The Role of Smart Technologies in French Hospitals’ Branding Strategies

Hospitals resort to different initiatives to build their brands, including media relations, events, and marketing campaigns. However, they face several challenges related to legal frameworks, patients’ new demands, and hospitals’ digital transformation. This paper analyzes how the best hospitals in France manage smart technologies to enhance their relationships with stakeholders and reinforce their brands. We resorted to the World’s Best Hospitals 2023 to identify the 150 best hospitals in this country. Then, we defined 34 branding indicators to evaluate how each hospital managed smart technologies for branding purposes. We adapted these criteria to different platforms and targets: homepage (patients), online newsroom (media companies), About Us section (suppliers, shareholders, and public authorities), and artificial intelligence department (employees). When analyzing these criteria, we resorted to a binary system and only considered hospitals’ official websites. Our results proved that 98% of hospitals had a website, but not all respected the criteria related to the homepage (4.54 of 11), online newsroom (2.52 of 11), or About Us section (1.56 of 6). The best hospitals in France, according to the number of criteria respected, were Institut Curie-Oncology (20), Institut Gustave Roussy–Oncology (19), and Hôpital Paris Saint-Joseph (19). We concluded that French hospitals should implement collective branding processes that include all stakeholders, not just patients: media companies, public authorities, suppliers, shareholders, and employees. Moreover, these organizations should implement an in-house artificial intelligence department that leads a digital transformation from a medical, branding, and communication perspective. Finally, French hospitals’ branding efforts on smart platforms should focus more on content about the brand so that stakeholders understand the uniqueness of these organizations

Caring moments within an interprofessional healthcare team: Children and adolescent perspectives

Patients are now recognized as key partners to improve healthcare outcomes. Some organisations such as the WHO or the Canadian Interprofessional Health Collaborative (CIHC) encourage considering patients as partners in the interprofessional healthcare team. However, limited knowledge exists on patients’ perspective of interprofessional collaboration (IPC) and of their role in the collaborative process, particularly in pediatric settings. The experiences and perspectives of patients regarding IPC have to be considered in order to fully understand the concept of IPC and integrate it into practice. This qualitative study aimed at gaining a better understanding of the perspective of children of IPC, how it affects their experiences of care and how they perceive their own role within the interprofessional team. Semi-structured interviews were used in the pediatric service of a Swiss university hospital, with ten children and adolescents aged between 11-17 years. The participants described the interactions they observed between nurses and physicians and provided insights into how they perceived the quality of that relationship. A respectful relationship between nurses and physicians may have improved the experience of a caring environment. The participants did not perceive their role to be pivotal into the interprofessional relationship. The findings of this study indicate that the interactions between healthcare professionals have an influence on the perspectives and experiences of the participants of their hospitalisation and of IPC. However, integrating children and adolescents into collaborative process will need a change of paradigm and beliefs regarding IPC

History of sports medicine in Germany: some preliminary reflections on a complex research project

The paper presents the concept underlying a research project on the history of sports medicine in Germany. The origins and most intensive development of sports medicine have been in Germany. In fact, sports medicine in Germany is associated with various doping scandals from the past, beginning with the Sports Medical Service in the former East Germany, which consistently delivered so-called 'sustaining means' to East German athletes. However, so too were there the West-German networks of doping doctors like those at Freiburg University, represented by such protagonists as Joseph Keul and Armin Klümper. However, (West-) German society has made these and other sports physicians into celebrities, which seems to be unique compared to other countries. Yet the history of German sports medicine is by no means limited to unethical or even illegal doping. Sports doctors also initiated anti-doping concepts. Beyond doping and antidoping, the history of German sports medicine reveals a broad spectrum of genuine medical aid and research, all located somewhere between prevention, medical and social aid, medication, trauma surgery, and rehabilitation by means of physical exercise, education, and sports. Sports medicine, not only in Germany, 'sells' movement and sport as the most effective and legitimate drug against diseases of every kind, and for health and well-being. The project aims to research the remarkable and ambivalent history of German sports medicine by studying new and complex historical documents and oral history. The first and main part of the article provides essentially a state of the art history of German sports medicine, including an overview of the essential steps comprising its complex historical development. The second part is an attempt to conceptualize the current research project with respect to the various issues within this history

La promoción de la reputación de marca hospitalaria a través de las mobile apps. Un análisis cuantitativo sobre los mejores hospitales de España

