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Showing results for tags 'Ethics'.
Found 56 results
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Content ArticleThis article discusses what advocacy actually entails and what values it ought to embody. The paper considers whether advocates are necessary since not only can they be dangerously paternalistic, but the salutary values advocacy embodies are already part of good professional health care.
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Content ArticleThis article by Angira Patel discusses the importance of health advocacy and a clinicians professional responsibility towards their patients. Angira also describes current attitudes and practices surrounding advocacy, particularly within the political and social sphere.
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Content ArticleIn this article, Brian Edwards, MD, discusses pharmacovigilance, society's changing approach to benefit and risk, confusion between compliance and ethics within pharmacovigilance and how ethical business practice is the basis of good business practice.
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Content ArticleThis manual by the Healthcare Quality Improvement Partnership provides an overview of the basic clinical audit process for non-clinician members of a clinical audit team. Topics include: What is Clinical Audit? How to Set Objectives How to Select an Audit Sample Clinical Audit Confidentiality and Ethics Comparing Performance Against Criteria and Standards Writing an Audit Report Implementing Change and Action Plans
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Content ArticleIn 2015 the Supreme Court judgement in the case of Montgomery v Lanarkshire Health Board created a significant change to the law in regard to gaining informed, or valid, consent. The case concerned Nadine Montgomery, a pregnant lady of small stature with diabetes who delivered her son vaginally in 2001. Her son experienced a hypoxic insult as a result of shoulder dystocia and consequently suffered cerebral palsy with severe disabilities. She successfully argued that had she been informed of the risk of shoulder dystocia she would have opted to have an elective caesarean section. This is part of NHS Education for Scotland's Advanced Practice Toolkit repository for credible and supportive resources.
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Content ArticleTwo professionals who treated Jack Adcock before his death were convicted of gross negligence manslaughter, receiving 24-month suspended sentences. His nurse, Isabel Amaro, was erased from the nursing register; but after reviews in the High Court and Court of Appeal, his doctor, Hadiza Bawa-Garba, was merely suspended. Nathan Hodson explores the proposition that nurses are at greater risk of erasure than doctors after gross negligence manslaughter through a close reading of the guidance for medical and nursing tribunals informed by analysis from the High Court and Court of Appeal in the Bawa-Garba cases.
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Content ArticleThe General Medical Council (GMC) has updated their ethical guidance on Good practice in prescribing and managing medicines and devices.
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Content ArticleMore than 1·8 million lives have been lost due to COVID-19. Two frontrunner vaccines from Moderna and Pfizer-BioNTech promise some relief, with data suggesting 95% efficacy,1 and have been granted emergency use authorisations in several countries. In an open letter responding to these developments, participants in COVID-19 vaccine trials argued that those who received placebos should be unmasked and given priority access to authorised vaccines. The letter cited the American Medical Association's Code of Medical Ethics, which highlights the importance of minimising the time research participants spend in a placebo group. Fulfilling these requests could help to foster trust in medicine and research, reward those who take risks for the many, and prevent future harm from COVID-19 for these participants. However, granting these requests also comes with tradeoffs and highlights competing interests inherent in vaccine development. Importantly, these requests also reveal shortcomings in bioethical resources, particularly clinical equipoise conceptualisations. Friesen et al. discuss this further in this Lancet correspondence.
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Content ArticleThis toolkit from the British Medical Association looks at some of the key challenges students may come across when undertaking a medical elective in a developing country. Topics covered include: Staying within your competence Emergency situations Maintaining ethical standards Minimising burdens on the host country.
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Content ArticleThis guidance, from the British Medical Association (BMA), provides doctors and medical students with the key legal and ethical considerations they need to take into account when working in conflicts and emergencies, and signposts to other sources of support and information. This guide is structured around areas known to be challenging, including: Threats to delivering care to appropriate standards, often linked to a shortage of resources. Pressures to transfer the injured, sick or wounded to substandard health facilities. Identifying an acceptable lower limit of quality: at what point do you draw the line?
