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Biomedical subjects

W A Nelson

Publications and source records attributed to W A Nelson.

At least 37 records · Page 2Linked to original sources
PubMed1989

Moral theory and neurology.

This article presents an outline of a general moral theory and shows its relationship to the concepts of paternalism and that of valid consent and refusal. The authors then show how this theory and these concepts can be usefully applied to the moral problems that neurologists often face in determining how to act when they have distressing information for their patients. Finally, a procedure is provided for determining when it is morally justified to deceive patients by withholding information about their diagnoses, prognoses, or about their prospective treatments.

Comprehension↗
PubMed1989

Decisions to withhold or terminate treatment.

Decisions to withhold or terminate treatment are common clinical dilemmas in patients dying from diseases of the nervous system. Decision making for such patients must be based upon ethical principles. Under the doctrine of valid consent and refusal, competent patients have the right to refuse life-sustaining therapies. For incompetent patients, this right may be exercised through their previously executed advanced directives or through appointed proxy decision makers. Physicians have the duty to assess the potential benefits and harms of various treatment options and to clearly communicate this information to patients and their proxies in a supportive manner. The authors illustrate the application of ethical principles in neurologists' management of patients in persistent vegetative states, dementia, and end-stage neuromuscular disease.

Beneficence↗
PubMed1988

Fine-needle aspiration of metastatic atrial myxoma.

Atrial myxoma is the most common primary neoplasm of the heart, but "metastatic" or embolic phenomena are rare. The first reported case of "metastatic" atrial myxoma diagnosed by fine-needle aspiration biopsy is presented. It occurred in a 54-yr-old woman with multiple metastatic lesions. The cytologic and histologic findings of the fine-needle aspiration biopsy and subsequent surgical excision are presented as is a discussion of the incidence, origin, and clinical findings of atrial myxoma and the characteristics of its emboli.

Biopsy, Needle↗
PubMed1987

The DRG era: a major opportunity for increased pastoral care impact or a crisis for survival?

Notes how the Diagnostic Related Group (DRG) system, now being utilized by a growing number of hospitals, may provide chaplains with ways of demonstrating their worth as team members in total health care. Claims that pastoral care ought to be a major clinical service in a hospital and that chaplains therefore need to provide objective evidence of their contribution to the well-being of patients, as do other major clinical areas. Suggests specific ways for chaplains to establish such data, including the use of objective measures of the spiritual conditions of patients. Offers examples of accountability procedures and notes that such meticulous chaplain accountability along with follow-up work with patients could lead to expansions of services and new roles in the chaplaincy fields.

Chaplaincy Service, Hospital↗
PubMed1980

Clinical teaching of care for terminally ill in a psychiatry clerkship.

Courses in dying and death and other human values issues have become an integral part of the curricula of many medical schools, but formal teaching of the phenomenon of dying is found less frequently in a clinical setting, especially as a portion of a required medical student rotation. In this paper the author describes the dying and death component of the required psychiatry clerkship at Dartmouth Medical School. The educational objectives and instructional methods were developed to enhance the student doctor's understanding of what terminal patients experience in psychosocial needs and to explore his role and skill in caring for patients in terminal situations.

Aged↗