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Ethical And Legal Issues In Neurology

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Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : James L. Bernat,Richard Beresford
Publisher : Newnes
Release : 2014-01-09
ISBN : 0444535047
Language : En, Es, Fr & De

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Book Description :

Advances in our understanding of the brain and rapid advances in the medical practice of neurology are creating questions and concerns from an ethical and legal perspective. Ethical and Legal Issues in Neurology provides a detailed review of various general aspects of neuroethics, and contains chapters dealing with a vast array of specific issues such as the role of religion, the ethics of invasive neuroscience research, and the impact of potential misconduct in neurologic practice. The book focuses particular attention on problems related to palliative care, euthanasia, dementia, and neurogenetic disorders, and concludes with examinations of consciousness, personal identity, and the definition of death. This volume focuses on practices not only in North America but also in Europe and the developing world. It is a useful resource for all neuroscience and neurology professionals, researchers, students, scholars, practicing clinical neurologists, mental health professionals, and psychiatrists. A comprehensive introduction and reference on neuroethics Includes coverage of how best to understand the ethics and legal aspects of dementia, palliative care, euthanasia and neurogenetic disorders Brings clarity to issues regarding ethics and legal responsibilities in the age of rapidly evolving brain science and related clinical practice

Ethical Issues in Neurology

Ethical Issues in Neurology Book
Author : James L. Bernat
Publisher : Lippincott Williams & Wilkins
Release : 2008
ISBN : 9780781790604
Language : En, Es, Fr & De

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Book Description :

Written by an eminent authority from the American Academy of Neurology's Committee on Ethics, Law, and Humanities, this book is an excellent text for all clinicians interested in ethical decision-making. The book features outstanding presentations on dying and palliative care, physician-assisted suicide and voluntary active euthanasia, medical futility, and the relationship between ethics and the law. New chapters in this edition discuss how clinicians resolve ethical dilemmas in practice and explore ethical issues in neuroscience research. Other highlights include updated material on palliative sedation, advance directives, ICU withdrawal of life-sustaining therapy, gene therapy, the very-low-birth-weight premature infant, the developmentally disabled patient, informed consent, organizational ethics, brain death controversies, and fMRI and PET studies relating to persistent vegetative state.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Marie-Aurélie Bruno,Steven Laureys,Athena Demertzi
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080795
Language : En, Es, Fr & De

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Book Description :

Patients in coma, vegetative state/unresponsive wakefulness syndrome, and in minimally conscious states pose medical, scientific, and ethical challenges. As patients with disorders of consciousness are by definition unable to communicate, the assessment of pain, quality of life, and end-of-life preferences in these conditions can only be approached by adopting a third-person perspective. Surveys of healthcare workers’ attitudes towards pain and end of life in disorders of consciousness shed light on the background of clinical reality, where no standard medical-legal framework is widely accepted. On the other hand, patients with locked-in syndrome, who are severely paralyzed but fully conscious, can inform about subjective quality of life in serious disability and help us to understand better the underlying factors influencing happiness in disease. In the medico-legal arena, such ethical issues may be resolved by previously drafted advance directives and, when absent, by surrogate representation. Lately, functional medical imaging and electrophysiology provide alternative means to communicate with these challenging patients and will potentially mediate to extract responses of medical-ethical content. Eventually, the clinical translation of these advanced technologies in the medical routine is of paramount importance for the promotion of medical management of these challenging patients.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Lois Margaret Nora
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080671
Language : En, Es, Fr & De

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Book Description :

There is dynamic interplay between the disciplines of law and ethics, and the result is often laws and regulation that impact the practice of clinical neurology. This chapter explores how the disciplines of law and ethics inform and intersect with each other, and how resulting law impacts the everyday work of the clinical neurologist. Examples of how the core bioethical principles of nonmaleficence, beneficence, respect for autonomy, and justice are manifest in legislative, common, and administrative laws are presented. Examples of how these laws, in turn, impact the practice of neurology through protection of patient privacy, the avoidance of conflict of interest, and informed consent and other issues are offered.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Gideon Yaffe
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080914
Language : En, Es, Fr & De

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Book Description :

