This is a lecture for my Summer 2012 Medical Ethics Course at Bowling Green State University. It focuses on ethical issues related to genetic interventions, particularly whether the distinction between treatment and enhancement is ethically useful.
This document discusses the complex care needs of patients with multiple chronic conditions. It notes that such patients often have high treatment burdens from multiple medications and self-care needs that can exceed their capacity. Guidelines and care are often focused on single diseases and do not consider patient context. The document calls for a focus on balancing patient workload from treatment with their capacity through strategies like prioritizing care, deprescribing unnecessary treatments, coaching, and connecting patients to community resources.
This document outlines Dave deBronkart's journey from being diagnosed with cancer in 2007 to becoming a prominent advocate for patient engagement and empowerment. It discusses how he used online resources and connected with other patients online to research his condition, treatment options, and find doctors. This marked a transformation from a closed medical system to an open network where patients can access information and support from each other. The document argues that engaged, empowered patients will be an essential part of the healthcare system going forward to address the growing demographic of older patients. It suggests the concept of patient engagement is going through a paradigm shift as more recognize the importance of patient perspectives in care.
This is the presentation Victor Montori (KER UNIT, Healthcare Delivery Research Program, Mayo Clinic) gave at the Normalization Process Theory symposium at King's Fund, London, UK on October 22, 2010.
This document summarizes research on how dementia affects caregiver well-being. It finds that factors like feeling trapped in the caregiver role, relationship quality with the care recipient, caregiver overload, and outside life stressors are stronger predictors of caregiver burden than the care recipient's symptoms. Interventions may help reduce caregiver depression, though success is moderate. More research is needed to identify the most effective treatments to support caregivers and prevent negative health outcomes.
This document discusses finding balance in a family medicine career. It begins by explaining why the author chose to talk about balance after practicing family medicine and raising a family for 30 years. It then discusses why one can feel good about choosing family medicine, noting that family physicians can make a big difference in society and health outcomes while finding mentors. The document also covers some of the challenges of practicing family medicine today and potential solutions to address these challenges, such as policies to improve reimbursement for primary care. It ends by emphasizing the importance of balance, continuity of care, and preventing burnout over the long career as a family physician.
1. The document presents 12 graphs and diagrams that depict important issues in population health.
2. The graphs show how lifestyle and health behaviors are the dominant influences on health outcomes, and how gaps in care lead to disappointing results.
3. Additional graphs illustrate challenges such as low medication adherence, clinical inertia, the slow adoption of new medical knowledge, and the impact of health literacy on population health.
Customizing End of Life Care: Believing the Bereaved
Antigone Kithas
Rachel Jaggi
Lisa Howell
Anna Beck
Presented at the 11th Annual HSR/ PCOR Conference: Partnering for Better Health: Bringing Utah's Patient Voices to Research 2016
This document discusses the complex care needs of patients with multiple chronic conditions. It notes that such patients often have high treatment burdens from multiple medications and self-care needs that can exceed their capacity. Guidelines and care are often focused on single diseases and do not consider patient context. The document calls for a focus on balancing patient workload from treatment with their capacity through strategies like prioritizing care, deprescribing unnecessary treatments, coaching, and connecting patients to community resources.
This document outlines Dave deBronkart's journey from being diagnosed with cancer in 2007 to becoming a prominent advocate for patient engagement and empowerment. It discusses how he used online resources and connected with other patients online to research his condition, treatment options, and find doctors. This marked a transformation from a closed medical system to an open network where patients can access information and support from each other. The document argues that engaged, empowered patients will be an essential part of the healthcare system going forward to address the growing demographic of older patients. It suggests the concept of patient engagement is going through a paradigm shift as more recognize the importance of patient perspectives in care.
This is the presentation Victor Montori (KER UNIT, Healthcare Delivery Research Program, Mayo Clinic) gave at the Normalization Process Theory symposium at King's Fund, London, UK on October 22, 2010.
This document summarizes research on how dementia affects caregiver well-being. It finds that factors like feeling trapped in the caregiver role, relationship quality with the care recipient, caregiver overload, and outside life stressors are stronger predictors of caregiver burden than the care recipient's symptoms. Interventions may help reduce caregiver depression, though success is moderate. More research is needed to identify the most effective treatments to support caregivers and prevent negative health outcomes.
This document discusses finding balance in a family medicine career. It begins by explaining why the author chose to talk about balance after practicing family medicine and raising a family for 30 years. It then discusses why one can feel good about choosing family medicine, noting that family physicians can make a big difference in society and health outcomes while finding mentors. The document also covers some of the challenges of practicing family medicine today and potential solutions to address these challenges, such as policies to improve reimbursement for primary care. It ends by emphasizing the importance of balance, continuity of care, and preventing burnout over the long career as a family physician.
