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Ethical And Legal Issues In Neurology
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Book Synopsis Ethical and Legal Issues in Neurology by : James L. Bernat
Download or read book Ethical and Legal Issues in Neurology written by James L. Bernat and published by Newnes. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advances in our understanding of the brain and rapid advances in the medical practice of neurology are creating questions and concerns from an ethical and legal perspective. Ethical and Legal Issues in Neurology provides a detailed review of various general aspects of neuroethics, and contains chapters dealing with a vast array of specific issues such as the role of religion, the ethics of invasive neuroscience research, and the impact of potential misconduct in neurologic practice. The book focuses particular attention on problems related to palliative care, euthanasia, dementia, and neurogenetic disorders, and concludes with examinations of consciousness, personal identity, and the definition of death. This volume focuses on practices not only in North America but also in Europe and the developing world. It is a useful resource for all neuroscience and neurology professionals, researchers, students, scholars, practicing clinical neurologists, mental health professionals, and psychiatrists. A comprehensive introduction and reference on neuroethics Includes coverage of how best to understand the ethics and legal aspects of dementia, palliative care, euthanasia and neurogenetic disorders Brings clarity to issues regarding ethics and legal responsibilities in the age of rapidly evolving brain science and related clinical practice
Book Synopsis Ethical Issues in Neurology by : James L. Bernat
Download or read book Ethical Issues in Neurology written by James L. Bernat and published by Lippincott Williams & Wilkins. This book was released on 2008 with total page 552 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by an eminent authority from the American Academy of Neurology's Committee on Ethics, Law, and Humanities, this book is an excellent text for all clinicians interested in ethical decision-making. The book features outstanding presentations on dying and palliative care, physician-assisted suicide and voluntary active euthanasia, medical futility, and the relationship between ethics and the law. New chapters in this edition discuss how clinicians resolve ethical dilemmas in practice and explore ethical issues in neuroscience research. Other highlights include updated material on palliative sedation, advance directives, ICU withdrawal of life-sustaining therapy, gene therapy, the very-low-birth-weight premature infant, the developmentally disabled patient, informed consent, organizational ethics, brain death controversies, and fMRI and PET studies relating to persistent vegetative state.
Book Synopsis Ethical and Legal Issues in Neurology by : Adam Zeman
Download or read book Ethical and Legal Issues in Neurology written by Adam Zeman and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Consciousness is a fundamentally important neurological capacity which is also of great relevance to ethical thinking and decision-making. The scientific basis of consciousness, and the philosophical questions raised by scientific discoveries about consciousness, have both attracted intense interest over recent decades. This chapter provides a wide-ranging review of the topic. It first considers the principal senses of “consciousness” and “self-consciousness,” acknowledging that both terms are as much colloquial as scientific: “consciousness” is used to refer first, to the waking state and second, to the contents of current experience or awareness; “self-consciousness” can be used to refer to self-perception, self-monitoring, self-recognition, the awareness of one’s own and others’ minds, and the capacity for mental time travel. Next, we review the biological basis of conscious states and conscious contents. The third section presents a taxonomy of states of altered consciousness. The fourth section reviews the major current overarching theories of consciousness. Finally we examine the main philosophic accounts of the relationship between consciousness and neural activity, emphasizing three strong but sometimes conflicting intuitions about consciousness: that it is a robust phenomenon, has a physical basis in neuronal activity, and plays a role in the control of behavior.
Book Synopsis Ethical and Legal Issues in Neurology by : Lois Margaret Nora
Download or read book Ethical and Legal Issues in Neurology written by Lois Margaret Nora and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: There is dynamic interplay between the disciplines of law and ethics, and the result is often laws and regulation that impact the practice of clinical neurology. This chapter explores how the disciplines of law and ethics inform and intersect with each other, and how resulting law impacts the everyday work of the clinical neurologist. Examples of how the core bioethical principles of nonmaleficence, beneficence, respect for autonomy, and justice are manifest in legislative, common, and administrative laws are presented. Examples of how these laws, in turn, impact the practice of neurology through protection of patient privacy, the avoidance of conflict of interest, and informed consent and other issues are offered.
