Determining approach to delivery after a previous cesarean is among the most contentious areas of obstetrics. We present a framework for ethically responsible guidelines and practice regarding vaginal birth after cesarean. We describe ethical complexities of 3 key issues that mark the debate: the cesarean delivery rate, safety, and patient autonomy. We then describe a … Read more
OBJECTIVES: The aim of this study was to assess empirically the social and ethical risks associated with implantable radio-frequency identification (RFID) devices. METHODS: Qualitative research included observational studies in twenty-three U.S. hospitals that have implemented new patient identification systems and eighty semi-structured interviews about the social and ethical implications of new patient identification systems, including … Read more
This article analyses the ways in which research coordinators forge professional identities in the highly gendered organizational context of the clinic. Drawing upon qualitative research on the organization of the clinical trials industry (that is, the private sector, for profit auxiliary companies that support pharmaceutical drug studies), this article explores the relationships between predominantly male … Read more
PARENTS OF SERIOUSLY ILL CHILDREN FACE difficult decisions when standard therapies are limited or ineffective. In their search for information, they may turn to websites created by other parents facing similar experiences. We conducted a qualitative content analysis of 21 websites created by families with children affected by cancer or genetic disease, two serious conditions … Read more
Jeremy Howick’s (2009) article is a welcome contribution to ethical debate surrounding the use of placebo-controlled clinical trials, because it approaches the issue from an unusual angle. Historically, the assumption that placebocontrolled trials (PCTs) are methodologically superior to active controlled trials (ACTs) has shaped the ethical debate by pitting those concerned about scientific rigor and … Read more
BACKGROUND: The objective of this study was to develop a culturally appropriate approach for obtaining assent from children aged eight to 17 years to participate in paediatric HIV-related operational research in Kinshasa, Democratic Republic of Congo (DRC). Included within this objective was to determine whether or not HIV disclosure should be included as part of … Read more
Structured AbstractObjectives:The Vanderbilt Evidence-based Practice Center systematically reviewed evidence on treatment of overactive bladder (OAB), urge urinary incontinence, and related symptoms. We focused on prevalence and incidence, treatment outcomes, comparisons of treatments, modifiers of outcomes, and costs.Data:We searched PubMed, MEDLINE®, EMBASE, and CINAHL.Review Methods:We included studies published in English from January 1966 to October 2008. … Read more
OBJECTIVE: To estimate the incidence of maternal cardiovascular and pulmonary events and the prevalence of other comorbid conditions among pregnant smokers. METHODS: We queried the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ) for pregnancy-related discharge codes for the years 2000-2004. The … Read more
To gain entry to the lucrative American market, newly developed drugs must be licensed by the U.S. Food and Drug Administration. Since 1975, the FDA has required applications for licensure from research studies conducted outside the United States to comply with the Declaration of Helsinki, one of the most influential international codes of research ethics. … Read more
Patients making difficult choices among therapeutic options often ask their physicians what they would do if they were in the same situation. When faced with that question, physicians might be concerned that a direct answer could infringe on a patient’s autonomy by substituting the physician’s unique worldview or experience for their patients’. However, refusing to … Read more
