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Biomedical subjects

S M Gallagher

Publications and source records attributed to S M Gallagher.

At least 37 records · Page 2Linked to original sources
PubMed2000

Legalism and ethics in healthcare.

Legalism is the translation of moral problems into legal problems--the repression of moral debate for fear it will be translated into a legal mandate. Some assert that legalism interferes with the serious debate of significant moral issues, while others believe that it elevates moral judgments to moral standards. The purpose of this article is to describe legalism and its impact on ethical decision-making, particularly in the wound care setting.

Delivery of Health Care↗
PubMed1999

Restructuring the therapeutic environment to promote care and safety for the obese patient.

Fifty-four percent of American adults are overweight. Obesity is a chronic disease associated with a number of conditions, such as diabetes, heart disease, hypertension, certain types of cancers, and breathing problems. The direct and indirect costs related to obesity exceed $70 billion annually. Because of the many cost and quality issues related to obesity, national attention is turning toward the special needs of this population. Strategies to restructure therapeutic intervention with attention to risk management, economic implications, and patient satisfaction are important considerations when managing the obese patient.

Adult↗
PubMed1999

Citizenship ethics: a call to action.

Ethics is the philosophical study of mortality--the study of goodness, moral values, and right action. Citizenship ethics is the part of public ethics that is concerned with the right action of citizens in the public arena. This article defines citizenship ethics and examines the ethics of individual citizens or groups as it relates to opportunities for healthcare professionals in their respective communities. The spirit of volunteerism among three professionals is highlighted as they make a positive contribution to their communities, and an appeal is made to healthcare professionals to seek their own opportunities to make a positive impact on their communities.

Community Networks↗
PubMed1999

The emotional face of harm.

Nonmaleficence refers to the maxim Primum non nocere, "Above all, do no harm." Nonmaleficence is an important ethical principle, especially in the face of advanced technology and other superordinary or extraordinary therapeutic interventions available to patients today. Chronic illness poses challenges in balancing the benefits with the burdens of therapeutic intervention. A discussion of nonmaleficence as a principle to consider in chronic conditions is presented.

Adult↗
PubMed1999

The meaning of "otherness" in healthcare planning.

Otherness holds special meaning in healthcare planning. When clinicians assign the quality of "otherness" to a patient or a patient group, they may justify inadequate care by blaming the patient for the numerous management difficulties he or she presents. This response suggests that as a culture we need to be aware of the moral dimensions of otherness and recognize how this influences care. A case study is offered to illustrate the numerous barriers otherness poses in healthcare planning.

Attitude of Health Personnel↗
PubMed1999

The beneficent nature of chronic wound care.

The principle of beneficence is one of four bioethical principles, which also include non-maleficence, autonomy, and justice. Beneficence is a moral term; it is the obligation to act for the benefit of others. Social policy is developed from informed choices with regard to a balance between costs, risks, and beneficence. Wound care clinicians conduct clinical and economic outcome studies to guide those responsible for making reimbursement decisions for patients with costly complications of chronic illness. This column discusses the balance of benefits, costs, and risks in the face of the principle of beneficence. Prevention, as an alternative to costly treatment of recurrent wounds, is presented as a strategy to balance cost, risk, and beneficence.

Chronic Disease↗
PubMed1999

The ethics of compassion.

The Georgetown Mantra of Bioethics, which includes the principles of beneficence, non-maleficence, autonomy, and justice, has largely been regarded as the mainstay of ethical principles in the healthcare setting. Moral or ethical decisions have been discussed using this framework. The purpose of this article is to argue that the ethics of compassion is a critical principle in making clinical decisions, especially in the case of the chronically ill patient. This suggests that the ethics of compassion may serve as an important adjunct to the Georgetown Mantra.

Decision Making↗
PubMed1999

The historical context of business ethics: implications for choices and challenges in wound care.

Wound care clinicians are regularly asked to make decisions of an ethical nature within their work settings. Business and business practices are influenced by a number of factors, such as history, culture, and individual choices. This article describes business practices and ultimately business ethics from an historical context, the meaning of business culture within the dominant culture, and the debate over business ethics as it relates to choices and challenges for wound care clinicians.

Commerce↗
PubMed1999

Rethinking access in an information age.

Medical information is part of the growing global resource that constitutes the World Wide Web. Researching health information is one of the most common reasons for using the Internet. In 1997, nearly half of U.S. users spent time looking for health information or support on the Internet. More recently, the Internet allows medically naive users to question physicians and other clinicians about health-related topics by e-mail and other digital communication methods. In the face of this growing technology, the term "access" now encompasses the availability of specialized information to the general public. This article reviews the meaning of access in terms of the growing information Movement, looks at opportunities this presents to clinicians, and analyzes barriers to widespread and appropriate information access.

Forecasting↗
PubMed1999

Issues of euthanasia.

