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Biomedical subjects

H Brody

Publications and source records attributed to H Brody.

At least 181 records · Page 10Linked to original sources
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Nondisclosure of human immunodeficiency virus and hepatitis C virus coinfection in a patient with hemophilia: medical and ethical considerations.

This article discusses a medical and ethical dilemma: whether to disclose a positive HIV (human immunodeficiency virus)/HCV (hepatitis C virus) coinfection to an adolescent boy without symptoms with hemophilia despite the objections of his parents. An actual case history is presented and the dilemma faced by the medical team is discussed. Numerous family conferences, all excluding the patient, held during the last 5 years discussed the medical team's obligation for full disclosure, the emerging autonomy of the patient, and the potential for medical disaster (e.g., HIV transmission) if full disclosure were not permitted. Despite this, the family did not agree to allow disclosure. The patient and parents assured us of his sexual inactivity. Legal opinion was sought from the university counsel. The dilemmas are multiple. Is there a convincing argument to insist on disclosure of these facts to this patient, particularly when there is ambiguity regarding the appropriateness of HIV and HCV treatment? Does the ethical argument that he is at potential risk for transmitting HIV/HCV outweigh the rights of the family? What are the rights of the rest of the family? What are the rights of the minor? Is it our ethical responsibility to disclose a probably fatal diagnosis?

Adolescent↗
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After the Cruzan case: the primary care physician and the use of advance directives.

In the case of Nancy Cruzan, involving an incompetent patient's right to have artificial feeding withdrawn, the Supreme Court of the United States upheld the State of Missouri's right to set evidenciary standards prior to the discontinuation of care. The "clear and convincing" standard of the Cruzan ruling highlights the primary care physician's importance in proactively addressing advance directives with patients in the outpatient setting. Primary care physicians need to familiarize themselves with and discuss with patients such advance directives as the living will and the durable power of attorney. Physicians also need to understand the legal requirements of advance directives, as well as the implications of the clear and convincing standard in their own state.

Adult↗
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The chief of medicine.

Explore the source record for details and available documents.

Anecdotes as Topic↗
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A policy imperative for primary care: reflections on Keystone II.

The Second Advanced Forum in Family Medicine (Keystone II) revealed that family practice and primary care continue to meet resistance to their approaches and methods within academic medicine, despite the demonstrated need for primary care and its demonstrated success in practice. It is futile to respond to this resistance by continued academic argument and pleading. Instead, primary care should turn its efforts toward questions of national health policy in the political realm. Ironically, academic success is more likely to result from new political initiatives than from new academic ones, as primary care shows its willingness to take on the difficult problems of care for the underserved in the face of cost constraints.

Family Practice↗
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Professional integrity and physician-assisted death.

The practice of voluntary physician-assisted death as a last resort is compatible with doctors' duties to practice competently, to avoid harming patients unduly, to refrain from medical fraud, and to preserve patients' trust. It therefore does not violate physicians' professional integrity.

Beneficence↗