Book Synopsis Ethical and Legal Issues in Neurology by : Jerry Menikoff
Download or read book Ethical and Legal Issues in Neurology written by Jerry Menikoff and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: A history of past abuses on research with human subjects has led to various sets of rules that are designed to insure ethical practices to protect research subjects appropriately. To understand these rules, it is important to appreciate the significant differences between being a patient, where protecting the best interests of that patient is the primary goal, and being a research subject, where that is generally not the case. In the research setting, there can be a conflict between attempting to answer the research question, and doing what is best for the subject. The rules for conducting research with human subjects attempt to manage this conflict in an ethically acceptable manner. This chapter provides an overview of those rules, including a somewhat extended discussion of the U.S. “Common Rule” as a particular example.
Book Synopsis Ethical and Legal Issues in Neurology by : Thomas I. Cochrane
Download or read book Ethical and Legal Issues in Neurology written by Thomas I. Cochrane and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: The ethics of decisions to withhold or withdraw life-sustaining therapies are reviewed. Special attention is paid to the ethical and moral distinctions – or lack thereof – between withholding and withdrawing. The ethical principles informing decisions to forgo life-sustaining therapy are covered, along with the difficulty of making such decisions in the face of prognostic uncertainty. Specific advice is provided regarding the decision-making process, and recent literature regarding decision-making in the neurologic intensive care unit is reviewed.
Book Synopsis Ethical and Legal Issues in Neurology by : James L. Bernat
Download or read book Ethical and Legal Issues in Neurology written by James L. Bernat and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: The definition and criterion of death have been rendered ambiguous by developments in organ support technology, particularly the positive-pressure ventilator and vasopressor medications, that uncouple the unitary loss of vital functions in death and create cases in which the brain has been destroyed while circulation and ventilation can be supported. Developing a biophilosophic analysis of the meaning of death before physicians can declare it requires four sequential steps: (1) agreement on the paradigm conditions that frame the analysis and clarify the task; (2) identifying the definition of death, which makes explicit the meaning of death that is accepted in our consensual usage of the term but that has become obscured by technology; (3) identifying the criterion of death that shows that the definition has been fulfilled, and that can be incorporated into a death statute; and (4) devising bedside tests of death for physicians to perform to satisfy the criterion. Although there is a strong consensus on death determination medical standards in countries around the world that has been enshrined into laws, and accepted by most societies and religions, there remains an active dispute among scholars on the precise definition and criterion of death.
Book Synopsis Ethical and Legal Issues in Neurology by : C. Christopher Hook
Download or read book Ethical and Legal Issues in Neurology written by C. Christopher Hook and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: The increasing complexity of healthcare creates numerous ethical challenges in patient care and in institutional functions and policies. During the past several decades, clinical ethics consultation services and institutional ethics committees have been developed to assist patients, medical professionals, and institutions in addressing ethical challenges. This chapter discusses the nature of clinical ethics consultation and the training of ethics consultants and committees. The authors review the experience at their institution (Mayo Clinic). Finally, the value of ethics consultation, as described in the medical literature, is reviewed.
Book Synopsis Ethical and Legal Issues in Neurology by : Robert M. Taylor
Download or read book Ethical and Legal Issues in Neurology written by Robert M. Taylor and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical ethics is the application of ethical theories, principles, rules, and guidelines to clinical situations in medicine. Therefore, clinical ethics is analogous to clinical medicine in that general principles and concepts must be applied intelligently and thoughtfully to unique clinical circumstances. The three major ethical theories are consequentialism, whereby the consequences of an action determine whether it is ethical; deontology, whereby to be ethical is to do one’s duty, and virtue ethics, whereby ethics is a matter of cultivating appropriate virtues. In the real world of medicine, most people find that all three perspectives offer useful insights and are complementary rather than contradictory. The most common approach to clinical ethical analysis is principlism. According to principlism, the medical practitioner must attempt to uphold four important principles: respect for patient autonomy, beneficence, nonmaleficence, and justice. When these principles conflict, resolving them depends on the details of the case. Alternative approaches to medical ethics, including the primacy of beneficence, care-based ethics, feminist ethics, and narrative ethics, help to define the limitations of principlism and provide a broader perspective on medical ethics.
