Patients' perspectives on allocation of publicly funded in vitro fertilization in Ontario: a qualitative study.

Background: The aim of this study was to determine consumers' perspectives on fair allocation of publicly funded in vitro fertilization (IVF) in the recently implemented Ontario Fertility Program (OFP). The research questions were as follows: 1) What factors do those who require IVF think are important to consider when distributing funded IVF? and 2) What are the barriers to accessing publicly funded IVF?

Methods: We approached this qualitative study with a social constructivist interpretative framework with grounded theory methodology. Data were obtained via focus group.

Adaptive behavior, functional outcomes, and quality of life outcomes of children requiring urgent ICU admission.

Objective: To describe the adaptive behavior and functional outcomes, and health-related quality of life of children who were urgently admitted to the ICU.

Design: Prospective observational study.

Setting: Critical Care Medicine program at a University-affiliated pediatric institution.

Approaching end-of-life care in organ transplantation: the impact of transplant patients' death and dying.

Despite the success of transplantation, many transplant candidates and transplant recipients die each year. Some die awaiting transplants and some die months or years after receiving an organ. Quality end-of-life care can play a valuable role in easing the impact of death and dying in transplantation, as it focuses on enhancing patients' quality of life near death.

"Futile" care: do we provide it? Why? A semistructured, Canada-wide survey of intensive care unit doctors and nurses.

Purpose: To qualitatively explore the process of the provision of futile care in Canadian intensive care units (ICUs).

Materials And Methods: A mailed, semistructured survey was sent to medical and nursing unit directors of all Canadian ICUs, asking them to estimate the frequency of provision of futile care, when care becomes "futile," the reasons such care is provided, and the resources that are available to help make end-of-life decisions. Nurse/physician agreement was assessed by chi(2) analysis or Fisher exact test.

Cultural considerations for Canadians in the diagnosis of brain death.

Purpose: This articles explores cultural perceptions and values related to brain death and organ donation from both a Western and non-Western perspective.

Source: Anthropological literature review of the historical concept of brain death in Canada using Eastern culture as a comparison.

Principal Findings: Although the concept of brain death and concomitant organ donation have become widely practiced in Western nations such as Canada, from a cross-cultural point of view these concepts and practices can be deeply troubling and may hold profoundly different meaning to people new to Canada.

Culture, brain death, and transplantation.

From the social sciences, we know the space between life and death is historically and culturally constructed, fluid and open to dispute. The definition of death has cultural, legal, and political dimensions. As healthcare becomes more culturally diverse, the interface between culture and the delivery of healthcare will increase.

Cultural pluralism in health care: a South-African-Canadian comparison.

Views on the acceptance of cultural pluralism in health care are shaped by myriad of social and cultural factors. Through the comparison of Canada and South Africa, this article examines how ideology, history, demographics, and the cultural understanding of illness have shaped the views of cultural pluralism in South Africa in a way that is distinct from the Canadian perspective. Canadian health-care workers must consider such differences as we must be careful not to apply the concept of cultural pluralism in a way that people of other cultures may not understand or value.

Quality end-of-life care: A global perspective.

BACKGROUND: Quality end-of-life care has emerged as an important concept in industrialized countries. DISCUSSION: We argue quality end-of-life care should be seen as a global public health and health systems problem. It is a global problem because 85 % of the 56 million deaths worldwide that occur annually are in developing countries.

Pro/con ethics debate: is nonheart-beating organ donation ethically acceptable?

This pro/con debate explores the ethical issues surrounding nonheart-beating organ donation (NHBD), a source of considerable controversy. It is estimated that NHBD can increase the number of organs available for transplant by 25% at a time of great need. However, should NHBD be ethically acceptable? In support of NHBD, it may be acceptable practice if there is a separation of the rationale to withdraw life support/to withhold cardiopulmonary resuscitation from the decision to recover organs, if no conflicts of interest exist, if a waiting time precluding spontaneous return of circulation is included, and if NHBD conforms to a standardized protocol.