Ethical aspects]

The relation is considered between ethical choices, morals and deontology in plastic surgery of the male external genitals. Ethics dictates the behavioural model applied by an individual or group in their actions. Professional ethics--deontology--is the collection of duties governing the exercise of a certain profession. Morals are the set of rules governing an individual's life in society. Ethics, deontology and morals do not always convey the same message, since environmental, racial and religious situations, custom, and even fashion can influence a patient's demands, reflecting his desire to improve his quality of life, even only from the purely hedonistic viewpoint, and the specialist's attitude. Surgeons are increasingly tending to bend to these demands or--much worse--even encourage and foster them, with a view to financial considerations. The attitude and ethical choices available are examined in relation to surgery to lengthen or enlarge the penis.     

Ethical and legal aspects of clinical supervision.

We review guidelines for providing supervision for trainees and employees, an expected part of the job for many psychologists, many of whom carry out their supervisory duties with only a cursory awareness of the ethical and legal pitfalls that may accrue. The guidelines are drawn from ethical principles, other documents promulgated by various sectors of professional psychology, and relevant legal cases. Specific suggestions are given for supervisors and training institutions to ensure appropriate supervision. The incorporation of training in supervision in all doctoral programs in professional psychology is recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical and legal aspects of survey research.

Sample surveys have been received as legal evidence since 1940. Judges have given weight to sample survey research in reaching decisions. Among the problems involved is the legal pressure to disclose names of respondents—a violation of the principle of confidentiality and anonymity under which much survey research is conducted. "It is the purpose of the present paper to call to the attention of relevant professional associations the need for guidance on this ethical and legal issue." Under what conditions should names of respondents be disclosed? Major sections are: The scientist in court, The dilemma, Estimating reliability, A case study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical, legal and medical aspects of transplantation

Tissue and organ transplantation is a very complex interdisciplinary treatment, particularly in regard to unpaired organs, and it carries numerous risks for all participants in such an action. For the purpose of minimizing the risks to the allowed level and the preservation the humanitarian goals in medicine when performing the transplantation, professional and scientific doctrines and the respect of ethical and legal principles should be strictly observed. The paper presents the basic approaches in the estimation of justification, usefulness and certain forms of responsibility in the process of transplantation. Ethical and legal postulates which support transplantation to prevent deviation, deprivation or delinquency have also been reviewed.     

Ethical aspects and problems in intensive care medicine

In the Intensive Care Unit important decisions in critically ill and often incompetent patients have to be made within a short period of time and without all the necessary information. Two main questions arise: 1. How can the autonomy of the patients be respected under these circumstances? 2. Which diagnostic and therapeutic activities are adequate and reasonable in each individual patient? An optimal communication between the people involved helps to find the best answers.     

Ethical aspects to be considered in brain banking

OBJECTIVE: To investigate MRI and proton spectroscopy changes in five patients with HIV associated dementia complex (HADC) treated with antiretroviral therapy. METHODS: Three markers were evaluated: (1) CSF/intracranial volume ratio; (2) T2 weighted signal ratio between parieto-occipital white and subcortical grey matter; and (3) metabolite ratios from long echo time (TE=135 ms) single voxel proton spectra of parieto-occipital white matter. RESULTS: Spectroscopic changes indicated initial increases in N-acetyl/(N-acetyl + choline + creatine) ratio (NA/(NA+ Cho+Cr)) and progression of atrophy after initiation of antiretroviral therapy in four of five patients. When the neurological status of the patients subsequently deteriorated (two of five patients), the NA/(NA+Cho+Cr) ratio also declined. CONCLUSIONS: Spectroscopic changes mirror reversible neuronal dysfunction. These objective, non-invasive techniques may be used for monitoring the neurological effects of antiretroviral drug therapy in patients with HADC.     

Ethical aspects of in vitro fertilization and embryo transfer

In vitro fertilization and embryo transfer (IVF-ET) confronts moral reflection with a wide range of concerns. Some are similar to those raised by artificial insemination such as the procurement of sperm, the goods of marriage and donor gametes. Others are unique to IVF-ET such as surrogacy, the status of the embryo and cryopreservation.     

