Refusal to Treat

Publication Title: 
The Cochrane Database of Systematic Reviews

BACKGROUND: Placebo interventions are often claimed to substantially improve patient-reported and observer-reported outcomes in many clinical conditions, but most reports on effects of placebos are based on studies that have not randomised patients to placebo or no treatment. Two previous versions of this review from 2001 and 2004 found that placebo interventions in general did not have clinically important effects, but that there were possible beneficial effects on patient-reported outcomes, especially pain. Since then several relevant trials have been published.

Author(s): 
Hróbjartsson, Asbjørn
Gøtzsche, Peter C.
Publication Title: 
The Journal of Medicine and Philosophy

Provider claims to conscientious objection have generated a great deal of heated debate in recent years. However, the conflicts that arise when providers make claims to the "conscience" are only a subset of the more fundamental challenges that arise in health care practice when patients and providers come into conflict. In this piece, the author provides an account of patient-provider conflict from within the moral tradition of St. Thomas Aquinas.

Author(s): 
Brothers, Kyle B.
Publication Title: 
Cambridge quarterly of healthcare ethics: CQ: the international journal of healthcare ethics committees

Recently the scope of protections afforded those healthcare professionals and institutions that refuse to provide certain interventions on the grounds of conscience have expanded, in some instances insulating providers (institutional and individual) from any liability or sanction for harms that patients experience as a result.

Author(s): 
Rich, Ben A.
Publication Title: 
Journal of counseling and development: JCD

Increasing numbers of students with severe personality disorders are presenting for psychological services at college and university counseling centers. The influx of these students poses a number of ethical dilemmas for counseling centers. Clinical decisions about appropriate treatment modalities, philosophical decisions about agency mission, and available resources to carry defined missions converge and influence ethical decisions in this area.

Author(s): 
Gilbert, S. P.
Publication Title: 
Journal of counseling and development: JCD

Increasing numbers of students with severe personality disorders are presenting for psychological services at college and university counseling centers. The influx of these students poses a number of ethical dilemmas for counseling centers. Clinical decisions about appropriate treatment modalities, philosophical decisions about agency mission, and available resources to carry defined missions converge and influence ethical decisions in this area.

Author(s): 
Gilbert, S. P.
Publication Title: 
Social Science & Medicine (1982)

As governments seek to expand access to quality health care services, policy makers in many countries are confronting the problem of informal payments to medical personnel. The aim of this study was to help health planners in Albania understand informal payments occurring in government health facilities. Researchers used in-depth interviews and focus groups with 131 general public and provider informants in three districts.

Author(s): 
Vian, Taryn
Gryboski, Kristina
Grybosk, Kristina
Sinoimeri, Zamira
Hall, Rachel
Publication Title: 
AIDS education and prevention: official publication of the International Society for AIDS Education

The intention to treat HIV-infected persons and correlates of those intentions were examined in a cross-sectional sample of 1st- and 2nd-year medical students (n = 201). An anonymous questionnaire measured knowledge of HIV transmission, intention to provide medical care to HIV-infected persons, comfort in performing a physical examination on patients from subgroups with high HIV prevalence, level of homophobia, professional altruism, and personal perceived risk of HIV infection. Intention to provide medical care was considered as the dependent variable.

Author(s): 
Simon, M. S.
Weyant, R. J.
Asabigi, K. N.
Zucker, L.
Koopman, J. S.
Publication Title: 
JONA'S healthcare law, ethics and regulation

A male patient was admitted to the acquired immune deficiency syndrome (AIDS) unit for hemodialysis. His history revealed that he was homeless and that he had tested positive for human immunodeficiency virus (HIV+). He also had a history of alcohol and intravenous drug abuse and tuberculosis. Based on the results of a chest X-ray, he was placed in respiratory isolation. During the next few days of his hospitalization, he exhibited nonadherent behavior toward the treatment regime.

Author(s): 
Bosek, M. S.
Burton, L. A.
Savage, T. A.
Publication Title: 
Annals (Royal College of Physicians and Surgeons of Canada)

BACKGROUND: The discrepancy between the demand for and the supply of physician's services is the result of actions of multiple parties, including physicians. This situation raises ethical challenges for physicians, because it involves the profession's core values. OBJECTIVE: To discuss physicians' ethical obligations regarding the quantity of services that they might provide.

Author(s): 
Kotalik, Jaro F.
Publication Title: 
Bioethics

The seriousness of the risk that healthcare workers faced during SARS, and their response of service in the face of this risk, brings to light unrealistic assumptions about duty and risk that informed the debate on duty to care in the early years of HIV/AIDS. Duty to care is not based upon particular virtues of the health professions, but arises from social reflection on what response to an epidemic would be consistent with our values and our needs, recognizing our shared vulnerability to disease and death.

Author(s): 
Reid, Lynette

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