Welcome to the Globethics Library!

 

  • Child-headed Households in South Africa: The Legal and Ethical Dilemmas when Children are the Primary Caregivers in a Therapeutic Relationship

    Andra le Roux-Kemp (17161918) (2013-01-01)
    Child-headed households (CHHs) have become a common and integral part of South African society. Millions of children have lost their parents and/or primary caregivers due to a variety of reasons of which the HIV/AIDS pandemic can be singled out as a major cause. It is therefore not uncommon today to have minors (under the age of 18 years) care for their younger siblings and/or ill parents or family. A child-headed household (CHH) refers to a living situation/arrangement where a child has taken charge of a household in terms of decision-making responsibilities as well as the responsibility to provide for the physical, social and emotional needs of others living with that particular child, in that household, and regardless of familial relationship. This paper is concerned with the legal and ethical dilemmas that arise in a therapeutic relationship where a minor is the primary caregiver of a patient unable to care for him-/herself. Where do a medical practitioner’s responsibilities lie in communicating important medical information about the patient’s condition to the patient’s minor caregiver? While the patient’s rights to privacy and confidentiality are important, the patient’s particular condition and medical care may also necessitate that certain information be disclosed to the minor caregiver. However, the minor caregiver may not always be a willing party to this collaborative therapeutic relationship and the ability of such a minor to consent to medical treatment on behalf of the patient, or take on responsibilities in terms of this therapeutic relationship can also be called into question. The various therapeutic approaches, roles, skills and conditions of this unique form of agency should therefore be given due consideration from both a legal and ethical point of view.
  • Postmortem Sperm Retrieval and Assisted Reproduction: Issues without Solutions?

    Nilesh K. Tumram; Rajesh V. Bardale (Naif University Publishing House, 2019-05-01)
    The issue of request for post-mortem sperm retrieval [PMSR] for reproductive purposes has gained momentum in the recent past in India and other countries. There are various methods for postmortem retrieval of sperm. Modern medicine has progressed to a stage where posthumous gamete retrieval with subsequent reproduction has become a possibility. However, very little has been discussed regarding guidelines orethical, social, and medical issues related to such a procedure. The procedure is a boon for families who might have become saddened by the untimely death of their son. The procedure can be useful for not only the spouse of married individuals but also to their parents. Also, such a procedure can be very helpful to the parents of their unmarried son, who was their sole support. However, there is no discussion of using such PMSR techniques in married as well as unmarried individuals if requested by close relatives. The present paper discusses the issues regarding PMSR in deceased individuals and the various issues that may arise.
  • Ethical Dilemma involving autonomy and COVID-19 testing

    Buowari DY (Nigerian Medical Association, Akwa Ibom State Branch, 2021-10-01)
    Background: In December 2019, an atypical form of pneumonia was discovered in Wuhan, China and it has spread to different parts of the world including Nigeria. Testing for the causative agent which is the severe acute respiratory distress syndrome coronavirus-2 is one of the strategies to contain the pandemic. For some reason, some patients with clinical symptoms suggestive of COVID-19 may refuse to be tested for the disease. Methodology: A review of studies conducted on COVID-19 testing and ethical dilemma associated with it was done using Google Scholar, PubMed and Cochrane reviews. Conclusion: Ethical dilemma exists in testing for COVID-19 as some patients may refuse testing even when it is necessary and they present with symptoms suggestive of COVID-19. The right to autonomy according to the principles of medical ethics is necessary for every medical consultation but may not be important in pandemics as the person becomes a health threat and harmful to the public.
  • The Distinction between Ordinary and Extraordinary Treatment: Can It Be Maintained?

    Emmerich, Nathan; Mallia, Pierre; Gordijn, Bert; Pistoia, Francesca; Kearns, Alan J.; Emmerich, Nathan; Gordijn, Bert (Springer, 2024-02-27)
    The distinction between ordinary and extraordinary treatment has a long history. Since it was first proposed and discussed in the medieval period, it has formed part of medical ethics, even as that discourse, and the landscape it comments on, has radically changed and developed. In this essay we briefly canvas the history of the debate on ordinary/extraordinary treatment and consider its relevance for professional medical practice in the present context.
  • Ethical, Legal, and Social Implications of Symptom Checker Apps in Primary Health Care (CHECK.APP): Protocol for an Interdisciplinary Mixed Methods Study

    Wetzel, Anna-Jasmin; Koch, Roland; Preiser, Christine; Müller, Regina; Klemmt, Malte; Ranisch, Robert; Ehni, Hans-Jörg; Wiesing, Urban; Rieger, Monika A.; Henking, Tanja (MISC, 2024-03-07)
    Background: Symptom checker apps (SCAs) are accessible tools that provide early symptom assessment for users. The ethical, legal, and social implications of SCAs and their impact on the patient-physician relationship, the health care providers, and the health care system have sparsely been examined. This study protocol describes an approach to investigate the possible impacts and implications of SCAs on different levels of health care provision. It considers the perspectives of the users, nonusers, general practitioners (GPs), and health care experts. Objective: We aim to assess a comprehensive overview of the use of SCAs and address problematic issues, if any. The primary outcomes of this study are empirically informed multi-perspective recommendations for different stakeholders on the ethical, legal, and social implications of SCAs. Methods: Quantitative and qualitative methods will be used in several overlapping and interconnected study phases. In study phase 1, a comprehensive literature review will be conducted to assess the ethical, legal, social, and systemic impacts of SCAs. Study phase 2 comprises a survey that will be analyzed with a logistic regression. It aims to assess the user degree of SCAs in Germany as well as the predictors for SCA usage. Study phase 3 will investigate self-observational diaries and user interviews, which will be analyzed as integrated cases to assess user perspectives, usage pattern, and arising problems. Study phase 4 will comprise GP interviews to assess their experiences, perspectives, self-image, and concepts and will be analyzed with the basic procedure by Kruse. Moreover, interviews with health care experts will be conducted in study phase 3 and will be analyzed by using the reflexive thematical analysis approach of Braun and Clark. Results: Study phase 1 will be completed in November 2021. We expect the results of study phase 2 in December 2021 and February 2022. In study phase 3, interviews are currently being conducted. The final study endpoint will be in February 2023. Conclusions: The possible ethical, legal, social, and systemic impacts of a widespread use of SCAs that affect stakeholders and stakeholder groups on different levels of health care will be identified. The proposed methodological approach provides a multifaceted and diverse empirical basis for a broad discussion on these implications. Trial Registration: German Clinical Trials Register (DRKS) DRKS00022465; https://tinyurl.com/yx53er67.

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