed

    Regidor, Enrique

    2004-11-01

    This paper discusses the moral justification for using personal data without informed consent, from both medical records and biological materials, in research where subjects are not physically present in the study and will never have any contact with the study investigators. Although the idea of waiving the requirement for informed consent in certain investigations has been mentioned in several ethical guidelines formulated by epidemiologists and physicians since the late 1980s, these guidelines are now of limited use due to legal restrictions on the use of personal data in most western countries. Several misconceptions that form the basis for legal restriction of health research are discussed: lack of knowledge of the need to link personal information from health services with personal information produced outside the health system in many biomedical investigations; the assumption of a deterministic model of disease causation in which the prediction of disease occurrence is based on a genetic association despite the fact that most genotypes for common diseases are incompletely penetrant; the lack of a logical rationale for the recommendation in the Declaration of Helsinki that only research that offers some benefit to study subjects is justified; the great lack of knowledge about research methodology revealed in some alternatives proposed to avoid using personal data; and the lack of a debate about the ethical double standard of institutions and investigators in countries that prohibit the use of personal data but finance and carry out studies in other countries where it is permitted.

  11. Bibliography Section.

    ERIC Educational Resources Information Center

    Totten, Sam

    1983-01-01

    This annotated listing describes materials dealing with nuclear warfare, including annotated bibliographies, nonfiction, fiction, organizations, journals, newsletters, and curriculum materials for elementary and secondary schools. (RM)

  12. Improving Ethical Attitudes or Simply Teaching Ethical Codes? The Reality of Accounting Ethics Education

    ERIC Educational Resources Information Center

    Cameron, Robyn Ann; O'Leary, Conor

    2015-01-01

    Ethical instruction is critical in accounting education. However, does accounting ethics teaching actually instil core ethical values or simply catalogue how students should act when confronted with typical accounting ethical dilemmas? This study extends current literature by distinguishing between moral/ethical and legal/ethical matters and then…

  13. Improving Ethical Attitudes or Simply Teaching Ethical Codes? The Reality of Accounting Ethics Education

    ERIC Educational Resources Information Center

    Cameron, Robyn Ann; O'Leary, Conor

    2015-01-01

    Ethical instruction is critical in accounting education. However, does accounting ethics teaching actually instil core ethical values or simply catalogue how students should act when confronted with typical accounting ethical dilemmas? This study extends current literature by distinguishing between moral/ethical and legal/ethical matters and then…

  14. Legal and Ethical Imperatives for Using Certified Sign Language Interpreters in Health Care Settings: How to "Do No Harm" When "It's (All) Greek" (Sign Language) to You.

    PubMed

    Nonaka, Angela M

    2016-09-01

    Communication obstacles in health care settings adversely impact patient-practitioner interactions by impeding service efficiency, reducing mutual trust and satisfaction, or even endangering health outcomes. When interlocutors are separated by language, interpreters are required. The efficacy of interpreting, however, is constrained not just by interpreters' competence but also by health care providers' facility working with interpreters. Deaf individuals whose preferred form of communication is a signed language often encounter communicative barriers in health care settings. In those environments, signing Deaf people are entitled to equal communicative access via sign language interpreting services according to the Americans with Disabilities Act and Executive Order 13166, the Limited English Proficiency Initiative. Yet, litigation in states across the United States suggests that individual and institutional providers remain uncertain about their legal obligations to provide equal communicative access. This article discusses the legal and ethical imperatives for using professionally certified (vs. ad hoc) sign language interpreters in health care settings. First outlining the legal terrain governing provision of sign language interpreting services, the article then describes different types of "sign language" (e.g., American Sign Language vs. manually coded English) and different forms of "sign language interpreting" (e.g., interpretation vs. transliteration vs. translation; simultaneous vs. consecutive interpreting; individual vs. team interpreting). This is followed by reviews of the formal credentialing process and of specialized forms of sign language interpreting-that is, certified deaf interpreting, trilingual interpreting, and court interpreting. After discussing practical steps for contracting professional sign language interpreters and addressing ethical issues of confidentiality, this article concludes by offering suggestions for working more effectively

  15. Yesterday's war; tomorrow's technology: peer commentary on ‘Ethical, legal, social and policy issues in the use of genomic technologies by the US military’

    PubMed Central

    Evans, Nicholas G.; Moreno, Jonathan D.

    2014-01-01

    A recent article by Maxwell J. Mehlman and Tracy Yeheng Li, in the Journal of Law and the Biosciences, sought to examine the ethical, legal, social, and policy issues associated with the use of genetic screening and germ-line therapies (‘genomic technologies’) by the US Military. In this commentary, we will elaborate several related matters: the relationship between genetic and non-genetic screening methods, the history of selection processes and force strength, and the consequences and ethics of, as Mehlman and Li suggest, engineering enhanced soldiers. We contend, first, that the strengths of genomic testing as a method of determining enrollment in the armed forces has limited appeal, given the state of current selection methods in the US armed forces. Second, that the vagaries of genetic selection, much like other forms of selection that do not bear causally or reliably on soldier performance (such as race, gender, and sexuality), pose a systematic threat to force strength by limiting the (valuable) diversity of combat units. Third, that the idea of enhancing warfighters through germ-line interventions poses serious ethical issues in terms of the control and ownership of ‘enhancements’ when members separate from service. PMID:27774182

  16. Legal and ethical obligations to conduct a clinical drug trial in Australia as an investigator initiated and sponsored study for an overseas pharmaceutical company.

