1
40
10
-
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April 2019 List
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April 2019 List
URL Address
<a href="http://doi.org/10.1007/s11673-018-9847-8" target="_blank" rel="noreferrer noopener">http://doi.o rg/10.1007/s11673-018-9847-8</a>
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Title
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Can the Ethical Best Practice of Shared Decision-Making lead to Moral Distress?
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Journal of bioethical inquiry
Date
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2018
Subject
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Neonatology; Humans; Burnout Professional; Attitude of Health Personnel; Patient Participation; Morals; Stress Psychological; Decision-making; Decision Making/ethics; Clinical ethics; End-of-life issues; Patient Care/ethics; Physicians/ethics/psychology; Professional-professional relationship
Creator
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Prentice TM; Gillam L
Description
An account of the resource
When healthcare professionals feel constrained from acting in a patient's best interests, moral distress ensues. The resulting negative sequelae of burnout, poor retention rates, and ultimately poor patient care are well recognized across healthcare providers. Yet an appreciation of how particular disciplines, including physicians, come to be "constrained" in their actions is still lacking. This paper will examine how the application of shared decision-making may contribute to the experience of moral distress for physicians and why such distress may go under-recognized. Appreciation of these dynamics may assist in cross-discipline sensitivity, enabling more constructive dialogue and collaboration.
Identifier
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<a href="http://doi.org/10.1007/s11673-018-9847-8" target="_blank" rel="noreferrer noopener">10.1007/s11673-018-9847-8</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2018
April 2017 List
Attitude Of Health Personnel
Burnout Professional
Clinical Ethics
Decision Making/ethics
Decision-making
End-Of-Life Issues
Gillam L
Humans
Journal of bioethical inquiry
Morals
Neonatology
Patient Care/ethics
Patient Participation
Physicians/ethics/psychology
Prentice TM
Professional-professional relationship
Stress Psychological
-
Text
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Citation List Month
June 2017 List
URL Address
http://www.ncbi.nlm.nih.gov/pubmed/28390923
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Title
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Ethical Considerations In Perinatal Palliative Care
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Journal Of Obstetric, Gynecologic, And Neonatal Nursing: Jognn
Date
A point or period of time associated with an event in the lifecycle of the resource
2017
Subject
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Clinical Ethics; Organ Donation; Perinatal Bereavement; Perinatal Palliative Care; Shared Decision Making
Creator
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Mendes Joana; Wool Jesse; Wool Charlotte
Description
An account of the resource
Clinicians may face new ethical considerations when parents continue pregnancies after receiving life-limiting fetal diagnoses and desire palliative care. In this article we present four ethical considerations in perinatal palliative care: ambiguous terminology in relation to diagnosis or prognosis, differences between bereavement support and palliative care, neonatal organ donation, and postdeath cooling. In this article, we enable readers to consider current topics from different perspectives and reflect on care when confronted with sensitive clinical scenarios.
Identifier
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10.1016/j.jogn.2017.01.011
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Clinical Ethics
Journal of obstetric, gynecologic, and neonatal nursing: JOGNN
June 2017 List
Mendes Joana
Organ Donation
perinatal bereavement
Perinatal Palliative Care
shared decision making
Wool Charlotte
Wool Jesse
-
Text
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Citation List Month
July 2016 List
Dublin Core
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Title
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Opinions Of Paediatricians Who Teach Neonatal Resuscitation About Resuscitation Practices On Extremely Preterm Infants In The Delivery Room.
Publisher
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Journal Of Medical Ethics
Date
A point or period of time associated with an event in the lifecycle of the resource
2016
Subject
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Management; Viability; Decision Making; Attitudes; Born; Ethics; Social Issues; Health; Social Sciences; Biomedical; Obstetricians; Ethics Medical; Care And Treatment; Ethical Aspects; Practice Guidelines (medicine); Cpr (first Aid); Methods; Infant
Clinical Ethics; Decision-making; End Of Life; Neonatology; Perinatal Mortality
Creator
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Ruth Guinsburg
Description
An account of the resource
Abstract
Objective To describe the opinions of paediatricians who teach resuscitation in Brazil regarding resuscitation practices in the delivery room (DR) of preterm infants with gestational ages of 23–26 weeks.