1. The document presents 12 graphs and diagrams that depict important issues in population health.
2. The graphs show how lifestyle and health behaviors are the dominant influences on health outcomes, and how gaps in care lead to disappointing results.
3. Additional graphs illustrate challenges such as low medication adherence, clinical inertia, the slow adoption of new medical knowledge, and the impact of health literacy on population health.
Customizing End of Life Care: Believing the Bereaved
Antigone Kithas
Rachel Jaggi
Lisa Howell
Anna Beck
Presented at the 11th Annual HSR/ PCOR Conference: Partnering for Better Health: Bringing Utah's Patient Voices to Research 2016
Strategies to improve linkage to HIV care aim to increase the percentage of people who enter care after receiving a positive HIV test result from 65% to 85%. Studies show those who enter care early are more likely to start antiretroviral therapy, achieve viral suppression, and reduce risky sexual behaviors. The document discusses various strategies tested in studies and used by agencies to improve different aspects of the linkage process, including messaging at diagnosis, counseling approaches, active versus passive referrals, engagement strategies, and care team coordination. The goal is to establish a seamless system to immediately link people to continuous, coordinated, and high-quality HIV care.
This document discusses strategies for improving linkage to care for people who test HIV positive. It highlights the importance of immediately linking people to continuous care when they learn they are infected in order to improve health outcomes. Barriers to entering care include lack of insurance, not wanting to acknowledge being HIV positive, and lack of support services. Successful strategies discussed include providing comprehensive counseling and messaging about benefits of early care, using a trauma-informed and motivational interviewing approach, actively facilitating referrals and follow through, and care team coordination through linkage specialists.
Two major trends dominate healthcare in the United States. Chronic Illness is on the rise, meaning American's are having more difficulty than ever attaining mental and physical wellness. Providers are facing an unfriendly business of medicine environment requiring them to solve complex management problems while maintaining a high level of clinical excellence. The payment goal posts have moved requiring providers to understand and measure the value they provide to patients, not just the services they complete or perform. As providers struggle to understand the meaning of value in medicine and what outcomes qualify, consumers continually turn to alternative medicine and wellness initiatives to maintain their health.
The document discusses group communication and abnormal psychology. It focuses on process vs content groups, roles of group members, and factors that facilitate communication. It also describes symptoms of groupthink. Dimensional models of childhood disorders are presented, including undercontrolled and overcontrolled behaviors. Attention-deficit/hyperactivity disorder and conduct disorder are examined in depth, covering definitions, studies on symptoms, problems associated, and biological and psychological theories for each disorder.
This document summarizes presentations from a training on trauma-informed care. It discusses the Adverse Childhood Experiences (ACE) Study which found that childhood trauma is common and influences adult health and behaviors. Presenters discuss how trauma impacts individuals over their lifetime through mental health issues, health risks, diseases, and social problems if left unaddressed. They advocate for trauma-informed systems and cultures of care across behavioral health, social services, and communities to facilitate recovery and prevent retraumatization. The speakers provide their visions of a future where trauma is addressed and communities are empowered partners in wellness promotion.
Jan 15 Communication Bridges And Barriers Oxfordlibrary
The document discusses empowering clients in healthcare. It defines empowerment as helping clients take a primary role in their healthcare by providing knowledge and skills. Five key features of empowerment are discussed: acceptance, affect, autonomy, alliance, and active participation. Three studies on empowerment are summarized showing benefits like improved compliance, treatment satisfaction, and emotional well-being when clients feel more empowered. Barriers to therapeutic relationships like stereotyping and anxiety are also covered.
An Interprofessional Approach to Substance Abuse in Primary CareASAMPUBS
An integrated model of treatment improves care by recognizing that patients need clear and consistent care from their primary care provider “in a way that thoroughly considers biological, social, behavioral, and psychological components of their presenting complaint” by integrating psychological, addiction, and other treatments into a cohesive whole.
The document discusses best practices for effective family meetings in medical ethics situations. It provides an overview of ethics and preventive ethics, reviews literature on the benefits of family meetings, and outlines a 10-step approach to structuring an effective family meeting based on lessons from the literature. The 10 steps include preparation, introducing participants and purpose, assessing family understanding, summarizing and educating the family, discussing prognosis and goals of care, addressing emotions, making a plan, follow up, and closure.