    PubMed

    Beran, Roy G

    2004-01-01

    Most multi-centre trials are both financed and sponsored by the pharmaceutical company involved. What follows will map the path adopted for an investigator initiated and sponsored study for a new indication of an established medication. The chief investigators of a company-sponsored, investigator-initiated, multi-centre, placebo-controlled study of an established medication, Pharmaceutical Benefit Scheme (PBS) listed for treatment of one condition but trialled in the management of another condition (trial of off-label use), were approached to submit a protocol to repeat the type of study with a different compound. The new study would test a different agent, also PBS listed, for the same condition as in the initial study and with the same off-licence application. The company would finance the study, provide the medication and matched placebo but only review the investigator-initiated protocol which would be sponsored by the principal investigator. This required the investigator to implement the trial, as would normally be done by the pharmaceutical company, yet also act as its principal investigator. The principal investigator, with colleagues and a Clinical Research Organisation (CRO), developed a protocol, adapted for the new agent, and submitted it for approval. Upon acceptance a contract was negotiated with the pharmaceutical company which had to overcome jurisdictional conflicts between common law and civil law legal systems. A CRO was contracted to undertake administrative functions which dictated special contractual agreements to overcome possible conflicts of interest for a sponsor/investigator to protect patient interests. There was need to find indemnification insurance with jurisdictional problems, co-investigators, ethics committee approvals and finance management as just some of the difficulties encountered. The paper will outline how these obstacles were overcome and how ethical and legal issues were respected through compromise. The ethical and legal

  17. Ethical and legal considerations in the care of the infant with end-stage renal disease whose parents elect conservative therapy. An American perspective.

    PubMed

    Cohen, C

    1987-04-01

    When parents elect conservative treatment for infants with end-stage renal disease (ESRD), their choice is medically, ethically, and legally acceptable, since dialysis and transplantation for young infants are still in the range of innovative and experimental treatments. Pediatric nephrologists have been reluctant to view these treatments as standard for very young infants because of doubts about their efficacy, technical difficulties in providing them for tiny patients, uncertainty about their short-term and long-term risks, and the suffering that they can create. Because these renal replacement therapies are not yet established, it is the responsibility of parents to determine whether the benefits of treatment outweigh its burdens for their infants. Physicians have an obligation to ensure that parents make a well-considered decision, and to provide them with counsel and support.

  18. The differing perspectives of workers and occupational medicine physicians on the ethical, legal and social issues of genetic testing in the workplace.

    PubMed

    Brandt-Rauf, Sherry I; Brandt-Rauf, Elka; Gershon, Robyn; Brandt-Rauf, Paul W

    2011-01-01

    Genetic testing in the workplace holds the promise of improving worker health but also raises ethical, legal, and social issues. In considering such testing, it is critical to understand the perspectives of workers, who are most directly affected by it, and occupational health professionals, who are often directly involved in its implementation. Therefore, a series of focus groups of unionized workers (n=25) and occupational medicine physicians (n=23) was conducted. The results demonstrated strikingly different perspectives of workers and physicians in several key areas, including the goals and appropriateness of genetic testing, and methods to minimize its risks. In general, workers were guided by a profound mistrust of the employer, physician, and government, while physicians were guided primarily by scientific and medical concerns, and, in many cases, by the business concerns distrusted by the workers.

  19. Human genome education model project. Ethical, legal, and social implications of the human genome project: Education of interdisciplinary professionals

    SciTech Connect

    Weiss, J.O.; Lapham, E.V.

    1996-12-31

    This meeting was held June 10, 1996 at Georgetown University. The purpose of this meeting was to provide a multidisciplinary forum for exchange of state-of-the-art information on the human genome education model. Topics of discussion include the following: psychosocial issues; ethical issues for professionals; legislative issues and update; and education issues.

  20. Legal and ethical standards for protecting women's human rights and the practice of conscientious objection in reproductive healthcare settings.

    PubMed

    Zampas, Christina

    2013-12-01

    The practice of conscientious objection by healthcare workers is growing across the globe. It is most common in reproductive healthcare settings because of the religious or moral values placed on beliefs as to when life begins. It is often invoked in the context of abortion and contraceptive services, including the provision of information related to such services. Few states adequately regulate the practice, leading to denial of access to lawful reproductive healthcare services and violations of fundamental human rights. International ethical, health, and human rights standards have recently attempted to address these challenges by harmonizing the practice of conscientious objection with women's right to sexual and reproductive health services. FIGO ethical standards have had an important role in influencing human rights development in this area. They consider regulation of the unfettered use of conscientious objection essential to the realization of sexual and reproductive rights. Under international human rights law, states have a positive obligation to act in this regard. While ethical and human rights standards regarding this issue are growing, they do not yet exhaustively cover all the situations in which women's health and human rights are in jeopardy because of the practice. The present article sets forth existing ethical and human rights standards on the issue and illustrates the need for further development and clarity on balancing these rights and interests.

  1. Legal, Ethical, and Financial Aspects of Providing Services to Children with Swallowing Disorders in the Public Schools.

    ERIC Educational Resources Information Center

    O'Toole, Thomas J.

    2000-01-01

    This article considers the role of the speech-language pathologist in providing services to children with swallowing disorders in the public school setting. Topics addressed include requirements (or aspects) under various federal laws and regulations, as well as ethical, liability, and funding issues. (Contains references.) (Author/CR)

  2. Legal and ethical consequences of international biobanking from a national perspective: the German BMB-EUCoop project.

    PubMed

    Goebel, Jürgen W; Pickardt, Thomas; Bedau, Maren; Fuchs, Michael; Lenk, Christian; Paster, Inga; Spranger, Tarde M; Stockter, Ulrich; Bauer, Ulrike; Cooper, David N; Krawczak, Michael

    2010-05-01

    The international transfer of human biomaterial and data has become a prerequisite for collaborative biomedical research to be successful. However, although a national legal framework for 'biobanking' has already been formulated in many countries, little is known about how an international exchange of data and samples might affect the legal position of national biobanks and their donors. The German Telematics Platform and the Competence Network 'Congenital Heart Defects' jointly instigated a project (BMB-EUCoop) to (i) identify and assess the legal risks ensuing for biobanks and their donors in the context of Europe-wide research collaborations, (ii) devise practical recommendations to minimize or avoid these risks, and (iii) provide generic informational text, contracts and agreements to facilitate their practical implementation. Four different countries were included in the study; namely, the UK, Netherlands, Austria and Switzerland. The results of the study indicate that the degree of similarity between legal systems in different countries varies according to the respective field of jurisdiction. Although personality and property rights have long been enshrined in virtually identical pieces of law, the applicable medical professional regulations were found to be somewhat heterogeneous. Furthermore, clear-cut differences were often found to be lacking between regulations that reflect either 'soft law' or the nationally binding 'hard law' that has emerged from it. In view of the potential ambiguities, the experts uniformly concluded that the rights and interests of national (in this case, German) biobanks and their donors would be best protected by explicitly addressing any uncertainties in formal contractual agreements.

