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Biomedical subjects

L Doyal

Publications and source records attributed to L Doyal.

At least 37 records · Page 2Linked to original sources
PubMed1997

Good ethical practice in the dental treatment of patients with HIV/AIDS.

Patients with HIV/AIDS have challenged the ethics of the dental profession. The seriousness, infectious character and social stigma of the illness have led to a range of ethical dilemmas about the treatment of such patients. This paper attempts to resolve some of the more difficult questions through exploring the moral boundaries of the rights and duties of both patients and dental practitioners. To accomplish this aim, the moral foundation for the general clinical duties of care is outlined, especially the obligations of providing treatment to a high standard, respecting the rights of patients to informed consent and doing both without personal prejudice. After illustrating why these duties require moral character as well as intellectual understanding, their practical consequences are outlined for specific issues in the treatment of seropositive patients. It is argued that patients should never be tested without their informed consent and that dentists have a duty to display courage, sensitivity and rigorous respect for confidentiality in the treatments they offer. The obligations of seropositive dentists are also considered, including their own obligations for disclosure toward regulatory authorities and patients. The moral debt which the dental profession owes to seropositive patients is highlighted.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Nurses taking on junior doctors' work: a confusion of accountability.

The number of hospital based posts in which nurses take over clinical work previously done by junior doctors is growing. Accountability for the scope of such new roles and the standards of practice which apply to them are still unclear. When analysed together and compared, the regulations arising from the professional bodies (GMC and UKCC), civil law concerning certain wrongs to patients, and employment law are sometimes contradictory and hard to interpret. The resulting uncertainties about appropriate management for clinical roles evolving between the professions, coupled with an increasingly litigious public, put the nurses and consultants involved at risk of complaints and of disciplinary and legal action. Drawing on our current research into changing clinical roles at the medical-nursing interface, we suggest strategies to reduce risk. Doctors and nurses should be equal partners in planning and managing these new posts, patients should be informed adequately about the nature of the postholder's role and training, significant changes in the work of such postholders should be formally acknowledged by the employer and relevant insurers, individuals taking up new roles should have access to legal advice and support to cover legal risk, and national regulatory bodies need to work together to harmonise their codes of practice in relation to changing clinical roles between the professions.

Humans↗
PubMed1996

The politics of women's health: setting a global agenda.

The last decade has been marked by a rapid growth in the women's health movement around the world. There has been a marked shift in activities away from the developed countries, as campaigns increase in intensity in Africa, Asia, and Latin America. The practice of women's health politics has also become increasingly international with sustained and effective collaboration across the north-south divide. Both the goals of these campaigns and their methods vary with the circumstances of the women involved. But despite this diversity, common themes can be identified: reproductive self-determination; affordable, effective, and humane medical care; satisfaction of basic needs; a safe workplace; and freedom from violence.

Developed Countries↗
PubMed1995

Informed consent and the practice of good dentistry.

The importance of obtaining informed consent in dentistry is increasingly recognised for moral and legal arguments which are explored. Morally, patients have the right to self-determination and respect for it underpins the relationship of trust deemed so important for clinical success. Legally, this right is reinforced through the risk of dentists being sued for battery or negligence if they do no adequately respect it. An explanation is offered as to why it can be difficult for patients in the UK to win such litigation. The practical implications of the doctrine of informed consent are sometimes unclear in clinical work--the reasons for this are assessed and illustrated. Standards of good practice in obtaining informed consent are suggested. Readers are invited to evaluate the degree to which a hypothetical case conforms to these standards and to compare their conclusions with those of the authors.

Adult↗
PubMed1995

Advance directives.

Explore the source record for details and available documents.

Advance Directives↗
PubMed1994

Withholding and withdrawing life sustaining treatment from elderly people: towards formal guidelines.

Clinicians often decide either to withhold or to withdraw lifesaving treatment in elderly patients. Considerable disagreement exists about the circumstances in which such actions can be defended. Debates about the scarcity of resources in the NHS add urgency to the need to resolve this disagreement. Competent elderly patients have a legal and moral right to decide whether to receive life sustaining treatment. Such treatment should not be withheld or withdrawn on the basis of a patient's age alone. Principles for making decisions about life sustaining treatment in incompetent elderly patients can be defended and should exist as written guidelines.

Aged↗
PubMed1994

Stopping treatment for end-stage renal failure: the rights of children and adolescents.

Dialysis and transplantation have been of obvious benefit to children with renal failure. Yet this is not always so. End-stage treatment can also create physical and mental suffering, for both patients and their families. For this reason, the availability of life-saving treatment creates difficult ethical and legal dilemmas concerning when it can morally and lawfully be rejected. These dilemmas are explored through a general account of the doctrine of informed consent and its application to the refusal of such therapy. Clinical and parental duties of care are outlined for young and adolescent children. For young children, the rights of parents are evaluated, recognising the significance of parental involvement and support for treatment for renal failure to be successful. It is further argued that adolescents who are deemed to be competent to give informed consent have the moral right to choose to die rather than to continue treatment. To minimise this prospect, the importance of effective counselling and peer group support is made clear, along with a partnership model of clinical negotiation.

Adolescent↗