This paper aims to evaluate how hospitals manage mobile applications to reinforce their relations with patients and promote their brands. To do that, we conducted a literature review about hospitals’ corporate communication, their branding initiatives, and their use of mobile apps for this purpose; then, we defined 36 indicators to quantitively analyze how the 150 best hospitals in Spain managed mobile apps to promote their brands: online integration, global app for patients, mobile apps for other targets, and mobile apps for patients facing non communicable diseases. We concluded that hospitals should follow a public health and branding logic to develop mobile apps that contribute to establish a new communication paradigm among these organizations and their patients.Este artículo evalúa cómo los hospitales gestionan las aplicaciones móviles para reforzar sus relaciones con el paciente y así promover sus marcas. Para ello, realizamos una revisión de literatura sobre la comunicación corporativa de estas organizaciones, sus iniciativas de marca y sus uso de las aplicaciones móviles en esta área; posteriormente, definimos 36 indicadores para analizar de un modo cuantitativo cómo los 150 mejores hospitales de España utilizan las aplicaciones móviles para promocionar sus marcas: integración online, app general para pacientes, apps para otros públicos, y apps para pacientes que sufren enfermedades no transmisibles. Concluimos que los hospitales deberían seguir una lógica de salud pública y de marca para desarrollar aplicaciones móviles que contribuyan a implementar un nuevo paradigma comunicativo entre dichas organizaciones y sus pacientes

Patient Privacy in the Genomic Era

According to many scientists and clinicians, genomics is taking on a key role in the field of medicine. Impressive advances in genome sequencing have opened the way to a variety of revolutionary applications in modern healthcare. In particular, the increasing understanding of the human genome, and of its relation to diseases and response to treatments brings promise of improvements in better preventive and personalized medicine. However, this progress raises important privacy and ethical concerns that need to be addressed. Indeed, each genome is the ultimate identifier of its owner and, due to its nature, it contains highly personal and privacy-sensitive data. In this article, after summarizing recent advances in genomics, we discuss some important privacy issues associated with human genomic information and methods put in place to address them

L’assistance médicalisée pour mourir demandée dans le cadre des soins de fin de vie : enjeux d’une éthique réflexive et critique pour l’humanisation de la mort