  3. Ethical, Legal, and Practical Issues in the Control and Regulation of Suicide Promotion and Assistance over the Internet

    ERIC Educational Resources Information Center

    Mishara, Brian L.; Weisstub, David N.

    2007-01-01

    The promotion of suicide and description of suicide methods on the Internet have led to widespread concern that legal control is mandated. Apart from value concerns pertaining to attitudes about suicide, the guarantee of freedom of expression presents a serious challenge to the introduction of restrictive laws. Recent developments in Australia and…

  4. Forensics Bibliography.

    ERIC Educational Resources Information Center

    Walsh, Grace

    This annotated bibliography lists and discusses 28 books on forensics, debate, argumentation, discussion, and public speaking. The books cover various topics in oral communication for secondary and college level study. (CH)

  5. Management of menstrual problems and contraception in adolescents with mental retardation: a medical, legal, and ethical review with new suggested guidelines.

    PubMed

    Paransky, Ora I; Zurawin, Robert K

    2003-08-01

    The controversial history of the reproductive rights of the mentally retarded has led to the formulation of laws in the past century designed to protect women from forced sterilization. Significantly, however, in their official ethical guidelines, The American College of Obstetricians and Gynecologists states that "sterilization should not be denied to individuals simply because they also may be vulnerable to coercion" (Int J Gynaecol Obstet 1999; 65:317). Recent advances in medical and surgical methods of contraception and control of menstrual abnormalities have led to a re-evaluation of the management of adolescents with special needs. Physicians, the courts, parents, and caretakers need to be aware of the latest medical and surgical options available, the current applicable laws in each state if such exist, and the ethical guidelines to determine what treatment option is in the best interests of the patient. This review examines the history of the sterilization of the mentally retarded, the latest surgical and pharmacologic treatments available, and the current legal environment and proposes an algorithm to facilitate the management of menstrual hygiene and contraception.

  6. [Knowledge and opinions concerning legal and ethical issues with abortion among physicians working in emergency wards in Ribeirão Preto, São Paulo, Brazil].

    PubMed

    Loureiro, David Câmara; Vieira, Elisabeth Meloni

    2004-01-01

    This study focused on the knowledge and opinions of physicians regarding legal and ethical aspects of abortion. A self-administered questionnaire was filled out by 57 physicians working in the emergency rooms of two hospitals in Ribeirão Preto, São Paulo State, Brazil in 2001. The questionnaire had 38 questions on general knowledge, legislation, and attitudes towards abortion. Interviewees' mean age was 28.3, most were females, 52.6% were single, 42.1% were married, 54.4% were Catholic, and 21% were Spiritists. Although most of the physicians had a good level of overall knowledge on abortion (70%), one in five was not aware that abortion is the main cause of maternal mortality in Brazil. Most accepted the prevailing legal conditions for performing an abortion in Brazil but would also include fetal malformation incompatible with life, while opposing decriminalization of abortion on other grounds. Limited knowledge is revealed by misconceptions concerning enforcement of the prevailing legislation in practice. The study strongly suggests that many physicians lack knowledge or face difficulties in conforming to the Brazilian legislation on abortion.

  7. [Ethical, technical and legal procedures of the medical doctor responsibility to accomplish the road enforcement law about driving under the influence of alcohol and psychotropic substances].

    PubMed

    Dinis-Oliveira, Ricardo Jorge; Nunes, Rui; Carvalho, Félix; Santos, Agostinho; Teixeira, Helena; Vieira, Duarte Nuno; Magalhães, Teresa

    2010-01-01

    The forensic toxicology (TF) is a science of analytical basis, aiming to clarify legal issues related to poisoning, whether or not fatal, within the various areas of law (criminal, civil, labor, etc.). The analysis that are more often requested (with a tendency to increase and gaining rising attention) are those concerning the procedures involving supervision of driving under the influence of alcohol and psychotropic substances, in the living individual and in the cadaver. The key players in this process, are: (a) the police agents carrying out the screening and quantification of alcohol on the exhaled breath and the screening of psychotropic and stupefacient substances in saliva; (b) the public health services that perform qualitative analysis of these substances in urine (if the test was not previously performed in saliva); (c) the doctor that collects blood samples from the living, or the dead victim; (d) the forensic toxicologist who conducts toxicological analysis in blood (or, eventually in another biological sample) and (e) the magistrate prosecutors that ultimately will receive the toxicological report to apply the law. Therefore it is important to understand and be acquainted with the road law enforcement of driving under the influence of alcohol and psychotropic substances, particularly in what concerns to the role of the medical doctor. Consequently, this paper aimed to review these topics, namely highlighting the necessary information to clarify the interested parties about the technical, ethical and legal procedures to consider.

  8. Ethical Attitudes of German Specialists in Reproductive Medicine and Legal Regulation of Preimplantation Sex Selection in Germany

    PubMed Central

    Wilhelm, Miriam; Dahl, Edgar; Alexander, Henry; Brähler, Elmar; Stöbel-Richter, Yve

    2013-01-01

    Background Because of its ethical and social implications, preimplantation sex selection is frequently the subject of debates. Methods In 2006, we surveyed specialists in reproductive medicine in Germany using an anonymous questionnaire, including sociodemographic data and questions regarding ethical problems occurring in the practice of reproductive medicine. Most questions focused on preimplantation sex selection, including 10 case vignettes, since these enabled us to describe the most difficult and ethically controversial situations. This is the first survey among specialists in reproductive medicine regarding this topic in Germany. Results 114 specialists in reproductive medicine participated, 72 males (63%) and 42 females (37%), average age was 48 years (age range 29–67 years). The majority of respondents (79%) favoured a regulation that limits the use of preimplantation sex selection only for medical reasons, such as X-linked diseases (including 18%: summoning an ethics commission for every case). A minority of 18% approved of the use of sex selection for non-medical reasons (4% generally and further 14% for family balancing). 90% had received obvious requests from patients. The highest approval (46%) got the counselling guideline against a preimplantation sex selection and advising a normal pregnancy, if preimplantation sex selection would be allowed in Germany. The majority (67%) was opposed the personal use of preimplantation sex selection for non-medical reasons, but would think about it in medical cases. In opposite to woman, 14% of the men were in favour of personal use for non-medical reasons (p = 0,043). 25% of specialists in reproductive medicine feared that an allowance of preimplantation sex selection would cause a shift in the sex ratio. Conclusions The majority of German specialists in reproductive medicine opposes preimplantation sex selection for non-medical reasons while recommending preimplantation sex selection for medical reasons, e

  9. www.mydrugdealer.com: Ethics and legal implications of Internet-based access to substances of abuse.

