Relevant bibliographies by topics / Medical consent

Academic literature on the topic 'Medical consent'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Medical consent"

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Eonas, Anthony, John D. McCoy, and Silviya H. M. Eaton. "Medical Informed Consent." Journal of Hospital Marketing & Public Relations 16, no. 1-2 (August 30, 2006): 69–88. http://dx.doi.org/10.1300/j375v16n01_06.

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Hadden, Kristie B., Latrina Y. Prince, Tina D. Moore, Laura P. James, Jennifer R. Holland, and Christopher R. Trudeau. "Improving readability of informed consents for research at an academic medical institution." Journal of Clinical and Translational Science 1, no. 6 (December 2017): 361–65. http://dx.doi.org/10.1017/cts.2017.312.

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IntroductionThe final rule for the protection of human subjects requires that informed consent be “in language understandable to the subject” and mandates that “the informed consent must be organized in such a way that facilitates comprehension.” This study assessed the readability of Institutional Review Board-approved informed consent forms at our institution, implemented an intervention to improve the readability of consent forms, and measured the first year impact of the intervention.MethodsReadability assessment was conducted on a sample of 217 Institutional Review Board-approved informed consents from 2013 to 2015. A plain language informed consent template was developed and implemented and readability was assessed again after 1 year.ResultsThe mean readability of the baseline sample was 10th grade. The mean readability of the post-intervention sample (n=82) was seventh grade.ConclusionsProviding investigators with a plain language informed consent template and training can promote improved readability of informed consents for research.
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Shreekrishna, H. K., and Aruna B. Rao. "Consent in medical practice." International Journal of Preclinical and Clinical Research 2, no. 1 (March 25, 2021): 13–17. http://dx.doi.org/10.51131/ijpccr/v2i1.4.

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Consent is an expression of autonomy and represents the right of a patient to make a decision in a medical matter concerning him. Consent is not just a procedural formality but also a legal requirement. The process of informed consent occurs when communication between a patient and physician results in the patient’s authorization or agreement to undergo a specific medical intervention. In India, the number of suits against doctors is increasing because of failure to take informed consent or inadequate consent from patients for various procedures. Any examination of a patient by the doctor without his consent amounts to assault (351IPC). Ignorance of laws is not a defense in negligence cases, so every practicing doctor should be aware of their responsibilities about consent in medical practice. Consent is not an option but a necessity in medical practice. Keywords: Consent; informed consent; autonomy
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Stauch, Marc. "Consent in Medical Law." British Journal of Nursing 7, no. 2 (January 22, 1998): 84. http://dx.doi.org/10.12968/bjon.1998.7.2.84.

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Heneghan, Christopher. "Consent to medical treatment." Lancet 337, no. 8738 (February 1991): 421. http://dx.doi.org/10.1016/0140-6736(91)91185-w.

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Fernando, LMB. "Consent in medical practice." Galle Medical Journal 12, no. 1 (September 25, 2009): 28. http://dx.doi.org/10.4038/gmj.v12i1.1082.

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Rhodes, Ann Marie. "Consent For Medical Treatment." MCN, The American Journal of Maternal/Child Nursing 12, no. 2 (March 1987): 133. http://dx.doi.org/10.1097/00005721-198703000-00012.

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Barnes, Stephen. "Consent to medical treatment." AustralAsian Journal of Cardiac and Thoracic Surgery 1, no. 1 (September 1991): 27–28. http://dx.doi.org/10.1016/1037-2091(91)90012-2.

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Yu, Bo, Duminda Wijesekera, and Paulo Costa. "Informed Consent in Electronic Medical Record Systems." International Journal of Reliable and Quality E-Healthcare 4, no. 1 (January 2015): 25–44. http://dx.doi.org/10.4018/ijrqeh.2015010103.

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Informed consents, either for treatment or use/disclosure, that protect the privacy of patient information subject to law that in certain circumstances may override patient wishes, are mandatory practice in healthcare. Although the healthcare industry has widely adopted Electronic Medical Record (EMR) systems, consents are still obtained and stored primarily on paper or scanned electronic documents. Integrating a consent management system into an EMR system involves various implementation challenges. The authors show how consents can be electronically obtained and enforced using a system that combines medical workflows and ontologically motivated rule enforcement. Finally, the authors describe an implementation that uses open-source software based addition of these components to an open-source EMR system, so that existing systems needn't be scrapped or otherwise rendered obsolete.
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Chuchalin, Alexandr G. "Consent. Modern interpretation: "Voluntary Informed Consent"." Terapevticheskii arkhiv 93, no. 5 (May 15, 2021): 640–44. http://dx.doi.org/10.26442/00403660.2021.05.200797.

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The article is devoted to voluntary informed consent. It considers the historical issues of the formation of this concept in modern health care and medical science. The article highlights a historical role of the Nuremberg Code which was taken as the basis for the Universal Declaration of Human Rights, the World Medical Association (WMA) Code of Ethics, the Declaration on Bioethics and Human Rights, i.e. documents that defined the world order after the end of World War II.
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Dissertations / Theses on the topic "Medical consent"

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Baker, Eileen F. "Autonomy and Informed Consent." Bowling Green State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1491391673593916.

