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Biomedical subjects

B Lo

Publications and source records attributed to B Lo.

At least 109 records · Page 6Linked to original sources
PubMed1989

Knowledge and concerns about acquired immunodeficiency syndrome and their relationship to behavior among adolescents with hemophilia.

The knowledge and concerns regarding acquired immunodeficiency syndrome (AIDS) and their relationship to certain behaviors among adolescents with hemophilia, a pediatric risk group with human immunodeficiency virus (HIV) antibody positivity rate as high as 70% to 90%, are described. Information was obtained from 26 patients, 13 to 19 years of age, through the use of a confidential self-administered questionnaire and a semistructured interview. In general, subjects demonstrated a high level of factual knowledge regarding the cause, natural history, transmission, and prevention of AIDS. Despite this, participants frequently behaved in ways that were potentially harmful to themselves and others. Specifically, although aware of the importance of using condoms, sexually active adolescents with hemophilia were not practicing safe sex. Restriction in the use of heat-treated clotting factor because of concerns about AIDS was also frequently reported. Professionals providing AIDS education and counseling for these individuals need to be cognizant of the concerns and social skills of this population; they should focus not only on factual information but also on the social and situational pressures confronting these teenagers, which may be more immediate determinants of their behavior and well-being. As AIDS continues to spread into the general population, these findings have relevance to AIDS education and health policy efforts aimed at all adolescents.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Artificial feeding--solid ground, not a slippery slope.

Decisions about artificial feeding arouse more controversy than those involving any other life-sustaining treatment. Because food and water are generally considered basic elements of humane care, representing love and concern for the helpless, it is often thought that they must always be provided. In a landmark decision, the Supreme Judicial Court of Massachusetts ruled that a feeding tube could be removed from a patient in a persistent vegetative state if this was consistent with his previously expressed wishes. The case of Paul E. Brophy, Sr., is part of an emerging medical and legal consensus on the withholding of artificial feeding from adult patients. The view is growing that tube and intravenous feeding should be likened to other medical interventions and not to the routine provision of nursing care or comfort. Competent patients have the right to refuse such feeding. Feeding can also be stopped incompetent patients who have earlier stated such a wish.

Coma↗
PubMed1986

To redeem them from death. Reactions of family members to autopsy.

Attitudes towards autopsy were examined in family members of 102 subjects who died in a university teaching hospital. The majority of responding families (88 percent) considered autopsy beneficial. Families permitting autopsy identified advancement of medical knowledge, comfort in knowing the cause of death, and reassurance that all appropriate care was given as the most important benefits. Fifty-five percent of the families of 40 subjects not undergoing autopsy declined permission and 45 percent had not been asked for such permission. The most frequent reasons given for not wanting autopsy were disfigurement of the body, stress of permitting autopsy, lack of information about autopsy, and family members' objections. Twenty-seven percent of 62 families permitting autopsy did not learn its results. Family members receiving results complained about long delays in receiving and complex terminology of autopsy reports. These findings suggest need for improvement in obtaining consent for autopsy, reporting autopsy results, and educating and counseling families of dying patients.

Attitude to Death↗
PubMed1986

The Bartling case. Protecting patients from harm while respecting their wishes.

The recent legal decision in the Bartling case affirmed that competent patients may refuse life-sustaining treatment, even if they are not terminal or comatose and even if physicians object because of ethics or conscience. However, clinicians may be concerned that patient refusal of treatment is not truly informed. Physicians have an obligation to benefit patients as well as to respect patients' wishes. They may fulfill both obligations by determining whether further medical treatment is indicated, identifying reversible conditions that may impair patient decision making, and checking that the patient's decision is informed.

Aged↗
PubMed1986

The case of Claire Conroy: will administrative review safeguard incompetent patients?

The emotional issue of withdrawing feeding tubes from incompetent patients was reviewed recently by the New Jersey Supreme Court in the case of Claire Conroy. The court ruled that artificial feedings do not differ from other life-sustaining treatments and may be withdrawn or withheld if they are against the patient's wishes or best interests. The ruling rejected the tradition of shared decision making by physicians and families of incompetent patients. Instead, the court required the State Ombudsman to investigate cases like that of Claire Conroy as possible cases of elder abuse. Although such review was intended to safeguard vulnerable patients, it may have detrimental effects and impede humane decisions to withhold care. To minimize cumbersome decision-making procedures, physicians should discuss life-sustaining treatment in advance with patients who are still competent. Such discussions should be more specific than is now customary.

Aged↗
PubMed1985

Ethical dilemmas in caring for patients with the acquired immunodeficiency syndrome.

Caring for patients with the acquired immunodeficiency syndrome (AIDS) raises ethical dilemmas about when to provide life-sustaining treatments such as mechanical ventilation and cardiopulmonary resuscitation. In addition, many patients become mentally incompetent and unable to participate in decisions. Homosexual men may want their lover or a friend to make decisions for them, but the patient's partner or friend cannot make these decisions unless he is legally designated. Decision-making guidelines may be hard to implement because caring for patients with AIDS is stressful. We describe three cases that illustrate the difficult ethical dilemmas and stresses of caring for these patients.

Acquired Immunodeficiency Syndrome↗