Methods Cross-sectional study with an internationally validated electronic questionnaire (December 2011–September 2013) sent to the instructors of the Neonatal Resuscitation Program of the Brazilian Society of Paediatrics on parental counselling practices, medical limits for resuscitation of extremely preterm infants and medical considerations for decision-making in this group of infants. The analysis was descriptive.
Results Among 685 instructors, 560 (82%) agreed to participate. Only 5%–13% reported having opportunity for antenatal counselling parents: if called, 22% reported discussing with the family about the possibility not to resuscitate in the DR; 63% about the possibility of death in the DR and 89% about the possibility of death in the neonatal unit. If the parents did not agree with the advice of the paediatrician, 30%–50% of the respondents would follow the procedures they advised regardless of the opinion of the parents. The higher the gestational age, the lower is the percentage of paediatricians who believed that parents should participate in decision-making. Only 9% participants reported the existence of written guidelines at their hospital on initiation of resuscitation in the DR at limits of viability, but 80% paediatricians reported using some criteria for limiting resuscitation in the DR.
Conclusion The picture obtained in this study of Brazilian paediatricians indicates that resuscitation of extremely preterm infants is permeated by ambivalence and contradictions.
Identifier
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doi:10.1136/medethics-2015-103173
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2016
Attitudes
Biomedical
Born
Care And Treatment
Clinical Ethics
Cpr (first Aid)
Decision Making
Decision-making
End Of Life
Ethical Aspects
Ethics
Ethics Medical
Health
Infant
Journal of Medical Ethics
July 2016 List
Management
Methods
Neonatology
Obstetricians
Perinatal Mortality
Practice Guidelines (medicine)
Ruth Guinsburg
Social Issues
Social Sciences
Viability
-
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Title
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May 2020 List
Text
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Citation List Month
May 2020 List
URL Address
<a href="http://doi.org/10.1111/apa.14969" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/apa.14969</a>
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Paediatric palliative care in practice: Perspectives between acute and long-term healthcare teams
Publisher
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Acta Paediatrica
Date
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2020
Subject
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clinical ethics; continuity of care; paediatric palliative care; quality of care
Creator
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Côté A; Payot A; Gaucher N
Description
An account of the resource
AIM: To explore and compare acute and long-term care professionals' perspectives about paediatric palliative care. METHODS: Focus group interviews were conducted in 2016-2017 with professionals from acute (Emergency Department, Intensive Care Unit) and long-term care (Complex Care Service, Palliative Care) teams. RESULTS: Fifty-eight participants were enrolled. Palliative care definitions were similar throughout groups: to provide active care early in the illness, focusing on the child as a whole and supporting families. Each group perceived a different role in the patient's illness trajectory, reflecting their own culture of care. They demonstrated important differences in their approach to palliative care. Disagreements regarding when or how to discuss goals of care were expressed. Acute care professionals reported discomfort when having to introduce these discussions for the first time, while long-term care professionals perceived negative judgements about their patients' quality of life by acute care teams during health events. Personalised care, communication with families and continuity of care were thought to be key elements to improve care. CONCLUSION: Paediatric palliative care is well recognised throughout specialties, yet continuity of care is challenged by groups' roles and interventions in a patient's illness. A reflective and mutual clinical approach is needed to improve quality of care and professionals' satisfaction.
Identifier
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<a href="http://doi.org/10.1111/apa.14969" target="_blank" rel="noreferrer noopener">10.1111/apa.14969</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Acta Paediatrica
Clinical Ethics
Continuity of care
Côté A
Gaucher N
May 2020 List
paediatric palliative care
Payot A
Quality Of Care
-
Text
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Citation List Month
November 2016 List
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Title
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Pediatric Ethics And Communication Excellence (peace) Rounds: Decreasing Moral Distress And Patient Length Of Stay In The Picu
Publisher
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Hec Forum
Date
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2016
Subject
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Health Care Delivery; Morality; Pediatrics; Intensive Care; Communication; Ethics Medical; Health Care Industry; Studies; Patient
Moral Distress; Ethics Intervention; Icu Length Of Stay; Clinical Ethics; Pediatrics
Creator
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Lucia Wocial; Veda Ackerman; Brian Leland; Brian Benneyworth; Vinit Patel; Yan Tong; Mara Nitu
Description
An account of the resource
This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers’ moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation. There were 60 patients in the interventional group and 66 patients in the historical control group. We evaluated the impact of weekly meetings (PEACE rounds) to establish goals of care for patients with longer than 10 days length of stay in the ICU for a year. Moral distress was measured intermittently and reported moral distress thermometer (MDT) scores fluctuated. "Clinical situations" represented the most frequent contributing factor to moral distress. Post intervention, overall moral distress scores, measured on the moral distress scale revised (MDS-R), were lower for respondents in all categories (non-significant), and on three specific items (significant). Patient outcomes before and after PEACE intervention showed a statistically significant decrease in PRISM indexed LOS (4.94 control vs 3.37 PEACE, p = 0.015), a statistically significant increase in both code status changes DNR (11 % control, 28 % PEACE, p = 0.013), and in-hospital death (9 % control, 25 % PEACE, p = 0.015), with no change in patient 30 or 365 day mortality. The addition of a clinical ethicist and senior intensivist to weekly inter-professional team meetings facilitated difficult conversations regarding realistic goals of care. The study demonstrated that the PEACE intervention had a positive impact on some factors that contribute to moral distress and can shorten PICU length of stay for some patients.