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Content ArticleNurses often express a desire to serve others as a volunteer. They volunteer within their communities and across borders in global settings. While nurses considering participation or serving as a volunteer express altruistic intention, their actions may result in unintended adverse consequences to the host community. The purpose of this position statement is to promote ethically responsible volunteer efforts classified as short-term (six months or less) practice experiences in local and global healthcare and public health.
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Content ArticleThis paper, published in Tropical Diseases, Travel Medicine and Vaccines, aims to present contemporary criticism of medical volunteering. A range of ethical concerns are identified and possible ways of alleviation suggested.
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Content ArticlePresentation from Dr Andrew Hider, Clinical Director, Consultant Clinical and Forensic Psychologist, Ludlow Street Healthcare, on mental health during the pandemic.
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Content ArticleIn these times where the pressure of track and trace is ramping up around the world in the wake of expectations of a return to normality, Matt Pattison talks with Professor Effy Vayena from ETH Zurich about her work with the Swiss government in ethics, digital and the risks and rewards viewed under an ethical lens in the TEN podcast.
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Content ArticleHow many of you know the full history of duty of candour in healthcare in the UK? It was Will Powell who, after the tragic death of his son Robbie, brought to light that there was none. Even today we only have an institutional duty of candour in place, leaving clinicians with the right to lie as no specific law exists to prevent this.
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News Article
Gene-edited babies: Current techniques not safe, say experts
Patient Safety Learning posted a news article in News
Current scientific techniques are not yet safe or effective enough to be used to create gene-edited babies, an international committee says. The technology could one day prevent parents from passing on heritable diseases to children, but the committee says much more research is needed. The world's first gene-edited babies were born in China in November 2018. The scientist responsible was jailed, amid a fierce global backlash. The committee was set up in response. Gene-editing could potentially help avoid a range of heritable diseases by deleting or changing troublesome coding in embryos. But experts worry that modifying the genome of an embryo could cause unintended harm, not only to the individual but also future generations that inherit these same changes. It made several recommendations, including: Extensive conversations in society before a country decides whether to permit this type of gene-editing. If proven to be safe and effective, initial uses should be limited to serious, life-shortening diseases which result from the mutation of one or both copies of a single gene, such as cystic fibrosis. Rigorous checks at every stage of the process to make sure there are no unintended consequences, including biopsies and regular screening of embryos. Pregnancies and any resulting children to be followed up closely. An international scientific advisory panel should be established to constantly assess evidence on safety and effectiveness, allowing people to report concerns about any research that deviates from guidelines. Read full story Source: BBC News, 4 September 2020 -
Content Article
Good Clinical Practice (GCP)
PatientSafetyLearning Team posted an article in Applying standards
Good Clinical Practice (GCP) is the international ethical, scientific and practical standard to which all clinical research is conducted. It is important that everyone involved in research is trained or appropriately experienced to perform the specific tasks they are being asked to undertake. GCP training is a requirement set out in the UK Policy Framework for Health and Social Care Research developed by the Health Research Authority for researchers conducting clinical trials of investigational medicinal products (CTIMPs). Different types of research may require different training, and some researchers are already well trained and competent in their area of expertise. Some researchers doing other types of clinical trials may also benefit from undertaking GCP training but other training may be more relevant. The National Institute of Health Research (NIHR) offers range of Good Clinical Practice (GCP) courses and training aids for the clinical research delivery workforce. -
Content ArticleHow work gets done in complex healthcare systems is ethically important. When healthcare professionals and other staff are pressured to improvise, fix structural problems, or comply with competing policies, the uncertainty and distress they experience have potential consequences for patients, families, colleagues, and the system itself. This book presents a new theory of healthcare ethics that is grounded in the nature of healthcare work and how it is shaped by the ever-changing conditions of complex systems, in particular, problems of safety and harm. By exploring workarounds and other improvised practices in complex healthcare systems that are difficult for professionals to talk about openly, yet have unclear effects, including their value or risk to patients, this book offers a realistic look at our changing healthcare system and how we can improve the way we manage moral problems arising in the care of the sick. Berlinger argues that healthcare ethics in complex and changing healthcare systems should reflect the moral complexity of healthcare work, analyse common ethical challenges with reference to behaviours and pressures driven by the system itself and support opportunities for healthcare professionals and staff at all levels to reflect on the problems they face and to take part in social change. The book's chapters include frameworks for looking at ethical challenges in healthcare as problems of safety and harm with consequences for patients. Are Workarounds Ethical? is designed to support clinician education in medicine, nursing, and interdisciplinary contexts and recommend methods for integrating ethics, safety, and justice in practice.
