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1

Franceschi, Claude. Conservative haemodynamic cure of incompetent and varicose veins in ambulatory patients. Précy-sous-Thil: Éditions de l'Armançon, 1993.

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2

Buchanan, Allen E. Surrogate decisionmaking for elderly individuals who are incompetent or of questionable competence. [Washington, D.C.?: The Office, 1985.

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3

Annas, George J. Withholding and withdrawing of life-sustaining treatment for elderly incompetent patients: A review of court decisions and legislative approaches. [Washington, D.C.?: The Office, 1985.

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4

Advance treatment directives and autonomy for incompetent patients: An international comparative survey of law and practice, with special attention to the Netherlands. Lewiston: Edwin Mellen Press, 2008.

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5

Carroll, Paula. Life wish: One woman's struggle against medical incompetence. Alameda, Calif: Medical Consumers Pub. Co., 1986.

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6

Robertson, Edward D. Personal autonomy and substituted judgment: Legal issues in medical decisions for incompetent patients. Diocesan Press, 1991.

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7

Ekundayo, Adedayo Adekemisola. THE LIVED EXPERIENCE OF SURROGATE DECISION MAKER AND REQUEST FOR DNR ORDERS ON BEHALF OF INCOMPETENT PATIENTS. 1995.

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8

Hertogh, Cees, und Jenny van der Steen. Ethics of living and dying with dementia. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0057.

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The gradual progression of dementia means there has to be a constant search for a reasonable balance between supporting autonomy and ensuring proper representation. ∙ Good end of life care for people with dementia depends on adequate advance care planning, startling early in the disease process ∙ Where possible, it involves striving for joint decision-making with the patient and next-of-kin about (future) medical treatment and (future) care. ∙ Written advance directives may support representatives of incompetent patients in their role of surrogate decision maker, but the contents of the directive require interpretation in the context of advance care planning. ∙ The concept of “palliative care” offers a (policy) framework for advance care planning as well as moral guideline for dealing with written advance directives of patients with dementia.
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9

Veatch, Robert M., Amy Haddad und E. J. Last. Consent and the Right to Refuse Treatment. Herausgegeben von Robert M. Veatch, Amy Haddad und E. J. Last. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190277000.003.0017.

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This chapter is concerned with one of the major ethical issues in contemporary health care practice: informed or valid consent. The chapter defines the elements of informed consent—that is, the types of information that need to be transmitted for consent to be adequately informed. The second section looks at cases involving questions of the standards of consent, referring to the question of what standard of reference should be used in determining whether a sufficient amount of a particular type of information has been transmitted: the professional standard, the reasonable person standard, or the subjective standard. The third section examines questions of whether the information transmitted is comprehended and whether the consent is adequately voluntary. Finally, the fourth section addresses whether incompetent patients can be expected to consent and what role parents, guardians, and other surrogates can play in giving approval for medical treatments for those who are legally incompetent to do so themselves.
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10

Consent and the incompetent patient: Ethics, law, and medicine. London: Gaskell, 1988.

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11

Flanigan, Jessica. Rethinking Prescription Requirements. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190684549.003.0003.

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Pharmaceutical policy should not discriminate between legitimate and illegitimate drug users, meaning that patients should have access to drugs for medical and non-medical purposes. This principle supports greater access to deadly and addictive drugs. But even if one doesn’t accept the argument that people should have legal access to deadly and addictive drugs, people should at least be permitted to access safe and non-addictive drugs for medical and non-medical uses. People have especially urgent claims to access drugs that protect people from harm and save lives. And there is a role for prescription requirements in limited cases. Dangerous and addictive drugs should remain behind the counter to prevent children and mentally incompetent people from accessing them. Finally, antibiotics should be regulated by a prescription system because antibiotics misuse could violate others’ rights.
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12

Samanta, Jo, und Ash Samanta. 9. The end of life. Oxford University Press, 2018. http://dx.doi.org/10.1093/he/9780198815204.003.0009.

