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A Guide to Shaping Shared Solutions, Revised and Expanded Edition
Expanded by two-thirds from the 2004 edition, the new edition features two new role plays, a new chapter on how to write chart notes, and a discussion of new understandings of the role of the clinical ethics consultant. **** Bioethics Mediation offers stories about patients, families, and health care providers enmeshed in conflict as they wrestle with decisions about life and death. It provides guidance for those charged with supporting the patient’s traditional and religious commitments and personal wishes. Today’s medical system, without intervention, privileges those within shared cultures of communication and disadvantages those lacking power and position, such as immigrants, the poor, and nonprofessionals. This book gives clinical ethics consultants, palliative care providers, and physicians, nurses, and other medical staff the tools they need to understand and manage conflict while respecting the values of patients and family members. Conflicts come in different guises, and the key to successful resolution is early identification and intervention. Every bioethics mediator needs to be prepared with skills to listen, “level the playing field,” identify individual interests, explore options, and help craft a “principled resolution”—a consensus that identifies a plan aligned with accepted ethical principles, legal stipulations, and moral rules and that charts a clear course of future intervention. The organization of the book makes it ideal for teaching or as a handbook for the practitioner. It includes actual cases, modified to protect the privacy of patients, providers, and institutions; detailed case analyses; tools for step-by-step mediation; techniques for the mediator; sample chart notes; and a set of actual role plays with expert mediator and bioethics commentaries. The role plays include: • discharge planning for a dying patient • an at-risk pregnancy • HIV and postsurgical complications in the ICU • treatment for a dying adolescent • dialysis and multiple systems failure
À partir de données probantes tirées de ces études, les auteures démontrent que l'allaitement diffère de l'alimentation avec une préparation commerciale, et ce, sous presque tous les aspects examinés. Elles souhaitent inciter les professionnels de la santé, qui continuent de considérer l'allaitement et l'alimentation avec des préparations commerciales comme des pratiques équivalentes ou permutables sans grande conséquence, à prendre conscience de l'immense potentiel du lait humain et de l'allaitement pour le mieux-être de nos sociétés.
Digitizing Life in the United States
Imagine biology and medicine today without computers. What would laboratory work be like without electronic databases and statistical software? Would disciplines like genomics even be feasible without the means to manage and manipulate huge volumes of digital data? How would patients fare in a world without CT scans, programmable pacemakers, and computerized medical records? Today, computers are a critical component of almost all research in biology and medicine. Yet, just fifty years ago, the study of life was by far the least digitized field of science, its living subject matter thought too complex and dynamic to be meaningfully analyzed by logic-driven computers. In this long-overdue study, historian Joseph A. November explores the early attempts, in the 1950s and 1960s, to computerize biomedical research in the United States. Computers and biomedical research are now so intimately connected that it is difficult to imagine when such critical work was offline. Biomedical Computing transports readers back to such a time and investigates how computers first appeared in the research lab and doctor's office. November examines the conditions that made possible the computerization of biology—including strong technological, institutional, and political support from the National Institutes of Health—and shows not only how digital technology transformed the life sciences but also how the intersection of the two led to important developments in computer architecture and software design. The history of this phenomenon is only vaguely understood. November's thoroughly researched and lively study makes clear for readers the motives behind computerizing the study of life and how that technology profoundly affects biomedical research even today.
“Over the last two decades, medical researchers have become more comfortable wit the idea that serious attention must be given to ethical issues when the tests of new technologies are being designed. They have come to see that experimental trials must meet certain standards, not only of scientific rigour, but also of moral acceptability.” (Introduction)
Presented by an international group of experts, the eight essays included in this volume evaluate the new technologies in fetal care and also wrestle with the new problems, often moral ones, that have accompanied techonological advancement. The opening chapters review state-of-the-art ultrasound imaging and molecular genetics and focus on the new patient—the fetus. From here, the efficacy of fetal therapy, the problem of assessing long-term viability, the ethical issues involved in both clinical practice and medical research, and the legal rights of the new patients and their parents are examined. The final chapter “Are Fetuses Becoming Children?” brings a fresh philosophical perspective to the question of a fetus’s status and rights.