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Maclean, Alasdair Rhuairidh. "Consent to medical treatment and the competent adult." Thesis, University of Glasgow, 2006. http://theses.gla.ac.uk/5448/.

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In this thesis I analyse the concept of consent to medical treatment. I explore its ethical basis in autonomy and examine how other principles and ethical approaches might interact with the rules derived from autonomy. I then situate the relevant ethical obligations within the context f the healthcare professional-patient relationship which subsequently allows me to develop a textured model of consent. The model is predicated on the theory that consent is a secondary right, derivative on the underlying right which it controls. By giving or withholding consent, the autonomous person determines who may justifiably infringe the primary right. Importantly, however, the context of the professional-patent relationship highlights the relevance of consent, not just as permission, but also as agreement. I subsequently utilise the model of consent to analyse the current law, which is found to be deficient. I explore the conceptual difficulties of the split regulation between the torts of battery and negligence. I examine the current standard of disclosure and conclude that while it seems to be moving towards more autonomy respecting prudent patient standard, the courts may still be affording expert witnesses too much say in determining which risks should be disclosed. Most importantly I expose the thin and unsatisfactory conception of autonomy that appears to ground the current legal approach. Some of the common law’s deficiencies lie in tort law’s focus on the outcome rather than the process of the interaction between healthcare professional and the patient. There are three responses to these deficiencies. The common law could be allowed to continue its piecemeal development. The deficiencies of the common law could be patched up by developing professional regulation, or new legislation could be drafted to deal specifically with consent to medical treatment. If there is a genuine commitment to patient autonomy and patient centred care then I submit that legislation is justified.
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McLean, Sheila Ann Manson. "Information disclosure, consent to medical treatment and the law." Thesis, University of Glasgow, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298800.

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Heywood, Robert James. "The law and practice of consent to medical intervention." Thesis, Sheffield Hallam University, 2006. http://shura.shu.ac.uk/3197/.

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This thesis explores the challenging concept of informed consent. It is an empirical study investigated in a medico-legal context. The research combines the use of quantitative and qualitative research methods to analyse the different views of the parties who are actively involved in the consent process in both medical and legal settings. The project provides a comprehensive review of the literature concerning the legal aspects of consent and information disclosure, critically analysing relevant case law and academic opinion. The problematic areas are highlighted and from these a number of research areas are identified forming the basis of the empirical inquiry. The thesis is then broken down into a number of individual studies incorporating a range of empirical techniques. These include:
  1. A quantitative study employing a questionnaire to evaluate medical students' knowledge and to identify what is important to them in respect of consent.
  2. A qualitative interview study exploring health care professionals' opinions on consent in primary care.
  3. A qualitative interview study exploring health care professionals' opinions on consent in secondary care.
  4. A qualitative interview study exploring patients' perspectives on consent.
  5. A qualitative observational study to assess how consent procedures operate in practice in secondary care.
  6. A qualitative interview study exploring consent litigation in practice from solicitors' perspectives.
Each project acts as a continuation of one another. The methodological position of the thesis is that knowledge is progressive and is accumulated as each study develops. This is achieved through the researcher being `situated' in the work and through continuous legal and sociological reflections. Accordingly, the findings are analysed and provide for a critical assessment of the law pertaining to consent and information disclosure. The project is a collaborative venture between the law and the medical profession and seeks to develop a clearer understanding of consent issues in practice. In doing so a number of problems are identified which have previously gone unnoticed and, as such, future recommendations for improvement are provided at the end of this thesis.
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Hoeyer, Klaus. "Biobanks and informed consent : An anthropological contribution to medical ethics." Doctoral thesis, Umeå universitet, Institutionen för folkhälsa och klinisk medicin, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-358.

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Background: 1985 saw the beginnings of a population-based biobank in Västerbotten County, Sweden. In 1999, a start-up genomics company, UmanGenomics, obtained ‘all commercial rights’ to the biobank. The company introduced an ethics policy, which was well received in prestigious journals, focusing on public oversight and informed consent. Aims: To explore how social anthropology can aid understanding of the challenges posed by the new role of the biobank in Västerbotten, and thus complement more established traditions in the field of medical ethics. An anthropological study of the ethics policy was executed. Theoretical perspective: Inspired by the anthropology of policy and social science perspectives on ethics and morality, the policy was studied at three analytical levels: policymakers (who formulate the policy), policy workers (who implement the policy, primarily nurses who obtain informed consent) and target group (for whom and on whom the policy is supposed to work: the potential donors to the biobank). Methods: Policymakers, nurses, and potential donors were interviewed, donations observed, and official documents analysed to mirror the moral problematizations made at the three levels in each other and to study the practical implications of the policy. To extend the reliability of the findings two surveys were executed: one among the general population, one among donors. Results: The qualitative studies show that policymakers distinguish between blood and data differently to potential donors. Informed consent seems more important to policymakers than potential donors, who are more concerned about political implications at a societal level. Among the respondents from the survey in the general public, a majority (66.8%) accepted surrogate decisions by Research Ethics Committees; a minority (4 %) stated informed consent as a principal concern; and genetic research based on biobank material was generally accepted (71%). Among the respondents to the survey in donors, 65% knew they had consented to donate a blood sample, and 32% knew they could withdraw their consent; 6% were dissatisfied with the information they had received; and 85% accepted surrogate decisions by Research Ethics Committees. Discussion: The ethics policy constitutes a particular naming and framing of moral problems in biobank-based research which overemphasises the need for informed consent, and underemphasises other concerns of potential donors. This embodies a political transformation where access to stored blood and medical information is negotiated in ethical terms, while it also has unacknowledged political implications. In particular, the relations between authorities and citizens in the Swedish welfare state are apparently transforming: from mutual obligation to individual contracts. Conclusion: Anthropology contributes to medical ethics with increased awareness of the practical implications of particular research ethical initiatives. This awareness promotes appreciation of the political implications of ethics policies and raises new issues for further consideration.
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Hoeyer, Klaus Lindgaard. "Biobanks and informed consent : an anthropological contribution to medical ethics /." Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-358.

