Do Physicians Have an Ethical Obligation to Care for Patients with AIDS?

This thesis responds to the question: Do physicians have an ethical obligation to care for patients with Acquired Immunodeficiency Syndrome (AIDS)? First, the social and political milieu in which this question arises is sampled. Here we find physicians as well as other members of the community exclaiming an unwillingness to be exposed to people with AIDS. Next, laws, regulations, ethical codes and principles and the history of the practice of medicine are examined, and the literature as it pertains to these areas is reviewed. The obligation to care for patients with AIDS, however, cannot be located in an orientation to morality defined in rules and codes and an appeal to legalistic fairness. By turning to the orientation to morality that emerges naturally from connection and is defined in caring, we find that physicians do, indeed, have an ethical obligation to care for patients with AIDS. Through an exploration of the writings of modern medical ethicists, it is clear that the purpose of the practice of medicine is healing which can only be accomplished in relationship with the patient. It is in relationship to patients that the physician has the opportunity for self-realization. In fact, the physician is physician in relationship to patients and only to the extent that he or she acts virtuously by being morally responsible for and to those patients. To not do so diminishes the physician\u27s ethical ideal, a vision of the physician as good physician, which has consequences for the physician\u27s capacity to care and for the practice of medicine

Impact of Stress and Decision Fatigue on Parenting Practices Related to Food and Physical Activity During COVID‐19

Background The COVID-19 pandemic has resulted in substantial disruptions to daily functioning and lifestyle behaviours, with negative health consequences for youth. Parents play a large role in their children\u27s health behaviour; yet changes to parenting behaviours during the pandemic related to food and physical activity remain relatively unexplored. The present study is the first to our knowledge to examine specific changes in American parents\u27 parenting behaviours related to food and physical activity during COVID-19, and potential correlates of such changes, including perceived stress and decision fatigue. Methods A total of 140 parents (88.57% female; 88.41% White; 87.59% married; with one to five children) from middle to upper income households completed an online survey assessing demographics, perceived stress (Perceived Stress Scale), decision fatigue (Decision Fatigue Scale) and food and activity parenting behaviour changes during COVID-19. Results Overall, a greater proportion of parents engaged primarily in positive (57.14%) than negative (22.86%) parenting practices related to food and physical activity during the pandemic. Moderation analyses showed that the negative relation between perceived stress and positive parental behaviour changes was stronger at higher perceived increases in decision fatigue during the pandemic. Conclusions In the face of a major public health crisis, adaptive parental responses may emerge, but perceived stress may inhibit such behaviour change. Perceived stress and decision fatigue may represent important explanatory factors in parental health promoting behaviours during times of uncertainty and change

Changes in standard of candidates taking the MRCP(UK) Part 1 examination, 1985 to 2002: Analysis of marker questions

The maintenance of standards is a problem for postgraduate medical examinations, particularly if they use norm-referencing as the sole method of standard setting. In each of its diets, the MRCP(UK) Part 1 Examination includes a number of marker questions, which are unchanged from their use in a previous diet. This paper describes two complementary studies of marker questions for 52 diets of the MRCP(UK) Part 1 Examination over the years 1985 to 2001 to assess whether standards have changed

Prescribing Safety Assessment 2016 : delivery of a national prescribing assessment to 7,343 UK final-year medical students

Aim(s) Newly graduated doctors write a large proportion of prescriptions in UK hospitals but recent studies have shown that they frequently make prescribing errors. The Prescribing Safety Assessment (PSA) has been developed as an assessment of competence in relation to prescribing and supervising the use of medicines. This report describes the delivery of the PSA to all UK final-year medical students in 2016 (PSA2016). Methods The PSA is a 2-hour online assessment comprising eight sections which cover various aspects of prescribing defined within the outcomes of undergraduate education identified by the UK General Medical Council. Students sat one of four PSA ‘papers’ which had been standard-set using a modified Angoff process. Results A total of 7,343 final-year medical students in all 31 UK medical schools sat the PSA. The overall pass rate was 95% with the pass rates for the individual papers ranging from 93 to 97%. The PSA was re-sat by 261 students who had failed and 80% of those candidates passed. The internal consistency (Cronbach's alpha) of the four papers ranged from 0.74 to 0.77 (standard error of measurement 4.13 to 4.24%). There was a statistically significant variation in performance between medical school cohorts (F = 32.6, p < 0.001) and a strongly positive correlation in performance for individual schools between PSA2015 and PSA2016 (r = 0.79, 95% CI 0.61 to 0.90; p < 0.01). Conclusions PSA2016 demonstrated the feasibility of delivering a standardised national prescribing assessment online. The vast majority of UK final-year medical students were able to meet a pre-specified standard of prescribing competence