Sufferers from neurologic and psychiatric disorders are not uncommonly defendants in criminal trials. This chapter surveys a variety of different ways in which neurologic disorder bears on criminal responsibility. It discusses the way in which a neurologic disorder might bear on the questions of whether or not the defendant acted voluntarily; whether or not he or she was in the mental state that is required for guilt for the crime; and whether or not he or she is deserving of an insanity defense. The discussion demonstrates that a just determination of whether a sufferer from a neurologic disorder is diminished in his or her criminal responsibility for harmful conduct requires equal appreciation of the nature of the relevant disorder and its impact on behavior, on the one hand, and of the legal import of facts about the psychologic mechanisms through which behavior is generated, on the other.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Paul J. Ford,Abhishek Deshpande
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080884
Language : En, Es, Fr & De

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Book Description :

A clear understanding of distinctions and definitions is necessary before determining which types of surgically invasive neuroscience research should be permitted and how the experimental protocols can properly be undertaken. A failure to clarify the ethical distinctions in invasive neuroscience research hinders attempts at ethical analysis and guidance. At least four main distinctions need to be addressed: “invasiveness” as an important moral characteristic; special brain–mind-related risks; research participant selection; and ideologic interpretation of human function. Harm and not invasiveness is the metric by which to measure the ethical permissibility of research. Because of a class of harms to minds and selves, special attention should be paid to value considerations. These considerations need to be addressed by researchers, funders, and review boards to create proper safeguards from conception of research through final application of results.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Eric Racine
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080922
Language : En, Es, Fr & De

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Book Description :

In this chapter, evolution of ethics and bioethics is traced to show how an abstract and individualistic paradigm was at the core of mainstream ethics prior to the advent of bioethics and applied ethics. Bioethics has transformed this individualistic paradigm because of its inherent interdisciplinarity and real-world connection. This evolution has raised questions regarding how nonabstract (e.g., experiential) and nonindividualistic (e.g., social, relational) components of ethics could be married to normative theory and ethics reflection, the latter usually not amenable to empiric research. In the first part of this chapter, pragmatism is introduced as an approach offering perspectives on the integration of social, nonindividualistic aspects of ethics, supporting the use of social science methods within ethics and neuroethics. In the second part of this chapter, using the example of disorders of consciousness, a pragmatic perspective is explored to reframe questions and help foster nonreductionistic understandings of ethical questions and ethical dilemmas. This chapter aims to generate reflections on a set of specific clinical contexts that will also stimulate a discussion on the nature of ethical approaches.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Ralf J. Jox,Ruth J. Horn,Richard Huxtable
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080752
Language : En, Es, Fr & De

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Book Description :

End-of-life care practices and attitudes in Europe are highly diverse, which is unsurprising given the variety of cultural and religious patterns across this region. The most marked differences are in the legal and ethical stances towards assisted dying, although there are also variations in limitation of life-sustaining treatment and the authority of advance directives to decline such treatment. Palliative care has made a rapid and impressive development in many European countries over the last decade, and alleviating symptoms at the end of life is permitted, even if the drugs used might (in the rare case) not only relieve suffering but also shorten life. Fueled by the politically led process of European harmonization, future policies and laws on end-of-life care might converge. However, at the base of many ethical conflicts there remain deeply rooted differences about promoting the sanctity of life, eradicating suffering, and respecting patients’ autonomous wishes.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : James A. Anderson,Marleen Eijkholt,Judy Illes
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080906
Language : En, Es, Fr & De

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Book Description :

In this chapter, we use the special features of neuroimaging to illustrate research ethics issues for the clinical neurologic sciences, and focus on one particularly compelling case: studies involving first-episode schizophrenic treatment-naïve individuals (FESTNIs) (). FESTNIs are scanned prior to the administration of medication in order to control for the confounding effects of treatment. By concentrating on this program of research, we capture the distinctive ethical challenges associated with neuroimaging research overall, and foreground the issues particular to neuroimaging research involving FESTNIs that have yet to receive sufficient attention in the literature. We highlight assessment of risks and burdens, including risks associated with treatment delays and incidental findings; assessment of benefit, including direct benefit, social value, and scientific quality; subject selection; justice questions related to responsiveness and poststudy access; and, finally, issues related to consent and capacity.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Leo Mccluskey
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080817
Language : En, Es, Fr & De

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Book Description :

