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At least 289 records · Page 16Linked to original sources
PubMed2000

[Confidentiality in medical oaths: (When the white crow becomes gray...)].

Confidentiality, together with the ethical principles of beneficence and non-maleficence, is the most important rule in Medical Oaths at the present time. However, the scientific-technical advances in medicine have made this rule one of the most controversial ones because of its exceptions. In consequence, the aim of the present paper is to comparatively analyze the rule of confidentiality in Medical Oaths of different places, times, origins and in different versions of the Hippocratic Oath in order to determine what should be kept a secret and with what degree of commitment (absolute or "prima facie"). Of the thirty six analyzed Oaths, twenty-seven manifest this rule and nine do not. No relation was found between the manifestation of this rule and the place, time, origin and different versions of the Hippocratic Oath. Most pledges suggest not to reveal what has been seen or heard during the medical act, the same as in the Hippocratic Oath. Seven texts point out that confidentiality should be absolute and four give exceptions in connection with beneficence and justice principles and the moral duty of causing no damage to third parties. Two pledges specify protection of privacy. In conclusion, today confidentiality is considered to be a moral duty for the benefit of the patient and out of consideration for his autonomy; however, at the present time in medicine the duty of keeping absolute secrecy is being reconsidered.

Confidentiality↗
PubMed2001

Chronic mountain sickness. A view from the crow's nest.

Chronic mountain sickness (CMS) is a poorly understood syndrome, characterized by hypoxemia and polycythemia and occurring in persons residing at high altitude. To better characterize the disorder, we have reviewed measurements in more than 750 men and 200 women living at altitude as published and as submitted by colleagues. In men, blood hemoglobin concentration (Hb) and arterial oxygen saturation (SaO2) related to altitude (r=0.72). There was greater variability in both SaO2 and hemoglobin above than below 3000 m, largely due to inter-individual variations in effective ventilation. For the entire cohort, a linear relationship (r=0.72) of an index of hematopoietic response (Hb) to an index of stimulus (SaO2) was independent of age, altitude, duration of altitude residence greater than one year, ethnic origin, geographic location, presence or absence of CMS and nearly independent of gender. A potentially important and usually unrecognized variation in the hypoxic stimulus was desaturation during sleep. Contributions to variation in response include ingested toxins, such as cobalt, and nutritional deficiencies, including iron. Pulmonary hypertension was related to chronic hypoxia, with an uncertain contribution from polycythemia. In CMS there were profound hypoxemia at night, decrease in cerebral blood flow, and loss of cerebral blood flow regulation, possibly causing the cerebral symptoms. We speculate that the relationship of Hb to SaO2 is more useful than of hemoglobin to altitude, that hypoventilation awake and asleep are the primary causes accentuating altitude-hypoxia, and that the brain is the primary target organ in the disorder.

Altitude↗
PubMed1953

[Crowe method].

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Ear Diseases↗