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Biomedical subjects

R M Ratzan

Publications and source records attributed to R M Ratzan.

At least 19 recordsLinked to original sources
PubMed1990

Ars medicina et conditio humana. Edmund D. Pellegrino, M.D., on his 70th birthday.

In his writings, Edmund Pellegrino analyzes four deficiencies in the humanity of those who fall ill: the loss of (1) freedom of action, (2) freedom to make rational choices, (3) freedom from the power of others, and (4) a sense of the integrity of the self. Since Pellegrino's analysis and commitment to virtue-based ethics preceded much of the attention later given by philosophers to the importance of the moral principle of autonomy (in contrast to beneficence) in patient care, it is helpful to trace the source of his commitment to virtue-based ethics and his account of freedom to Aristotle's analysis of the human soul, as an entelechy of an intact and healthy living organism that, unimpeded by illness, moves itself to act, to actualize its intellectual potential in the form of making rational choices, and to free itself from the power of others by remaining independent and without need of continuous assistance, while at the same time retaining the integrity of a unified self that can act, think, and choose for itself autonomously.

Ethics, Medical↗
PubMed1987

Yellow professionalism. Advertising by physicians in the Yellow Pages.

We compared the specialty listings of physicians in the Yellow Pages of the 1983 Hartford, Connecticut, telephone book with the board certifications in specialties of the American Board of Medical Specialties as listed in the American Medical Association directory or the Marquis Directory of Medical Specialists. There were 1179 listings by 946 physicians under 61 specialty headings in the Yellow Pages. We found that a mean of 12 percent of "specialists" listed in the Yellow Pages were not board-certified in a specialty, although they had had ample opportunity to obtain board certification. We conclude that specialty advertising in the Yellow Pages is potentially misleading to consumers and that member boards of the American Board of Medical Specialties should consider ways to diminish this possible misrepresentation.

Advertising↗
PubMed1987

Defining a rational back-up policy for emergency departments.

All emergency departments face the possibility of having insufficient personnel to provide adequate care for patients. Such occasions may present an emergency department with several severely injured patients or merely an unusually large number of that emergency department's usual patient profile. When such staffing inadequacies occur, emergency department directors must respond with additional personnel. Since there is no national standard for back-up policies for emergency departments, emergency medicine has a responsibility to examine this question in order to arrive at some possible solutions. In addition, emergency department directors have an obligation to consider their particular staffing and usage patterns in order to try to devise the most efficient back-up policy prior to need. Finally, assessment of the success with which such back-up policies are used is discussed.

Disaster Planning↗
PubMed1987

Risk, Las Vegas, and "The Deer Hunter".

Risk is inherent in every medical setting. Emergency medicine is an especially risky specialty for both patient and emergency physician, eg, the risk of death from trauma and the risk of adverse outcome from medical intervention that can't wait for more favorable circumstances. Risk assessment (the numerical quantification of certain risks) and risk acceptability (the qualification of risks as acceptable or not) are helpful concepts in understanding risk. Comparing the risks and attitudes toward these risks of gambling in Las Vegas and the movie "The Deer Hunter" with emergency medicine demonstrates the need for emergency physicians to become involved in measures designed to promote prophylactic risk avoidance.

Attitude of Health Personnel↗
PubMed1986

Communication and informed consent in clinical geriatrics.

Obtaining a valid informed consent from an elderly person, especially with possible senile dementia of the Alzheimer's type (SDAT), first may involve solving the practical problems of effective communication. Perceptual constraints that frequently occur in the elderly and that may interfere with communication, i.e., the sharing of information, are auditory and/or visual. The most common auditory obstacle, presbycusis (the hearing loss for pure tones due to normal aging) and other hearing impairments, may make the communication of any information about a proposed research project difficult, if not impossible, when not suspected and successfully overcome. Speech and language impediments, whether as a result of stroke or SDAT, are also common and need to be addressed if the person is to communicate his or her concerns and questions effectively with the researcher. Included in such constraints are the misunderstandings that arise from the use of confusing vocabulary, especially "medicalese." Presbyopia, cataract, and glaucoma are some of the visual constraints that may play an important role in making it difficult for the person to read the informed consent form. This article discusses these and other impediments to effective communication with SDAT elderly and makes suggestions how to obviate them.

Aged↗
PubMed1985

Unsolicited medical opinion.

By virtue of their professional ethics as healers and because of their specialized technical knowledge and clinical experience in assessing and reacting to real and potential emergencies, physicians have an obligation to offer an unsolicited medical opinion when the following conditions are met: (1) physicians assess a high probability of potentially serious disease in a stranger because of information presented to them, either in the form of a communication or physical signs; (2) physicians judge this information to be latent (not readily interpretable as potentially dangerous by the stranger) and likely to remain latent prior to the onset of symptoms; (3) the physicians possess the medical knowledge appropriate to the professional interpretation of this information. Although not a morally risk-free endeavor (invasion of privacy and the potential creation of a 'sick role' whether or not the diagnosis is correct), offering an unsolicited medical opinion under the above conditions can prevent suffering and save lives in unsuspecting strangers.

Acromegaly↗
PubMedDate not supplied

Keep in touch.

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Anger↗
PubMedDate not supplied

The blue scrotum sign of Bryant: a diagnostic clue to ruptured abdominal aortic aneurysm.

A 73-year-old man presented to the emergency department twice with nonspecific abdominal pain. He was diagnosed as having mild diverticulitis and was discharged. Four days later he presented to the emergency department in severe abdominal pain with scrotal and penile ecchymoses. After an initial urologic consultation the correct diagnosis of ruptured abdominal aortic aneurysm was made. We discuss the pathogenesis of the genital discoloration and make the correct historical attribution of this sign to John Henry Bryant, a turn-of-the-century physician at Guy's Hospital.

Aged↗
PubMedDate not supplied

A near miss.

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Adult↗