    PubMed

    Klein, Carolina A; Kandel, Surendra

    2011-01-01

    The Internet has increasingly become an intrinsic part of everyday life, offering countless possibilities for education, services, recreation, and more. In fact, an entire virtual life within the digitalized World Wide Web is possible and common among many Internet users. Today's psychiatrists must therefore incorporate this dimension of human life into clinical practice, to achieve an adequate assessment of the tools and risks available to the patient. We focus on the Internet as a portal for the trade of and access to substances of abuse. We review the legal regulations that may inform care and standards of practice and analyze the difficulties that arise in assessment and monitoring of the current situation. We consider the potential impact of Internet-based narcotics trade on addiction morbidities and the practice of clinical psychiatry, as well as on the potential legal implications that the forensic expert may face.

  10. Legal and ethical consequences of international biobanking from a national perspective: the German BMB-EUCoop project

    PubMed Central

    Goebel, Jürgen W; Pickardt, Thomas; Bedau, Maren; Fuchs, Michael; Lenk, Christian; Paster, Inga; Spranger, Tarde M; Stockter, Ulrich; Bauer, Ulrike; Cooper, David N; Krawczak, Michael

    2010-01-01

    The international transfer of human biomaterial and data has become a prerequisite for collaborative biomedical research to be successful. However, although a national legal framework for ‘biobanking' has already been formulated in many countries, little is known about how an international exchange of data and samples might affect the legal position of national biobanks and their donors. The German Telematics Platform and the Competence Network ‘Congenital Heart Defects' jointly instigated a project (BMB-EUCoop) to (i) identify and assess the legal risks ensuing for biobanks and their donors in the context of Europe-wide research collaborations, (ii) devise practical recommendations to minimize or avoid these risks, and (iii) provide generic informational text, contracts and agreements to facilitate their practical implementation. Four different countries were included in the study; namely, the UK, Netherlands, Austria and Switzerland. The results of the study indicate that the degree of similarity between legal systems in different countries varies according to the respective field of jurisdiction. Although personality and property rights have long been enshrined in virtually identical pieces of law, the applicable medical professional regulations were found to be somewhat heterogeneous. Furthermore, clear-cut differences were often found to be lacking between regulations that reflect either ‘soft law' or the nationally binding ‘hard law' that has emerged from it. In view of the potential ambiguities, the experts uniformly concluded that the rights and interests of national (in this case, German) biobanks and their donors would be best protected by explicitly addressing any uncertainties in formal contractual agreements. PMID:19953124

  11. Pipe protection bibliography

    SciTech Connect

    Guy, N.G.

    1987-01-01

    Pipes and pipelines are being used for an ever widening range of materials, for increasing flows and in harsher applications. There is also more legal and social pressure to reduce the hazards associated with handling materials in pipes. All of this increases the demand for improved pipe reliability. Two of the major preventable causes of pipe failure are corrosion and wear. These may result from the pipe surroundings, or from the material which is carried and it is often impossible to prevent failure by the choice of pipe materials and design. However, additional pipe protection measures are available and it is these measures which are considered in this bibliography. The most common pipe protection methods are the application of coatings and the use of cathodic protection. Accordingly, much of this bibliography is devoted to these techniques. Articles dealing with other means of protecting pipes have also been included. The bibliography covers the protection of oil pipes, (both offshore and on land); water supply systems; gas distribution systems; sewer pipes; pipes for hydraulic and pneumatic transport of solids; power plant pipework; process plant pipework.

  12. Legal Issues in Clinical Supervision. ACA Legal Series, Volume 10.

    ERIC Educational Resources Information Center

    Disney, M. Janelle; Stephens, Anthony M.

    In recent decades, mental health professionals have expanded their role in the legal process. This monograph tries to help clinical supervisors avoid legal pitfalls by explaining some of the legal principles involved in their work. Although familiarity with relevant ethical standards is important, a discussion of these standards is presented only…

  13. Legal Issues in Clinical Supervision. ACA Legal Series, Volume 10.

    ERIC Educational Resources Information Center

    Disney, M. Janelle; Stephens, Anthony M.

    In recent decades, mental health professionals have expanded their role in the legal process. This monograph tries to help clinical supervisors avoid legal pitfalls by explaining some of the legal principles involved in their work. Although familiarity with relevant ethical standards is important, a discussion of these standards is presented only…

  14. DNA banking and DNA databanking: Legal, ethical, and public policy issues. Progress report, [April 1, 1993--March 31, 1994

    SciTech Connect

    Reilly, P.R.; McEwen, J.E.; Small, D.

    1994-02-18

    The purpose of the grant was to provide support to enable us to: (1) perform legal and empirical research and critically analyze DNA banking and DNA databanking as those activities are conducted by state forensic laboratories, the military, academic researchers, and commercial enterprises; and (2) develop a broadcast quality educational videotape for viewing by the general public about DNA technology and the privacy and related issues that it raises. The grant thus has both a research and analysis component and a public education component. This report outlines the work completed since the inception of the project and describes the activities still in progress.

  15. Ethical, legal, and practical issues in the control and regulation of suicide promotion and assistance over the Internet.

