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[Ethical boundary decisions in intensive care medicine].
Inn Med (Heidelb)
October 2024
Zentrum für Intensivmedizin, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Schweiz.
Article Synopsis
- Ethical decision-making is crucial in intensive care and emergency medicine, where clinicians often make quick, high-stakes choices under pressure and with limited information.
- Key principles like patient autonomy, beneficence, non-maleficence, and justice guide these decisions, alongside tools like advanced directives and quality of life assessments.
- A holistic, multidisciplinary approach is needed, especially for older patients and those with complex health issues, while remaining adaptable in the face of resource limitations and integrating human judgment with technological advancements.
Modern insights into the pathophysiology and treatment of pseudoachalasia.
Langenbecks Arch Surg
February 2024
Department of Surgery, University of Virginia, Charlottesville, USA.
Background: Secondary achalasia or pseudoachalasia is a clinical presentation undistinguishable from achalasia in terms of symptoms, manometric, and radiographic findings, but associated with different and identifiable underlying causes.
Methods: A literature review was conducted on the PubMed database restricting results to the English language. Key terms used were "achalasia-like" with 63 results, "secondary achalasia" with 69 results, and "pseudoachalasia" with 141 results.
Disclosing and Managing Non-Financial Conflicts of Interest in Scientific Publications.
Res Ethics
April 2023
NIEHS/NIH.
In the last decade, there has been increased recognition of the importance of disclosing and managing non-financial conflicts of interests to safeguard the objectivity, integrity, and trustworthiness of scientific research. While funding agencies and academic institutions have had policies for addressing non-financial interests in grant peer review and research oversight since the 1990s, scientific journals have been only recently begun to develop such policies. An impediment to the formulation of effective journal policies is that non-financial interests can be difficult to recognize and define.
View Article and Find Full Text PDFFutility and Shared Decision-Making.
Neurol Clin
August 2023
Program in Ethics in Science and Medicine, Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, NC5.832, Dallas, TX 75390-9070, USA; Department of Applied Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, NC5.832, Dallas, TX 75390-9070, USA.
Medical futility is an ancient and yet consistent challenge in clinical medicine. The means of balancing conflicting priorities and stakeholders' preferences has changed as much as the science that powers the understanding and treatment of disease. The introduction of patient self-determination and choice in medical decision-making shifted the locus of power in the physician-patient relationship but did not obviate the physician's responsibilities to provide benefit and prevent harm.
View Article and Find Full Text PDFChallenges in Implementing Futility Schemes, with Reference to Aducanumab.
Ther Innov Regul Sci
May 2023
Pfizer Inc, New York, NY, USA.
Stopping an ongoing clinical trial based on an interim analysis that shows poor outcomes, often referred to as a judgment of "futility", is a familiar feature in current clinical trials practice. Interim data can be misleading, and the implications of prematurely terminating a trial that should not stop are severe. It is thus critical that designs allowing futility stopping be planned and implemented carefully and cautiously.
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