Outpatient IV Antibiotic Therapy: Practical and Ethical Considerations

Patients must rely on their caregivers for disinterested advice in making cost-related clinical decisions that are essentially equivalent in efficacy. It is in this context that the pros and cons of home IV regimens are discussed.     

Surrogacy: Ethical and Legal Issues

Surrogacy refers to a contract in which a woman carries a pregnancy “for” another couple. Number of infertile couples from all over the World approach India where commercial surrogacy is legal. Although this arrangement appears to be beneficial for all parties concerned,there are certain delicate issues which need to be addressed through carefully framed laws in order to protect the rights of the surrogate mother and the intended parents.     

Sex Selection: Some Ethical And Policy Considerations

Sex selection, which refers to the attempt to choose or control the sex of a child prior to its birth, has become the subject of increasing ethical scrutiny and many jurisdictions have criminalized it except for serious sex-linked diseases or conditions that cannot easily be ameliorated or remedied. This paper argues that such a blanket prohibition is ethically unwarranted because it is based on a flawed understanding of the difference between sexist values and mere sex-oriented preferences. It distinguishes between ethics and public policy, and suggests a way of allowing preference-based sex selection as a matter of public policy without permitting value-based sex selection. It further argues that medically-based sex selection should be publicly funded but that preference-base sex selection should not be paid for by society, and that the prohibition against value-based sex selection should be enforced through legislation that controls the licensing of health care facilities and through disciplinary procedures against health care professionals.     

Keown,J. (ed.): 1995, Euthanasia Examined; Ethical,Clinical and Legal Perspectives

Medicine, Health Care and Philosophy -     

Wilderness Therapy: Ethical Considerations for Mental Health Professionals

Wilderness therapy is a growing treatment modality for adolescents presenting with a variety of clinical concerns, and wilderness therapy clinicians and referring mental health professionals must carefully consider the ethical issues that are unique to this modality. Following an overview of wilderness therapy as a mental health treatment, relevant ethical issues for mental health professionals are described and discussed, including the distinction between therapy and therapeutic experiences, the use of efficacious treatment, consent and confidentiality, therapeutic boundaries, a continuum of care and family involvement, and aftercare. A thorough reflection of the unique ethical issues faced by wilderness therapists is not only necessary, but will also assist in moving the field of wilderness therapy and outdoor behavioral healthcare forward in its establishment as both a recognizable and ethical treatment option.     

Accessibility of Occupational Therapy Community Services: A Legal,Ethical, and Clinical Analysis

ABSTRACT

Accessibility of health care services is a major concern in many countries. This paper examines the impact of limited access to occupational therapy community services on the right to services, distributive justice (resource distribution based on social solidarity), and service quality. Legal documents and relevant scientific papers were analyzed from three standpoints: legal, ethical, and clinical. Random use of criteria to prioritize requests, partial response to complex needs, task delegation, and long waiting times, all affect distributive justice and compromise the right to and quality of services. Various alternatives are suggested to ensure a balance between the distribution and quality of occupational therapy services.     

Ethical and Professional Liability Considerations for the Administrator

This paper follows the format suggested for the entire issue in each incident used. The content will focus on selected areas of the administrative functions of occupational therapy at any level, functions in which there are particular professional ethical and liability constraints. Principles and guidelines will be provided which should enable the therapist to avoid the problems raised by these and similar incidents. Aspects of supervision and consultation will be explored as will be dealing with standard care given by others and the safeguarding of the reputation of others. The incidents included under each major topic will be construed as having taken place in the same setting so that the reader may become better aquainted with the personnel in the program.     

Emotions and Ethical Considerations of Women Undergoing IVF-Treatments

Women who suffer from fertility issues often use in vitro fertilization (IVF) to realize their wish to have children. However, IVF has its own set of strict administration rules that leave the women physically and emotionally exhausted. Feeling alienated and frustrated, many IVF users turn to internet IVF-centered forums to share their stories and to find information and support. Based on the observation of Dutch and Greek IVF forums and a selection of 109 questionnaires from Dutch and Greek IVF forum users, we investigate the reasons why users of IVF participate in online communities centered on IVF, their need for emotional expression and support, and how they experience and use the information and support they receive through their participation in the online community. We argue that the emotional concerns expressed in such forums should be taken into account by health care ethics committees for IVF-related matters in order to promote more patient-oriented care and support for women going through IVF.     

Some Practical Considerations of Hyperactivity and Drugs

The use of psychoactive medication to control the activity levels of children has reached a heightened level in recent years. Parents, teachers and other professionals are involved in treatment programs often in spite of limited knowledge of the mechanisms through which drugs operate, the types of drugs being used, and the anticipated and unanticipated effects of those drugs. Information regarding the critical factors in drug treatment programming is presented in this paper; it is hoped that this information will enable individuals to better function as drug monitors.     

Micronutrient Supplementation in Adult Nutrition Therapy: Practical Considerations

Preexisting micronutrient (vitamins and trace elements) deficiencies are often present in hospitalized patients. Deficiencies occur due to inadequate or inappropriate administration, increased or altered requirements, and increased losses, affecting various biochemical processes and resulting in organ dysfunction, poor wound healing, and altered immune status with deleterious sequelae. Guidelines for the 13 essential vitamins and 10 essential trace elements have been established. These recommendations, however, are applicable to healthy adults and not to critically ill patients, in whom decreased serum levels may indicate actual deficiencies or a deficiency due to redistribution. Benefits of supplementation over and above the daily requirements, which may not result in increased serum levels, are also unclear and may, in fact, be detrimental. Vitamin requirements are increased in disease states, but a similar recommendation for trace elements has not been initiated except for selenium (Se) and zinc (Zn). In practice, a multivitamin preparation and a multiple trace element admixture (containing Zn, Se, copper, chromium, and manganese) are added to parenteral nutrition formulations. Most enteral nutrition preparations also contain adequate amounts of vitamins and trace elements, although bioavailability may be an issue. Detailed information about individual micronutrient use specifically in hospitalized adult patients receiving nutrition therapy will be discussed, emphasizing the practical and clinical aspects. Clinicians are encouraged to think of micronutrients not as nutritional supplements alone but also as therapeutic agents and nutraceuticals.