    PubMed

    Mishara, Brian L; Weisstub, David N

    2007-02-01

    The promotion of suicide and description of suicide methods on the Internet have led to widespread concern that legal control is mandated. Apart from value concerns pertaining to attitudes about suicide, the guarantee of freedom of expression presents a serious challenge to the introduction of restrictive laws. Recent developments in Australia and Europe are presented, noting jurisdictional complexity as an obstacle to effective application. Finally, scientific data of an epidemiological nature are revealed to be insufficient to warrant making causal assertions about the Internet and its relation to suicidal acts, including those of vulnerable populations. Recommendations are made with respect to public education, suicide prevention, and future research.

  16. Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: “Medicalization” of Dying versus Medical Mission

    PubMed Central

    Frati, Paola; Montanari Vergallo, Gianluca; Di Luca, Natale Mario; Turillazzi, Emanuela

    2014-01-01

    A critical controversy surrounds the type of allowable interventions to be carried out in patients who are potential organ donors, in an attempt to improve organ perfusion and successful transplantation. The main goal is to transplant an organ in conditions as close as possible to its physiological live state. “Elective ventilation” (EV), that is, the use of ventilation for the sole purpose of retrieving the organs of patients close to death, is an option which offsets the shortage of organ donation. We have analyzed the legal context of the dying process of the organ donor and the feasibility of EV in the Italian context. There is no legal framework regulating the practice of EV, neither is any real information given to the general public. A public debate has yet to be initiated. In the Italian cultural and legislative scenario, we believe that, under some circumstances (i.e., the expressed wishes of the patient, even in the form of advance directives), the use of EV does not violate the principle of beneficence. We believe that the crux of the matter lies in the need to explore the real determination and will of the patient and his/her orientation towards the specific aim of organ donation. PMID:25126582

  17. Responsibility in Governmental-Political Communication: A Selected, Annotated Bibliography.

    ERIC Educational Resources Information Center

    Johannesen, Richard L.

    This annotated bibliography lists 43 books, periodicals, and essays in the area of governmental-political communication. Topics include: social justice, lying, cheating, ethics, public duties, public policy, language, rhetorical strategies, and propaganda. (MS)

  18. Selected bibliography of ground-water in the United States

    SciTech Connect

    Ward-McLemore, E.

    1984-01-01

    This bibliography contains 899 records related to the hydrology of the US. Specific topics include, but are not limited to: aquifers; artesian wells; geophysics; ground water; flow models; pollution; tritium; water levels; water policy; and legal aspects. The subject index provides listings of records related to each state. Some of the items (81) are themselves bibliographies.

  19. Ethical and legal implications of the risks of medical tourism for patients: a qualitative study of Canadian health and safety representatives' perspectives.

    PubMed

    Crooks, Valorie A; Turner, Leigh; Cohen, I Glenn; Bristeir, Janet; Snyder, Jeremy; Casey, Victoria; Whitmore, Rebecca

    2013-01-01

    Medical tourism involves patients' intentional travel to privately obtain medical care in another country. Empirical evidence regarding health and safety risks facing medical tourists is limited. Consideration of this issue is dominated by speculation and lacks meaningful input from people with specific expertise in patient health and safety. We consulted with patient health and safety experts in the Canadian province of British Columbia to explore their views concerning risks that medical tourists may be exposed to. Herein, we report on the findings, linking them to existing ethical and legal issues associated with medical tourism. We held a focus group in September 2011 in Vancouver, British Columbia with professionals representing different domains of patient health and safety expertise. The focus group was transcribed verbatim and analysed thematically. Seven professionals representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control participated. Five dominant health and safety risks for outbound medical tourists were identified by participants: (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity of medical documentation and (5) (un)informed decision-making. Concern was expressed that medical tourism might have unintended and undesired effects upon patients' home healthcare systems. The individual choices of medical tourists could have significant public consequences if healthcare facilities in their home countries must expend resources treating postoperative complications. Participants also expressed concern that medical tourists returning home with infections, particularly antibiotic-resistant infections, could place others at risk of exposure to infections that are refractory to standard treatment regimens and thereby pose significant public health risks.

  20. Ethical and legal implications of the risks of medical tourism for patients: a qualitative study of Canadian health and safety representatives’ perspectives

    PubMed Central

    Crooks, Valorie A; Turner, Leigh; Cohen, I Glenn; Bristeir, Janet; Snyder, Jeremy; Casey, Victoria; Whitmore, Rebecca

    2013-01-01

    Objectives Medical tourism involves patients’ intentional travel to privately obtain medical care in another country. Empirical evidence regarding health and safety risks facing medical tourists is limited. Consideration of this issue is dominated by speculation and lacks meaningful input from people with specific expertise in patient health and safety. We consulted with patient health and safety experts in the Canadian province of British Columbia to explore their views concerning risks that medical tourists may be exposed to. Herein, we report on the findings, linking them to existing ethical and legal issues associated with medical tourism. Design We held a focus group in September 2011 in Vancouver, British Columbia with professionals representing different domains of patient health and safety expertise. The focus group was transcribed verbatim and analysed thematically. Participants Seven professionals representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control participated. Results Five dominant health and safety risks for outbound medical tourists were identified by participants: (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity of medical documentation and (5) (un)informed decision-making. Conclusions Concern was expressed that medical tourism might have unintended and undesired effects upon patients’ home healthcare systems. The individual choices of medical tourists could have significant public consequences if healthcare facilities in their home countries must expend resources treating postoperative complications. Participants also expressed concern that medical tourists returning home with infections, particularly antibiotic-resistant infections, could place others at risk of exposure to infections that are refractory to standard treatment regimens and thereby pose

  1. [Ethical and legal principles for the activities of bioprospection in relation to human beings and the human genome].

    PubMed

    Romeo Casabona, Carlos María

    2012-01-01

    During recent decades, bioprospecting has become an important field of research, which looks for development alternatives, entry into global (environmental) markets, and the subsequent obtention of benefits under sustainable development principles. However, there is still so much to discuss regarding the social and environmental impacts produced by this activity, as well as its main limitations. To this end, the Forum/round-table discussion, entitled "Bioprospección, Etica y Sociedad" was organised to take place on 28 March 2012 at the National University of Colombia. Its main objective was to enrich our knowledge on bioprospecting considering the ethical considerations that involve society. The presentation given by Professor ROMEO CASABONA, regarding the connection between bioprospecting and the human genome deserves special attention and is presented below.