Book Synopsis Ethical and Legal Issues in Neurology by : Robert C. Macauley
Download or read book Ethical and Legal Issues in Neurology written by Robert C. Macauley and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Perhaps no other field of medicine illustrates the ethical dilemmas occasioned by the explosion of technology more than neurology. Many dilemmas which at first appear to be ethical, however, are actually biotechnical, informational, or interpersonal in nature. For those which are, indeed, ethical, a review of existing information and acquisition of additional data can often serve to identify the proper response. When the optimal course of action remains unclear, the comprehensive, structured approach described in this chapter is both philosophically rigorous and clinically relevant. It takes into account a variety of critical considerations – including rights, duties, consequences, virtues, and similar cases – while utilizing both inductive and deductive methods. The end result is the “least bad” of available options, or, at the very least, a practical response which preserves future options and avoids crucial mistakes.
Book Synopsis Ethical and Legal Issues in Neurology by : Marie-Aurélie Bruno
Download or read book Ethical and Legal Issues in Neurology written by Marie-Aurélie Bruno and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patients in coma, vegetative state/unresponsive wakefulness syndrome, and in minimally conscious states pose medical, scientific, and ethical challenges. As patients with disorders of consciousness are by definition unable to communicate, the assessment of pain, quality of life, and end-of-life preferences in these conditions can only be approached by adopting a third-person perspective. Surveys of healthcare workers’ attitudes towards pain and end of life in disorders of consciousness shed light on the background of clinical reality, where no standard medical-legal framework is widely accepted. On the other hand, patients with locked-in syndrome, who are severely paralyzed but fully conscious, can inform about subjective quality of life in serious disability and help us to understand better the underlying factors influencing happiness in disease. In the medico-legal arena, such ethical issues may be resolved by previously drafted advance directives and, when absent, by surrogate representation. Lately, functional medical imaging and electrophysiology provide alternative means to communicate with these challenging patients and will potentially mediate to extract responses of medical-ethical content. Eventually, the clinical translation of these advanced technologies in the medical routine is of paramount importance for the promotion of medical management of these challenging patients.
Book Synopsis Ethical and Legal Issues in Neurology by : James A. Anderson
Download or read book Ethical and Legal Issues in Neurology written by James A. Anderson and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this chapter, we use the special features of neuroimaging to illustrate research ethics issues for the clinical neurologic sciences, and focus on one particularly compelling case: studies involving first-episode schizophrenic treatment-naïve individuals (FESTNIs) (). FESTNIs are scanned prior to the administration of medication in order to control for the confounding effects of treatment. By concentrating on this program of research, we capture the distinctive ethical challenges associated with neuroimaging research overall, and foreground the issues particular to neuroimaging research involving FESTNIs that have yet to receive sufficient attention in the literature. We highlight assessment of risks and burdens, including risks associated with treatment delays and incidental findings; assessment of benefit, including direct benefit, social value, and scientific quality; subject selection; justice questions related to responsiveness and poststudy access; and, finally, issues related to consent and capacity.
Book Synopsis Ethical and Legal Issues in Neurology by : H. Richard Beresford
Download or read book Ethical and Legal Issues in Neurology written by H. Richard Beresford and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ethically salient issues in neurologic care may have important legal overtones. This chapter considers some of these, emphasizing how law may influence the outcome of controversies over how best to promote autonomy, beneficence, and justice in the care of individuals with neurologic disorders. Constitutional, statutory, and judicial dimensions are addressed. With respect to autonomy, discussion emphasizes legal dimensions of the doctrine of informed consent and the obligations of medical professionals to protect the privacy and confidentiality of their patients. The discussion of beneficence focuses on issues relating to actual or potential conflicts of interest in the care of patients and on the conduct of research involving human subjects. The section on justice considers how law aims to define protectable rights and interests of individuals and to provide a fair and efficient process for resolving disputes. Applications of legal principles and doctrines are illustrated primarily through the examples afforded by judicial decisions. These cases demonstrate how law both promotes ethical decision-making and protects the rights and interests of those affected. The cases also highlight some of the ethical quandaries that evoke resort to litigation and the limits of law in advancing ethically appropriate outcomes.