Par une approche analytique, cette étude en éthique clinique a examiné la problématique de la demande d’assistance médicalisée pour mourir formulée dans le cadre des soins de fin de vie. Partant du fait que cette demande sollicite les soignants dans leur savoir et leur savoir-faire, surtout dans leur savoir-être, cette étude rend d’abord compte d’un fait : bon gré mal gré l’interdit de l’euthanasie par la loi et la déontologie médicale, ainsi que le débat contradictoire à son sujet qui dure déjà voici quelques décennies, il arrive de temps à autres que les soignants œuvrant en soins de fin de vie, soient confrontés à une demande d’assistance médicalisée pour mourir. Cette demande qui émane de certaines personnes en fin de vie et / ou de leurs proches, est souvent source de malaise pour les soignants à l’endroit de qui elle crée des défis majeurs et fait naître des dilemmes éthiques importants. Plus particulièrement, cette demande interroge toujours la finalité même des soins de fin de vie : est-ce que l’aide pour mourir fait partie de ces soins ? En réponse à cette question difficile, cette démarche réflexive de soignant chercheur en éthique montre qu’il est difficile de donner une réponse binaire en forme de oui / non ; il est difficile de donner une réponse d’application universalisable, et de définir une généralisable conduite à tenir devant une telle demande, car chaque cas est singulier et unique à son genre. Cette étude montre prioritairement que l’humanisation de la mort est à la fois un enjeu éthique important et un défi majeur pour notre société où la vie des individus est médicalisée de la naissance à la mort. En conséquence, parce que la demande d’assistance médicalisée pour mourir sollicite les soignants dans leur savoir et leur savoir-faire, cette étude montre toute l’importance de la réflexivité et de la créativité que doivent développer les soignants pour apporter une réponse constructive à chaque demande : une réponse humanisant le mourir et la mort elle-même, c’est-à-dire une réponse qui soit, sur le plan éthique, raisonnable et cohérente, une réponse qui soit sur le plan humain, porteuse de sens. D’où, outre l’axiologie, cette démarche réflexive montre que l’interdisciplinarité, la sémantique, l’herméneutique et les grilles d’analyse en éthique, constituent des outils réflexifs efficaces pouvant mieux aider les soignants dans leur démarche. Sur quelles bases éthiques, les soignants doivent-ils examiner une demande d’assistance médicalisée pour mourir, demande qui se présente toujours sous la forme d’un dilemme éthique? Cette question renvoie entre autre au fait que cette demande sollicite profondément les soignants dans leur savoir-être en relation des soins de fin de vie. Aussi bonnes les unes que les autres, qu’on soit pour ou contre l’euthanasie, plusieurs stratégies et méthodes d’analyse sont proposées aux soignants pour la résolution des conflits des valeurs et des dilemmes éthiques. Mais, ce n’est pas sur cette voie-là que cette étude invite les soignants. C’est plutôt par leur réflexivité et leur créativité, enrichies principalement par leur humanisme, leur expérience de vie, leur intuition, et secondairement par les différentes méthodes d’analyse, que selon chaque contexte, les soignants par le souci permanent de bien faire qui les caractérisent, trouveront toujours par eux-mêmes ce qui convient de faire dans l’ici et maintenant de chaque demande. C’est pourquoi, devant une demande d’assistance médicalisée pour mourir qui leur est adressée dans le cadre des soins de fin de vie, cette démarche éthique invite donc les soignants à être « des cliniciens créatifs, des praticiens réflexifs» . C’est pour cette raison, sur le plan proprement dit de la réflexion éthique, cette étude fait apparaître les repères de l’éthique humaniste de fin de vie comme bases axiologiques sur lesquels les soignants peuvent construire une démarche crédible pour répondre au mieux à cette demande. L’éthique humaniste de fin de vie située dans le sillage de l’humanisme médical , où l’humain précède le médical, renvoie au fait qu’en soins de fin de vie où émerge une demande d’aide à la mort, entre le demandeur de cette aide et le soignant, tout doit être basé sur une confiante relation d’homme à homme, même si du côté du soignant, son savoir être dans cette relation est aussi enrichi par sa compétence, ses connaissances et son expérience ou son savoir-faire. Basée sur l’humanité du soignant dans la démarche de soins, l’éthique humaniste de fin de vie en tant que pratique réflexive émerge de la créativité éthique du soignant lui-même et de l’équipe autour de lui ; et cette éthique se situe entre interrogation et transgression, et se définit comme une éthique « du vide-de-sens-à-remplir » dans un profond souci humain de bien faire. Car, exclue l’indifférence à la demande de