  2. Transfusion Requirements in Microsurgical Reconstruction in Maxillofacial Surgery: Ethical and Legal Problems of Patients Who Are Jehovah's Witnesses.

    PubMed

    Martin, Lorena Pingarron; Arias-Gallo, Javier; Perez-Chrzanowska, Hanna; Seco, Pilar Ruiz; Moro, Javier Gonzalez M; Burgueño-Garcia, Miguel

    2013-03-01

    Objective To study transfusion requirements in patients with cancer undergoing head and neck reconstructive surgery and to discuss surgical and anesthetic strategies to reduce blood loss when the patient is a Jehovah's Witness. Material and Methods A descriptive study to expose the percentage of blood transfusions performed in patients with cancer undergoing microsurgical reconstructions in the department of oral and maxillofacial surgery of the referred hospital in the past 9 years. Results Two hundred thirty-seven microsurgical reconstructions were performed in head and neck tumors between January 2001 and December 2009. Statistical analysis shows a significant decrease (p = 0.035) in the number of patients needing transfusions patients in recent years. Conclusions The treatment of patients who are Jehovah's Witnesses is an ethical and moral dilemma for the clinician and in particular for surgeons.

  3. The ethical, legal and human rights concerns raised by licensing HIV self-testing for private use.

    PubMed

    Allais, Lucy; Venter, Francois

    2014-07-01

    We argue that there are no compelling ethical grounds for not allowing the sale of HIV self-tests to the public, so long as reasonably robust protections are in place to protect against coerced testing, and so long as the ease of use of the test is validated carefully in each country in which it is used, with attention to information about linkage to treatment, social and psychological support. The tests are not likely to be harmful in a way that justifies restricting people's access to them, and have plausible benefits. Whether and how self-testing should be used in public health programs will depend on complex policy questions concerning priorities, efficacy and cost.

  4. Transfusion Requirements in Microsurgical Reconstruction in Maxillofacial Surgery: Ethical and Legal Problems of Patients Who Are Jehovah's Witnesses

    PubMed Central

    Martin, Lorena Pingarron; Arias-Gallo, Javier; Perez-Chrzanowska, Hanna; Seco, Pilar Ruiz; Moro, Javier Gonzalez M.; Burgueño-Garcia, Miguel

    2013-01-01

    Objective To study transfusion requirements in patients with cancer undergoing head and neck reconstructive surgery and to discuss surgical and anesthetic strategies to reduce blood loss when the patient is a Jehovah's Witness. Material and Methods A descriptive study to expose the percentage of blood transfusions performed in patients with cancer undergoing microsurgical reconstructions in the department of oral and maxillofacial surgery of the referred hospital in the past 9 years. Results Two hundred thirty-seven microsurgical reconstructions were performed in head and neck tumors between January 2001 and December 2009. Statistical analysis shows a significant decrease (p = 0.035) in the number of patients needing transfusions patients in recent years. Conclusions The treatment of patients who are Jehovah's Witnesses is an ethical and moral dilemma for the clinician and in particular for surgeons. PMID:24436733

  5. Training Bibliography.

    ERIC Educational Resources Information Center

    Vocational Training Council, Wellington (New Zealand).

    This bibliography is intended primarily for managers and trainers but will also be of interest to employers, unions, and all parties interested in improving the competency of trade and nonprofessional workers through improved training. Materials represent the topics of needs assessment, identification of training objectives, monitoring and…

  6. Selected Bibliography.

    ERIC Educational Resources Information Center

    Shirley, Wayne, Comp.

    This bibliography lists approximately 1,100 titles of technical and vocational publications in the following areas: Accounting; Agriculture; Air Conditioning and Refrigeration; Aircraft; Architectural and Building Technology; Arts; Automobiles and Diesels; Biography; Body, Health, and Nutrition; Business; Chemistry; Civil Engineering; Computers;…

  7. LOGO Bibliography.

    ERIC Educational Resources Information Center

    Proud, Jim

    This bibliography lists 168 articles, books, and instructional materials for anyone interested in learning more about the LOGO programming language. Items listed range from research reports and program descriptions to lesson plans and activities. Specific titles include "A Beginner's Guide to LOGO"; "LOGO Music"; "Printing…

  8. Chicano Bibliography.

    ERIC Educational Resources Information Center

    Trejo, Francisco

    Over one-hundred and fifty citations of books, journals and a few dissertations dating from 1938 to 1971 (the majority of which were published in the 1960's) are included in this bibliography focusing on the Chicano. The broad scope deals with Mexicans in America in general, with social, economic, political, and educational problems of this…

  9. Hydrogen Bibliography

    SciTech Connect

    Not Available

    1991-12-01

    The Hydrogen Bibliography is a compilation of research reports that are the result of research funded over the last fifteen years. In addition, other documents have been added. All cited reports are contained in the National Renewable Energy Laboratory (NREL) Hydrogen Program Library.

  10. Autism Bibliography.

    ERIC Educational Resources Information Center

    MacGregor, Kelly; Sobsey, Dick

    The bibliography contains 392 citations relevant to education and related services for children with autism and their families published between 1983 and 1988. Most of the citations are journal articles but a number of relevant books are also included. Citations are alphabetized by title. An author index (by first author) and a subject index are…

  11. Ethical and legal issues in emergency research: barriers to conducting prospective randomized trials in an emergency setting.

