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  • 1
    Language: English
    In: JAMA, 22 December 2010, Vol.304(24), pp.2697-8; author reply 2698
    Keywords: Physician'S Role ; Physician-Patient Relations ; Decision Making -- Ethics
    ISSN: 00987484
    E-ISSN: 1538-3598
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  • 2
    Article
    Article
    BMJ Publishing Group Ltd and Institute of Medical Ethics
    Language: English
    In: Journal of Medical Ethics, 15 January 2011, Vol.37(1), p.45
    Description: The ‘best interests’ decision making standard is used in clinical care to make necessary health decisions for non-capacitated individuals for whom neither explicit nor inferred wishes are known. It has been also widely acknowledged as a basis for enrolling some non-capacitated adults into clinical research such as emergency, critical care, and dementia research. However, the best interests standard requires that choices provide the highest net benefit of available options, and clinical research rarely meets this criterion. In the context of modern norms of bioethics, the best interests standard rarely supports surrogate consent for research and should not be accepted as a routine provision.
    Keywords: Best Interests ; Surrogate Decision Making ; Informed Consent ; Research Ethics ; Philosophy of Medicine ; Third Party Consent/Incompetents ; Research on Special Populations
    ISSN: 0306-6800
    ISSN: 03066800
    E-ISSN: 1473-4257
    E-ISSN: 14734257
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  • 3
    Language: English
    In: Journal of Pain and Symptom Management, April 2012, Vol.43(4), pp.802-805
    Description: Patients in the advanced stages of amyotrophic lateral sclerosis often are faced with the dilemma of whether to use or continue to use mechanical ventilation. Patients who elect to terminate ventilatory support may be subject to significant and even extreme respiratory symptoms. Severe dyspnea and other symptoms are sometimes treated with palliative sedation, which is generally recommended as a last resort approach to refractory symptoms. However, the preemptive use of palliative sedation is sometimes appropriate. The preemptive use of palliative sedation is examined through a case-based analysis of a patient with advanced amyotrophic lateral sclerosis.
    Keywords: Ethics ; Palliative Sedation ; Amyotrophic Lateral Sclerosis ; Medicine
    ISSN: 0885-3924
    E-ISSN: 1873-6513
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  • 4
    Language: English
    In: Journal of General Internal Medicine, Feb, 2014, Vol.29(2), p.395(4)
    Description: Byline: Jeffrey T. Berger (1,2,3) Abstract: Moral distress is the experience of cognitive-emotional dissonance that arises when one feels compelled to act contrary to one's moral requirements. Moral distress is common, but under-recognized in medical education and training, and this relative inattention may undermine educators' efforts to promote empathy, ethical practice, and professionalism. Moral distress should be recognized as a feature of the clinical landscape, and addressed in conjunction with the related concerns of negative role modeling and the goals and efficacy of medical ethics curricula. Author Affiliation: (1) Stony Brook University School of Medicine, Stony Brook, NY, USA (2) Division of Palliative Medicine, Winthrop University Hospital, 222 Station Plaza North, Mineola, NY, 11501, USA (3) Department of Medicine, Winthrop University Hospital, 222 Station Plaza North, Mineola, NY, 11501, USA Article History: Registration Date: 27/09/2013 Received Date: 31/05/2013 Accepted Date: 20/09/2013 Online Date: 22/10/2013
    Keywords: Medical Schools ; Medical Personnel Training ; Professional Employees ; Medical Ethics
    ISSN: 0884-8734
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  • 5
    Language: English
    In: Annals of internal medicine, 07 July 2015, Vol.163(1), pp.69-70
    Keywords: Developed Countries ; Ethics, Institutional ; Hemorrhagic Fever, Ebola -- Therapy ; Hospitals -- Ethics ; Life Support Care -- Ethics
    ISSN: 00034819
    E-ISSN: 1539-3704
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  • 6
    Language: English
    In: Annals of internal medicine, 02 August 2011, Vol.155(3), pp.206
    Keywords: Decision Making ; Caregivers -- Psychology ; Stress, Psychological -- Etiology
    ISSN: 00034819
    E-ISSN: 1539-3704
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  • 7
    Language: English
    In: Archives of internal medicine, 24 January 2011, Vol.171(2), pp.178-9
    Keywords: Anorexia -- Therapy ; Dementia -- Complications ; Enteral Nutrition -- Ethics ; Third-Party Consent -- Ethics
    ISSN: 00039926
    E-ISSN: 1538-3679
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  • 8
    Language: English
    In: Journal of General Internal Medicine, 2014, Vol.29(2), pp.395-398
    Description: Moral distress is the experience of cognitive-emotional dissonance that arises when one feels compelled to act contrary to one’s moral requirements. Moral distress is common, but under-recognized in medical education and training, and this relative inattention may undermine educators’ efforts to promote empathy, ethical practice, and professionalism. Moral distress should be recognized as a feature of the clinical landscape, and addressed in conjunction with the related concerns of negative role modeling and the goals and efficacy of medical ethics curricula.
    Keywords: Emotions ; Morals ; Students, Medical ; Education, Medical -- Ethics ; Internship and Residency -- Ethics;
    ISSN: 0884-8734
    E-ISSN: 1525-1497
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  • 9
    In: Critical Care Medicine, 2011, Vol.39(3), pp.610-610
    ISSN: 0090-3493
    E-ISSN: 15300293
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  • 10
    Language: English
    In: Critical care medicine, October 2010, Vol.38(10 Suppl), pp.S518-22
    Description: Intensive care units (ICUs) in different parts of the world provide care to patients with advanced age and terminal illness at different rates and in different patterns. In the United States, ICU beds make up a disproportionate number of acute care beds. Nearly half of all patients who die in U.S. hospitals have received ICU, some of which may be futile. The objective of this study was to examine ways in which the delivery of futile care in the ICU can cause harm to patients other than those receiving the futile care. Review of available studies of patient and family attitudes about cardiopulmonary resuscitation and other supportive modalities, including antibiotic therapy, and the relationship of the delivery of such care to the outcomes of others treated in the ICU. Those treated in ICUs and those receiving futile care. Compared with younger patients, the elderly in the United States use more ICU care, at higher cost, have more serious comorbidities, and have a higher mortality rate. Certain populations demand ICU care more than others and often with less benefit than less-demanding populations. In a situation of unlimited resources, the provision of ICU care, even when futile, has been viewed as an individual patient decision with no harm to others within the hospital. However, even with unlimited resources, the use of antibiotics for those who are receiving futile care can be considered unethical by egalitarian theory because it can lead to antibiotic resistance that may make the treatment of other patients impossible. In the setting of limited resources, like in pandemic influenza, or with the potential limiting of resources, in a pay-for-performance environment, the provision of futile care can also harm the hospital population as a whole. The delivery of futile care is not only an individual patient decision, but must be viewed in a broader context. Societal awareness of this problem is necessary, and better scoring systems to identify when ICU care has limited benefit are needed to address these difficult and challenging realities.
    Keywords: Intensive Care Units ; Medical Futility
    ISSN: 00903493
    E-ISSN: 1530-0293
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