Article
Surgery
David Fischkoff, Kenneth Prager, Joyeeta Dastidar, Lydia Dugdale, Gerald Neuberg, Samantha Nemeth, Katherine Fischkoff
Summary: The issue of proceeding with medical intervention over a patient's objection is common but lacks ethical guidelines. A retrospective study on consultations for treatment over objection found that logistical barriers and imminent harm to the patient were key factors in determining whether to proceed against the objection.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
(2021)
Article
Ethics
Melodie Labuschaigne, Safia Mahomed, Ames Dhai
Summary: This article examines the ethico-legal regulation of adolescent children's participation in health research in South Africa and evaluates the inconsistencies between the existing framework and constitutional requirements. The article provides specific recommendations to address these issues and align the regulations with constitutional and international rights considerations.
DEVELOPING WORLD BIOETHICS
(2022)
Review
Medicine, General & Internal
Karina W. Davidson, Carol M. Mangione, Michael J. Barry, Wanda K. Nicholson, Michael D. Cabana, Aaron B. Caughey, Esa M. Davis, Katrina E. Donahue, Chyke A. Doubeni, Martha Kubik, Li Li, Gbenga Ogedegbe, Lori Pbert, Michael Silverstein, James Stevermer, Chien-Wen Tseng, John B. Wong
Summary: This article summarizes the ethical and scientific principles of shared decision-making, emphasizes the importance of patient involvement in care, and reaffirms the role of shared decision-making in patient-centered preventive care decisions.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2022)
Article
Ethics
Victoria Shepherd, Mark Sheehan, Kerenza Hood, Richard Griffith, Fiona Wood
Summary: Research on proxy decision making for adults lacking capacity to consent reveals a disparity between normative accounts and empirical evidence. Proxies aim to make decisions that balance the wishes of the person they represent with what they believe is in the person's best interests, while also considering authenticity to the person's values and life. Trust and trustworthiness play crucial roles in the decision-making process, with proxies acting in dual roles as both proxy and carer.
JOURNAL OF MEDICAL ETHICS
(2021)
Article
Gerontology
Oluwatoyin Sorinmade, Alex Ruck Keene, Carmelle Peisah
Summary: The article discusses the challenges faced by individuals with dementia in enjoying intimate relationships and proposes a tool called the Advance Decision on Intimacy to empower them to make decisions about their sexuality when they no longer have the capacity to consent.
Article
Psychiatry
Michael R. MacIntyre, Richard G. Cockerill, Omar F. Mirza, Jacob M. Appel
Summary: The rapid advancement of AI and machine learning provide new tools for clinicians. AI has the potential to assist in medical decision-making capacity assessments, but concerns such as biased decisions, autonomy, and accountability make it unlikely to replace human evaluators anytime soon.
PSYCHIATRY RESEARCH
(2023)
Article
Medicine, General & Internal
Pardis Zalmay, Justin Collis, Helen Wilson
Summary: This study utilized a retrospective intervention of cognitively impaired hip fracture patients to show that simple feedback interventions can significantly improve communication between clinicians and patients' next of kin. The study found an increase in attempts to contact next of kin before surgery and an improvement in completion of the next of kin section of the consent form.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Ethics
Giles Birchley
Summary: Theoretical accounts of best interests in medical policy and practice vary, drawing from consequentialism, deontology, political philosophy, and other perspectives. Decision-making processes consider factors such as preferences, dignity, and quality of life, with a bias towards negative interests over positive interests reflecting the prevalence of neoliberalism. Emphasis on private familial authority and the influence of socio-political trends highlight potential frictions between theory and practice in navigating best interests.
BMC MEDICAL ETHICS
(2021)
Editorial Material
Ethics
Ben Gray
Summary: This paper argues that the capacity of the decision-maker should be the sole consideration in deciding whether a decision should stand, regardless of the risks involved. However, it fails to acknowledge the perspectives of those who question the wisdom of a decision. Instead, the paper suggests that healthcare decisions should be evaluated based on four parameters - patient experience, resource utilization, public health impact, and clinician experience - rather than solely relying on patient autonomy.
