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Biomedical subjects

N Lynöe

Publications and source records attributed to N Lynöe.

At least 19 recordsLinked to original sources

Physicians and alternative medicine--an investigation of attitudes and practice.

In the present paper, the attitudes of three different groups of physicians toward treatment with alternative medicine have been investigated. One of the groups studied consisted of randomly selected licensed physicians from the Swedish National Board of Health and Welfare. The other two groups comprised two different associations of physicians involved with alternative medicine. One third of the former groups were positively disposed toward one or more of the alternative medical technologies, while the latter groups were more positive toward alternative medicine in general. Attitudes, along with motives for such interest, varied depending on the orientations of the different interest groups. The most common motives for expressing interest in alternative medicine included a feeling of clinical powerlessness in the face of certain problems for which patients consult a physician, and a dissatisfaction with the scientific approach of academic medicine. A minority stated that their interest in alternative medicine pre-dated their medical education. Physicians' interest in alternative medicine can be understood both as a critical reaction to academic medicine and as evidence that some alternative medical technologies are effective. Hence there is a need to determine whether there are shortcomings to be found in academic medical education and scientific ideals, and also to assess alternative medical technologies at regular intervals.

Anthroposophy

Ethical and professional aspects of the practice of alternative medicine.

The question of who should provide alternative medical treatment raises a number of different problems of both an ethical and a professional nature. Providing medical treatment, including alternative medical treatment, presupposes that the physician in question possesses diagnostic competence. It is in the best interests of society that medical care is safe, and therefore society must monitor the medical profession, e.g. in order to assure itself that the treatment provided is in agreement with the tenet of science and proven experience. The democratization of the patient-doctor relationship and the liberalization of the availability of medical and alternative medical treatments means that society also has an interest in ensuring that physicians offer alternative medical treatments or cooperate with practitioners of alternative medicine. A question is whether this is also of interest to the physicians? Another question touching on professional ethics is whether the doctor has the same responsibility to respect the desire of a patient to receive alternative medical treatment as he would have to respect the patient's right to forego ordinary medical treatment. These questions are analysed here against the background of the perspective of the relevant interest groups and are graded with regard to the disease and treatment concerned, how far the disease has advanced, the age of the patient, and whether or not the patient is competent to make his own decisions. These considerations are relevant in a discussion of who is qualified to provide or prescribe alternative medical treatment. This study points out that the individual physician should have the possibility to compromise and improvise from case to case.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Informed consent: study of quality of information given to participants in a clinical trial.

OBJECTIVE: To determine whether the participants in a clinical trial had perceived adequate information about the trial according to the guidelines of the Declaration of Helsinki. DESIGN: About 18 months after the end of a gynaecological clinical trial the participants received a questionnaire by post, which focused on the quality of the information given to them before entering the trial. Neither researchers nor participants were aware in advance that the trial would become the subject of this follow up investigation. SETTING: Eight different centres in Sweden. SUBJECTS: 43 women out of the 53 who completed the trial (mean (range) age 23 (16 to 35) years) returned the questionnaire. MAIN OUTCOME MEASURES: Adequacy of the information (based on requirements of the Declaration of Helsinki) to enable the following: understanding of the aims of the study; awareness of what participation meant; and awareness of the possibility of withdrawing from participation at any time. Motives for agreeing to participate, and a subjective evaluation of the given information were also recorded. RESULTS: All but one of the participants had been aware that they were taking part in a research project. Five women stated that they had not been aware that a second laparoscopy was performed only for research reasons. Seven women reported that they had not been aware of the meaning of participating in the project and 17 that they had had no information about the possibility of withdrawing from the study whenever they wanted. In the subjective rating 22 women considered the information given as good or very good. There was a systematic variation in the quality of the given information among the eight centres. CONCLUSION: Although all but one of the participants had been aware that they were taking part in a clinical trial, the quality of the information understood and recalled by participants varied, and in many cases clearly did not meet the guidelines of the Declaration of Helsinki. Variations among centres in participants' perception of information suggest that deficiencies in perception may be caused by informers rather than the participants.

Clinical Trials as Topic

Is the effect of alternative medical treatment only a placebo effect?

A common assertion about alternative medical technologies is that their results are solely built upon the placebo effect. The reason for this assertion is due to the facts that the placebo effect is perceived as an irrational quantity, and that the placebo effect is considered unspecific. If it is possible to rehabilitate the placebo effect by interpreting it as a specific effect, what consequences would it have for school medicine and the view of certain alternative medical technologies? To answer these questions it is necessary to investigate just what sort of phenomenon the placebo effect is, and what determines its dimensions.

Attitude of Health Personnel

Theoretical and empirical problems in the assessment of alternative medical technologies.

Critical situations help to clarify and define otherwise indistinct and vague phenomena. The paradigm-collision which occurs when assessing alternative medical phenomena against the background of a medical school paradigm is analogous to a critical situation. An analysis of the conditions for such an appraisal has helped to highlight aspects which are not normally ascribed any great significance in the assessment of technology. It turns out that theoretical requirements, the specific concept and certain irrational elements play a large role in the assessment of medical and alternative medical technology. One conclusion is that in the appraisal of e.g. alternative medical technology, one must take into account these conditions for forming a judgement, as a basic requirement for an objective appraisal of the technology in question.

Attitude of Health Personnel