Finger recording electrode system for electrical impedance plethysmograph

System facilitates location of recording electrodes of impedance plethysmograph that is used for measuring flow of blood in finger segment; electrodes can be relocated accurately and volume of finger segment under study can be determined precisely. System minimizes movement artifacts in plethysmograph trace because finger segment is held firmly

Readout electrode assembly for measuring biological impedance

The invention comprises of a pair of readout ring electrodes which are used in conjunction with apparatus for measuring the electrical impedance between different points in the body of a living animal to determine the amount of blood flow therebetween. The readout electrodes have independently adjustable diameters to permit attachment around different parts of the body between which it is desired to measure electric impedance. The axial spacing between the electrodes is adjusted by a pair of rods which have a first pair of ends fixedly attached to one electrode and a second pair of ends slidably attached to the other electrode. Indicia are provided on the outer surface of the ring electrodes and on the surface of the rods to permit measurement of the circumference and spacing between the ring electrodes

Conscientious Objection, Professional Ethics and Public Spheres

Conscience matters deeply, but professional roles are not merely personal. They involve shared identities, values and responsibilities. We all have multiple roles and identities. Professor Bernhardi is at once a doctor and a Jew, a hospital director and a father. These identities are both personal and archetypal. They are also vocational, as is the role of priest. The ‘calling’ is to something pre-defined, to serve in a particular role. Professional conscience can never be a truly private matter. The four acts illuminate the interplay between roles and expectations; changing by location, time and space, including the degree to which they can accommodate personal adaption. The clinic has its own hierarchy of authority. Professor Bernhardi, as doctor, is in charge. There is no place for conscientious objection. The focus is on matters of the body. The patient becomes a person only when the priest challenges the jurisdiction of the doctor, and in response Professor Bernardi becomes her protector. Professor Bernhardi the Director has different responsibilities. The reputation of his hospital matters. He can contemplate an apology now that time is not critical. It is about the ‘big picture’ and the conflict is portrayed within grand battles; faith against science, darkness against light. We should encourage full, unconstrained, conscientious engagement in such debates. In the Hospital Board Room, the play makes comedy of the rivalries and factions of hospital life, but it also models a process of negotiation over the resolution of competing claims. We should respect conscience in service organization, but balance it with patient’s rights. Finally, in the privacy of Professor Bernhardi's home, the doctor and priest might unburden themselves of their roles in favour of an underlying common humanity. In fact, the attempt to do so collapses and they cannot avoid their public identities

Bioethics as a Governance Practice

Bioethics can be considered as a topic, an academic discipline (or combination of disciplines), a field of study, an enterprise in persuasion. The historical specificity of the forms bioethics takes is significant, and raises questions about some of these approaches. Bioethics can also be considered as a governance practice, with distinctive institutions and structures. The forms this practice takes are also to a degree country specific, as the paper illustrates by drawing on the author’s UK experience. However, the UNESCO Universal Declaration on Bioethics can provide a starting point for comparisons provided that this does not exclude sensitivity to the socio-political context. Bioethics governance practices are explained by various legitimating narratives. These include response to scandal, the need to restrain irresponsible science, the accommodation of pluralist views, and the resistance to the relativist idea that all opinions count equally in bioethics. Each approach raises interesting questions and shows that bioethics should be studied as a governance practice as a complement to other approaches

Conscientious Objection: Personal and Professional Ethics in the Public Square

English law expects health professionals to have, and act upon, consciences, but formal con- science clauses are not the main legal recognition of this expectation. Rather, they should be regarded as an anomaly with roots in very specific political settlements between society and health professions, whose legitimacy is historically contingent, and as an aspect of the ‘price’ to be paid for securing services. There are sound reasons for the protection of conscientious discretion as an aspect of professional identify, but specific rights of personal conscientious objection are difficult to reconcile with legitimate public expectations of comprehensive and non-discriminatory services. Professional identities include moral commitments, such as the privileging of patient safety over administrative convenience. These should not be permitted to be overridden by personal moralities during the course of service delivery (as opposed to debating in the abstract what the proper courses of action should be). Consequently, formal conscientious objection clauses should be reduced to a minimum and regularly revisited. It is generally more satisfactory to address clashes between the personal moralities of professionals and public expectations through more flexible means, enabling accommodation of a plurality of views where possible but acknowledging that this is a matter of striking an appropriate balance. Employment law rather than healthcare law provides the best mechanism for regulating this process

Report of Research on Consistency of Decision-Making in s29 Case Meetings of Council members of CHRE

This Report was commissioned to examine the decision-making in Case Meetings of Council members of CHRE from April 2004' including an analysis of consistency of decision-making, including use of learning points, referrals to the High Court, consistency of seemingly similar cases across regulatory bodies and consistency within categories of misconduct The Report concludes that • there is very little evidence of inconsistency (see above for the one example), • two tools to promote consistency could be considered. One deals with those cases where the key concern is the management of identifiable risks to the public. Here, consistency of process is the most helpful approach. The other deals with those cases where the most important factor is properly reflecting the nature of the misconduct. The benefits of the typology of ‘risk factors’ that is being developed by CHRE may not be fully realised without some indicative tariff

Patient No Longer? What next in health care law?

A series of Supreme Court decisions since 2013 have revisited the fundamental principles of healthcare and medical law established during the 1980s in which the Bolam test became pre-eminent. These decisions represent a watershed and suggest that a reorientation is underway, in which the law is reducing the significance of the status of patients in favour of greater recognition of the human rights of health service users as citizens. Aintree (2013) suggests that respect for professional expertise probably remains intact, but its scope is expressly limited by Montgomery (2015). That case purports to bring the law’s understanding of patients into the modern era, although a close examination reveals that the analysis is deeply flawed. The Supreme Court Justices have shown an intent to give greater scope for human rights arguments, although the basis for this, as yet, lacks a clear rationale or coherence. Montgomery claims to be a radical departure from the previous orthodoxy and suggests a need to revisit many earlier cases. The human rights turn not only alters the doctrines that underpin the law affecting healthcare, but also provides a basis for the courts to assert jurisdiction. While the European Court of Human Rights has developed jurisprudence that defers to a margin of appreciation for democratic legislatures, Nicklinson (2014) shows the UK Supreme Court asserting its authority over Parliament and may indicate that the boundaries of healthcare law are being redrawn. A v N CCG (2017) seems to continue some features of the traditional approach, but R (A & B) v Sec State for Health (2017) confirms Article 8 of the ECHR as a limiting factor, while Doogan (2014) seems to limit its scope in healthcare law (in favour of being able to balance human rights issues through employment law). Together, these developments may represent a profound shift in the constitution of healthcare law