159 results match your criteria: "and Clinical Ethics[Affiliation]"

Health AI poses distinct harms and potential benefits for disabled people.

Nat Med

January 2025

Department of Otolaryngology-Head & Neck Surgery and Clinical Ethics Service, Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

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Advance Care Planning in Palliative Care in Asia: Barriers and Implications.

J Hosp Palliat Care

December 2024

Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si and Department of Medicine, College of Medicine, Dongguk University, Seoul, Korea.

Advance care planning (ACP) in palliative care is essential for patient autonomy and quality of dying. This review explores ACP practices in South Korea, Japan, and Taiwan, highlighting how legislation and cultural values shape those practices. In these three sectors, which are influenced by Confucian values, family involvement plays a significant role in decision-making.

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Individuals diagnosed with advanced cancer often experience stress and depression, factors linked to worse survival. Curability belief-defined as the hope and expectation of cure through treatment, based on affective forecasting-may differ from the patient's actual life expectancy (i.e.

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Article Synopsis
  • Korea is facing increasing dementia rates in its super-aged society, prompting a need for effective end-of-life care strategies amidst existing legislative gaps in addressing medical and ethical challenges.* -
  • A web-based survey assessed the attitudes of 500 general population members and 200 clinicians regarding end-of-life treatment decisions, particularly focusing on nasogastric tube (NGT) use and mechanical ventilation (MV).* -
  • The study found significant differences in attitudes toward NGT withdrawal, with more general population members supporting it compared to clinicians, while both groups largely accepted withholding MV when patient intentions were clear; emphasizing the need for careful consideration of patient wishes in treatment decisions.*
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Objective: Palliative care is a specialized approach designed to enhance the quality of life for both patients and their families, offering patient-centered care through comprehensive assessment and care planning. However, the integration of palliative care within neuro-critical care settings has been relatively understudied. This descriptive study aims to identify the characteristics, palliative care needs, and outcomes of patients referred to palliative care services during admission to the neurosurgical intensive care unit (NS-ICU).

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Parental Preferences and Shared Decision-Making for the Management of Febrile Young Infants.

Pediatrics

October 2024

Division of Pediatric Emergency Medicine, Montreal Children's Hospital, McGill University Health Centre, and the Department of Biostatistics, Epidemiology and Occupational Health, McGill University, Montreal, Quebec, Canada.

Article Synopsis
  • The study aimed to identify parental preferences for managing febrile infants to enhance shared decision-making in healthcare settings.
  • Involving 432 parents, the research used questionnaires and focus groups to explore their experiences, revealing that many parents were not prepared for decisions about lumbar puncture (LP) and hospitalization, which they found stressful.
  • Key findings highlighted the importance of parental involvement, the need for customized information, and the impact of medical recommendations on their decision-making preferences.
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Background: The vegetative state (VS) after severe acute brain injury (SABI) is associated with significant prognostic uncertainty and poor long-term functional outcomes. However, it is generally distinguished from imminent death and is exempt from the Life-Sustaining Treatment (LST) Decisions Act in Korea. Here, we aimed to examine the perspectives of the general population (GP) and clinicians regarding decisions on mechanical ventilator withdrawal in patients in a VS after SABI.

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Background: Despite medical advancements in neonatal survival rates, many children have poor neurological outcomes. Because the law in Korea restricts the withdrawal of life-sustaining treatment to only cases of imminent death, treatment discontinuation may not be an option, even in patients with poor neurological prognosis. This study investigated the opinions of the general population and clinicians regarding life-sustaining treatment withdrawal in such cases using hypothetical scenarios.

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Background: As long-term, regular aesthetic botulinum neurotoxin A (BoNT-A) use becomes more commonplace, it is vital to understand real-world risk factors and impact of BoNT-A immunoresistance. The first Aesthetic Council on Ethical Use of Neurotoxin Delivery panel discussed issues relating to BoNT-A immunoresistance from the health care professionals' (HCPs') perspective. Understanding the implications of BoNT-A immunoresistance from the aesthetic patient's viewpoint allows HCPs to better support patients throughout their aesthetic treatment journey.

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Machine learning-based model to predict delirium in patients with advanced cancer treated with palliative care: a multicenter, patient-based registry cohort.

Sci Rep

May 2024

Division of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 13496, South Korea.

This study aimed to present a new approach to predict to delirium admitted to the acute palliative care unit. To achieve this, this study employed machine learning model to predict delirium in patients in palliative care and identified the significant features that influenced the model. A multicenter, patient-based registry cohort study in South Korea between January 1, 2019, and December 31, 2020.

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Introduction/aims: The care burden of people living with amyotrophic lateral sclerosis (pALS) increases with disease progression. This study aimed to investigate the home care status and preparedness of care partners of pALS (cALS) in Korea.

Methods: An online survey was conducted with family care partners of patients diagnosed with ALS for over 1 year in 2022.

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Advancements in the treatment and management of patients with cancer have extended their survival period. To honor such patients' desire to live in their own homes, home-based supportive care programs have become an important medical practice. This study aims to investigate the effects of a multidimensional and integrated home-based supportive care program on patients with advanced cancer.