Book Synopsis Ethical and Legal Issues in Neurology by : Emily B. Rubin
Download or read book Ethical and Legal Issues in Neurology written by Emily B. Rubin and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Standards of conduct in any profession reflect the shared values of that profession and define behaviors by its members that are considered either mandatory or proscribed. This chapter will provide an overview of several of the primary aspects of professional conduct and misconduct by physicians, with an emphasis on the neurologist where appropriate. It will start with an overview of the foundations of the physician–patient relationship, then cover topics including initiation of the physician–patient relationship, communication, therapeutic privilege, disclosure of medical errors, empathy and professional boundaries, barriers to care and termination of the physician–patient relationship, conflicts of interest, self-care, deception of third parties, reporting impaired colleagues, and expert testimony.
Book Synopsis Ethical and Legal Issues in Neurology by : Marc R. Nuwer
Download or read book Ethical and Legal Issues in Neurology written by Marc R. Nuwer and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Public policy in healthcare affects physician and patient choices. In many ways it may limit choices. These choices present conflicts that are discussed here. Some issues depend on the laws enacted to enable either a single-payer system or that mixed with a private-payer system. In each case, the systems attain some cost controls through means such as gatekeepers, long wait lists, authorization processes, national fee schedules, complex coding schemes, or placing physicians on salary. National health systems are compared here. No one system has proven completely satisfactory, and each has its advantages. There are many factors that contribute to the escalating costs of care that lead to many healthcare public policies to constrain costs. Initiatives to incentivize preventive actions are a more positive step, but ones that are difficult to define in detail.
Book Synopsis Ethical and Legal Issues in Neurology by : Eran Klein
Download or read book Ethical and Legal Issues in Neurology written by Eran Klein and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Caring for persons with Alzheimer’s disease presents neurologists with ethical challenges. Some of these, such as end-of-life care or research participation, are well known and have significant overlap with challenges in other areas of medicine or other neurologic diseases, such as cancer or traumatic brain injury, while others, such as the rise of biomarker-based diagnostics, are more novel and reflect the impact of developments in the science and clinical care of Alzheimer’s disease. A thoughtful and systematic approach to these challenges, from the preclinical to the late symptomatic stage of this disease, is required and will help clinicians be better advocates and stewards of their patients. This chapter addresses a number of the most pressing ethical problems facing patients, caregivers, and clinicians during this disease, including early and presymptomatic testing, assessment of decision-making capacity for treatment or research participation, restriction of driving, remote monitoring, assisted suicide, and treatment of disruptive behaviors.
Book Synopsis Ethical and Legal Issues in Neurology by : Peter B. Kang
Download or read book Ethical and Legal Issues in Neurology written by Peter B. Kang and published by Elsevier Inc. Chapters. This book was released on 2014-01-09 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of neurogenetics is moving so rapidly that new discoveries are announced almost weekly. The tools available for the diagnosis of neurogenetic disorders have become powerful and complex, and raise new ethical dilemmas that did not exist just a few years ago. In addition to previous concerns about presymptomatic genetic testing and carrier testing, the widening availability of next-generation sequencing raises concerns about the reporting of incidental findings of unclear significance. Genetically targeted therapies have now been proven to be efficacious for a few neurogenetic diseases, and it is likely that gene therapies and cell-based therapies will soon be applied to other neurologic disorders. These therapies are generally quite expensive compared to other treatments. Given the cost constraints that will be needed in the healthcare system in the United States and other countries, and the likelihood that new genetically targeted therapies will be introduced, society will face difficult questions regarding its obligations to fund expensive therapies both for large populations and for small numbers of patients with rare diseases. Potential conflicts of interest involving both individuals and institutions will need ongoing vigilance. Scientific advances will continue to raise consequential ethical questions in the field of neurogenetics.