Identifier
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doi:10.1007/s10730-016-9313-0
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2016
Brian Benneyworth
Brian Leland
Clinical Ethics
Communication
Ethics Intervention
Ethics Medical
Health Care Delivery
Health Care Industry
HEC Forum
Icu Length Of Stay
Intensive Care
Lucia Wocial
Mara Nitu
Moral Distress
Morality
November 2016 List
Patient
Pediatrics
Studies
Veda Ackerman
Vinit Patel
Yan Tong
-
Text
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Citation List Month
November 2017 List
Notes
<p>1572-8498<br />Wocial, Lucia<br />Ackerman, Veda<br />Leland, Brian<br />Benneyworth, Brian<br />Patel, Vinit<br />Tong, Yan<br />Nitu, Mara<br />Journal Article<br />Netherlands<br />HEC Forum. 2017 Mar;29(1):75-91. doi: 10.1007/s10730-016-9313-0.</p>
URL Address
<a href="https://link.springer.com/article/10.1007/s10730-016-9313-0" target="_blank" rel="noreferrer">https://link.springer.com/article/10.1007/s10730-016-9313-0</a>
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Title
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Pediatric Ethics and Communication Excellence (PEACE) Rounds: Decreasing Moral Distress and Patient Length of Stay in the PICU
Publisher
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HEC Forum
Date
A point or period of time associated with an event in the lifecycle of the resource
2017
Subject
The topic of the resource
Communication; Length Of Stay; Adult; Clinical Ethics; Ethics Intervention; Female; Humans; Icu Length Of Stay; Intensive Care Units Pediatric/ Ethics; Interprofessional Relations; Life Support Care/ethics; Male; Middle Aged; Moral Distress; Pediatrics; Psychometrics/instrumentation/methods; Severity Of Illness Index; Stress Psychological/ Psychology; Teaching Rounds/manpower/methods; Unnecessary Procedures/ Ethics
Creator
An entity primarily responsible for making the resource
Wocial L; Ackerman V; Leland B; Benneyworth B; Patel V; Tong Y; Nitu M
Description
An account of the resource
This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers' moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation. There were 60 patients in the interventional group and 66 patients in the historical control group. We evaluated the impact of weekly meetings (PEACE rounds) to establish goals of care for patients with longer than 10 days length of stay in the ICU for a year. Moral distress was measured intermittently and reported moral distress thermometer (MDT) scores fluctuated. "Clinical situations" represented the most frequent contributing factor to moral distress. Post intervention, overall moral distress scores, measured on the moral distress scale revised (MDS-R), were lower for respondents in all categories (non-significant), and on three specific items (significant). Patient outcomes before and after PEACE intervention showed a statistically significant decrease in PRISM indexed LOS (4.94 control vs 3.37 PEACE, p = 0.015), a statistically significant increase in both code status changes DNR (11 % control, 28 % PEACE, p = 0.013), and in-hospital death (9 % control, 25 % PEACE, p = 0.015), with no change in patient 30 or 365 day mortality. The addition of a clinical ethicist and senior intensivist to weekly inter-professional team meetings facilitated difficult conversations regarding realistic goals of care. The study demonstrated that the PEACE intervention had a positive impact on some factors that contribute to moral distress and can shorten PICU length of stay for some patients.