l’assistance médicalisée pour mourir, son acceptation ou son refus par le soignant, doit porter sur l’humanisation de la mort. Cette dernière étant fondamentalement définie par rapport à ce qui déshumanise la fin de vie.In an analytical approach, this clinical ethics study analyzes the issue of medical assistance request in dying in the context of end-of-life care. Runner of the fact that this request seeks the healthcare professionals in their knowledge and their know-how as well as in their knowledge-being in relation of the end-of-life care, this study gives first account of a fact: like it or not the prohibition of voluntary euthanasia by law and ethics, and the controversial debate about it in the last few decades, healthcare professionals involved in end-of-life care every so often are faced with a request of medical assistance to die. The request from some dying patients and / or their relatives often causes discomfort for the healthcare professionals to the point that it creates challenges and raises significant ethical dilemmas. Specifically, this request always challenges the very purpose of end-of-life care: Is medical assistance to dying part of the end-of-life care? In response to this difficult question, my reflexive ethics as medical researcher shows that: it is difficult to give a binary response yes / no. It is difficult to answer by a universalized application and define a generalized course of action, because each case is singular and unique to its kind. Accordingly, this study demonstrates the importance of reflexivity and creativity to be developed by the healthcare professionals to respond constructively to every request: a response humanizing dying and death itself. Hence, because the request of the assistance provided with medical care to die seeks the healthcare professionals in their knowledge and their know-how, in addition to axiology, this reflexive approach shows that interdisciplinarity, semantics, hermeneutics and analysis grids in ethics are effective reflexive tools that can better assist healthcare professionals in their approach. On what ethical basis, the healthcare professionals have to consider a request of medical assistance to dying, request that always presents itself as an ethical dilemma? This question sends back among others to the fact that this request seeks the healthcare professionals in their knowledge-being in relation of the end of life care. Several strategies and analysis methods, all equally good, are available to healthcare professionals for the resolution of ethical dilemmas. However, this is not the perspective this study invites healthcare professionals to discuss. Rather, it is through their reflexivity and creativity, enriched mainly by their humanity, life experience, intuition, and secondly helped by the different methods, that, according to each context, healthcare professionals in their ongoing effort to do right, that characterizes them, always find by themselves what is best to do here and now for each request. That is why, in front of a request of the assistance provided with medical care to die which is sent to them within the framework of the care of the end of life, this ethical approach thus invites the healthcare professionals to be “creative clinicians, reflexive practitioners " . Also, that is why, in terms of ethical reflection, this study exposes the framework of the humanistic ethics in end-of-life issues as axiological foundations on which health care providers can build their approach to best meet the request of medical assistance to die that they may receive in the context of end-of-life care. The humanistic ethics in end-of-life issues studied in the context of medical humanism , in which human precedes medical, refers to the fact that end-of-life care from which emerges a request for assisted death, between the one requesting such an assistance and the healthcare professional, everything must be based on a trusting human relationship between two persons, even if on the healthcare professional’s side, his personal and practical skills in this relationship are also enriched by his competence, knowledge and experience. Based on the humanity of the healthcare professionals in the medical process, humanistic ethics of end of life as a reflexive practice emerges from the ethical creativity of the healthcare professional himself and the team around him. This ethics is between query and transgression, and is defined as an ethics "vide-de-sens-à-remplir" in a deep human desire to do right. For, excluding indifference towards the request of medical assistance to dying, its acceptance or its rejection by the healthcare professionals must be a reasoned response and meaningful to the person who makes the request, whoever he may be, the dying patient or his relatives, and for the caregiver himself