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Community PostWay back in March I applied to re-join the NHS to help with COVID-19. I am a mental health nurse prescriber with an unblemished clinical record. I have had an unusual career which includes working in senior management before returning to clinical work in 2002. I have also helped deliver several projects that achieved nation recognition, including one that was highly commented by NICE in 2015, and one that was presented at the NICE Annual Conference in 2018. Several examples of my work can be found on the NICE Shared Learning resource pages. Since applying as an NHS returner. I have been interviewed online 6 times by 3 different organisations, all repeating the same questions. I was told that the area of work I felt best suited to working in - primary care/ community / mental health , specialising in prescribing and multi-morbidity - was in demand. A reference has been taken up and my DBS check eventually came through. I also received several (mostly duplicated) emails. On 29th June I received a call from the acute trust in Cornwall about returning. I explained that I had specified community / primary care as I have no recent acute hospital experience. The caller said they would pass me over to NHS Kernow, an organisation I had mentioned in my application. I have heard nothing since. I can only assume the backlisting I have suffered for speaking out for patients, is still in place. If this is true (and I am always open to being corrected) it is an appalling reflection on the NHS culture in my view. Here is my story: http://www.carerightnow.co.uk/i-dont-want-to-hear-anything-bad-whistleblowing-in-health-social-care/
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Content ArticleThis book explores patient safety themes in developed, developing and transitioning countries. A foundation premise is the concept of ‘reverse innovation’ as mutual learning from the chapters challenges traditional assumptions about the construction and location of knowledge. hub members can receive a 20% discount. Please email: feedback@pslhub.org to request the discount code.
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Content ArticleThe National Institute for Health and Care Excellence (NICE) is a non-departmental public body that provides national guidance and advice to improve health and social care in England. This manual explains the processes and methods used to develop and update NICE guidelines.
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Content Article
The right – and duty – of NHS staff to speak up
Hugh Wilkins posted an article in Whistle blowing
A blog from hub topic lead Hugh Wilkins on the recent messages from NHS England and NHS Improvement leaders reminding everyone, including those at board level, of the duty and right of staff to speak up about anything which gets in the way of patient care and their own wellbeing. Hugh highlights the real risk of reprisals against some staff who have raised concerns in the public interest, and points out that much needs to change before NHS staff can be sure that it is safe for them to speak up.- Posted
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Content ArticleOn 24 July 2017, the long-running, deeply tragic and emotionally fraught case of Charlie Gard reached its sad conclusion. Following further medical assessment of the infant, Charlie’s parents and doctors finally reached agreement that continuing medical treatment was not in Charlie’s best interests. Life support was subsequently withdrawn and Charlie died on 28 July 2017. This paper from Dominic Wilkinson and Julian Savulescu summarises the case and looks at the key factual and ethical questions arising from the Charlie Gard case, and parents’ role in decision-making for children.
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Community Post
Coexistence of Accreditation and Regulation in Healthcare
Dr Akhil Sangal posted a topic in Innovation programmes in health and care
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Content ArticleIs a focus on wellbeing a ‘nice thing to do’ in organisations, or are there more fundamental arguments? In this article in Hindsight, Suzanne Shale outlines ethical arguments for making wellbeing a priority.
