Nurses in psychiatric and forensic departments encounter unique difficulties and ethical dilemmas regarding the contrast between providing care and maintaining safety. Are psychiatric nurses incarceration wardens or agents of nursing care?
View Article and Find Full Text PDFBackground: While several studies have noted smell impairment in schizophrenia, it is unclear whether this impairment extends to acute psychosis and whether it is associated with more severe illness as expressed in extended hospitalization.
Objectives: To evaluate the olfactory function of patients in an acute psychotic state and correlate it with clinical symptomatology and length of hospitalization.
Methods: Olfactory function was assessed in 20 patients with schizophrenia in their first week of hospital admission for acute psychosis compared with matched controls.
The recovery model guides mental health services. However, the delivery of recovery-oriented services in inpatient settings is still a challenge. Factors affecting recovery model implementation can be classified into three types: the hospital environment, the inpatient and the service provider.
View Article and Find Full Text PDFAm J Phys Med Rehabil
December 2022
Ethical allocation of scare medical resources is a ubiquitous challenge in many, if not all, medical specialties. The field of physical medicine and rehabilitation is no exception and presents its own unique dilemmas. We report on a small inpatient rehabilitation unit at a large university medical center with a large catchment area representing a vast range of socioeconomic classes.
View Article and Find Full Text PDFFew if any methodologically robust studies of first-episode psychosis have been carried out in the ultra-Orthodox Jewish population. The opening of an inpatient psychiatry department within an ultra-Orthodox neighborhood in Israel offered the unique opportunity to study the specifics of first -episode psychosis in this subpopulation. Medical records of 60 ultra-Orthodox male Jewish patients with first-episode psychosis were examined over the first 18 months of the new department's operation.
View Article and Find Full Text PDFThis study evaluates the nature and intensity of anxiety, interpretations of the COVID-19 pandemic and coping modalities of hospitalized patients with mental illness compared with their caregivers. One hundred and fifty-one subjects were evaluated with a specially designed questionnaire. Psychiatric inpatients reported more anxiety and more negative feelings than staff members and healthy subjects, but inpatients felt protected by the hospital and Ministry of Health (MoH) measures.
View Article and Find Full Text PDFJ Med Ethics
November 2021
During the Nazi era, physicians provided expertise and a veneer of legitimacy enabling crimes against humanity. In a creative educational initiative to address current ethical dilemmas in clinical medicine, we conduct ethics learning missions bringing senior physicians to relevant Nazi era sites in either Germany or Poland. The tours share a core curriculum contextualising history and medical ethics, with variations in emphasis.
View Article and Find Full Text PDFIn principle, all patients deserve to receive optimal medical treatment equally. However, in situations in which there is scarcity of time or resources, medical treatment must be prioritized based on a triage. The conventional guidelines of medical triage mandate that treatment should be provided based solely on medical necessity regardless of any non-medical value-oriented considerations ("worst-first").
View Article and Find Full Text PDFThis study aims to describe the role that religion and belief may play in members of the Israeli ultra-Orthodox Jewish population hospitalized in the Mayanei Hayeshua Medical Center and diagnosed with a psychotic disorder. Religion was judged essential by the patients in the management of their illness. Forty percent of the patients perceive their illness as their destiny, 26.
View Article and Find Full Text PDFA recent update to the Geneva Declaration's 'Physician Pledge' involves the ethical requirement of physicians to share medical knowledge for the benefit of patients and healthcare. With the spread of COVID-19, pockets exist in every country with different viral expressions. In the Chareidi ('ultra-orthodox') religious community, for example, rates of COVID-19 transmission and dissemination are above average compared with other communities within the same countries.
View Article and Find Full Text PDFReligious coping is prevalent among individuals diagnosed with psychotic disorders, however its clinical relevance has been insufficiently studied. Thirty ultra-Orthodox Jewish patients experiencing current psychotic symptoms and receiving treatment in the inpatient and day-care units were administered measures assessing severity of psychotic symptoms, psychological distress/well-being, beliefs about treatment credibility/expectancy, and aspects of religious belief and coping. Among men, negative religious coping was associated with lower treatment credibility.
