Managing pain in chronic pancreatitis:therapeutic value of opioid treatment

The value of opioid pharmacotherapy in the management of chronic pancreatitis pain is described. The role of kappa receptor opioid agonists and specifically oxycodone as compared to other opioid agonists is discussed. Limitations in the published studies on this topic are delineated as are difficulties in extrapolating form animal studies to clinical care.     

Neglected conflicts in the discipline of nursing: perceptions of the importance and value of practical skill

The patient's body has moved out of focus in nursing This has led to the diminishing importance of practical skill in the discipline of nursing Patients, however, consider these skills to be a vital part of good nursing care How can nursing as a practical discipline live with the long-standing conflicts that these disparate views create^? It is time that theoretical discourse within the discipline paid attention to the patient's perception of good nursing care, and that efforts are made to investigate how nurses in the clinical setting develop and consolidate the practical skills needed for the patients hygiene, comfort and medical treatment In this paper the conflicts are delineated and conditions relevant to their development are discussed     

Special report: resolving conflicts. Resolve conflicts between ED and other departments

Physicians and nurses have a tendency to avoid conflict, but ED staff must learn strategies to manage common conflicts that arise with other departments. There are often conflicts over whether patients should be admitted or which service admitted patients should be sent to. On-call physicians often focus on peripheral issues in patient care, which can seem patronizing to ED staff. If ED nursing leadership reports to the same director as critical care nurses, both departments will have shared goals with less chance of conflict. Educate staff in other departments that 30% to 40% of hospital admissions come through the ED.     

Ethical conflicts in placebo treatment

In this paper the pros and cons of using placebo are discussed from the point of view of ethical theories and principles. The effects of placebo are exemplified by findings from previous studies, and an authentic case serves to illustrate ethical dilemmas arising both for the caregiver and the patient in conjunction with the use of placebo. Placebo treatment is discussed from deontological and utilitarianist points of view, and violation of the ethical principles, beneficence, non-maleficence, justice, autonomy and truth-telling, are considered.     

Managed care and ethical conflicts

Managed care systems achieve efficiencies by rationing the resources used to deliver care. This rationing has led to widespread perceptions of patient abuse and neglect in the form of restricted access to care, denial of choice, and overall reduction in the quality of care delivered. Conflicts of interest and fundamental ethical principles are perceived as often compromised in the managed care environment. We argue that ethical issues are inherent in managed care and cannot be avoided. Recently, federal and state governments have passed legislation and regulations to deal with the issue.     

Interprofessional conflicts. A risk

Interprofessional conflicts are a persistent phenomenon among nursing professionals. In this article, the author hopes to provide insight from a nursing perspective based on experience, observation and reflection which allows one to understand the mechanics of these conflicts and a manner to prevent them.     

Overregulation of conflicts hinders medical progress

The revolution in medicine and technology over the past few decades is largely the result of partnerships--or a "harmony of interests"--between private companies and entrepreneurial scientists and clinicians. Regulations to prevent conflicts of interest by restricting medical education, medical research, expert advisory functions, or researcher ownership of inventions may have the unintended consequence of slowing medical progress.     

Ethical conflicts in prehospital emergency care

This article analyses and presents a survey of ethical conflicts in prehospital emergency care. The results are based on six focus group interviews with 29 registered nurses and paramedics working in prehospital emergency care at three different locations: a small town, a part of a major city and a sparsely populated area. Ethical conflict was found to arise in 10 different nodes of conflict: the patient/carer relationship, the patient's self-determination, the patient's best interest, the carer's professional ideals, the carer's professional role and self-identity, significant others and bystanders, other care professionals, organizational structure and resource management, societal ideals, and other professionals. It is often argued that prehospital care is unique in comparison with other forms of care. However, in this article we do not find support for the idea that ethical conflicts occurring in prehospital care are unique, even if some may be more common in this context.