Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Legal Approach”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed1995

The limits of empirical studies on research ethics.

The results of empirical research in psychology and psychiatry are increasingly being used to formulate as well as understand problems at the interface of law and psychiatry. There has been a proliferation of studies, such as the determinants of individual competence or threat to self or others, the results of which are influencing policy and legislative decisions as well as buttressing holdings in court cases. In this article, I explore the issues of interpretation of epidemiological studies, particularly the role of ideological positions on the design and results of empirical findings, the importance of the way data are interpreted, and the role of ideologies in the way research findings are presented to provide support for policy positions. Two levels of analysis are involved in determining the validity of a study. The first addresses the questions of whether the study meets the statistical and epidemiological requirements for reliable results. These include considerations such as the appropriateness of the study design and methods for gathering and interpreting data. The second focuses on the underlying framework of the study. This involves factors such as the perspectives and values of those conducting the study, the explicit and implicit dominating ideologies where they operate, and the extent to which the study is constructed to reaffirm specific ideologies. This level of analysis is essential for disclosing the influences of ideologies on the results of studies and the way in which data are interpreted. In this article, I try to demonstrate through critiques of selected studies that the first stage of analysis is insufficient without an examination of underlying preconceived values to establish the meaningfulness of results.

Aged↗
PubMed1999

Public information and private search: evaluating the Patient Self-Determination Act.

Despite substantial regulatory efforts to improve consumer information regarding health and health care, little is known about the impact of such efforts on consumer behavior. This article examines the effect of federal legislation to enhance consumer information regarding the use of life-sustaining technology in end-of-life medical treatment decision making. Using a unique set of data abstracted from the medical records of six hundred elderly patients in nursing homes, the study finds a substantial impact of the law in promoting improved documentation of patient wishes for end-of-life medical care. Further, the data reveal that the effect of the law varies among identifiable subgroups. Consistent with the theory of search, the article demonstrates that the effects of regulatory efforts that promote the public provision of consumer information are greatest among individuals for whom information is most beneficial but for whom private search is costly. Implications for health policy are discussed.

Advance Directives↗
PubMed2002

Risk, response, and mental health policy: learning from the experience of the United Kingdom.

Policy makers in the United States and the United Kingdom recognize that mentally disordered offenders present special challenges to law enforcement, mental health, and social service systems, as well as the community. Although various policy initiatives have advanced over the past twenty years to improve the management of mentally disordered offenders, mental health policy has chronically failed in both countries. Because safety concerns have emerged as the mental health system has been "deinstitutionalized," debate is growing about whether the community-care approach works-for the community. This study argues that mental health policy fails because policy makers focus on the wrong risks and design policies that manage these risks in ways that increase the possibility of adverse clinical and economic outcomes. The argument made here uses the case of persons with severe mental illness in the United Kingdom as an example of the complex relationship between risk and policy making in democratic governance. Emphasis is on the nature of risk in mental health policy and how government responds to policy and political risks. Mental health policy in Britain is then analyzed in terms of its response to and management of risks. Mental health policy has historically mismanaged the risk issue in the United Kingdom and as such has set in motion the growing community-care backlash. The path to a better outcome lies in the responsible management of the right risks. Lessons from the United Kingdom experience can be usefully applied to mental health issues in many industrial democracies.

Attitude to Health↗
PubMed2003

Attitudes of people with disabilities toward physician-assisted suicide legislation: broadening the dialogue.

This article presents the methods, findings, and implications of a participatory action research project that attempted to shed additional light on the debate over death with dignity (DWD) or physician-assisted suicide (PAS) legislation. In-depth, qualitative interviews with forty-five physically disabled residents of the San Francisco Bay Area, conducted by others with disabilities, revealed a wide breadth of opinions about and attitudes toward such legislation. For close to half of the participants, the desire for autonomy in making end-of-life decisions was a primary concern, yet fear that PAS legislation could violate this autonomy in various ways was a deep concern as well. Also reported were widespread accounts of disability-based discrimination and frequent expressions of fear about openly discussing positions that diverge from the official, publicly held opinions of disability leaders who oppose such legislation. The findings support those of a recent Harris poll demonstrating considerable diversity of opinion about PAS legislation among people with disabilities. The findings further suggest the need for additional research on the apparent disjunction between the diversity of attitudes held by those interviewed and the more unified position taken by many disability activists. Use of the study findings to promote greater dialogue within the community and to better position people with disabilities to take their place at the policy table also is discussed. In addition, the findings are seen as reinforcing the need for the public health community to become more engaged in this central ethical debate.

Attitude to Health↗
PubMed2002

How much do doctors know about consent and capacity?