View Article and Find Full Text PDFPharmaceutical companies in countries that have community-oriented models of healthcare, unlike other countries with highly privatised healthcare systems, such as the United States, cannot legally advertise medications directly to patients. Thus, the physician is entirely responsible for choosing the right medication, and needs to take important professional and ethical concerns into consideration during this decision-making process. Pharmaceutical companies invest considerably in in marketing products to physicians.
View Article and Find Full Text PDFCOVID-19 presents new challenges for psychiatry as clinical management, ethical dilemmas and administrative complications need to be addressed. The psychiatrist should protect the needs and rights of the mentally ill while maximising population health and ensuring solidarity, reciprocity and community well-being for all.
View Article and Find Full Text PDFThe Holocaust represents a seminal event in the annals of medicine. For the first time in history, doctors played a prominent role in the extreme abuse of medical rights, violation of medical obligation to patients, infringement of patient autonomy, forced and unnecessary invasive and damaging procedures for political purposes and the ultimate injustice of involuntary euthanasia. Physicians provided the legitimacy, know-how and momentum that allowed these processes to take place in a symbiotic relationship with the political establishment during the Nazi era.
View Article and Find Full Text PDFEur Neuropsychopharmacol
March 2020
Recent success of established treatment has driven concerns about the ethics of using placebo-controlled trials in psychiatry. Active-controlled (superiority or non-inferiority) trials do not include a placebo-arm and thus avoid the associated ethical concerns but show disadvantages in other respects. The aim of this paper is to review the available literature and critically discuss the evidence regarding the use of placebo-controlled- versus active-controlled trials.
View Article and Find Full Text PDFIn recent years, the importance of cultural sensitivity and the adaptation of mental health services to diverse populations has been growing. Simultaneously, awareness of psychiatric illnesses and treatment is increasing, even among the Haredi (ultra-orthodox) population in Israel, with specialized services developing. Many studies have emphasized the central role of religion and belief in the coping styles of those with mental illness and their healing processes.
View Article and Find Full Text PDFProg Neuropsychopharmacol Biol Psychiatry
August 2019
Tardive dyskinesia (TD) is an adverse movement disorder induced by chronic treatment with antipsychotics drugs. The contribution of common genetic variants to TD susceptibility has been investigated in recent years, but with limited success. The aim of the current study was to investigate the potential contribution of rare variants to TD vulnerability.
View Article and Find Full Text PDFCurr Opin Anaesthesiol
April 2019
Purpose Of Review: The world has seen a major upturn in international terror awareness. Medicine has had to respond. In addition to the unique physical and mental injuries caused by terror which require special clinical attention, so too terror represents a challenge for medicine from an ethics perspective.
View Article and Find Full Text PDFBackground: Psychiatrists may face challenging core medical ethics questions since the media encourages their assistance and participation at various levels. This paper examines attitudes of psychiatrists regarding their involvement with the media and their view of their professional association in such incidents.
Methods: A survey was completed by a convenience sample of 81 Israeli psychiatrists.
Background: Although exercise has been shown to improve mood and well-being, the precise mechanism remains unknown. Neurosteroids are important neuroactive molecules with demonstrated involvement in several neurophysiological and disease processes. Previous research has noted neurosteroid changes in dehydroepiandrosterone (DHEA) levels following exercise.
View Article and Find Full Text PDFBackground: In Israel a general code of ethics exists for physicians, drafted by the Israel Medical Association. The question arises whether psychiatrists require a separate set of ethical guidelines.
Objectives: To examine the positions of Israeli psychiatrists with regard to ethics in general and professional ethics in particular, and to explore opinions regarding a code of ethics or ethical guidelines for psychiatry.