154 research outputs found
Informed Consent - Balance zwischen Patientenschutz und Forschungsinteressen
Forschungsethische Debatten haben sich in den letzten Jahren hÀufig der Frage gewidmet,
ob Ausnahmen bei der strikten Forderung nach individueller Einwilligung
des Patienten zulÀssig oder gar geboten sind. Einige Studiendesigns mit solchen Ausnahmeregelungen
werden im Folgenden zur Diskussion vorgestellt
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: âCare of
patients in the end of lifeâ, âPalliative careâ, âBorderline
questions in intensive-care medicineâ and
âThe determination of death in the context of organ
transplantationâ.
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 âCare of patients in the end of lifeâ,
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
âPalliative careâ and âBorderline questions in intensive-
care medicineâ yielded similar results. By
contrast, only 0.5% of responding physicians reported
never having heard of the guidelines âThe
determination of death in the context of organ
transplantationâ, 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 âThe determination of death in the
context of organ transplantationâ, as a legally
binding document, are even better known and
routinely implemented in medical practice
Synthetic Biology for Human Health: Issues for Ethical Discussion and Policy-making
Synthetic biology, the application of engineering principles to (re)design and construct novel biological systems and devices, provides an emerging focus for ethical and policy debates on emerging biotechnologies. Happily, no scandal or accident has occurred to give rise to this ethical attention. Rather, it was the researchers themselves who invited the involvement of ethicists, explaining their work and asking for ethical commentary. This proactive stance was fuelled by the intention to avoid another backlash like the one that occurred against some gene technologies. Many consumers have been and are still highly sceptical about genetically modified food, with field trials (for example) regularly being met with public protest. By engaging with the ethical implications of their work early on, many researchers in synthetic biology hoped to prevent such reactions. So far, it looks as if they have been successful, as public attitudes towards synthetic biology are largely positive
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
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