This document discusses allied health professionals and their role in the healthcare system. It lists various allied health roles and describes how they rehabilitate and enable patients by taking a collaborative and holistic approach focused on patient needs. The document emphasizes that allied health professionals help reduce health service needs by facilitating patients' independence and ability to remain in their communities. It argues that capturing allied health data can help provide visibility into their services, allow for quality improvement, and ultimately benefit patients through a more coordinated system where the "right intervention" is delivered at the "right time". The challenges of engaging stakeholders and integrating passive data extraction are also addressed.
The document discusses several key points about palliative care:
1) Palliative care aims to relieve suffering and improve quality of life for patients with advanced illnesses alongside medical treatment.
2) Two studies found that early palliative care led to improved quality of life and mood, less aggressive end-of-life care, and longer survival times for cancer patients.
3) A study of Medicaid patients found that palliative care consultations reduced hospital costs without reducing quality of care.
PTSD and Allostatic Load: Beneath the skin interrupting the pathways to path...Michael Changaris
This slideshow explores the way that stress leads to biological pathology. It attempts to connect the adverse childhood events study with Bruce McEwen's work on cortisol and stress. It explored the impact of PTSD, early childhood trauma and stress on health and longevity.
In this presentation, we highlight 5 of these commonly held myths about the US healthcare industry and provide some insight into why they simply are not true.
In order to improve the overall healthcare system and create informed consumers it is necessary to negate the common myths surrounding the US healthcare system. Many myths over-simplify the complexity of an industry that generates $2.7 trillion each year and employs 16 million Americans. Other myths try to place blame for problems within the system or arise from a lack of understanding of care delivery and cost drivers within the industry.
https://payerfusion.com/ceos-blog/5-myths-us-healthcare-system
1. The document discusses patient engagement behaviors which are actions individuals must take to benefit from available health care services.
2. A review found that for most engagement behaviors, one third or less of people regularly perform them, while two thirds do them sporadically or not at all.
3. Patterns in the data show that people are more likely to participate in simpler, predictable tasks but participation is often shallow. People prefer just-in-time information to solve immediate problems over ongoing engagement.
Women in Bangladesh often suffer from chronic obstetric morbidities such as prolapse, fistulas, and incontinence following childbirth. However, many do not seek professional healthcare due to embarrassment, lack of access to female doctors, cost, and beliefs that the conditions are normal. A study of 183 women in Dhaka found that only 24% sought any healthcare for these issues, mostly from untrained providers like drug vendors or homeopaths rather than doctors. Women were more likely to get care if they discussed their problems with their husbands. The low use of appropriate healthcare highlights barriers that need to be addressed to improve women's health after childbirth.
In Search of What Works: Re-Defining Post Acute Partnerships to Reduce Readmissions, Using the Integrated Chronic Disease Care at Home Model
Ms. Ann Rodriguez-McConnell, R.N.
Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013
Dolores Keating , Head of Pharmacy Services, Saint John of God HospitalInvestnet
This document discusses engaging with medication and supporting patient activation and optimization. It emphasizes adopting a person-centered approach to medication use that involves providing information, supporting interactive consultations, shared decision making, actively managing side effects, and engaging with patients more frequently. This helps patients build knowledge, confidence, and skills to better manage their own healthcare and medications. The document also highlights barriers clinicians face in adopting these approaches and the need for quality improvement initiatives focused on medication safety.
This document summarizes the findings of a national survey on family caregivers who provide complex medical and nursing care to their loved ones. Some key findings:
- 46% of family caregivers performed medical/nursing tasks like medication management, wound care, using medical equipment.
- Tasks like wound care, medication management and incontinence care were especially difficult for family caregivers. Many lacked training.
- Caregivers who performed more medical tasks reported poorer health and increased feelings of depression. However, they also felt they helped avoid nursing home placement.
- The survey highlights the need to better support family caregivers through improved training, coordination of care, and policies that acknowledge their role in caring for loved ones.
National Consensus Project Clinical Practice Guidelines Disseminationlsmit132
The document summarizes the 3rd edition of the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines. It was created by a consortium of six palliative care organizations to improve palliative care quality in the US. The guidelines provide recommendations for interdisciplinary palliative care delivery across various clinical domains and settings. The 3rd edition features expanded recommendations regarding palliative care delivery requirements and quality standards based on recent healthcare reforms and evidence.
This document discusses the impact that a person's problematic substance use can have on their family members and friends. It notes that while interventions often focus on supporting the individual with the substance use problem, less attention is paid to the effects on family and friends. These effects can include physical and mental health problems, financial issues, relationship challenges, and domestic violence. The severity of impact depends on factors like whether family members live with the individual, provide their care, experience abuse, or use substances themselves. The document provides an overview of research demonstrating the stress, health problems, and emotional difficulties family members may face when a loved one has problematic substance use.
This is a lecture I put together as part of a Medical Ethics course that I am teaching at Bowling Green State University this summer. It is about ethical issues related to genetic screening and counseling, and prenatal genetic diagnosis.
This document discusses several ethical issues that arise during epidemics like AIDS, including a health care provider's duty to treat patients, maintain confidentiality, and determine appropriate testing and treatment approaches. It also examines ethical considerations in treating infected health care workers and conducting experimental research. Globally, questions are raised about distributive justice and the duties of developed nations in responding to epidemics threatening vulnerable populations.
Strategies to improve linkage to HIV care aim to increase the percentage of people who enter care after receiving a positive HIV test result from 65% to 85%. Studies show those who enter care early are more likely to start antiretroviral therapy, achieve viral suppression, and reduce risky sexual behaviors. The document discusses various strategies tested in studies and used by agencies to improve different aspects of the linkage process, including messaging at diagnosis, counseling approaches, active versus passive referrals, engagement strategies, and care team coordination. The goal is to establish a seamless system to immediately link people to continuous, coordinated, and high-quality HIV care.
This document discusses strategies for improving linkage to care for people who test HIV positive. It highlights the importance of immediately linking people to continuous care when they learn they are infected in order to improve health outcomes. Barriers to entering care include lack of insurance, not wanting to acknowledge being HIV positive, and lack of support services. Successful strategies discussed include providing comprehensive counseling and messaging about benefits of early care, using a trauma-informed and motivational interviewing approach, actively facilitating referrals and follow through, and care team coordination through linkage specialists.
Two major trends dominate healthcare in the United States. Chronic Illness is on the rise, meaning American's are having more difficulty than ever attaining mental and physical wellness. Providers are facing an unfriendly business of medicine environment requiring them to solve complex management problems while maintaining a high level of clinical excellence. The payment goal posts have moved requiring providers to understand and measure the value they provide to patients, not just the services they complete or perform. As providers struggle to understand the meaning of value in medicine and what outcomes qualify, consumers continually turn to alternative medicine and wellness initiatives to maintain their health.
The document discusses group communication and abnormal psychology. It focuses on process vs content groups, roles of group members, and factors that facilitate communication. It also describes symptoms of groupthink. Dimensional models of childhood disorders are presented, including undercontrolled and overcontrolled behaviors. Attention-deficit/hyperactivity disorder and conduct disorder are examined in depth, covering definitions, studies on symptoms, problems associated, and biological and psychological theories for each disorder.
This document summarizes presentations from a training on trauma-informed care. It discusses the Adverse Childhood Experiences (ACE) Study which found that childhood trauma is common and influences adult health and behaviors. Presenters discuss how trauma impacts individuals over their lifetime through mental health issues, health risks, diseases, and social problems if left unaddressed. They advocate for trauma-informed systems and cultures of care across behavioral health, social services, and communities to facilitate recovery and prevent retraumatization. The speakers provide their visions of a future where trauma is addressed and communities are empowered partners in wellness promotion.
Jan 15 Communication Bridges And Barriers Oxfordlibrary
The document discusses empowering clients in healthcare. It defines empowerment as helping clients take a primary role in their healthcare by providing knowledge and skills. Five key features of empowerment are discussed: acceptance, affect, autonomy, alliance, and active participation. Three studies on empowerment are summarized showing benefits like improved compliance, treatment satisfaction, and emotional well-being when clients feel more empowered. Barriers to therapeutic relationships like stereotyping and anxiety are also covered.
An Interprofessional Approach to Substance Abuse in Primary CareASAMPUBS
An integrated model of treatment improves care by recognizing that patients need clear and consistent care from their primary care provider “in a way that thoroughly considers biological, social, behavioral, and psychological components of their presenting complaint” by integrating psychological, addiction, and other treatments into a cohesive whole.
The document discusses best practices for effective family meetings in medical ethics situations. It provides an overview of ethics and preventive ethics, reviews literature on the benefits of family meetings, and outlines a 10-step approach to structuring an effective family meeting based on lessons from the literature. The 10 steps include preparation, introducing participants and purpose, assessing family understanding, summarizing and educating the family, discussing prognosis and goals of care, addressing emotions, making a plan, follow up, and closure.
This document discusses allied health professionals and their role in the healthcare system. It lists various allied health roles and describes how they rehabilitate and enable patients by taking a collaborative and holistic approach focused on patient needs. The document emphasizes that allied health professionals help reduce health service needs by facilitating patients' independence and ability to remain in their communities. It argues that capturing allied health data can help provide visibility into their services, allow for quality improvement, and ultimately benefit patients through a more coordinated system where the "right intervention" is delivered at the "right time". The challenges of engaging stakeholders and integrating passive data extraction are also addressed.
The document discusses several key points about palliative care:
1) Palliative care aims to relieve suffering and improve quality of life for patients with advanced illnesses alongside medical treatment.
2) Two studies found that early palliative care led to improved quality of life and mood, less aggressive end-of-life care, and longer survival times for cancer patients.
3) A study of Medicaid patients found that palliative care consultations reduced hospital costs without reducing quality of care.
PTSD and Allostatic Load: Beneath the skin interrupting the pathways to path...Michael Changaris
This slideshow explores the way that stress leads to biological pathology. It attempts to connect the adverse childhood events study with Bruce McEwen's work on cortisol and stress. It explored the impact of PTSD, early childhood trauma and stress on health and longevity.
In this presentation, we highlight 5 of these commonly held myths about the US healthcare industry and provide some insight into why they simply are not true.
In order to improve the overall healthcare system and create informed consumers it is necessary to negate the common myths surrounding the US healthcare system. Many myths over-simplify the complexity of an industry that generates $2.7 trillion each year and employs 16 million Americans. Other myths try to place blame for problems within the system or arise from a lack of understanding of care delivery and cost drivers within the industry.
https://payerfusion.com/ceos-blog/5-myths-us-healthcare-system
1. The document discusses patient engagement behaviors which are actions individuals must take to benefit from available health care services.
2. A review found that for most engagement behaviors, one third or less of people regularly perform them, while two thirds do them sporadically or not at all.
3. Patterns in the data show that people are more likely to participate in simpler, predictable tasks but participation is often shallow. People prefer just-in-time information to solve immediate problems over ongoing engagement.
Women in Bangladesh often suffer from chronic obstetric morbidities such as prolapse, fistulas, and incontinence following childbirth. However, many do not seek professional healthcare due to embarrassment, lack of access to female doctors, cost, and beliefs that the conditions are normal. A study of 183 women in Dhaka found that only 24% sought any healthcare for these issues, mostly from untrained providers like drug vendors or homeopaths rather than doctors. Women were more likely to get care if they discussed their problems with their husbands. The low use of appropriate healthcare highlights barriers that need to be addressed to improve women's health after childbirth.
In Search of What Works: Re-Defining Post Acute Partnerships to Reduce Readmissions, Using the Integrated Chronic Disease Care at Home Model
Ms. Ann Rodriguez-McConnell, R.N.
Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013
Dolores Keating , Head of Pharmacy Services, Saint John of God HospitalInvestnet
This document discusses engaging with medication and supporting patient activation and optimization. It emphasizes adopting a person-centered approach to medication use that involves providing information, supporting interactive consultations, shared decision making, actively managing side effects, and engaging with patients more frequently. This helps patients build knowledge, confidence, and skills to better manage their own healthcare and medications. The document also highlights barriers clinicians face in adopting these approaches and the need for quality improvement initiatives focused on medication safety.
This document summarizes the findings of a national survey on family caregivers who provide complex medical and nursing care to their loved ones. Some key findings:
- 46% of family caregivers performed medical/nursing tasks like medication management, wound care, using medical equipment.
- Tasks like wound care, medication management and incontinence care were especially difficult for family caregivers. Many lacked training.
- Caregivers who performed more medical tasks reported poorer health and increased feelings of depression. However, they also felt they helped avoid nursing home placement.
- The survey highlights the need to better support family caregivers through improved training, coordination of care, and policies that acknowledge their role in caring for loved ones.
National Consensus Project Clinical Practice Guidelines Disseminationlsmit132
The document summarizes the 3rd edition of the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines. It was created by a consortium of six palliative care organizations to improve palliative care quality in the US. The guidelines provide recommendations for interdisciplinary palliative care delivery across various clinical domains and settings. The 3rd edition features expanded recommendations regarding palliative care delivery requirements and quality standards based on recent healthcare reforms and evidence.
This document discusses the impact that a person's problematic substance use can have on their family members and friends. It notes that while interventions often focus on supporting the individual with the substance use problem, less attention is paid to the effects on family and friends. These effects can include physical and mental health problems, financial issues, relationship challenges, and domestic violence. The severity of impact depends on factors like whether family members live with the individual, provide their care, experience abuse, or use substances themselves. The document provides an overview of research demonstrating the stress, health problems, and emotional difficulties family members may face when a loved one has problematic substance use.