Making the (Business) Case for Clinical Ethics Support in the UK

This paper provides a series of reflections on making the case to senior leaders for the introduction of clinical ethics support services within a UK hospital Trust at a time when clinical ethics committees are dwindling in the UK. The paper provides key considerations for those building a (business) case for clinical ethics support within hospitals by drawing upon published academic literature, and key reports from governmental and professional bodies. We also include extracts from documents relating to, and annual reports of, existing clinical ethics support within UK hospitals, as well as extracts from our own proposal submitted to the Trust Board. We aim for this paper to support other ethicists and/or health care staff contemplating introducing clinical ethics support into hospitals, to facilitate the process of making the case for clinical ethics support, and to contribute to the key debates in the literature around clinical ethics support. We conclude that there is a real need for investment in clinical ethics in the UK in order to build the evidence-base required to support the wider introduction of clinical ethics support into UK hospitals. Furthermore, our perceptions of the purpose of, and perceived needs met through, clinical ethics support needs to shift to one of hospitals investing in their staff. Finally, we raise concerns over the optional nature of clinical ethics support available to practitioners within UK hospital

Les conflits en lien avec la détermination du niveau de soins en gériatrie - Un projet d'éthique appliquée

La population mondiale vieillit et accumule des problèmes de santé qui nécessitent un séjour sur les unités de gériatrie. Il est donc impératif d’étudier les perspectives éthiques lors de la discussion de niveau de soins en gériatrie. Lors de celle-ci, le patient donne son consentement pour divers soins (massage cardiaque, traitements antibiotiques, soins palliatifs, entre autres). La discussion a habituellement lieu entre le médecin et le patient (ou son représentant). Par la suite, les membres du personnel soignant appliquent la décision. Il peut alors survenir des conflits sur la base de perspectives éthiques différentes. Plusieurs philosophes ont écrit sur le consentement aux soins. La théorie du consentement libre et éclairé est bien représentée dans les textes de loi actuels. Le paternalisme libertaire, le paternalisme classique et l’expertise-bienfaisante sont des théories qui peuvent guider la manière de déterminer le niveau de soins. Au second volet de ce processus, les comorbidités du patient, sa qualité de vie et la futilité sont des principes qui facilitent l’orientation du niveau de soins. Certaines notions sont plus conflictuelles comme le vitalisme. L’émotivité joue aussi un rôle important. Un ancrage pratique est nécessaire pour l’éthique appliquée et empirique. Nous avons cherché à mettre en lumière les perspectives éthiques qu’implique la détermination conflictuelle des niveaux de soins en gériatrie par une étude qualitative. Le recrutement de proche en proche nous a permis de faire 16 entrevues qualitatives semi-dirigées. Lors de notre étude nous avons questionné les acteurs des unités gériatriques. Les thèmes exposés par l’analyse statistique des réponses aux questionnaires sont similaires à notre cadre d’analyse ont été incorporés à une réflexion éthique. Dans l’optique de l’éthique du consensus, nous avons pu déterminer que l’expertise bienfaisante , ainsi que la qualité de vie étaient des concepts qui permettaient de réduire les conflits, contrairement au vitalisme et à l’émotivité (surtout des familles).Aging populations are becoming a pressing global health issue. Indeed, elders accumulate health problems while getting older. These conditions then often require a stay on a geriatric ward. Then, more conflicts pertaining to goals of care can arise in geriatrics. But why? During the discussion on goals of care, the patient gives his/her consent in case of emergency for several treatments (cardiac massage, antibiotics, palliative care, and so on). Patients (or their legal representative) and physicians have a central role to play in this conversation. Thereafter, other formal caregivers carry out the decision into clinical contexts. Yet, conflicts can arise because of caregivers, patients and legal representatives different ethical perspectives on the goals of care especially for frail elders. So, the first ethical aspect of goals of care is pertaining to how the discussion takes place. Several philosophers wrote theories in relation to consent in medicine. First, the theory of informed consent is embodied in the law and many codes of conduct. Second, libertarian paternalism, classic paternalism, and beneficent-expertise are also theories that can guide the discussion on final goals of care. We delineate the other ethical aspects as pertaining to what notions are implied in the discussion and decision on goals of care. Moreover, practical foundations are necessary for applied and empirical ethics. Then, we sought to highlight the ethical perspectives involved in the conflictual determination of goals of care in geriatrics through a qualitative study. A step-by-step recruitment allowed us to conduct 16 semistructured interviews. During our study we interviewed people involved in the geriatric care, such as patients, legal representatives and caregivers. Themes that we exposed by qualitative analysis of interviews were mostly similar to the ones contained in our initial analytical framework. We also brought to light new themes. Finally, we incorporated all of those in an meticulous ethical reasoning to obtain our final results on how to reduce conflicts in geriatrics and obtain consensual goals of care. We also found that the patient's illnesses, and quality of life, as well as futility can facilitate the decision on the level of care. Notions like vitalism and emotionality also play important roles, while being more problematic for clinicians. Thus, in the vein of consensus ethics, we determined that beneficent-expertise, as well as quality of life reduce conflicts. Whilst, vitalism and emotionality (especially families’ emotions) aggravate conflicts

Les Neurosciences au Tribunal: de la responsabilité à la dangerosité

In recent years, an explosion of interest in neuroscience has led to the development of "Neuro-law," a new multidisciplinary field of knowledge whose aim is to examine the impact and role of neuroscientific findings in legal proceedings. Neuroscientific evidence is increasingly being used in US and European courts in criminal trials, as part of psychiatric testimony, nourishing the debate about the legal implications of brain research in psychiatric-legal settings. During these proceedings, the role of forensic psychiatrists is crucial. In most criminal justice systems, their mission consists in accomplishing two basic tasks: assessing the degree of responsibility of the offender and evaluating their future dangerousness. In the first part of our research, we aim to examine the impact of Neuroscientific evidence in the assessment of criminal responsibility, a key concept of law. An initial jurisprudential research leads to conclude that there are significant difficulties and limitations in using neuroscience for the assessment of criminal responsibility. In the current socio-legal context, responsibility assessments are progressively being weakened, whereas dangerousness assessments gain increasing importance in the field of forensic psychiatry. In the second part of our research we concentrate on the impact of using neuroscience for the assessment of dangerousness. We argue that in the current policy era of zero tolerance, judges, confronted with the pressure to ensure public security, may tend to interpret neuroscientific knowledge and data as an objective and reliable way of evaluating one's dangerousness and risk of reoffending, rather than their responsibility. This tendency could be encouraged by a utilitarian approach to punishment, advanced by some recent neuroscientific research which puts into question the existence of free will and responsibility and argues for a rejection of the retributive theory of punishment. Although this shift away from punishment aimed at retribution in favor of a consequentialist approach to criminal law is advanced by some authors as a more progressive and humane approach, we believe that it could lead to the instrumentalisation of neuroscience in the interest of public safety, which can run against the proper exercise of justice and civil liberties of the offenders. By advancing a criminal law regime animated by the consequentialist aim of avoiding social harms through rehabilitation, neuroscience promotes a return to a therapeutical approach to crime which can have serious impact on the kind and the length of sentences imposed on the offenders; if neuroscientific data are interpreted as evidence of dangerousness, rather than responsibility, it is highly likely that judges impose heavier sentences, or/and security measures (in civil law systems), which can be indeterminate in length. Errors and epistemic traps of past criminological movements trying to explain the manifestation of a violent and deviant behavior on a biological and deterministic basis stress the need for caution concerning the use of modern neuroscientific methods in criminal proceedings