JOURNAL OF MEDICAL ETHICS
(2022)
Article
Critical Care Medicine
Charles Feldman, Charles L. Sprung, Spyros D. Mentzelopoulos, Anne Pohrt, Christiane S. Hartog, Christopher Danbury, Manfred Weiss, Alexander Avidan, Angel Estella, Gavin M. Joynt, Alexandre Lautrette, Edoardo Geat, Gabor Elo, Eldar Soreide, Olivier Lesieur, Maria G. Bocci, Sudakshina Mullick, Annette Robertsen, Roshni Sreedharan, Hans-Henrik Bulow, Paulo A. Maia, Maria Cruz Martin-Delgado, Joseph F. Cosgrove, Nikki Blackwell, Silvia Perez-Protto, Guy A. Richards
Summary: The possibility of prolonging life in the ICU is increasing, resulting in decisions to limit life-sustaining therapies. This study examined communication practices at the end of life in ICUs worldwide and found significant regional differences. The study also suggested that ethical practice and the presence of an advance directive may increase the likelihood of communication. Efforts are needed to align treatment with patients' wishes.
Article
Ethics
Greg Moorlock, Heather Draper
Summary: This paper proposes a novel approach to allow the public to record more nuanced wishes regarding organ donation. The implementation of an online form can provide more detailed information and consider competing wishes, promoting autonomous decision-making and improving confidence in medical staff's actions.
JOURNAL OF MEDICAL ETHICS
(2023)
Article
Law
John Coggon, Camillia Kong
Summary: The Mental Capacity Act 2005 governs personal decision-making for adults and includes five overarching principles, emphasizing that incapacity cannot solely be inferred from unwise decisions and decisions must be made in the best interests of the person lacking capacity. Analysis of judicial treatment, parliamentary debates, and philosophical critique reveals that these principles are problematically irreconcilable, with the Act's radical under-specificity leading to resolution through abstract values rather than the individual themselves.
CAMBRIDGE LAW JOURNAL
(2021)
Article
Health Care Sciences & Services
Cheryl Tilse, Lindy Willmott, Jill Wilson, Rachel Feeney, Ben White
Summary: The study identified barriers and facilitators to the operationalization of legal rights in end-of-life decision-making for terminally-ill patients, family members, and substitute decision-makers in Australia. These factors were found across systemic, individual, and communication domains, illustrating the importance of healthcare practitioners in supporting or excluding individuals in decision-making processes.
PALLIATIVE MEDICINE
(2021)
Article
Ethics
Emily A. A. Largent, Justin Clapp, Jennifer S. S. Blumenthal-Barby, Christine Grady, Amy L. L. McGuire, Jason Karlawish, Joshua D. D. Grill, Shana D. D. Stites, Andrew Peterson
Summary: In the course of human life, health care decision-making is often interdependent, with patients engaging nonclinicians in reaching decisions. This interdependence is common in all stages of life and is closely related to decision-making capacity. The article presents various approaches to decision-making along a continuum of interdependence and explores the ethical challenges that arise when transitioning between different types of interdependence across the life span.
HASTINGS CENTER REPORT
(2022)
Review
Public, Environmental & Occupational Health
Mette Bach Larsen, Rikke Stokholm, Pia Kirkegaard, Henrik Sehested Laursen, Pernille Gabel, Berit Andersen
Summary: The systematic review found that self-administered decision aids can increase participation and knowledge levels in colorectal cancer screening, but their impact on attitudes towards screening remains inconclusive.
PATIENT EDUCATION AND COUNSELING
(2022)
Letter
Anesthesiology
Robert Sibbald
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2018)
News Item
Medicine, General & Internal
Andrew B. Cooper, Paula Chidwick, Robert Sibbald
CANADIAN MEDICAL ASSOCIATION JOURNAL
(2011)
Editorial Material
Medicine, General & Internal
Robert Sibbald, Paula Chidwick, Laura Hawryluck
CANADIAN MEDICAL ASSOCIATION JOURNAL
(2014)
Article
Respiratory System
Rohit K. Singal, Robert Sibbald, Brenda Morgan, Mel Quinlan, Neil Parry, Michael Radford, Claudio M. Martin
CANADIAN RESPIRATORY JOURNAL
(2014)
Article
Critical Care Medicine
Andrew B. Cooper, Robert Sibbald, Robert Sibbald, Damon C. Scales, Linda Rozmovits, Tasnim Sinuff
CRITICAL CARE MEDICINE
(2013)
Article
Critical Care Medicine
Laura Hawryluck, Robert Sibbald, Paula Chidwick
JOURNAL OF CRITICAL CARE
(2013)
Article
Critical Care Medicine