The debate surrounding euthanasia may have existed before recorded history, yet it continues today. Advanced technology, with its implication on prolonging life and postponing death in some cases, further complicates the debate. This column includes a historical review of euthanasia, related terminology, and proposed guidelines. The implications of recent legislation on enhancing discussions around terminal care are also reviewed.

Ethics, Medical↗
PubMed1999

Barriers to informed consent in clinical trials.

Clinical trials are a type of scientific study conducted in human beings. They are designed to evaluate the safety and effectiveness of new drugs, procedures, or other means of treating, diagnosing, or preventing diseases. The ethical issues involved in clinical trials are nothing new, but because of the increased access to studies, they are steadily affecting more people. The sheer volume of clinical trials, as well as the number of patients and professionals involved in them, has increased in the past decade. Informed consent is a key element of clinical research. Meaningful informed consent requires that subjects weight the associated risks and benefits of an experimental intervention and then voluntarily give consent. One concern regarding informed consent in research is the confusion between therapeutic intervention and experimental treatment. This confusion could lead to barriers in informed consent. This column addresses this concern and includes a case study to illustrate the misunderstandings that might arise from the patient who is compelled to consent to clinical trials because of his sense of hopelessness from a chronic health condition and the traditional medical intervention he is receiving.

Adult↗
PubMed1999

Competency in informed consent.

Assessing a patient's capacity to make competent decisions concerning her own care is an important clinical skill in healthcare, especially among those who are elderly, chronically ill, and institutionalized. Competency is an important presupposition to autonomous decision making. Assessing competency becomes increasingly critical when the patient's wish is to forego a life-saving procedure. Supporting a patient's choice regardless of the outcome of that decision is an important part of patient advocacy and therefore an important component of patient care. The essence of autonomy is described as it relates to defining meaningful informed consent. This article includes a model for assessing competence.

Humans↗
PubMed1998

Shaping an ethical workplace.

Ethical choices in business are often troublesome because business ethics are not simply an extension of personal ethics. Moral standards learned from private experiences may not translate to the business world. This article analyzes choices in the workplace and offer suggestions to move toward more ethical business practices.

Choice Behavior↗
PubMed1998

The clinician as patient advocate.

This article presents alternative strategies to traditional methods of patient advocacy. These alternative strategies are designed to improve the quality of patient care by appealing to the clinician's sense of ethical reasoning and responsibility rather than being strictly driven by the legal system. The author appeals to the clinician to effect an organization that encourages professional debate, promotes client:clinician communication, and builds an ethical culture within the workplace. By acknowledging patient's rights, clinician's duty, and institutional responsibility, clinician's are better prepared to engage in behaviors that encourage trust and collaboration between one another and their clients.

Communication↗
PubMed1998

Paternalism in healthcare decision making.

Paternalism is described as a dominant attitude of one over another. It was widely practiced years ago because clinicians were usually expected to make the best decision for the patient. Modern healthcare, with its many technically advanced diagnostic and treatment modalities complicates decision making. The trend legally and morally is to include the patient in the decision making process because patients are increasingly informed and able to participate in the decision making process. However, the risks of paternalism continue to be a debatable issue in healthcare. The purpose of this article is to describe types of paternalism, to present justification for paternalism, and to offer a case study to illustrate the struggle that occurs when decisions made by clinicians collide with decisions made by patients.

Amputation, Surgical↗
PubMed1998

Needs of the homebound morbidly obese patient: a descriptive survey of home health nurses.

The purpose of this descriptive survey was to identify challenges encountered by the home care provider when caring for a morbidly obese client in the home care setting and to provide recommendations to those involved in the transition of the patient from the acute care setting to the home. This descriptive study used a convenience sample of 25 RNs employed in one of the many referral home care agencies in the greater Los Angeles, California area. The referral home care agencies were selected randomly. Criterion for inclusion was that the nurse had cared for at least three patients in the past 12 months with a Body Mass Index (BMI) of > or = 40. A semi-structured interview was completed using a ten item survey tool which included open ended questions. One hundred percent of the subjects approached participated (N = 25). The home care setting was their primary place of employment for at least 2 years (mean 5 years), and each RN had cared for an average of 4 patients with a BMI of greater than 40 in the past years. Challenges expressed by the nurses in the home care setting include: equipment (n = 25), reimbursement (n = 25), access to resources (n = 18), client motivation (n = 8), and family/significant other support (n = 10).

Attitude of Health Personnel↗
PubMed1998

Exploring the relationship between ethics committees and the wound care clinician.

Ethics Committees have gained increasing popularity since the mid-1970s. This is likely due to the recognized need to more openly discuss the legal and ethical issues of clinicians and their patients. Wound care clinicians play an important role in the interdisciplinary care of the patient. The typical framework of a hospital-based Ethics Committee is described, Ethics Committees as a resource to the wound care clinician is presented, and the role of the wound care clinician as a consultant to the Ethics Committee, from an interdisciplinary perspective, is illustrated.

Consultants↗