This is a lecture I put together as part of a Medical Ethics course that I am teaching at Bowling Green State University this summer. It is about ethical issues related to genetic screening and counseling, and prenatal genetic diagnosis.
This document discusses several ethical issues that arise during epidemics like AIDS, including a health care provider's duty to treat patients, maintain confidentiality, and determine appropriate testing and treatment approaches. It also examines ethical considerations in treating infected health care workers and conducting experimental research. Globally, questions are raised about distributive justice and the duties of developed nations in responding to epidemics threatening vulnerable populations.
Foundation & principles of Bioethics.pptxPriyanka Meel
This document provides an overview of the foundations of bioethics. It defines ethics and health ethics, discusses important principles like beneficence, non-maleficence, and autonomy. It also covers topics like informed consent, truth-telling, conflicts of interest, capacity assessments, futile care, and the role of ethics committees. The document establishes that bioethics aims to guide complex medical decisions using moral frameworks to balance patient welfare, rights, justice, and professional standards.
The document discusses ethical dilemmas in clinical genetics. It begins with an introduction to ethical dilemmas and frameworks for ethical decision making. It then addresses various issues in genetic engineering, genetic testing, and genetic counseling. Some key issues discussed include risks of experimental animals and creating new diseases, predictive testing and determining who should access results, prenatal testing and potential pressure not to have children with disabilities. The document stresses the importance of informed consent, counseling, and respecting individual values in navigating these complex ethical issues.
Genetic counseling involves assessing risk factors for genetic disorders, constructing pedigrees, estimating disease risk, providing information to clients, and helping them make decisions. It aims to educate clients, provide support, and allow for informed reproductive choices. Genetic counselors are specially trained to communicate complex genetic information in a caring, non-directive manner. They work with clients in a variety of settings to address legal, ethical and psychosocial issues surrounding genetic testing and diagnosis. Nurses play an important supporting role by recognizing genetic conditions, assisting with testing and counseling, and providing ongoing education and support.
Ethical Dilemma In the documentary The Invisible.docxhumphrieskalyn
Ethical Dilemma
In the documentary The Invisible Patients, Jessica, a nurse practitioner for home-limited patients, is faced with several ethical dilemmas. For example, Jessica provides care for an elderly couple named Wink and Patty Sherrill. Both Patty and Wink are prescribed narcotics to manage their arthritis pain. During a routine urine drug screen, it is discovered that Patty does not have any trace of her pain medication in her system, yet she is still having her narcotic prescription refilled regularly. This obviously raises concerns for medication diversion. Patty is presumably giving her narcotics to her husband or selling her narcotics, which is a clear violation of her pain contract. She is banned from her primary care MD’s practice, which causes her great difficulty in finding another healthcare provider. Jessica feels that it is her responsibility to provide care for this couple.
This scenario raises the ethical dilemma of beneficence versus nonmaleficence. The principle of beneficence is “the duty to do good and prevent or remove harm" (Hamric, Hanson, Tracy, O'Grady, 2014, p. 337). Prescribing narcotics to those experiencing chronic pain and disability is a necessary and beneficent act of healthcare providers. The principle of nonmaleficence is “the duty not to inflict harm or evil” (Hamric et al., 2014, p.337). Prescribing narcotics to a patient who is suspected of narcotics diversion has the potential to cause harm to the person who is taking the narcotics illicitly. Jessica must now decide which principle to follow and which principle to potentially break. Jessica decides that even though Patty is abusing her prescription, she does in fact still need her narcotics and continues to prescribe the pain medicine.
My
Solution
In this scenario, I would not continue to prescribe Patty narcotics. Since she is not taking her pain medications but still seeking refills, she is abusing her prescription and the trust placed in her. If she is diverting her narcotics to her husband and/or selling them on the street, this places Wink and/or the narcotic abuser at risk for health complications such as respiratory depression, constipation, drug dependence, increased tolerance, and narcotic withdrawal in the future. I believe Wink has a legitimate need for pain medications, but he should be honest and open with Jessica about the need to increase his pain medications or try different modalities if his pain is not properly controlled. Regardless of motive, illegally diverting narcotics is a breach in contract and should not be overlooked.
If I were presented with this scenario, I would have talked with Patty and Wink about Patty’s narcotic diversion and sought an alternative solution to continuing to prescribe narcotics. If Patty were in fact giving her narcotics to her husband to help control his pain, I would adjust Wink’s medications and pain management strategy. If they were selling their excess n.
