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  • SAGE Publications  (5)
  • Caplan, Arthur  (5)
  • 1
    Online Resource
    Online Resource
    Rationing health and social goods during pandemics: Guidance for Ghanaian decision makers
    SAGE Publications ; 2021
    In:  Clinical Ethics Vol. 16, No. 3 ( 2021-09), p. 165-170
    Details
    In: Clinical Ethics, SAGE Publications, Vol. 16, No. 3 ( 2021-09), p. 165-170
    Abstract: Healthcare rationing during pandemics has been widely discussed in global bioethics literature. However, existing scenarios and analyses have focused on high income countries, except for very few disease areas such as HIV treatment where some analyses related to African countries exist. We argue that the lack of scholastic discourse, and by extension, professional and democratic engagement on the subject constitute an unacceptable ethical omission. Not only have African governments failed to develop robust ethical plans for pandemics, ethicists in this region have been unable to ignite public discourse on rationing. Therefore, we aim to initiate a debate on how rationing health and social goods could be done ethically in Ghana during the current and future pandemics. The paper discusses and critiques some moral considerations (utilitarian, equity, equal worth, urgent need, and the prioritarian principles) for rationing and their relevance in the Ghanaian context. This contribution may facilitate ethical decision-making during the current (COVID-19) pandemic - in Ghana and other African settings where hardly any rationing guidelines exist
    Type of Medium: Online Resource
    ISSN: 1477-7509 , 1758-101X
    URL: Article
    DOI: 10.1177/1477750920977095
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2231775-2
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  • 2
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    Physician Attitudes Toward Living Kidney Donation
    SAGE Publications ; 2019
    In:  Progress in Transplantation Vol. 29, No. 1 ( 2019-03), p. 78-83
    Details
    In: Progress in Transplantation, SAGE Publications, Vol. 29, No. 1 ( 2019-03), p. 78-83
    Abstract: Compared to dialysis, living kidney donation has a greater chance of restoring health and is associated with better outcomes than deceased kidney donation. Although physicians advocate for this treatment, it is uncertain how they would act as potential living kidney donors or recipients. Methods: We surveyed 104 physicians, pediatric, and internal medicine nephrologists, to ascertain their attitudes toward living donation. Results: Among surveyed nephrologists, there was nearly universal support for living kidney donation as a viable medical option, and nearly all of them would support a healthy and medically cleared patient who wishes to participate. Although support was still strong, nephrologists were significantly less likely to support their friends and relatives participating in living kidney donation, and their support declined further for friends and relatives donating to nonrelatives. Conclusion: Our findings suggest the need to more deeply examine physician-perceived risks involved in serving as a living kidney donor. Based on differences in surveyed nephrologist attitudes regarding donation to and from loved ones versus nonrelatives, we suggest that physicians should give careful consideration to how they describe the risks of living donation to potential donors.
    Type of Medium: Online Resource
    ISSN: 1526-9248 , 2164-6708
    URL: Article
    DOI: 10.1177/1526924818817063
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2864264-8
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  • 3
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    Online Resource
    Who is watching the watchmen: Is quality reporting ever harmful?
    SAGE Publications ; 2014
    In:  SAGE Open Medicine Vol. 2 ( 2014-01-01), p. 205031211452342-
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    In: SAGE Open Medicine, SAGE Publications, Vol. 2 ( 2014-01-01), p. 205031211452342-
    Abstract: Quality reporting is increasingly used as a tool to encourage health systems, hospitals, and their practitioners to deliver the greatest health benefit. However, quality reporting systems may have unintended negative consequences, such as inadvertently encouraging “cherry-picking” by inadequately adjusting for patients who are challenging to take care of, or underpowering to reliably detect meaningful differences in care. There have been no reports seeking to identify a minimum level of accuracy that ought to be viewed as a prerequisite for quality reporting. Method: Using a decision analytic model, we seek to delineate minimal standards for quality measures to meet, using the simplest assumptions to illustrate what those standards may be. Results: We find that even under assumptions regarding optimal performance of the quality reporting system (sensitivity and specificity of 1), we can identify a minimal level of accuracy required for the quality reporting system to “do no harm”: the increase in health-related quality of life from a higher rather than lower quality practitioner must be greater than the number of practitioners per patient divided by the proportion of patients willing to switch from a lower to a higher quality provider. Conclusion: Quality measurement systems that have not been demonstrated to improve health outcomes should be held to a specific standard of measurement accuracy.
    Type of Medium: Online Resource
    ISSN: 2050-3121 , 2050-3121
    URL: Article
    DOI: 10.1177/2050312114523425
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2735399-0
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  • 4
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    Evolving ethics, policy and reimbursement issues of vascularized composite allotransplantation: Symposium summary
    SAGE Publications ; 2019
    In:  SAGE Open Medicine Vol. 7 ( 2019-01), p. 205031211986694-
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    In: SAGE Open Medicine, SAGE Publications, Vol. 7 ( 2019-01), p. 205031211986694-
    Abstract: In this article, we present a report from a national meeting titled, “Evolving Issues of Vascularized Composite Allotransplantation—A Symposium on Ethics, Policy, and Reimbursement Issues,” which convened in September 2017. We discuss the maturation of vascularized composite allotransplantation from an emerging technology to becoming an extension of clinical practice for select patients with complex reconstructive needs. Viewpoints and action items were presented by and discussed among the 70+ clinicians, researchers, policymakers, ethicists, healthcare administrators, and third-party payers who attended the symposium with the goals of implementing a collaborative roadmap for vascularized composite allotransplantation growth, evaluation, and sustainability by establishing a unified plan to help address concerns of the public, policymakers, and healthcare finance. We review the current status of vascularized composite allotransplantation in clinical practice and summarize symposium discussions regarding ethical considerations, reimbursement, payer strategies, and standardization of data collection.
    Type of Medium: Online Resource
    ISSN: 2050-3121 , 2050-3121
    URL: Article
    DOI: 10.1177/2050312119866944
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2735399-0
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  • 5
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    Duty and 'Euthanasia': the Nurses of Meseritz-Obrawalde
    SAGE Publications ; 2007
    In:  Nursing Ethics Vol. 14, No. 6 ( 2007-11), p. 781-794
    Details
    In: Nursing Ethics, SAGE Publications, Vol. 14, No. 6 ( 2007-11), p. 781-794
    Abstract: This article examines the actions and testimonies of 14 nurses who killed psychiatric patients at the state hospital of Meseritz-Obrawalde in the Nazi 'euthanasia' program. The nurses provided various reasons for their decisions to participate in the killings. An ethical analysis of the testimonies demonstrates that a belief in the relief of suffering, the notion that the patients would 'benefit' from death, their selection by physicians for the 'treatment' of 'euthanasia', and a perceived duty to obey unquestioningly the orders of physicians were the primary ethical reasons that were stated for their behavior. However, 20 years had elapsed between the killings and the trial, thus giving ample opportunity for the defendants to develop comfortable rationales for their actions and for their attorneys to have observed successful defenses of others accused of euthanasia.
    Type of Medium: Online Resource
    ISSN: 0969-7330 , 1477-0989
    URL: Article
    DOI: 10.1177/0969733007082118
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2031461-9
    SSG: 0
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