Ethical and legal aspects of assisted reproduction practice in Asia

This report describes the ethical and legal aspects of assisted reproduction technology (ART) that have been instituted in Asian countries. The data were collected by a questionnaire circulated to ART units in Asia. These are Taiwan, Singapore, Korea, Indonesia, Thailand, Japan, Iran, India, Jordan, Malaysia, China, Israel, Hong Kong, Pakistan, Lebanon, Saudi Arabia, and Persian Gulf countries. According to the survey, there are approximately 260 ART centers in Asia (half of which are in Japan). On a global basis each ART centre in Asia serves an average population of 13 million people. On the other hand, in those Asian countries where the standards of living are relatively high, the availability of ART services, including the more sophisticated and costly ART procedures like micromanipulation, is similar to that in the Western world. In most of the Asian countries practising ART, however, no state registry exists. Taiwan is the only country that has specific legislation, and in six other countries some kind of ministerial regulations are practised. We conclude that ART is now practised in 20 countries in Asia. The prevailing rules and cultural heritage in many of these Asian countries has a major influence on the implementation of ART in Asia. However, in view of the complicated and sensitive issues involved, and as no supervision on ART clinics exists in most of the Asian countries, we advocate that some kind of quality control should be urgently instituted in all centres practising ART. In this way, it is hoped that the highest standards be attained for all parties concerned.     

Ethical and psychiatric aspects of torture: a Canadian study

In the last two decades widespread use of torture by totalitarian governments has been reported in over 60 countries. This situation concerns physicians who are sometimes called upon to see the victims. This paper reports the psychiatric findings in a group of 41 Latin American refugees who arrived in Canada from 1977 to 1979 and alleged to have been subjected to political persecution and torture under the military rulers of their own countries. Most of them, young educated men, were apprehended violently and imprisoned under conditions below the minimum international standards. Systematic physical and psychological torture was the rule, including blindfolding, beatings, electrical shocks, sexual abuse and threats of execution or sham executions. These experiences were followed by a cluster of psychiatric symptoms and physical evidence of trauma compatible with the history given. This pattern constitutes the torture syndrome included under category 308 and 309 of the DSM-III and ICD-9. The alleged professional conduct of 19 doctors who saw 21 of these patients is discussed. A list of codes of medical ethics, intended to guide and protect doctors confronted with this difficult problem, is included.     

Confidentiality: Ethical and legal aspects for Canadian psychologists.

Discusses the ethical and legal aspects of confidentiality for Canadian psychologists, with particular emphasis on clinical psychology. The concepts of confidentiality, privileged communication, and privacy are clarified. The law of privileged communication in Canada is presented. Ethical standards, provincial and federal legislation, and case law bearing on confidentiality in clinical practice are discussed. Issues of mandatory child abuse reporting, the duty to protect, informed consent, and 3rd-party and client access to records are explored. Suggestions are made to the psychologist regarding the management of confidentiality. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical dilemmas in sport psychology: A dialogue on the unique aspects impacting practice.

[Correction Notice: An erratum for this article was reported in Vol 41(3) of Professional Psychology: Research and Practice (see record 2010-11935-001). Due to a production error, the name of Amy B. Stapleton was substituted for the name of Jeffrey E. Barnett as the editor of the Focus on Ethics section in the April issue of Professional Psychology: Research and Practice, 41, 2, 143–152.] The multidisciplinary field of applied sport psychology, a specialty area of psychology practice, has been acknowledged as a proficiency area by the American Psychological Association (APA, 2007). This unique discipline often requires the psychologist to work outside the realm of traditional practice. In doing so, sport psychologists frequently encounter unique ethical dilemmas. In an effort to promote awareness and dialogue, this article describes some of the more commonly faced ethical considerations in applied sport psychology. Issues related to developing and maintaining competence in the field, confidentiality, and boundary issues are discussed, and case examples are provided to illustrate the relevant ethical consideration. Subsequently, three applied sport psychology experts respond to the lead article’s discussion and offer poignant reflections on ethical issues presented. In addition, suggestions for successfully resolving ethical dilemmas related to competence, confidentiality, and boundary issues in sport psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The misuse of cardiopulmonary resuscitation

Over a 41-month period, 1,233 "Code Blues" were retrospectively reviewed. Twenty-five codes on infants and children < 16 years of age were eliminated from the study group. The adult survivors of 1,208 codes numbered 243 (20.1%). Clinical chart review revealed that 49 (4.0%) did not involve cardiopulmonary resuscitation (CPR) or intubation and were "non-codes." Of the remaining 1,159 codes, there were 194 (16.7%) survivors. Of these survivors, 102 (52.5%) were patients with respiratory distress or failure and required intubation only. No CPR was needed. Thus, only the remaining 92 survivors of the 1,057 codes were cardiac cases for which CPR was appropriate (8.7% survival). Ventricular tachycardia and fibrillation, promptly defibrillated, was the most important rhythm factor for survival. Underlying ischemic heart disease (acute myocardial infarction and chronic ischemic heart disease with arrhythmia) was the most common underlying disease entity among the survivors. CPR performed in the group of patients unlikely to survive was expensive.