    PubMed

    Morrison, C Anne; Horwitz, Irwin B; Carrick, Matthew M

    2009-11-01

    As in any area of medicine, clinical trials are crucial to the advancement of trauma care and the establishment of evidence-based guidelines. This work identifies consent regulations that impede advances in trauma resuscitation research and examines several ethical issues underlying current policies in the United States which regulate how clinical trials are conducted in an emergency setting. Trauma is a leading cause of mortality in the U.S. Minorities and those in low socioeconomic groups are subject to a disproportional amount of traumatic injuries and have worse treatment outcomes than non-minority individuals. Current regulations guiding consent requirements in emergency research were enacted to protect such vulnerable populations from exploitation. Ironically, these same regulations also serve as barriers to clinical trials in trauma research, thus depriving these same vulnerable groups from the benefits of advances in trauma care. A literature review was conducted on areas affecting emergency medical research including: informed consent, socioeconomic and racial disparities, federal regulations in trauma research and biomedical ethics. In the ten year period following the passage of the FDA's Common Rule (21 CFR 50.24) in 1995, 21 published emergency research studies were conducted under the waiver of informed consent. Misconceptions regarding federal regulations and cumbersome internal review board approval processes are frequently cited as significant barriers to conducting prospective randomized trials in the emergency setting. Given the history of past abuses in medical research, the principle of maintaining autonomy of choice is of paramount importance. However, trauma resuscitation is unique in that patients are either unconscious or of limited mental capacity at the time treatment is required, and thus the standard of informed consent is unable to be achieved as in other areas of medicine. While this paradox was recognized by the FDA in 1995 with the

  12. Toward a Conceptualization of the Content of Psychosocial Screening in Living Organ Donors: An Ethical Legal Psychological Aspects of Transplantation Consensus.

    PubMed

    Ismail, Sohal Y; Duerinckx, Nathalie; van der Knoop, Marieke M; Timmerman, Lotte; Weimar, Willem; Dobbels, Fabienne; Massey, Emma K; Busschbach, Jan J J V

    2015-11-01

    Across Europe, transplant centers vary in the content of the psychosocial evaluation for eligible living organ donors. To identify whether a common framework underlies this variation in this evaluation, we studied which psychosocial screening items are most commonly used and considered as most important in current psychosocial screening programs of living organ donors. A multivariate analytic method, concept mapping, was used to generate a visual representation of the "psychosocial" screening items of living kidney and liver donors. A list of 75 potential screening items was derived from a systematic literature review and sorted and rated for their importance and commonness by multidisciplinary affiliated health care professionals from across Europe. Results were discussed and fine-tuned during a consensus meeting. The analyses resulted in a 6-cluster solution. The following clusters on psychosocial screening items were identified, listed from most to least important: (1) personal resources, (2) motivation and decision making, (3) psychopathology, (4) social resources, (5) ethical and legal factors, and (6) information and risk processing. We provided a conceptual framework of the essential elements in psychosocial evaluation of living donors which can serve as a uniform basis for the selection of relevant psychosocial evaluation tools, which can be further tested in prospective studies.

  13. The ethical, legal and social implications of umbilical cord blood banking: learning important lessons from the protection of human genetic information.

    PubMed

    Weisbrot, David

    2012-03-01

    Internationally networked umbilical cord blood banks hold great promise for better clinical outcomes, but also raise a host of potential ethical and legal concerns. There is now significant accumulated experience in Australia and overseas with regard to the establishment of human genetic research databases and tissue collections, popularly known as "biobanks". For example, clear lessons emerge from the controversies that surrounded, stalled or derailed the establishment of some early biobanks, such as Iceland's deCODE, Autogen's Tonga database, a proposed biobank in Newfoundland, Canada, and the proposed Taiwan biobank. More recent efforts in the United Kingdom, Japan, Quebec and Tasmania have been relatively more successful in generating public support, recognising the critical need for openness and transparency, and ample public education and debate, in order to build community acceptance and legitimacy. Strong attention must be paid to ensuring that other concerns--about privacy, discrimination, informed consent, governance, security, commercial fairness and financial probity--are addressed in structural terms and monitored thereafter, in order to maintain public confidence and avoid a backlash that inevitably would imperil such research. Once lost, credibility is very difficult to restore.

  14. Applying ethical and legal principles to new technology: the University of Auckland Faculty of Medical and Health Sciences' policy 'Taking and Sharing Images of Patients.'

    PubMed

    Jonas, Monique; Malpas, Phillipa; Kersey, Kate; Merry, Alan; Bagg, Warwick

    2017-01-27

    To develop a policy governing the taking and sharing of photographic and radiological images by medical students. The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers' Rights were applied to the taking, storing and sharing of photographic and radiological images by medical students. Stakeholders, including clinicians, medical students, lawyers at district health boards in the Auckland region, the Office of the Privacy Commissioner and the Health and Disability Commissioner were consulted and their recommendations incorporated. The policy 'Taking and Sharing Images of Patients' sets expectations of students in relation to: photographs taken for the purpose of providing care; photographs taken for educational or professional practice purposes and photographic or radiological images used for educational or professional practice purposes. In addition, it prohibits students from uploading images of patients onto image-sharing apps such as Figure 1. The policy has since been extended to apply to all students at the Faculty of Medical and Health Sciences at the University of Auckland. Technology-driven evolutions in practice necessitate regular review to ensure compliance with existing legal regulations and ethical frameworks. This policy offers a starting point for healthcare providers to review their own policies and practice, with a view to ensuring that patients' trust in the treatment that their health information receives is upheld.

  15. Why we should not legalize euthanasia. The foundational ethical principle obliging us to protect life must be translated into a concrete norm.

    PubMed

    Place, M D

    1993-03-01

    The euthanasia debate is really the backdrop for a discussion within our society about the very nature of human life and meaning. Because the origin of life is in God, human beings do not have dominion over life but are stewards of life. The powerful combination of sanctity and stewardship is expressed in the foundational ethical principle. This principle says that no person has the right to directly take innocent human life and in fact there is a positive obligation to nurture and protect life. In our secular society there is a need to develop a "natural" metaphysic of sacredness. Such a metaphysic can serve as bedrock from which a foundational principle can be developed and then applied in concrete moral norms. It can show that life contributes to the full dignity of the human person. For this perspective to be effective in countering the movement to legalize euthanasia, this sense of integral wholeness of human personhood must be demonstrated in a convincing manner. It can be because a dualistic philosophical bias has been found wanting by Western culture. We must arrive at what ethicists would call concrete norms that guide individual choices. At issue is how we translate our foundational principle--Do not directly attack innocent human life--into a concrete norm when confronted with the possibility of death. Some persons question whether the concrete norm opposing euthanasia should be a matter of public morality. To answer this question, we must turn to our foundational principle.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Shared decision-making: is it time to obtain informed consent before radiologic examinations utilizing ionizing radiation? Legal and ethical implications.

