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Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.
In the context of a growing criticism on the influence of the pharmaceutical industry on physicians, scientists, or politicians, Conflict of Interest and Medicine offers a comprehensive analysis of the conflict of interest in medicine anchored in the social sciences, with perspectives from sociology, history, political science, and law. Based on in-depth empirical investigations conducted within different territories (France, the European Union, and the United States) the contributions analyze the development of conflict of interest as a social issue and how it impacts the production of medical knowledge and expertise, physicians’ work and their prescriptions, and also the framing of health crises and controversies. In doing so, they bring a new understanding of the transformations in the political economy of pharmaceutical knowledge, the politicization of public health risks, and the promotion of transparency in science and public life. Complementing the more normative and quantitative understandings of conflict of interest issues that dominate today, this book will be of interest to researchers in a broad range of areas including social studies of sciences and technology, sociology of health and illness, and political sociology and ethics. It will be also a valuable resource for health professionals, medical scientists, or regulators facing the question of corporate influence.
Conflict and Catastrophe Medicine - A Practical Guide provides a framework for use by health professionals visiting a resource-constrained environment. Encompassing problems brought about by local conflict or natural disasters, the book covers preparation, organisation, logistics, treatment of major trauma and medical emergencies, and the special problems of delivering medicine in a hostile environment. Conflict and Catastrophe Medicine - A Practical Guide comprehensively tackles: - self-preparation of health professionals to face a range of medical and related problems which occur in hostile and remote environments; - war and disaster medicine, covering acute management, rehabilitation, reconstruction and prevention; - bridging the fields of medicine, nursing, international relations, history, politics and economics. The book also touches on nutrition, infection, trauma, psychiatry and psychological medicine and training. James Ryan, Leonard Cheshire Professor of Conflict Recovery, Royal Free and University College Medical School, London, UK Peter F Mahoney, Consultant Anaesthetist and Honorary Senior Lecturer in Conflict Medicine, Leonard Cheshire Centre, Royal Free and University College Medical School, London, UK Ian Greaves, Lecturer in Conflict Medicine, Leonard Cheshire Centre, Royal Free and University College Medical School, London, UK Gavin Bowyer, Consultant in Orthopaedic Surgery, Southampton General Hospital, UK.
The proven four-step method for improving communication and managing conflict in any healthcare setting The Exchange Strategy for Managing Conflict in Health Care delivers a wealth of strategies and techniques for structuring conversations about conflicts and issues in groups large and small. "A fresh, clear-eyed view of how to approach conflict in the American healthcare system . . . shows how direct, immediate, tactful, and open communication will greatly improve any workplace setting." -- KATHLEEN SELLICK, President and CEO, Rady Children's Hospital "Having worked in large hospital systems for many years, I wish I had known these skills and techniques when I supervised nurses and coordinated teams." -- KIM PHILLIPS, MSN, RN, CFCN, Nurse's Touch, Inc. "During the past 12 months, over 450 managers and supervisors on my team at Sanford Health have gone through this training, and it works!" -- EVAN BURKETT, Chief Human Resources Officer, Sanford Health "The strategy and skills laid out in this book . . . are truly effective. Ignore this at your peril." -- DR. SAMUEL B. HO, Chief, Gastroenterology Section, Veterans Affairs San Diego Healthcare System, Professor of Medicine, University of California, San Diego
An analysis of medical ethics during war and the inherent conflict between the principles of bioethics and the morally legitimate but competing demands of military necessity.
Pervasive violence against hospitals, patients, doctors, and other health workers has become a horrifically common feature of modern war. These relentless attacks destroy lives and the capacity of health systems to tend to those in need. Inaction to stop this violence undermines long-standing values and laws designed to ensure that sick and wounded people receive care. Leonard Rubenstein—a human rights lawyer who has investigated atrocities against health workers around the world—offers a gripping and powerful account of the dangers health workers face during conflict and the legal, political, and moral struggle to protect them. In a dozen case studies, he shares the stories of people who have been attacked while seeking to serve patients under dire circumstances including health workers hiding from soldiers in the forests of eastern Myanmar as they seek to serve oppressed ethnic communities, surgeons in Syria operating as their hospitals are bombed, and Afghan hospital staff attacked by the Taliban as well as government and foreign forces. Rubenstein reveals how political and military leaders evade their legal obligations to protect health care in war, punish doctors and nurses for adhering to their responsibilities to provide care to all in need, and fail to hold perpetrators to account. Bringing together extensive research, firsthand experience, and compelling personal stories, Perilous Medicine also offers a path forward, detailing the lessons the international community needs to learn to protect people already suffering in war and those on the front lines of health care in conflict-ridden places around the world.
