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At least 415 records · Page 23Linked to original sources
PubMed1987

Medicalization and its discontents.

This paper raises the question of the ethically proper balance in health care policy between the medical-clinical-high technology model of health service and the grass-roots, community based or traditional models of care. Paradoxical imbalances between the two approaches are traced to political, economic or prestige factors. Case studies examined include the hospitalization of non-contagious leprosy patients while protecting the anonymity of AIDS-infected prostitutes, medical resistance to the adoption of a clinical role by Community Cancer Centers, and the continued preference in some quarters for elaborate (and often delayed) hospital treatment for such problems as infant diarrhea, despite the availability of much simpler solutions, as in the case of the widely successful oral rehydration therapy. A balanced approach to world health problems, we argue, rests not on inflationary lowering of health care standards to achieve nominal victories, nor on stainless steel high technology panaceas but on mobilizing resources around human needs.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Use of live animals in the curricula of U.S. medical schools in 1994.

In 1994, the AAMC surveyed the 126 U.S. medical schools to obtain data on live-animal use in the undergraduate medical curriculum. The questions focused entirely on the use of live animals in teaching laboratories that are either required or optional parts of the undergraduate medical curriculum. Seventy-seven of the 125 responding schools used live animals in one or more courses; of the required courses, animals were most often used in physiology courses (49 schools), followed by surgical clerkships (21) and pharmacology courses (13). Although these data show that the majority of schools used live animals in their curricula, the data also show that the majority of schools did not use live animals as part of the teaching of any specific course of discipline in 1994. The animals most often used were dogs (54 schools) and pigs (12). Forty-three of the 77 schools that used live animals offered a variety of alternatives to their use. The respondents' data indicate a steady decline in the number of schools using live animals in teaching labs since before 1982. The reasons most often reported for discontinuing live-animal use were expense, changes in curriculum or curriculum focus, and lack of time, faculty, or space. Several other reasons were also listed, but live animals' value in teaching was seldom a factor. Only 15 schools indicated they had experienced harassment, protests, or legal actions arising from their use of live animals in the previous two years.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Experimentation↗
PubMed1983

Organ donation.

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Coercion↗
PubMed1999

Can we learn from eugenics?

Eugenics casts a long shadow over contemporary genetics. Any measure, whether in clinical genetics or biotechnology, which is suspected of eugenic intent is likely to be opposed on that ground. Yet there is little consensus on what this word signifies, and often only a remote connection to the very complex set of social movements which took that name. After a brief historical summary of eugenics, this essay attempts to locate any wrongs inherent in eugenic doctrines. Four candidates are examined and rejected. The moral challenge posed by eugenics for genetics in our own time, I argue, is to achieve social justice.

Cultural Diversity↗
PubMed1985

A proposal for cadaver organ procurement: routine removal with right of informed refusal.

In order to alleviate the shortage of vital organs for transplant, we propose a system of routine removal of cadaver organs with an option of informed refusal by family. Unless an individual registered an objection during his or her lifetime, or unless the family objected to the procedure, clinicians would be permitted routinely to salvage vital organs for transplant. Our proposal charts a middle path between the current ineffective policy based on "encouraged voluntarism" and "presumed consent" policies that promise effectiveness at the cost of violating traditional ethical and legal principles. In this article, we analyze the failure of the current regime, articulate a policy of routine removal subject to the right of informed refusal, and defend this policy against several possible objections.

Cadaver↗
PubMed1991

The HIV-infected health care worker: another AIDS policy conundrum.

To ascertain the degree of patient risk for acquiring HIV from an infected health care worker, several key questions have arisen: Beyond a single dental practice, has there been doctor-to-patient HIV transmission; are some procedures inherently more dangerous to patients than others; can HIV be transmitted despite good technique and universal precautions; is hepatitis B virus (HBV) transmission from physician to patient a relevant model for HIV transmission; is operator skill and technique as much or more of a factor in the risk for transmission than the nature of the procedure itself? The Centers for Disease Control (CDC) released recommendations about HIV-infected health care workers last year....The CDC proposed that sufficient data existed to declare that certain procedures were "exposure-prone," that is, that transmission of HIV to a patient could occur despite good technique and proper precautions.... Because of the major concerns expressed by many medical specialty societies, the CDC has indicated plans to review and revise the recommendations.

AIDS Serodiagnosis↗