The reception and implementation of ethical guidelines of the Swiss Academy of Medical Sciences in medical and nursing practice

Questions under study: We conducted a survey among Swiss health care professionals on the reception and implementation of a number of selected ethical guidelines of the Swiss Academy of Medical Sciences (SAMS). The following guidelines were chosen for evaluation: “Care of patients in the end of life”, “Palliative care”, “Borderline questions in intensive-care medicine” and “The determination of death in the context of organ transplantation”. Methods: Anonymous questionnaires were sent to 1933 physicians (general practitioners and internists) and nurses, randomly chosen from address lists of the relevant professional associations. We conducted a statistical analysis using SPSS 16.0. Results: The response rate was 43.1%. 16.3% of the responding physicians had never heard of the guidelines “Care of patients in the end of life”, 30.5% had already heard of them, 34.1% knew some of their contents and 19.1% were familiar with the complete content of the guidelines. 60.5% of those physicians and 56.0% of those nurses who had at least heard of these guidelines utilised them in clinical practice. The guidelines “Palliative care” and “Borderline questions in intensive- care medicine” yielded similar results. By contrast, only 0.5% of responding physicians reported never having heard of the guidelines “The determination of death in the context of organ transplantation”, 2.9% had already heard of them, 24.4% knew some of their contents and the vast majority of respondents (72.2%) considered themselves to be completely familiar with the guidelines. Conclusion: Knowledge of the evaluated guidelines is fairly widespread among Swiss GPs, internists and nurses. The guidelines are utilised in clinical practice by the majority of those care providers who are aware of their existence. The guidelines “The determination of death in the context of organ transplantation”, as a legally binding document, are even better known and routinely implemented in medical practice

Use of placebo interventions among Swiss primary care providers

Background: Placebo interventions can have meaningful effects for patients. However, little is known about the circumstances of their use in clinical practice. We aimed to investigate to what extent and in which way Swiss primary care providers use placebo interventions. Furthermore we explored their ideas about the ethical and legal issues involved. Methods: 599 questionnaires were sent to general practitioners (GPs) and paediatricians in private practice in the Canton of Zurich in Switzerland. To allow for subgroup analysis GPs in urban, suburban, and rural areas as well as paediatricians were selected in an even ratio. Results: 233 questionnaires were completed (response rate 47%). 28% of participants reported that they never used placebo interventions. More participants used impure placebos therapeutically than pure placebos (57% versus 17%, McNemar's chi2 = 78, p<0.001). There is not one clear main reason for placebo prescription. Placebo use was communicated to patients mostly as being "a drug or a therapy" (64%). The most frequently chosen ethical premise was that they "can be used as long as the physician and the patient work together in partnership" (60% for pure and 75% for impure placebos, McNemar's chi2 = 12, p<0.001). A considerable number of participants (11-38%) were indecisive about statements regarding the ethical and legal legitimacy of using placebos. Conclusions: The data obtained from Swiss primary care providers reflect a broad variety of views about placebo interventions as well as a widespread uncertainty regarding their legitimacy. Primary care providers seem to preferentially use impure as compared to pure placebos in their daily practice. An intense debate is required on appropriate standards regarding the clinical use of placebo interventions among medical professionals

Primera cita de <i>Quadrastichus mendeli</i> (Hymenoptera: Eulophidae: Tetrastichinae) de Argentina, asociado a agallas de <i>Leptocybe invasa</i> (Hymenoptera: Eulophidae: Tetrastichinae)

Se cita por primera vez en la Argentina la presencia de Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) asociada a agallas producidas por Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) en eucaliptos de la provincia de Buenos Aires. Quadrastichus mendeli es originaria de Australia y fue introducida en Israel en el año 2007, para ser utilizada como biocontrolador de la «avispa de la agalla», importante plaga de los cultivos de Eucalyptus.First record of Quadrastichus mendeli (Hymenoptera: Eulophidae: Tetrastichinae) in Argentina associated with galls of Leptocybe invasa (Hymenoptera: Eulophidae: Tetrastichinae)». Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) is reported for the first time in Argentina, associated to galls produced by Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae). It was found in Eucalyptus crops in Buenos Aires province. Quadrastichus mendeli is native to Australia and it was introduced into Israel in 2007 to be used as anatural enemy of the eucalyptus gall wasp.Centro de Estudios Parasitológicos y de Vectore