    PubMed

    Berlin, Leonard

    2014-03-01

    Concerns about the possibility of developing cancer due to diagnostic imaging examinations utilizing ionizing radiation exposure are increasing. Research studies of survivors of atomic bomb explosions, nuclear reactor accidents, and other unanticipated exposures to similar radiation have led to varying conclusions regarding the stochastic effects of radiation exposure. That high doses of ionizing radiation cause cancer in humans is generally accepted, but the question of whether diagnostic levels of radiation cause cancer continues to be hotly debated. It cannot be denied that overexposure to ionizing radiation beyond a certain threshold, which has not been exactly determined, does generate cancer. This causes a dilemma: what should patients be informed about the possibility that a CT or similar examination might cause cancer later in life? At present, there is no consensus in the radiology community as to whether informed consent must be obtained from a patient before the patient undergoes a CT or similar examination. The author analyzes whether there is a legal duty mandating radiologists to obtain such informed consent but also, irrespective of the law, whether there an ethical duty that compels radiologists to inform patients of potential adverse effects of ionizing radiation. Over the past decade, there has been a noticeable shift from a benevolent, paternalistic approach to medical care to an autonomy-based, shared-decision-making approach, whereby patient and physician work as partners in determining what is medically best for the patient. Radiologists should discuss the benefits and hazards of imaging with their patients. Copyright © 2014. Published by Elsevier Inc.

  17. The ethical and legal implications of nanotechnologies: a preliminary survey to picture the perceptions of law students and medical students.

    PubMed

    Daloiso, V; Ricci, G; Minacori, R; Sacchini, D; Spagnolo, A G

    2014-01-01

    The aim of this preliminary survey was to picture the current knowledge and opinions of law students and medical students about nanotechnologies. Data were collected in June 2012 by interviews with 60 students of the University of Camerino (Macerata, Italy) defined as "jurist population" and 159 medical students of the Università Cattolica del Sacro Cuore (Rome, Italy) defined as "medical population". The Authors found that both law and medical students have some knowledge on what nanotechnologies are; with regards to the ethical issues and risks perception, both categories indicated that nanotechnologies generate bioethical issues. Nevertheless, a high percentage of respondents believed that neither existing technologies nor nanotechnologies pose risks for human health. Opinions on regulation of nanotechnologies are instead different. These preliminary findings underlined the ambiguity surrounding nanotechnologies both concerning the bioethical dimension and risks perception and their regulation. These early data therefore showed a need of additional reflection on these technologies that should be investigated more in detail; moving from students, future scientists and regulators, these data could contribute to clarify the debate on them.

  18. Dialysis: prolonging life or prolonging dying? Ethical, legal and professional considerations for end of life decision making.

    PubMed

    White, Y; Fitzpatrick, G

    2006-01-01

    There are over 7,000 people on dialysis in Australia and this is predicted to increase due to the ageing population and the high incidence of diabetes mellitus. Discontinuation of dialysis is the second most frequent cause of death in dialysis patients in Australia. Risk factors for the discontinuation of dialysis include: co-morbidities (especially diabetes mellitus) and being older. Because the decision to discontinue dialysis is a major life choice, collaborative decision making should be encouraged, and the patient needs assurances of the continuation of care and kindness, a palliative care plan, and the alleviation of suffering. Patients decide to discontinue dialysis because of an unacceptable quality of life, depression and a chronic failure to thrive. Health professionals need to support end of life decision making using an ethical decision framework. A review of current literature was undertaken and revealed a paucity of information in regard to palliation in those with end stage renal disease who had discontinued dialysis. The fear of dying, pain, suffering, and abandonment that a patient and/or their family may perceive as being associated with death may create barriers to decisions to discontinue with dialysis treatments. Therefore health care personnel should provide information with honesty to allow patients to predict their quality of life and death. Support for the patient and family during the dying period should be multi-disciplinary, with clear and timely communication between all members of the team.

  19. Ethical coding.

    PubMed

    Resnik, Barry I

    2009-01-01

    It is ethical, legal, and proper for a dermatologist to maximize income through proper coding of patient encounters and procedures. The overzealous physician can misinterpret reimbursement requirements or receive bad advice from other physicians and cross the line from aggressive coding to coding fraud. Several of the more common problem areas are discussed.

  20. Barcelona 2002: law, ethics, and human rights. HIV testing for peacekeeping forces: legal and human rights issues.

    PubMed

    Jürgens, Ralf

    2002-12-01

    In 2001, the United Nations Security Council established an Expert Panel to study the issue of whether the UN should institute HIV testing of peacekeeping personnel. This article, based on a 9 July 2002 presentation to the XIV International AIDS Conference (abstract TuOrG1173), reports on the findings of a paper prepared for the Expert Panel by the Canadian HIV/AIDS Legal Network. The paper examined whether it is permissible for the UN to implement mandatory HIV testing of its peacekeeping personnel, and whether HIV-positive UN peacekeeping personnel should be excluded or restricted from service on the basis of their HIV status or HIV disease progression. The article describes some of the court cases in which these issues have been considered; discusses the importance of analyzing such issues in the context of a human rights-based approach to the pandemic; and formulates a series of key principles for guiding UN decision-making. The article concludes that a policy of mandatory HIV testing for all UN peacekeeping personnel cannot be justified on the basis that it is required in order to assess their physical and mental capacity for service; that HIV-positive peacekeeping personnel cannot be excluded from service based on their HIV status alone, but only on their ability to perform their duties; and that the UN cannot resort to mandatory HIV testing for all UN peacekeeping personnel to protect the health and safety of HIV-negative personnel unless it can demonstrate that alternatives to such a policy would not reduce the risk sufficiently. In the end, the Expert Panel unanimously rejected mandatory testing and instead endorsed voluntary HIV counselling and testing for UN peacekeeping personnel.