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Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. Concentrates show you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. This chapter deals with key legal and ethical issues surrounding end-of-life decisions, with particular reference to physician-assisted death such as euthanasia. Suicide and assisted suicide, administration of pain relief, and futility are considered. Relevant legislation such as the Suicide Act 1961 (as amended by the Coroners and Justice Act 2009), the Human Rights Act 1998, and the Mental Capacity Act 2005 are discussed. The chapter examines several bioethical principles, including sanctity-of-life and quality-of-life debates; autonomy, beneficence, and medical paternalism; personhood, palliative care, and the double effect doctrine. Finally, it considers human rights issues, treatment requests, incompetent patients, and the concept of the minimally conscious state and locked-in syndrome. Recent cases are cited.
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13

Plioplys, Sigita, Shan Abbas und Brien Smith. Clinicians’ Response to the Diagnosis. Herausgegeben von Barbara A. Dworetzky und Gaston C. Baslet. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190265045.003.0011.

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This chapter explores clinicians’ attitudes toward the diagnosis and treatment of psychogenic nonepileptic seizures (PNES). Across medical specialties, many clinicians report misconceptions about the nature of PNES, which contributes to a negative attitude toward this disorder and difficulties interacting with PNES patients. When working with PNES patients, clinicians often experience feelings of professional incompetency, frustration, and anxiety, which can negatively impact the clinician–patient relationship and treatment outcome. Recommendations to increase clinicians’ knowledge about PNES, promote more positive attitudes toward the disorder, and improve the clinician–patient relationship are provided.
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14

Hirsch, Steven R. Consent and the Incompetent Patient: Ethics, Law, and Medicine : Proceedings of a Meeting Held at the Royal Society of Medicine, 9 December 1986. Royal College of Psychiatrists, 1988.

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15

Lancellotti, Patrizio, Raluca Dulgheru, Mani Vannan und Kiyoshi Yoshida. Heart valve disease (mitral valve disease): mitral regurgitation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0036.

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Mitral regurgitation (MR) is increasingly prevalent in Europe. Echocardiography has a key role in the diagnosis and management of patients with MR. Each echocardiographic study in patients with MR should aim to characterize mitral valve morphology, identify the mechanism of valve dysfunction, quantify the severity of MR, and give hints regarding the aetiology of the disease affecting the valve. Assessment of MR severity should be based on a step-wise approach including two-dimensional-derived Doppler data and, when available, data derived from three-dimensional echocardiography. MR assessment by quantitative methods should be implemented in each patient when possible. It is imperative not only to quantify the MR severity, but also to assess its consequences on the left ventricle, left atrium, and pulmonary vascular bed and to put everything into the clinical context (presence of symptoms, individual risk assessment, etc.) before taking any decision to correct the valvular incompetence. A rigorous echocardiographic study and a correct interpretation in the individual clinical context are needed to decide if the patient should be operated on or followed up closely. Exercise stress echocardiography, when appropriate, should be part of the evaluation algorithm in patients with both primary and secondary MR, as it has proved to be useful in individual risk stratification.
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16

Veatch, Robert M., Amy Haddad und E. J. Last. Fidelity. Herausgegeben von Robert M. Veatch, Amy Haddad und E. J. Last. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190277000.003.0009.

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In general, a pharmacist who is in an ongoing relationship with a patient has a duty to disclose information. This duty can be attributed to the principle of veracity (truthfulness, honesty, correctness, and accuracy), but it can also be associated with the principle of fidelity, where special duties derive from special relationships. This chapter focuses on situations when the pharmacist is faced with a question invoking the principle of fidelity and with related scenarios involving confidentiality. The different obligations of the principles of veracity and fidelity are explained, confidentiality is defined, and the moral limits of confidentiality are examined. The cases in this chapter describe the explicit and implicit ethics of promises, the promise of confidentiality and the limits on such a promise, and the principle of fidelity in terms of professional obligations and loyalty when dealing with incompetent, impaired, or dishonest colleagues.
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