Third-party management of utilization of health services.
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Biomedical subjects
Publications and source records attributed to D A Sargent.
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Psychiatrists should refrain from treating mentally ill prisoners on death row in order to restore their "competency to be executed." Such "treatment" renders them double agents, in the service of the state as well as the prisoner. Participation in an act that will bring about a prisoner's death is expressly forbidden by the AMA Code of Ethics. It recalls the behavior of Nazi physicians, who used their professional skills not to heal but to kill.
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The impaired physician movement gained prominence in 1972 with the American Medical Association (AMA) council on mental health report entitled The Sick Physician. The movement grew as a necessary reaction to the conflicts inherent in the healing profession's attempt to heal its own members. The author traces the growth of the impaired physician movement, highlighting the contributions that the AMA, the American Psychiatric Association, and students of physician suicide have made to the laws and programs now in existence. Problems faced by the movement, areas requiring further efforts, such as restoration of the physician to practice, and the outlook for the future are also discussed.
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Psychological barriers in the minds of the failing physician, his family, and colleagues may thwart prevention of physician-suicide. The failing physician may be shunned by colleagues for his disturbed behavior. He denies illness, resorts to self-medication, and avoids treatment. Recognition and rational handling of this presuicidal state may be hindered by the need of the doctor, family, and colleagues to preserve a fantasy of the doctor's omnipotence. Treatment also may be impeded by the failing physician's reluctance to form a therapeutic relationship with the treating psychiatrist. The psychiatrist must help his doctor-patient to determine if he should continue practicing. The key to successful intervention may depend solely on our awareness and handling of these problems.
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Ibutilide fumarate injection is the first antiarrhythmic drug approved by the Food and Drug Administration for acute conversion of atrial fibrillation and flutter of recent onset (up to 90 days). This drug will find its greatest use in critical care units and emergency departments. Critical care nurses monitor the patients, recognize and assist in treating adverse events, and evaluate patient outcomes. Advanced practice nurses will find this information useful for teaching patients, colleagues, and new critical care nurses.