Paula Chidwick, Robert Sibbald, Laura Hawryluck
JOURNAL OF CRITICAL CARE
(2013)
Article
Health Care Sciences & Services
James Downar, Tracy Luk, Robert W. Sibbald, Tatiana Santini, Joseph Mikhael, Hershl Berman, Laura Hawryluck
JOURNAL OF GENERAL INTERNAL MEDICINE
(2011)
Article
Ethics
D. S. Silva, J. L. Gibson, R. Sibbald, E. Connolly, P. A. Singer
JOURNAL OF MEDICAL ETHICS
(2008)
Article
Ethics
James Downar, Robert Sibbald, Neil M. Lazar
JOURNAL OF MEDICAL ETHICS
(2010)
Editorial Material
Anesthesiology
Ian M. Ball, Simon Oczkowski, Robert Sibbald
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2021)
Article
Ethics
Cheryl Cline, Andrea Frolic, Robert Sibbald
Article
Oncology
L. Minuk, R. Sibbald, J. Peng, S. Bejaimal, I. Chin-Yee
Article
Pharmacology & Pharmacy
AJ O'Brien, AJ Wilson, R Sibbald, M Singer, LH Clapp
BRITISH JOURNAL OF PHARMACOLOGY
(2001)
Article
Critical Care Medicine
Christina Boncyk, Kimberly Rengel, Joanna Stollings, Matt Marshall, Xiaoke Feng, Matthew Shotwell, Pratik P. Pandharipande, Christopher G. Hughes
Summary: This study describes the incidence and factors associated with recurrent delirium in the intensive care unit (ICU). The researchers found that over 10% of delirious ICU patients experienced recurrent symptoms, and factors such as age, duration of mechanical ventilation, and medication exposure were associated with recurrence.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Thomas C. Rollinson, Luke A. McDonald, Joleen Rose, Glenn Eastwood, Rahul Costa-Pinto, Lucy Modra, Akinori Maeda, Zoe Bacolas, James Anstey, Samantha Bates, Scott Bradley, Jodi Dumbrell, Craig French, Angaj Ghosh, Kimberley Haines, Tim Haydon, Carol L. Hodgson, Jennifer Holmes, Nina Leggett, Forbes McGain, Cara Moore, Kathleen Nelson, Jeffrey Presneill, Hannah Rotherham, Simone Said, Meredith Young, Peinan Zhao, Andrew Udy, Ary Serpa Neto, Anis Chaba, Rinaldo Bellomo
Summary: Neuromuscular blockers (NMBs) used during prone positioning in COVID-19 ARDS patients can improve oxygenation and have a sustained effect upon returning to supine position.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Kyung Hun Nam, Jason Phua, Bin Du, Shinichiro Ohshimo, Hwa Jung Kim, Chae-Man Lim, Sheila Nainan Myatra, Nik Azman Bin Nik Adib, Yaseen M. Arabi, Ming-Cheng Chan, Mohammad Omar Faruq, Ike Sri Redjeki, Do Ngoc Son, Khalid Mahmood Khan Nafees, Dilshan Priyankara, Boonsong Patjanasoontorn, Jose Emmanuel Palo, Aidos Konkayev, Gentle Sunder Shrestha, Younsuck Koh
Summary: This study investigated the current practices of mechanical ventilation in Asian intensive care units. The results showed that low tidal volume ventilation and sufficient PEEP were underused in patients with ARDS, while intermediate tidal volumes were commonly used in patients without ARDS. Country income, age, and severity of illness were associated with mortality.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Rudolf Likar, Ilia Aroyo, Katrin Bangert, Bjorn Degen, Rainer Dziewas, Oliver Galvan, Michaela Trapl Grundschober, Markus Kostenberger, Paul Muhle, Joerg C. Schefold, Patrick Zuercher
Summary: This article presents expert opinions on the diagnosis and management of dysphagia in ICU patients. The panel suggests adopting clinical algorithms to promote standardized and high-quality care, and proposes two clinical management algorithms to improve early detection and effective treatment of dysphagia in ICU patients.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Pawel Pasieka, Anna Surowka, Jakub Fronczek, Evan Skwara, Miroslaw Czuczwar, Michal Borys, Pawel Krawczyk, Miroslaw Zietkiewicz, Lukasz R. Nowak, Maciej Zukowski, Katarzyna Kotfis, Katarzyna Cwyl, Jacek Skowronek, Joanna Solek-Pastuszka, Jowita Biernawska, Pawel Grudzien, Pawel Nasilowski, Natalia Popek, Waldemar Cyrankiewicz, Katarzyna Sierakowska, Wojciech Mudyna, Szymon Bialka, Dorota Studzinska, Szymon Bernas, Mariusz Piechota, Waldemar Machala, Lukasz Sadowski, Jan Stefaniak, Radoslaw Owczuk, Malgorzata Szymkowiak, Ryszard Gawda, Natalia Kozera, Barbara Adamik, Waldemar Gozdzik, Agnieszka Wieczorek, Jaroslaw Janc, Anna Kluzik, Janusz Trzebicki, Pawel Zatorski, Wojciech Gola, Hubert Hymczak, Lukasz J. Krzych, Szymon Czajka, Urszula Kosciuczuk, Bartosz Kudlinski, Hans Flaatten, Wojciech Szczeklik