"The goal of military medicine is to conserve the fighting force necessary to prosecute just wars. Just wars are defensive or humanitarian. A defensive war protects one's people or nation. A humanitarian war rescues a foreign, persecuted people or nation from grave human rights abuse. To provide medical care during armed conflict, military medical ethics supplements civilian medical ethics with two principles: military-medical necessity and broad beneficence. Military-medical necessity designates the medical means required to pursue national self-defense or humanitarian intervention. While clinical-medical necessity directs care to satisfy urgent medical needs, military-medical necessity utilizes medical care to satisfy the just aims of war. Military medicine may therefore attend the lightly wounded before the critically wounded or use medical care to win hearts and minds. The underlying principle is broad, not narrow, beneficence. The latter addresses private interests, while broad beneficence responds to the collective welfare of the political community"--
What should happen when doctors and parents disagree about what would be best for a child? When should courts become involved? Should life support be stopped against parents' wishes? The case of Charlie Gard, reached global attention in 2017. It led to widespread debate about the ethics of disagreements between doctors and parents, about the place of the law in such disputes, and about the variation in approach between different parts of the world. In this book, medical ethicists Dominic Wilkinson and Julian Savulescu critically examine the ethical questions at the heart of disputes about medical treatment for children. They use the Gard case as a springboard to a wider discussion about the rights of parents, the harms of treatment, and the vital issue of limited resources. They discuss other prominent UK and international cases of disagreement and conflict. From opposite sides of the debate Wilkinson and Savulescu provocatively outline the strongest arguments in favour of and against treatment. They analyse some of the distinctive and challenging features of treatment disputes in the 21st century and argue that disagreement about controversial ethical questions is both inevitable and desirable. They outline a series of lessons from the Gard case and propose a radical new 'dissensus' framework for future cases of disagreement. - This new book critically examines the core ethical questions at the heart of disputes about medical treatment for children. - The contents review prominent cases of disagreement from the UK and internationally and analyse some of the distinctive and challenging features around treatment disputes in the 21st century. - The book proposes a radical new framework for future cases of disagreement around the care of gravely ill people.
This book focuses on an important but neglected aspect of the Spanish Civil War, the evolution of medical and surgical care of the wounded during the conflict. Importantly, the focus is from a mainly Spanish perspective ¿ as the Spanish are given a voice in their own story, which has not always been the case. Central to the book is General Franco¿s treatment of Muslim combatants, the anarchist contribution to health, and the medicalisation of propaganda ¿ themes that come together in a medico-cultural study of the Spanish Civil War. Suffusing the narrative and the analysis is the traumatic legacy of conflict, an untreated wound that a new generation of Spaniards are struggling to heal.
The history of warfare and the history of medicine are closely intertwined. War has been an accelerator of advances in medical treatment and surgery. As modern weaponry became more destructive, medicine developed techniques and procedures to deal with the volume and nature of battlefield casualties. Preventative medicine has also increased the effectiveness of fighting forces through improvements in soldiers' health and disease resistance.This book is a collection of chapters by historians, medical practitioners and researchers, former and serving military medical officers, surgeons, nurses and veterans, who explore the impact of war, wounds and trauma through the historical record, reported narratives and personal experiences. The book includes major sections on World War One (including chapters on shell shock and plastic surgery), World War Two (including a chapter on the Nazi death camps), the Vietnam War (including chapters on Agent Orange and sexually transmitted diseases), together with chapters on the Korean War and the current conflict in Afghanistan. In addition, the book includes several personal stories in which veterans describe their experiences of injury and recovery. War Wounds is a truly unique book, which offers considerable insights into an aspect of war that is often mentioned but seldom examined as it is here. Medical professionals, military personnel and the general public will all find it a remarkably revealing read.