Global Ethics and Nanotechnology: A Comparison of the Nanoethics Environments of the EU and China

The following article offers a brief overview of current nanotechnology policy, regulation and ethics in Europe and The People’s Republic of China with the intent of noting (dis)similarities in approach, before focusing on the involvement of the public in science and technology policy (i.e. participatory Technology Assessment). The conclusions of this article are, that (a) in terms of nanosafety as expressed through policy and regulation, China PR and the EU have similar approaches towards, and concerns about, nanotoxicity—the official debate on benefits and risks is not markedly different in the two regions; (b) that there is a similar economic drive behind both regions’ approach to nanodevelopment, the difference being the degree of public concern admitted; and (c) participation in decision-making is fundamentally different in the two regions. Thus in China PR, the focus is on the responsibility of the scientist; in the EU, it is about government accountability to the public. The formulation of a Code of Conduct for scientists in both regions (China PR’s predicted for 2012) reveals both similarity and difference in approach to nanotechnology development. This may change, since individual responsibility alone cannot guide S&T development, and as public participation is increasingly seen globally as integral to governmental decision-making

Primera cita de <i>Quadrastichus mendeli</i> (Hymenoptera: Eulophidae: Tetrastichinae) de Argentina, asociado a agallas de <i>Leptocybe invasa</i> (Hymenoptera: Eulophidae: Tetrastichinae)

Se cita por primera vez en la Argentina la presencia de Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) asociada a agallas producidas por Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) en eucaliptos de la provincia de Buenos Aires. Quadrastichus mendeli es originaria de Australia y fue introducida en Israel en el año 2007, para ser utilizada como biocontrolador de la «avispa de la agalla», importante plaga de los cultivos de Eucalyptus.First record of Quadrastichus mendeli (Hymenoptera: Eulophidae: Tetrastichinae) in Argentina associated with galls of Leptocybe invasa (Hymenoptera: Eulophidae: Tetrastichinae)». Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) is reported for the first time in Argentina, associated to galls produced by Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae). It was found in Eucalyptus crops in Buenos Aires province. Quadrastichus mendeli is native to Australia and it was introduced into Israel in 2007 to be used as anatural enemy of the eucalyptus gall wasp.Centro de Estudios Parasitológicos y de Vectore

Primera cita de <i>Quadrastichus mendeli</i> (Hymenoptera: Eulophidae: Tetrastichinae) de Argentina, asociado a agallas de <i>Leptocybe invasa</i> (Hymenoptera: Eulophidae: Tetrastichinae)

Se cita por primera vez en la Argentina la presencia de Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) asociada a agallas producidas por Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) en eucaliptos de la provincia de Buenos Aires. Quadrastichus mendeli es originaria de Australia y fue introducida en Israel en el año 2007, para ser utilizada como biocontrolador de la «avispa de la agalla», importante plaga de los cultivos de Eucalyptus.First record of Quadrastichus mendeli (Hymenoptera: Eulophidae: Tetrastichinae) in Argentina associated with galls of Leptocybe invasa (Hymenoptera: Eulophidae: Tetrastichinae)». Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) is reported for the first time in Argentina, associated to galls produced by Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae). It was found in Eucalyptus crops in Buenos Aires province. Quadrastichus mendeli is native to Australia and it was introduced into Israel in 2007 to be used as anatural enemy of the eucalyptus gall wasp.Centro de Estudios Parasitológicos y de Vectore

Empowerment or Engagement? Digital Health Technologies for Mental Healthcare

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare