Codes of Ethics in Research and Experimentation in Man

Professor Liley\u27s most notable contribution to medicine was the introduction of intrauterine fetal blood transfusion in the management of Rh sensitization. His work has had worldwide recognition. He is Research Professor in Perinatal Physiology, Postgraduate School of Obstetrics and Gynecology, University of Auckland. It would be illogical for the founder of fetology to accept the thesis that his intrauterine patients had no right to life. Dr. Liley is the first president of the Society for the Protection of the Unborn Child. Not a Catholic, his leadership is particularly effective in a pluralistic society that sometimes regards abortion as merely a Catholic issue

Ambiguous-Purpose Statements of Children and Other Victims of Abuse under the Confrontation Clause

The author examines in this paper two kinds of ambiguous-purpose out-of-court statements that are especially problematic under current Confrontation law--problematic in ways that we hope will be solved directly or indirectly by the Supreme Court when it renders its decision in Ohio v. Clark. The statements he examines are: (1) Statements made by abused children concerning their abuse, for example to police, physicians, teachers, welfare workers, baby sitters, or family members, some of whom may be under a legal duty to report suspected abuse to legal authorities. At least some of these statements will be directly addressed by the Court in Ohio v. Clark. (2) Statements made by adult victims of sexual assaults to specially trained medical personnel (sometimes known as S.A.N.E. nurses or members of D.O.V.E. hospital units, or S.A.R.T. units) whose task is simultaneously to medically treat the victim and to gather or preserve evidence for a legal case or investigation. These statements may be inferentially address by the Court in Ohio v. Clark. U.S. Supreme Court Confrontation-Clause jurisprudence stemming from Crawford v. Washington (2004) holds that when a declarant (like the child or adult victim here) does not testify, her out-of-court statement’s admissibility against the alleged perpetrator in a criminal case is normally determined by what the “primary purpose” was when the statement was made, at least if it was made to law enforcement or its affiliates. If that “primary purpose” was prosecutorial or evidentiary the statement will ordinarily be inadmissible. If the purpose was something else—for example a primarily medical or treative purpose or a relatively immediate protective purpose or to deal with an on-going emergency—the statement is normally admissible insofar as the Confrontation Clause is concerned. The main problem with the victims’ and children’s statements identified above, is the difficulty in determining their “primary purpose.” Is it medical? Legal? Protective? Is it responding to an emergency? A related problem is whether the person to whom the statement was made had a substantial enough connection to law enforcement or government (if such connection is an independent requirement for there to be a Confrontation issue). A subsidiary question is whether there has to be anything like a questioning or interrogation—or some kind of formality attending the taking of the statement--in order for the Confrontation Clause to be applicable

A study of the understanding and use of social agencies by physicians in a given community

Thesis (M.S.)--Boston Universit

Feigned Consensus: Usurping the Law in Shaken Baby Syndrome/Abusive Head Trauma Prosecutions

Few medico-legal matters have generated as much controversy--both in the medical literature and in the courtroom--as Shaken Baby Syndrome (SBS), now known more broadly as Abusive Head Trauma (AHT). The controversies are of enormous significance in the law because child abuse pediatricians claim, on the basis of a few non-specific medical findings supported by a weak and methodologically flawed research base, to be able to “diagnose” child abuse, and thereby to provide all of the evidence necessary to satisfy all of the legal elements for criminal prosecution (or removal of children from their parents). It is a matter, therefore, in which medical opinion claims to fully occupy the legal field. As controversies flare up increasingly in the legal arena, child abuse pediatricians and prosecutors now respond by claiming both that there is actually no real controversy about SBS/AHT, and that it is a purely medical “diagnosis” and not a legal conclusion, so testimony in support of the SBS hypothesis should not be challenged in court. This article, coauthored by four law professors, two physicians, and a physicist, demonstrates that there is very much a live controversy about the SBS/AHT hypothesis and maintains that, under traditional principles of evidence law, physicians should not be permitted to “diagnose” abuse in court (as opposed to identifying specific symptoms or medical findings)

Adding Dental Therapists to the Health Care Team to Improve Access to Oral Health Care for Children

Oral Health in America: A Report of the Surgeon General, and the subsequent National Call to Action to Promote Oral Health, contributed significantly to raising awareness regarding the lack of access to oral health care by many Americans, especially minority and low-income populations, with resulting disparities in oral health. The problem is particularly acute among children. The current dental workforce in the United States is inadequate to meet the oral health care needs of children. It is inadequate in terms of numbers of dentists, as well as their geographic distribution, ethnicity, education, and practice orientation. Dental therapists, paraprofessionals trained in a 2 academic-year program of postsecondary education, have been employed internationally to improve access to oral health care for children. Research has documented that utilizing dental therapists is a cost-effective method of providing quality oral health care for children. Dental therapists have recently been introduced in Alaska by the Alaska Native Tribal Health Consortium. Dental therapists could potentially care for children in dental offices, public health clinics, and school systems, as well as in the offices of pediatricians and family physicians. Adding dental therapists to the health care team would be a significant strategy for improving access to care for children and reducing oral health disparities

To Get the Shot or Not: Narratives, Rhetoric, and the Childhood Vaccination Crisis

Parents in developed countries like the United States are questioning the need for and safety of childhood vaccinations. Incidences of disease have risen as fewer parents have vaccinated their children. Perhaps the most significant public figure to reinforce the choices of parents not-to-vaccinate is Jenny McCarthy, whose best-selling book details her theory about the cause of, and cure for, her son‘s autism. As I demonstrate, the study of the narratives is vital for understanding the vaccination crisis, not the least because of the extent to which McCarthy‘s (2007) story has echoed through parenting communities. I examine whether chosen anti- and pro-vaccination narratives meet the requirements of Fisher‘s (1984) narrative paradigm. In addition, I examine how the narratives might promote a sense of identification with audience members, particularly in how the narrators deal with a sense of guilt about the condition of their children (Burke, 1969). Further, I concentrate on both the functional nature of these narratives and on the constitutive components. The public is clearly divided on the vaccination issue. As I argue, this division may well come down to the way in which these distinct narratives constitute audiences differently, constitutions that both encourage people to act in particular ways through a sense of identification, and also outline the boundaries of what it means to be a ―good‖ parent, such that one may be more swayed, consciously or unconsciously, by one type of narrative than another. Finally, I examine how the narratives deal with the conflict between personal choice and the public good. This dissertation also addresses the question of how to make Fisher‘s paradigm a powerful tool for the rhetorical analysis of narratives. As I argue, focusing more explicitly than has previously been done on the Burkean (1969a, 1969b) concept of identification and including Burke‘s guilt/purification/redemption cycle in the analysis of narratives, we begin to see why stories that ―should‖ be rejected by readers for failing to achieve the requirements of the narrative paradigm become widely accepted instead. In addition, this dissertation contributes to the field of communication, particularly health communication

Writing in the Health Sciences: A Collection of Exemplary Student Writing Spring 2019

The narratives that appear beyond this foreword, plus one modest literature review, one integrative study, and one healthcare guideline analysis, were written last spring by students from the College of Nursing and Health Professions in sections of English 205. English 205 is a writing-intensive course offered by the English department, listed in the catalog as “Writing in the Health Professions.” As titles go, that’s pretty bland, for a course or for a collection of writing. Writing in the health professions is anything but bland, as you’ll find out if you read any of the work in this collection. Health professionals write in a variety of genres, for different purposes and for different audiences. This collection features just three types of writing health professionals both read and write: the patient narrative, the literature review, and the integrative study. It also includes a genre of writing that you may not encounter in the profession, but which allows its writer to practice analyzing published professional practice guidelines. In the future, this collection may include other types of writing students encounter and produce in English 205, including print and online materials for patient education and patient advocacy. (from Foreword)https://scholar.valpo.edu/engl_oer/1000/thumbnail.jp

Developing and Deploying a New Member of the Dental Team: A Pediatric Oral Health Therapist

There are inadequate numbers of dentists able and willing to treat America\u27s children, specifically children from low income and minority populations. This has led to the well-publicized disparities in oral health among children. In the early part of the 20th century New Zealand faced a significant problem with oral disease among its children and introduced a School Dental Service, staffed by allied dental professionals with two years\u27 training in caring for the teeth of children, school dental nurses. A significant number of countries have adopted the model. This article reviews the history of attempts to develop such an approach in the United States. It advocates for the development and deployment of pediatric oral health therapists as a means of addressing the disparities problem that exists in America with such individuals being trained in children\u27s dentistry in a two-year academic program. The article asserts that adding a pediatric oral health therapist to the dental team is one way in which the profession of dentistry can fulfill its moral obligation to care for the oral health of America\u27s children and ensure that all children are treated justly. Recently, the American Association of Public Health Dentistry promulgated a strategic plan that endorsed such an approach

Developing Community Connections: Qualitative Research Regarding Framing Policies

The objective of this phase of research was to determine how Prevent Child Abuse America can effectively frame the organization's communications to advance a broad agenda of policies for children and families, including both policies that directly address maltreatment as well as policies less directly associated with maltreatment, such as early education, health, economic security, and family work issues. To that end, focus group participants were asked to review and respond to four articles, each designed to represent one of four frames: Child Abuse, Parenting, Child Development, and Community. In real news coverage these frames can, and do, overlap, but the research deliberately kept each frame distinct to attempt to isolate the effects of each frame on a proxy list of representative policies and programs. Nevertheless, some order effects were observed and these are noted where relevant in the analysis.This research analysis is part of our New FrameWorks Research on Child Abuse and Neglect Prevention, and was conducted in collaboration with the FrameWorks Institute, and commissioned by Prevent Child Abuse America, with funding from the Doris Duke Charitable Foundation. Please visit our website for more information

Parent resistance to physicians' treatment recommendations: One resource for initiating a negotiation of the treatment decision

This article examines pediatrician-parent interaction in the context of acute pediatric encounters for children with upper respiratory infections. Parents and physicians orient to treatment recommendations as normatively requiring parent acceptance for physicians to close the activity. Through acceptance, withholding of acceptance, or active resistance, parents have resources with which to negotiate for a treatment outcome that is in line with their own wants. This article offers evidence that even in acute care, shared decision making not only occurs but, through normative constraints, is mandated for parents and physicians to reach accord in the treatment decision