The document discusses strategies to resolve health disparities in the United States using policy interventions. It begins by reviewing the Healthy People Initiative, which sets national health goals and tracks progress. The goals of Healthy People 2020 include attaining high quality lives free of disease for all groups by achieving health equity and eliminating disparities. The document then reviews frameworks for resolving racial/ethnic, socioeconomic status, and health insurance disparities through policies like anti-discrimination laws and expanding access to care. It concludes by discussing a course of action for implementing interventions through awareness, feasibility studies, and evaluation.
Infertility is a common problem that affects millions of couples. It can be caused by factors in the male or female partner and sometimes both. While the main symptom is not being able to get pregnant, infertility can have wide-ranging emotional, psychological, physical, financial, social, and spiritual impacts on individuals and their relationships. Effective support and treatment requires addressing both the medical factors impacting fertility as well as the psychosocial needs of couples.
1) Health care aims to normalize human functioning and prevent disability, viewing atypical functioning as inferior. This amounts to a form of negative eugenics.
2) Medical training, practice, and insurance prioritize normalizing treatments over functional outcomes, seeking to avoid disability throughout life.
3) Metrics used to distribute scarce health resources, like in public health emergencies, disadvantage those with disabilities by falsely assuming typical functioning indicates better health.
4) Viewing disability as a mere difference rather than something inherently detrimental supports individuals' choice in functioning atypically and receiving enhancements to do so effectively.
Elsi of gene therapy, stem cell research copyjayaganesh13
The document discusses the ethical issues surrounding gene therapy, stem cell research, and the Human Genome Project. It describes how these areas of research offer promise for new medical treatments but also raise concerns about germline editing, enhancement, identity, and equitable access. Specific issues addressed include the difference between somatic and germline gene therapy; debates over therapy versus enhancement; impacts on personal identity; and concerns about eugenics, resource allocation, and social context.
1. The document discusses the eugenics movement and genetic counseling. Eugenics aims to improve the human species through selective breeding by encouraging reproduction among genetically advantageous individuals and discouraging it among genetically disadvantaged individuals.
2. Genetic counseling involves obtaining a family history, establishing a diagnosis, discussing genetic testing options, providing risk assessments, discussing options available to patients, and long-term follow-up support. Nurses play an important role in genetic counseling by educating patients and the public.
3. Legal and ethical issues in genetic counseling include obtaining informed consent, allowing for informed choice, respecting patient autonomy, and maintaining confidentiality. The goal of genetic counseling is to allow patients to make their own independent
The document discusses the tension between patient autonomy and paternalism in medical decision making. It explores different models of the patient-physician relationship and how the standard for informed consent has evolved from a professional to a patient-centered standard. Key concepts are that modern healthcare prioritizes patient autonomy, with competent adults having the right to refuse treatment, though some question if this has been taken too far in cases demanding futile care or pregnant women refusing testing.
YolReview the Healthy People 2020 objectives for the older a.docxherminaprocter
Yol
Review the Healthy People 2020 objectives for the older adult. Of the objectives listed for the older adult, which do you feel is most important? Be sure to include examples and references to support your response.
Objective: Increase the proportion of older adults with one or more chronic health conditions who report confidence in managing their conditions
(Healthy People 2020).
Chronic conditions may be difficult to manage based on the complexities of a disease. Additionally, managing one or more chronic conditions may be time consuming. Time consuming tasks may take the form of monitoring (e.g. checking blood glucose), keeping a diary, scheduling appointments, sorting and taking medications, exercising, meal planning, etc.. The Agency for Healthcare Research and Quality (2015) suggests the burden of these tasks significantly impact how patients manage their chronic conditions, and that patients often find it difficult to complete all these tasks in order to manage their condition effectively. Personally, I see examples of this every day at the hospital: Patients are not confident in their self-management ability and are therefore unable to demonstrate skill or awareness in regards to their condition. Despite receiving adequate medical attention from outstanding multidisciplinary teams, patients continue to show little interest in self-management, ultimately resulting in an overwhelming number of older adults who lack the confidence to manage one or more chronic conditions (Bodenheimer, 2005). Healthcare providers are being forced to seek new and innovative ways to connect with patients and reinforce educational material in order to give patients the confidence and skill to manage their care. I believe this objective to be most important because self-management is clinically proven to result in better outcomes. It is proven that support for patients and caregivers improve confidence in managing conditions. Recently, my hospital has added to its emphasis on education and follow up... Simply providing information to patients is not enough to build confidence, skill, nor the knowledge to manage their health. Therefore, nursing must collaborate to reinforce behaviors and promote better health outcomes in patients.