Acute and chronic peripheral and/or central disorders of the voluntary motor system can produce profound paresis or paralysis, at times with ophthalmoplegia, while preserving consciousness and language function. Although at times appearing to be unconscious, these patients are awake and alert but unable to communicate, manipulate their environment, or participate in medical decision-making. Clinicians caring for these patients are ethically tasked with recognizing this clinical reality, enacting measures to facilitate communication, and abiding by ethical and legal principles that support autonomous patient-centered decision-making. This chapter reviews the various disorders that may cause this state while using three exemplary disorders – locked-in syndrome, caused by an anterior pontine lesion; high cervical spinal cord lesion; and amyotrophic lateral sclerosis – to discuss the management of these patients.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : H. Richard Beresford
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080663
Language : En, Es, Fr & De

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Book Description :

Ethically salient issues in neurologic care may have important legal overtones. This chapter considers some of these, emphasizing how law may influence the outcome of controversies over how best to promote autonomy, beneficence, and justice in the care of individuals with neurologic disorders. Constitutional, statutory, and judicial dimensions are addressed. With respect to autonomy, discussion emphasizes legal dimensions of the doctrine of informed consent and the obligations of medical professionals to protect the privacy and confidentiality of their patients. The discussion of beneficence focuses on issues relating to actual or potential conflicts of interest in the care of patients and on the conduct of research involving human subjects. The section on justice considers how law aims to define protectable rights and interests of individuals and to provide a fair and efficient process for resolving disputes. Applications of legal principles and doctrines are illustrated primarily through the examples afforded by judicial decisions. These cases demonstrate how law both promotes ethical decision-making and protects the rights and interests of those affected. The cases also highlight some of the ethical quandaries that evoke resort to litigation and the limits of law in advancing ethically appropriate outcomes.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Eran Klein,Jason Karlawish
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080825
Language : En, Es, Fr & De

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Book Description :

Caring for persons with Alzheimer’s disease presents neurologists with ethical challenges. Some of these, such as end-of-life care or research participation, are well known and have significant overlap with challenges in other areas of medicine or other neurologic diseases, such as cancer or traumatic brain injury, while others, such as the rise of biomarker-based diagnostics, are more novel and reflect the impact of developments in the science and clinical care of Alzheimer’s disease. A thoughtful and systematic approach to these challenges, from the preclinical to the late symptomatic stage of this disease, is required and will help clinicians be better advocates and stewards of their patients. This chapter addresses a number of the most pressing ethical problems facing patients, caregivers, and clinicians during this disease, including early and presymptomatic testing, assessment of decision-making capacity for treatment or research participation, restriction of driving, remote monitoring, assisted suicide, and treatment of disruptive behaviors.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Emily B. Rubin
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080698
Language : En, Es, Fr & De

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Book Description :

Standards of conduct in any profession reflect the shared values of that profession and define behaviors by its members that are considered either mandatory or proscribed. This chapter will provide an overview of several of the primary aspects of professional conduct and misconduct by physicians, with an emphasis on the neurologist where appropriate. It will start with an overview of the foundations of the physician–patient relationship, then cover topics including initiation of the physician–patient relationship, communication, therapeutic privilege, disclosure of medical errors, empathy and professional boundaries, barriers to care and termination of the physician–patient relationship, conflicts of interest, self-care, deception of third parties, reporting impaired colleagues, and expert testimony.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Tracy K. Koogler
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080809
Language : En, Es, Fr & De

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Book Description :

The debate surrounding neurologically devastated newborns, whether due to severe prematurity or genetic malformations, has continued for over 40 years. Duff and Campbell (1973) first discussed allowing these children to die in the 1970s. In the 1980s, others fought to make sure these children with disabilities were afforded all the rights of other children. Recently, some commentators have advocated for withdrawal of therapies and even euthanasia in the Netherlands. Who is right? What are the ethical principles that should be followed? What decisions are appropriate for distraught parents to make? This chapter reviews international views, laws, and guidelines surrounding the therapies and limitations of care for these imperiled newborns. An ethical argument is presented for how to determine best interests for these special children utilizing the best interest standard. Parents and physicians need to use their individual expertise and values to work together to determine each individual child’s best interests. Physicians may have to carry the burden for making final determinations to alleviate the guilt families may have in deciding to limit therapies.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Thomas I. Cochrane
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080744
Language : En, Es, Fr & De

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Book Description :