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Opioid use and subsequent delirium risk in patients with advanced cancer in palliative care: a multicenter registry study.

Sci Rep

March 2024

Division of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-Ro, Bundang-Gu, Seongnam, 13496, South Korea.

The prevalent use of opioids for pain management in patients with advanced cancer underscores the need for research on their neuropsychiatric impacts, particularly delirium. Therefore, we aimed to investigate the potential association between opioid use and the risk of delirium in patients with advanced cancer admitted to the acute palliative care unit. We conducted a retrospective observational study utilizing a multicenter, patient-based registry cohort by collecting the data from January 1, 2019, to December 31, 2020, in South Korea.

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Development of a Prediction Model for Delirium in Hospitalized Patients with Advanced Cancer.

Cancer Res Treat

October 2024

Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Purpose: Delirium is a common neurocognitive disorder in patients with advanced cancer and is associated with poor clinical outcomes. As a potentially reversible phenomenon, early recognition of delirium by identifying the risk factors demands attention. We aimed to develop a model to predict the occurrence of delirium in hospitalized patients with advanced cancer.

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Ethics of Managing an Adolescent Living with Disability.

Indian Pediatr

February 2024

Departments of Family Medicine and Clinical Ethics, St. John's Medical College, Bengaluru, Karnataka, India. Correspondence to: Dr. Sanjiv Lewin, Professor, Department of Family Medicine and Clinical Ethics, St. John's Medical College, Bengaluru, Karnataka, India.

Article Synopsis
  • The parents of an adolescent girl with severe intellectual disability sought a hysterectomy to prevent menstruation and pregnancy, raising ethical concerns about consent and autonomy.
  • The family's challenging circumstances, including rural living and lack of support, heightened parental distress and the situation's complexity.
  • The text examines differing perspectives from healthcare professionals, emphasizing the need for an ethical decision-making process based on existing literature.
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Background And Purpose: Despite the growing demands and challenges faced by patients with amyotrophic lateral sclerosis (ALS) in accessing healthcare services, our understanding of this access remains poor. This study aimed to investigate the healthcare utilization patterns and timing of nutritional and respiration support in patients with ALS in South Korea.

Methods: A retrospective cohort study was conducted on patients diagnosed with ALS at a single tertiary hospital between 2016 and 2019 and followed up for 2 years.

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This study aimed to examine the impact of the COVID-19 pandemic on the emergency department (ED) visits of cardiovascular disease (CVD) patients. The customized data of the National Health Insurance Service (NHIS) from 2017 to 2020 were analyzed. CVD patients were defined by the code 'V192' based on the NHIS coverage benefit expansion policy.

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Objectives: This study systematically reviewed the literature on the effect of home-based supportive care (HbSC) programmes on the quality of life (QoL) of patients with advanced cancer.

Methods: The research question 'Do home-based supportive care programmes for patients with advanced cancer improve their QoL?' was addressed. After registering the plan with PROSPERO (CRD42022341237), literature published from 1 January 1990 to 30 May 2023 was searched on PubMed, Embase, Cochrane database, CINAHL and Web of Science, and reviewed for inclusion based on predefined criteria.

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Introduction: Patients with hematologic malignancies (HMs) often face challenges in accessing palliative care (PC) and receiving quality end-of-life (EOL) care. We examined factors associated with referrals to tertiary PC and the effects of tertiary PC on EOL care in patients with HMs.

Method: We included patients with HMs who were admitted to a university-affiliated hospital and died during hospitalization between January 2018 and December 2021.

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Introduction: The COVID-19 pandemic led to visitor restrictions in many hospitals. Since care in the surgical intensive care unit (SICU) often engages visitors as surrogate decision-makers, we investigated whether there was an association between COVID-19-related visitor restrictions, goals of care discussions (GOCD), and patient outcomes in SICU patients.

Methods: We conducted a retrospective review of trauma and emergency general surgery (EGS) patients admitted to a rural tertiary SICU between July 2019 and April 2021, dividing patients into those admitted during COVID-19 visitor restrictions and those admitted at other times.

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Consultation-Based Deprescribing Service to Optimize Palliative Care for Terminal Cancer Patients.

J Clin Med

November 2023

College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.

(1) Background: A pharmacist-led deprescribing service previously developed within the Consultation-Based Palliative Care Team (CB-PCT) was implemented for terminal cancer patients. (2) Objective: To evaluate the clinical outcomes of the developed deprescribing service for terminal cancer patients in CB-PCT. (3) Methods: A retrospective analysis compared the active care (AC) group to the historical usual care (UC) group.

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Purpose: Social distancing and strict visitor restrictions at hospitals have been national policies since the onset of the coronavirus disease 2019 (COVID-19) pandemic. This has challenged the concept of a good death in comfort with the opportunity to say goodbye. Little is known about how these measures have influenced end-of-life (EOL) care among cancer patients who die in acute care hospitals.

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In neonatology, multiple pregnancies are common. Unfortunately, it is not rare for one baby to die. Communication with parents in these circumstances has been demonstrated to be sub-optimal.

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