There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges.
Based on recent events that have transpired in the news, one might acknowledge that refugees and immigrants are a vulnerable population... many of whom are struggling with chronic illness, and undeniably experiencing challenges related to our healthcare delivery system. Several barriers exist for this group, including language and technology barriers, expectations of medical care, cultural differences, as well as unique ...
Is respecting patient autonomy enough or must we promote patient autonomy as ...Mark Sullivan
In this presentation, I examine the duty to respect patient autonomy through the requirement for informed consent. I argue that this is inadequate for outpatients with chronic disease. In these patients, we must also promote patient autonomy, understood broadly as the capacity to do and be things of value, for this is the core of the health that is the goal of care.
Advantage and disadvantage of gene therapy.docxJuliusArciaga
Gene therapy is a promising technique that aims to treat or prevent diseases by modifying an individual's genetic material. It involves introducing new genes into the body to replace or supplement faulty genes. While gene therapy holds great potential to treat genetic disorders like cystic fibrosis and provide targeted treatment, it also faces challenges. Gene therapy has safety concerns as the field is still evolving. It raises ethical issues regarding genetic manipulation. Gene therapy treatments can also be expensive due to their complex nature. Further research is needed to address these disadvantages before gene therapy can be widely adopted.
bioethical considerations for preventative enhancementsLuke Brennan
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9
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1. What’s Wrong With Genetic
Enhancement?
BOWLING GREEN STATE UNIVERSITY
SUMMER 2012
MEDICAL ETHICS-ELI WEBER
2. Lecture Goals
Identify the various kinds of genetic
intervention available
Identify some of the ethical concerns with
each
Focus on the ethical debate regarding
treatment of genetic diseases versus genetic
enhancement
Formulate some arguments for and against
genetic enhancement
3. What is Genetic Disease?
Carrier versus Disease
Predispositions versus Disease
Genetic versus Developmental
4. Types of Genetic Intervention
Genetic Screening
Some Concerns:
1. Cost-effectiveness
2. Potential for Discrimination
5. Types of Genetic Intervention
Genetic Counseling
Some Concerns:
1. Selective abortion on the basis of
probabilities
2. No basis for denying couples the right to
reproduce
6. Types of Genetic Intervention
Pre-Natal Genetic Diagnosis
Some Concerns:
1. Possibility of Selective Abortion
2. How Extensively to Test
7. Arguments for Genetic
Intervention
Allows for an increase in patient autonomy
Reduces health care costs overall
Prevents avoidable suffering
Prevents the spread of genetic disease
9. Treatment vs. Enhancement
What’s the Issue?
It is frequently thought that if genetic
interventions are ever permissible, they
should be limited to interventions that count
as treatment. Interventions that constitute
enhancement are not similarly permissible.
10. What’s the Difference?
Treatment involves either the prevention of
disease or the restoration of the patient to
normal functioning.
Enhancement does not involve either of
these things, but instead involves elevating
the patient beyond normal functioning.
11. Why That Can’t Be Right?
Certain interventions that we regard as
treatment are clearly a type of enhancement.
(vaccinations, treatments for osteoperosis
designed to increase bone density,etc.)
The concept of normal functioning is socially
and historically relative.
12. An Alternative Approach
Whatever a disability is, it is something that
involves a harm to the person who suffers it,
irrespective of any notion of normal
functioning or the person’s attitudes about
their condition .
Whether a genetic intervention is permissible
depends on whether it prevents a harm and
protects life and health.
13. Against Enhancement
Gives some people an unfair advantage over
others, and would most likely increase already
existing inequalities.
Threatens the ideal of human equality
Potentially undermines autonomy
May have unforeseen cognitive and emotional
costs.
14. Another Argument Against
Enhancement
Is it possible to give informed consent to enhancement?
Presumably, it will be some time before we understand the full
range of potential side effects and costs of genetic
enhancement.
Because it is not possible to acquire the necessary level of
informed consent in the case of genetic enhancement, we
ought not allow it, because we ought not allow medical
interventions without informed consent.
15. Related Issues
The Sorities Problem of Genetic Intervention
Genetic Interventions that Cause Disability
Selective Abortion in Non-Futile Cases
16. The Bottom Line
There are a variety of ethical concerns related to
various forms of genetic enhancement; there is
no single ethical concern
The distinction between treatment and
enhancement is not an obvious guideline for
when an intervention is permissible.
It may be that whether an intervention is
permissible has little to do with this distinction.