Identifier
An unambiguous reference to the resource within a given context
<a href="https://doi.org/10.1007/s10730-016-9313-0" target="_blank" rel="noreferrer">10.1007/s10730-016-9313-0</a>
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Ackerman V
Adult
Benneyworth B
Clinical Ethics
Communication
Ethics Intervention
Female
HEC Forum
Humans
Icu Length Of Stay
Intensive Care Units Pediatric/ Ethics
Interprofessional Relations
Leland B
Length Of Stay
Life Support Care/ethics
Male
Middle Aged
Moral Distress
Nitu M
November 2017 List
Patel V
Pediatrics
Psychometrics/instrumentation/methods
Severity Of Illness Index
Stress Psychological/ Psychology
Teaching Rounds/manpower/methods
Tong Y
Unnecessary Procedures/ Ethics
Wocial L
-
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Title
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October 2019 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
October 2019 List
URL Address
<a href="http://doi.org/10.1111/apa.14969" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/apa.14969</a>
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Title
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Pediatric Palliative Care in Practice: Perspectives between Acute and Long-term Healthcare Teams
Publisher
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Acta Paediatrica
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
The topic of the resource
Pediatric palliative care; clinical ethics; continuity of care; quality of care
Creator
An entity primarily responsible for making the resource
Cote A J; Payot A; Gaucher N
Description
An account of the resource
AIM: To explore and compare acute and long-term care professionals' perspectives about pediatric palliative care. METHODS: Focus group interviews were conducted in 2016-2017 with professionals from acute (Emergency Department, Intensive Care Unit) and long-term care (Complex Care Service, Palliative Care) teams. RESULTS: Fifty-eight participants were enrolled. Palliative care definitions were similar throughout groups: to provide active care early in the illness, focusing on the child as a whole and supporting families. Each group perceived a different role in the patient's illness trajectory, reflecting their own culture of care. They demonstrated important differences in their approach to palliative care. Disagreements regarding when or how to discuss goals of care were expressed. Acute care professionals reported discomfort when having to introduce these discussions for the first time, while long-term care professionals perceived negative judgments about their patients' quality of life by acute care teams during health events. Personalized care, communication with families and continuity of care were thought to be key elements to improve care. CONCLUSION: Pediatric palliative care is well recognized throughout specialties, yet continuity of care is challenged by groups' roles and interventions in a patient's illness. A reflective and mutual clinical approach is needed to improve quality of care and professionals' satisfaction. This article is protected by copyright. All rights reserved.
Identifier
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<a href="http://doi.org/10.1111/apa.14969" target="_blank" rel="noreferrer noopener">10.1111/apa.14969</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2019
Acta Paediatrica
Clinical Ethics
Continuity of care
Cote A J
Gaucher N
October 2019 List
Payot A
Pediatric Palliative Care
Quality Of Care
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/j.jpainsymman.2010.12.002" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpainsymman.2010.12.002</a>
<a href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2011-03653-020&site=ehost-live" target="_blank" rel="noreferrer">http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2011-03653-020&site=ehost-live</a>
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Title
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Shades of truth: Cultural and psychological factors affecting communication in pediatric palliative care
Publisher
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Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2011
Subject
The topic of the resource
Palliative Care; Pediatrics; Communication; Charting the Territory; Neoplasms; Best Practices (Davies); truth telling; clinical ethics; cultural factors; hepatoblastoma; Professional Ethics; Sociocultural Factors; Truth
Creator
An entity primarily responsible for making the resource
Hatano Y; Yamada M; Fukui K
Description
An account of the resource
Communication with children who have life-threatening illnesses is a major challenge. Communication practices are greatly influenced by factors such as the child’s age, the parents’ wishes, and the cultural norms. This article presents the case of a 12-year-old Japanese boy with advanced hepatoblastoma. The patient also was diagnosed with Asperger’s syndrome, which impairs interpersonal communication. The case is discussed from the perspective of clinical ethics, especially with regard to truth telling. The health care team faced an ethical dilemma because of the complications involved. Physicians treating children with cancer should be aware of these issues to be able to effectively communicate with their patients. (PsycINFO Database Record (c) 2011 APA, all rights reserved) (journal abstract)
Identifier
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<a href="http://doi.org/10.1016/j.jpainsymman.2010.12.002" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2010.12.002</a>