To assess knowledge of capacity issues across different medical specialties we conducted a cross-sectional survey with a structured questionnaire at academic meetings, lectures and conferences. Of 190 individuals who received the questionnaire 129 (68%) responded-35 general practitioners, 31 psychiatrists, 29 old-age physicians [corrected] and 34 final year medical students. Correct answers on capacity to consent to or refuse medical treatment were given by 58% of the psychiatrists, 34% of the geriatricians, 20% of the general practitioners and 15% of the students. 15% of all respondents wrongly believed that a competent adult could lawfully be treated against his or her will, with no obvious differences by specialty. As judged by this survey, issues of capacity and consent deserve more attention in both undergraduate and postgraduate medical education.

Adult↗
PubMed2004

Euthanasia and physician-assisted suicide policy in The Netherlands and Oregon: a comparative analysis.

This article presents a comparative analysis of euthanasia and physician-assisted suicide policy in The Netherlands and the state of Oregon in the United States. The topics of euthanasia and physician-assisted suicide are discussed in the context of the historical setting of The Netherlands and the United States with special emphasis placed on public opinion, role of the courts and the legislative bodies, and opinions of physicians. Major similarities and differences in the laws of The Netherlands and Oregon are discussed. The article examines whether the passage of the law has led to a slide down the slippery slope in The Netherlands and Oregon as had been suggested by the opponents of the law. The article concludes that the empirical evidence does not support the contention of the opponents. However, the author argues that the potential for this happening is much greater in The Netherlands than in Oregon.

Empirical Research↗
PubMed2001

Medical malpractice, mistake prevention, and compensation.

Clinicians' fear of malpractice litigation is the most significant obstacle to the open reporting of medical mistakes. Without open reporting of medical mistakes, however, root cause analysis of mistakes cannot be done, thus undermining efforts to implement safeguards to minimize the occurrence of future mistakes. Efforts to prevent medical mistakes, therefore, must first directly address clinicians' fear of malpractice litigation. In this paper, we explore the relationship between the current malpractice system and clinicians' fear of litigation. Ultimately, we argue that both the prevention of medical mistakes and the goals of malpractice litigation itself will be better served if substantial malpractice reform is undertaken.

Attitude of Health Personnel↗
PubMedDate not supplied

Health information, the HIPAA privacy rule, and health care: what do physicians think?

This study examines physicians' attitudes toward key Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule requirements and assesses the effects of their implementation. We found that despite physicians' generally negative views toward the Privacy Rule, they rated organizations implementing more rule requirements better at protecting the privacy of patient records than organizations that have not implemented the requirements. The policy implications of the findings are discussed.

Adult↗
PubMed1998

Immigration reporting laws: ethical dilemmas in pediatric practice.

Objectives. This study assessed the potential impact of immigration reporting requirements on pediatricians' referrals to child protective services.Methods.A random sample of 200 Massachusetts pediatricians were surveyed. Chi-square and logistic regression analyses were performed.Results.Asked whether potential deportation of the family would cause them to question or alter a decision to refer, 50% of the respondents said yes.Conclusions.Pediatricians, as mandated reporters of child abuse, will face ethical dilemmas if laws requiring reporting of immigration status are enacted. (Am J Public Health. 1998;88:967-968)

Attitude of Health Personnel↗
PubMed1998

The community treatment order: clinical and ethical issues.

OBJECTIVE: In the light of recent legislation, this paper reviews the implementation of the Community Treatment Order (CTO) in terms of clinical efficacy and ethical issues involved in its use. The debate surrounding the introduction of CTOs in other countries is explored. METHOD: A Medline search was conducted and references of recent articles followed up, with attention to Australian, New Zealand and international trends. A review of relevant legislation and government reports was conducted. RESULTS: There has been limited debate in the Australian and New Zealand literature concerning the operation of CTOs. Despite their increasing and widespread use, there is a paucity of research on the efficacy of CTOs. Concerns about their negative effects on civil liberties have been stressed in the United Kingdom and American literature. CONCLUSIONS: If the continued use of CTO is to be justified, both clinically and from the civil liberties perspective, controlled research needs to be carried out to identify whether CTOs are more effective than comprehensive assertive community outreach programs in reducing relapse rates and hospitalisation, and increasing compliance. Clinical guidelines concerning who is most likely to respond to such orders need to be developed. Alternatives to the CTO are explored, and future directions in research are outlined.

Australia↗
PubMed2003

Emerging trends in international law concerning global infectious disease control.

International cooperation has become critical in controlling infectious diseases. In this article, I examine emerging trends in international law concerning global infectious disease control. The role of international law in horizontal and vertical governance responses to infectious disease control is conceptualized; the historical development of international law regarding infectious diseases is described; and important shifts in how states, international institutions, and nonstate organizations use international law in the context of infectious disease control today are analyzed. The growing importance of international trade law and the development of global governance mechanisms, most prominently in connection with increasing access to drugs and other medicines in unindustrialized countries, are emphasized. Traditional international legal approaches to infectious disease control--embodied in the International Health Regulations--may be moribund.

Communicable Disease Control↗