Some of humankind's greatest tools have been forged in the research laboratory. Who could argue that medical advances like antibiotics, blood transfusions, and pacemakers have not improved the quality of people's lives? But with each new technological bre
This comprehensive volume is the first to offer guidance to clinicians and researchers treating or studying bipolar disorder in older adults. Growing numbers of elderly people are affected by this serious mental illness. Presenting the most recent information, experts in the fields of bipolar disorder, geriatrics, and mental health services research cover late-life bipolar disorder in four major domains: epidemiology and assessment, treatment, complexity and comorbidity, and specialized care delivery. Revealing the effect of the aging process on the disease, they address diagnosis patterns over the life course, rating scales of assessment, pharmacologic and psychological therapies, adherence to treatment, effects of cultural factors, assessing the quality of care, and legal and ethical issues. An important tool for clinicians, this book will serve as a springboard for further research into this complex disorder.
There was a time when birth was treated as a natural process rather than a medical condition. Before 1800, women gave birth seated in birth chairs or on stools and were helped along by midwives. Then societal changes in attitudes toward women and the practice of medicine made birthing a province of the male-dominated medical profession.
In Birth Chairs, Midwives, and Medicine, Amanda Carson Banks examines the history of the birth chair and tells how this birthing device changed over time. Through photographs, artists' renditions of births, interviews, and texts from midwives and early obstetricians, she creates an evolutionary picture of birthing practices and highlights the radical redefinition of birth that has occurred in the last two centuries.
During the 1800s the change from a natural philosophy of birth to a medical one was partly a result of heightened understandings of anatomy and physiology. The medical profession was growing, and with it grew the awareness of the economic rewards of making delivery a specialized practice. In the background of the medical profession's rise was the prevailing perception of women as fragile invalids. Gradually, midwives and birth chairs were relegated to rural and isolated settings.
The popularity of birth chairs has seen a revival in the late twentieth century as the struggle between medical obstetrics and the alternative birth movement has grown. As Banks shows through her careful examination of the chairs themselves, these questions have been answered and reconsidered many times in human history. Using the artifacts from the home and medical office, Banks traces sweeping societal changes in the philosophy of how to bring life into the world.
A Comparative Study
Throughout the fourteenth century AD/eighth century H, waves of plague swept out of Central Asia and decimated populations from China to Iceland. So devastating was the Black Death across the Old World that some historians have compared its effects to those of a nuclear holocaust. As countries began to recover from the plague during the following century, sharp contrasts arose between the East, where societies slumped into long-term economic and social decline, and the West, where technological and social innovation set the stage for Europe’s dominance into the twentieth century. Why were there such opposite outcomes from the same catastrophic event? In contrast to previous studies that have looked to differences between Islam and Christianity for the solution to the puzzle, this pioneering work proposes that a country’s system of landholding primarily determined how successfully it recovered from the calamity of the Black Death. Stuart Borsch compares the specific cases of Egypt and England, countries whose economies were based in agriculture and whose pre-plague levels of total and agrarian gross domestic product were roughly equivalent. Undertaking a thorough analysis of medieval economic data, he cogently explains why Egypt’s centralized and urban landholding system was unable to adapt to massive depopulation, while England’s localized and rural landholding system had fully recovered by the year 1500.
Depression and Gender in the Age of Self-Care
Winston Churchill called his own depression his "black dog." Black Dogs and Blue Words analyzes contemporary rhetoric surrounding depression and maintains that the techniques and language of depression marketing strategies target women and young girls, encoding a series of gendered messages about health and illness and encouraging self-diagnosis and self-medication. As depression and other forms of mental illness move from the medical-professional sphere to the consumer-public, the boundary at which distress becomes disease grows ever-more encompassing, the need for remediation and treatment increasingly warranted.