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Type
The nature or genre of the resource
Journal Article
2011
Backlog
Best Practices (Davies)
Clinical Ethics
Communication
cultural factors
Fukui K
Hatano Y
hepatoblastoma
Journal Article
Journal of Pain and Symptom Management
Neoplasms
Palliative Care
Pediatrics
Professional Ethics
Sociocultural Factors
Truth
truth telling
Yamada M
-
Dublin Core
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Title
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January 2022 List
Text
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Citation List Month
January 2022 List
URL Address
<a href="http://doi.org/10.1089/jpm.2021.0521" target="_blank" rel="noreferrer noopener">http://doi.org/10.1089/jpm.2021.0521</a>
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Title
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Top Ten Tips Palliative Care Clinicians Should Know About Their Work's Intersection with Clinical Ethics
Publisher
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Journal of Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Subject
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palliative care; ethics; clinical ethics; teamwork; health care ethics
Creator
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Weaver MS; Boss RD; Christopher MJ; Gray TF; Harman S; Madrigal VN; Michelson KN; Paquette ET; Pentz RD; Scarlet S; Ulrich CM; Walter JK
Description
An account of the resource
Palliative care (PC) subspecialists and clinical ethics consultants often engage in parallel work, as both function primarily as interprofessional consultancy services called upon in complex clinical scenarios and challenging circumstances. Both practices utilize active listening, goals-based communication, conflict mediation or mitigation, and values explorations as care modalities. In this set of tips created by an interprofessional team of ethicists, intensivists, a surgeon, an attorney, and pediatric and adult PC nurses and physicians, we aim to describe some paradigmatic clinical challenges for which partnership may improve collaborative, comprehensive care.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1089/jpm.2021.0521" target="_blank" rel="noreferrer noopener">10.1089/jpm.2021.0521</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
Boss RD
Christopher MJ
Clinical Ethics
Ethics
Gray TF
Harman S
health care ethics
January 2022 List
Journal of Palliative Medicine
Madrigal VN
Michelson KN
Palliative Care
Paquette ET
Pentz RD
Scarlet S
Teamwork
Ulrich CM
Walter JK
Weaver MS
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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December 2019 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
December 2019 List
URL Address
<a href="http://doi.org/10.1136/medethics-2019-105639" target="_blank" rel="noreferrer noopener">http://doi.org/10.1136/medethics-2019-105639</a>
Dublin Core
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Title
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Worth living or worth dying? The views of the general public about allowing disabled children to die
Publisher
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Journal of Medical Ethics
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
The topic of the resource
Allocation of Health Care Resources; Clinical Ethics; End-of-life; Ethics; Quality/Value of Life/Personhood
Creator
An entity primarily responsible for making the resource
Brick C; Kahane G; Wilkinson D; Caviola L; Savulescu J
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BACKGROUND: Decisions about withdrawal of life support for infants have given rise to legal battles between physicians and parents creating intense media attention. It is unclear how we should evaluate when life is no longer worth living for an infant. Public attitudes towards treatment withdrawal and the role of parents in situations of disagreement have not previously been assessed. METHODS: An online survey was conducted with a sample of the UK public to assess public views about the benefit of life in hypothetical cases similar to real cases heard by the UK courts (eg, Charlie Gard, Alfie Evans). We then evaluated these public views in comparison with existing ethical frameworks for decision-making. RESULTS: One hundred and thirty participants completed the survey. The majority (94%) agreed that an infant's life may have no benefit when well-being falls below a critical level. Decisions to withdraw treatment were positively associated with the importance of use of medical resources, the infant's ability to have emotional relationships, and mental abilities. Up to 50% of participants in each case believed it was permissible to either continue or withdraw treatment. CONCLUSION: Despite the controversy, our findings indicate that in the most severe cases, most people agree that life is not worth living for a profoundly disabled infant. Our survey found wide acceptance of at least the permissibility of withdrawal of treatment across a range of cases, though also a reluctance to overrule parents' decisions. These findings may be useful when constructing guidelines for clinical practice.
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<a href="http://doi.org/10.1136/medethics-2019-105639" target="_blank" rel="noreferrer noopener">10.1136/medethics-2019-105639</a>
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2019
Allocation of Health Care Resources
Brick C
Caviola L
Clinical Ethics
December 2019 List
end-of-life
Ethics
Journal of Medical Ethics
Kahane G
Quality/Value of Life/Personhood
Savulescu J
Wilkinson D