The complexity of the healthcare organization with emphasis on efficiency and productivity has led to an increase in value conflicts as well as moral and ethical conflicts. The aim of this study was to explore nurse m...The complexity of the healthcare organization with emphasis on efficiency and productivity has led to an increase in value conflicts as well as moral and ethical conflicts. The aim of this study was to explore nurse managers’ perceptions of ethical conflicts when caring for older patients who wish to die. A qualitative method was employed and data were collected by means of a focus group interview with eight nurse managers. The results revealed one theme: A struggle due to responsibility for decision making and four sub-themes:?Understanding the meaning of free will, wondering about how serious the death wish is, providing more worthy elder care and lack of competent healthcare professionals to provide safe care. Nurse managers’ have no structure for bringing ethical conflicts to the attention of their leaders or the next level of the organization. Consequently, they appear to need supervision, support and clear, flexible lines of communication with leadership.展开更多
Off-label use of medication is common in many areas of medicine and particularly in dermatology. Off-label use of medication, whether by prescription or use of samples, creates special ethical issues that include info...Off-label use of medication is common in many areas of medicine and particularly in dermatology. Off-label use of medication, whether by prescription or use of samples, creates special ethical issues that include informed consent, patient autonomy and the fundamental adage “first, do no harm”. The choice of medication is also influenced by the patient and appropriate use ultimately depends on a thorough discussion of the risks and benefits as well as a mutually agreed treatment plan.展开更多
AIM To quantify the variability of financial disclosures by authors presenting orthopaedic trauma research. METHODS Self-reported authorship disclosure information published for the 2012 American Academy of Orthopaedi...AIM To quantify the variability of financial disclosures by authors presenting orthopaedic trauma research. METHODS Self-reported authorship disclosure information published for the 2012 American Academy of Orthopaedic Surgeons(AAOS) and Orthopaedic Trauma Association(OTA) meetings was compiled from meeting programs. Both the AAOS and OTA required global disclosures for participants. Data collected included:(1) total number of presenters;(2) number of presenters with financial disclosures;(3) number of disclosures per author;(4) total number of companies supporting each author; and(5) specific type of disclosure. Disclosures made by authors presenting at more than one meeting were then compared for discrepancies.RESULTS Of the 5002 and 1168 authors presenting at the AAOS and OTA annual meetings, respectively, 1649(33%) and 246(21.9%) reported a financial disclosure(P < 0.0001). At the AAOS conference, the mean number of disclosures among presenters with disclosures was 4.01 with a range from 1 to 44. The majority of authors with disclosures reported three or more disclosures(n = 876, 53.1%). The most common cited disclosurewas as a paid consultant(51.5%) followed by research support(43.0%) and paid speaker(34.8%). Among the 256 physicians with financial disclosures presenting at the OTA conference, the mean number of disclosures was 4.03 with a range from 1 to 22. Similar to the AAOS conference, the majority of authors with any disclosures at the OTA conference reported three or more disclosures(n = 140, 54.7%). Most authors with a disclosure had three or more disclosures and the most common type of disclosure was paid consulting. At the OTA conference, the most commonly cited form of disclosure was paid consultant(54.3%) followed by research support(46.1%) and paid speaker(42.6%). Of the 346 researchers who presented at both meetings, 112(32.4%) authors were found to have at least one disclosure discrepancy. Among authors with a discrepancy, 36(32.1%) had three or more discrepancies. CONCLUSION There were variability and inconsistencies in financial disclosures by researchers presenting orthopaedic trauma research. Improved transparency of conflict of interest disclosures is warranted among trauma researchers presenting at national meetings.展开更多
文摘The complexity of the healthcare organization with emphasis on efficiency and productivity has led to an increase in value conflicts as well as moral and ethical conflicts. The aim of this study was to explore nurse managers’ perceptions of ethical conflicts when caring for older patients who wish to die. A qualitative method was employed and data were collected by means of a focus group interview with eight nurse managers. The results revealed one theme: A struggle due to responsibility for decision making and four sub-themes:?Understanding the meaning of free will, wondering about how serious the death wish is, providing more worthy elder care and lack of competent healthcare professionals to provide safe care. Nurse managers’ have no structure for bringing ethical conflicts to the attention of their leaders or the next level of the organization. Consequently, they appear to need supervision, support and clear, flexible lines of communication with leadership.
文摘Off-label use of medication is common in many areas of medicine and particularly in dermatology. Off-label use of medication, whether by prescription or use of samples, creates special ethical issues that include informed consent, patient autonomy and the fundamental adage “first, do no harm”. The choice of medication is also influenced by the patient and appropriate use ultimately depends on a thorough discussion of the risks and benefits as well as a mutually agreed treatment plan.
文摘AIM To quantify the variability of financial disclosures by authors presenting orthopaedic trauma research. METHODS Self-reported authorship disclosure information published for the 2012 American Academy of Orthopaedic Surgeons(AAOS) and Orthopaedic Trauma Association(OTA) meetings was compiled from meeting programs. Both the AAOS and OTA required global disclosures for participants. Data collected included:(1) total number of presenters;(2) number of presenters with financial disclosures;(3) number of disclosures per author;(4) total number of companies supporting each author; and(5) specific type of disclosure. Disclosures made by authors presenting at more than one meeting were then compared for discrepancies.RESULTS Of the 5002 and 1168 authors presenting at the AAOS and OTA annual meetings, respectively, 1649(33%) and 246(21.9%) reported a financial disclosure(P < 0.0001). At the AAOS conference, the mean number of disclosures among presenters with disclosures was 4.01 with a range from 1 to 44. The majority of authors with disclosures reported three or more disclosures(n = 876, 53.1%). The most common cited disclosurewas as a paid consultant(51.5%) followed by research support(43.0%) and paid speaker(34.8%). Among the 256 physicians with financial disclosures presenting at the OTA conference, the mean number of disclosures was 4.03 with a range from 1 to 22. Similar to the AAOS conference, the majority of authors with any disclosures at the OTA conference reported three or more disclosures(n = 140, 54.7%). Most authors with a disclosure had three or more disclosures and the most common type of disclosure was paid consulting. At the OTA conference, the most commonly cited form of disclosure was paid consultant(54.3%) followed by research support(46.1%) and paid speaker(42.6%). Of the 346 researchers who presented at both meetings, 112(32.4%) authors were found to have at least one disclosure discrepancy. Among authors with a discrepancy, 36(32.1%) had three or more discrepancies. CONCLUSION There were variability and inconsistencies in financial disclosures by researchers presenting orthopaedic trauma research. Improved transparency of conflict of interest disclosures is warranted among trauma researchers presenting at national meetings.