Summary: The study aims to evaluate whether there is an increased propensity to limit life-sustaining treatment (LST) among elderly patients in Poland from 2018-2019 compared to 2016-2017. The results show that clinicians in Poland have become more proactive in limiting LST in critically ill patients aged 80 and above during the studied period, although the prevalence of LST limitations in Poland remains low.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Jihad Mallat, Malcolm Lemyze, Marc-Olivier Fischer
Summary: In mechanically ventilated patients with acute circulatory failure, changes in PVI induced by PLR accurately predict fluid responsiveness.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Jingyuan Xu, Yanjie Zhang, Jie Jiang, Yi Yang, Fengmei Guo
Summary: This meta-analysis examined the effect of milrinone on prognosis in adult critically ill patients and found a significant decrease in the incidence of ventricular arrhythmia in patients with cardiac surgery. However, there was no significant reduction in all-cause mortality or the incidence of myocardial infarction. More research is needed to determine the reliable and conclusive evidence for the effects of milrinone.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Zhi-Tao Li, Da-Bing Huang, Jian-Feng Zhao, Hui Li, Shui-Qiao Fu, Wei Wang
Summary: Venous congestion is associated with AKI after cardiac surgery, but not necessarily with CRRT. Among the markers tested, IRVF exhibits the strongest correlation with AKI.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Sarah E. Nelson, Spyridoula Tsetsou, John Liang
Summary: This article discusses a range of issues associated with tracking CLABSI and CAUTI metrics, including lack of evidence, moral distress, and definition problems. It recommends forming a task force consisting of key stakeholders to improve the use of these metrics.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Ross Prager, Eric Walser, Kaan Y. Balta, Anton Nikouline, William R. Leeper, Kelly Vogt, Neil Parry, Robert Arntfield
Summary: Resuscitative TEE has been shown to be a valuable diagnostic tool in trauma care, with the potential to impact treatment strategies and diagnostic approaches for patients in the trauma bay.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Jaeyun Sung, Sanu S. Rajendraprasad, Kemuel L. Philbrick, Brent A. Bauer, Ognjen Gajic, Aditya Shah, Krzysztof Laudanski, Johan S. Bakken, Joseph Skalski, Lioudmila V. Karnatovskaia
Summary: With a large number of cells and genes, the human gut microbiome is crucial for health and disease. Modern living disrupts the balance between the host and its microbiome, leading to adverse impacts on critical illness and patient outcomes. Restoring the gut microbiome shows promise for preventing and treating critical illnesses.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Claire Chaignat, Laurent Lagrost, Karena Moretto, Jean-Paul Pais de Barros, Hadrien Winiszewski, Jacques Grober, Philippe Saas, Gael Piton
Summary: The aim of this study was to investigate the correlation between plasma citrulline levels and plasma lipopolysaccharide (LPS) concentration, as well as the impact of sepsis on gut function in critically ill patients. The results showed no correlation between plasma citrulline concentration and plasma LPS concentration or activity. However, septic patients had significantly lower plasma citrulline levels. Additionally, abdominal sepsis was associated with higher plasma LPS activity compared to extra-abdominal sepsis.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Pyoung Jik Lee, Thomas Hampton
Summary: This study found that smartphone applications with low-cost external microphones can reliably measure average noise levels in both laboratory and field settings, but show significant differences compared to professional equipment when measuring maximum noise levels.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Greg Roberts, James S. Krinsley, Jean-Charles Preiser, Stephen Quinn, Peter R. Rule, Michael Brownlee, Guillermo E. Umpierrez, Irl B. Hirsch
Summary: Relative hypoglycemia was commonly seen in patients with HbA1c ≥ 8% and was independently associated with mortality. Absolute hypoglycemia was associated with mortality regardless of HbA1c.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Katsura Hayakawa, Shigehiko Uchino, Hideki Endo, Kazuki Hasegawa, Kazuya Kiyota
Summary: This study assessed the performance of the APACHE III and JROD models under different conditions of missing variables and found that a higher number of missing physiological variables led to underestimated predicted mortality rates and higher standardized mortality ratios.
JOURNAL OF CRITICAL CARE
(2024)