The ethics of decisions to withhold or withdraw life-sustaining therapies are reviewed. Special attention is paid to the ethical and moral distinctions – or lack thereof – between withholding and withdrawing. The ethical principles informing decisions to forgo life-sustaining therapy are covered, along with the difficulty of making such decisions in the face of prognostic uncertainty. Specific advice is provided regarding the decision-making process, and recent literature regarding decision-making in the neurologic intensive care unit is reviewed.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Eelco F.M. Wijdicks
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080787
Language : En, Es, Fr & De

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Book Description :

The diagnosis of brain death should be based on a simple premise. If every possible confounder has been excluded and all possible treatments have been tried or considered, irreversible loss of brain function is clinically recognized as the absence of brainstem reflexes, verified apnea, loss of vascular tone, invariant heart rate, and, eventually, cardiac standstill. This condition cannot be reversed – not even partly – by medical or surgical intervention, and thus is final. Many countries in the world have introduced laws that acknowledge that a patient can be declared brain-dead by neurologic standards. The U.S. law differs substantially from all other brain death legislation in the world because the U.S. law does not spell out details of the neurologic examination. Evidence-based practice guidelines serve as a standard. In this chapter, I discuss the history of development of the criteria, the current clinical examination, and some of the ethical and legal issues that have emerged. Generally, the concept of brain death has been accepted by all major religions. But patients’ families may have different ideas and are mostly influenced by cultural attitudes, traditional customs, and personal beliefs. Suggestions are offered to support these families.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Anjan Chatterjee
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080892
Language : En, Es, Fr & De

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Book Description :

In the wake of our improving abilities to treat or modulate the impaired nervous system, we are also learning how we might improve the abilities of the healthy nervous system. We can modulate our motor, cognitive, and affective systems in ways that potentially enhance us. Pharmacologic enhancements are used widely in some circles and their use is likely to increase. Newer noninvasive stimulation techniques also have the potential to be used as enhancements. Neuroenhancements raise deep ethical concerns about safety, compromised character, distributive justice, and coercion. The ethical concerns apply to adults in general, but also in unique ways to children who are not completely autonomous and to soldiers who choose to relinquish some of their autonomy. There are no easy solutions to these ethical concerns. Prohibition of enhancements is not a viable option. Lay and professional discussions will help establish cultural norms and guide clinical practice as well as public policy.

Ethical and Legal Issues in Neurology

Ethical and Legal Issues in Neurology Book
Author : Winston Chiong
Publisher : Elsevier Inc. Chapters
Release : 2014-01-09
ISBN : 0128080949
Language : En, Es, Fr & De

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Book Description :

Changes in personality and judgment in dementia raise both practical and philosophic problems concerning personal identity. For example, if a patient’s values and preference have been altered by disease, should caregivers’ decisions for the patient be guided by their understanding of the patient’s premorbid values and preferences, or of the patient’s current values and preferences? Some authors have argued, based on philosophic accounts of personal identity, that the previously healthy person and the demented patient should be regarded as two different people; therefore, previous values and preferences lose their authority. Meanwhile, others have argued that when patients lose their ability to act autonomously, their “precedent autonomy” must be respected by following their earlier wishes. These debates can inform our thinking about the proper interpretation of advance directives, as well as other practical questions such as how carriers of dementia gene mutations should think about their future.

Ethical Dilemmas in Neurology

Ethical Dilemmas in Neurology Book
Author : Adam Zeman,Linda L. Emanuel
Publisher : Bailliere Tindall Limited
Release : 2000
ISBN : 0987650XXX
Language : En, Es, Fr & De

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Book Description :

An international team of recognized authorities offer a collection of thought provoking essays on ethical questions often faced by neurologists in clinical practice. Each chapter covers a difficult situation that isfrequently encountered, and for which there is no clear right answer International contributors bring a wide range of backgrounds and perspectives to the different dilemmas Hot topics such as the ethics of clinical trials are discussed. Review of topics such as new drugs and their impact on health care budgets, and other pros and cons of continued curative treatment are discussed

Ethical Issues in Behavioral Neuroscience

Ethical Issues in Behavioral Neuroscience Book
Author : Grace Lee,Judy Illes,Frauke Ohl
Publisher : Springer
Release : 2015-02-09
ISBN : 3662448661
Language : En, Es, Fr & De

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Book Description :

Behavioral neuroscience encompasses the disciplines of neurobiology and psychology to study mechanisms of behavior. This volume provides a contemporary overview of the current state of how ethics informs behavioral neuroscience research. There is dual emphasis on ethical challenges in experimental animal approaches and in clinical and nonclinical research involving human participants.