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Devereux, John Anthony. "Competence to consent to medical treatment in England and Australia." Thesis, University of Oxford, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.358468.

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Barit, Avi. "The doctrine of informed consent in South African medical law." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/60104.

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Walker, Nancy L. Hamilton. "The relationship between patient perceptions of informed consent and recall of information received during the informed consent process." Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/865959.

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Informed consent is a requirement by law. Informed consent is a two part process: giving the patient sufficient information so that an educated choice can be made and obtaining assent in writing (Coy, 1989; Fiesta 1991; Sweeney, 1991;). The purpose of this study is to determine the ability to recall information and the perception of patients about the process of receiving information after signing a consent to participate in a large research trial. Patients signing consents for participation in the Breast Cancer Prevention Trial were asked to complete the surveys. Thirty three patients were asked to complete the questionnaires. Twenty - four (72%) of the respondents returned the completed questionnaires. Confidentiality will be maintained since no names or identifying markers will be used.A modified Patient Recall Survey (Casselith, Zupkis, Sutton - Smith, & March, 1980) and a modified Consent Form Survey (Casselith et al, 1980) were used. The significance of the study is that the results will assist in improving the type of information given to patients and how that information is provided. By increasing patients awareness about the need for and rights of giving informed consent patients will be more knowledgeable health care consumers. Imogene King(1981) provides the theoretical framework for this study using the concept of perceptions as the basis.The first research question illustrated that the majority of the respondents were able to recall at least three risks or complications of participation in the Breast Cancer Prevention Trial. The second research question revealed eighty - seven percent of the patients agreed that informed consents are necessary. However, 27.8 % of the respondents perceived the informed consent as a legal document to protect the physician rights, while only 19.6 % felt that the consent represented a legal document to protect patient rights. Eighty three percent of the respondents understood that a consent did not have to be signed. However, responses to a second question revealed only 21.3 % understood that the informed consent was a chance to refuse or change treatment. Results to research question 3 illustrated that patients felt that informed consents are necessary. Finally, 79.2 % of patients reported that nurses provided the majority of informed consent information. When patients are able to understand and participate in health care decisions, patients will feel more control in determining outcomes.
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Morin, Sophie. "La place des droits du patient à l'intérieur de la conception actuelle de l'obligation de renseigner en matière médicale /." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30319.

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This thesis deals with the concept of the medical duty to inform focusing on the rights of the patient. It emerges that the notions governing medical responsibility do not adequately address the question of the protection and application of the rights of the patient. Existing conceptions of the notions of dereliction, causality and damage are analysed in order to point out the many inadequacies with the rights of the patient, source of the obligation to inform. Particular emphasis is given to the situation in Quebec and to the eventual place that could be occupied by conception of the duty to inform that is more sensitive to the situation and rights of the patient.
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Books on the topic "Medical consent"

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Davies, Rhys. Consent to medical treatment. [London]: MIND Publications, 1995.

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Carmi, Amnon. Informed consent. Edited by UNESCO Chair in Bioethics at the University of Haifa. Haifa, Israel: Israel National Commission for UNESCO, 2003.

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Victoria, Law Reform Commission of. Informed consent. [Melbourne: The Commission], 1987.

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Law Reform Commission of Victoria. Informed consent to medical treatment. Melbourne: The Commission, 1987.

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Informed consent: A tutorial. [Owings Mills, MD]: National Health Pub., 1986.

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Competence to consent. Washington, D.C: Georgetown University Press, 1994.

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Working Party on the Legal, Medical and Ethical Issues of Mental Handicap. Competency and consent to medical treatment. London: MENCAP, 1989.

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Palmer, R. N. Consent, confidentiality, disclosure of medical records. London: The Medical Protection Society, 1988.

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Consent to treatment. Oxford: Radcliffe Pub., 2011.

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National Center for Clinical Ethics (U.S.), ed. Informed consent: Policy & practice. White River Junction, VT (VAMC & ROC, White River Junction 05009): National Center for Clinical Ethics, 1996.

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Book chapters on the topic "Medical consent"

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Dean, Michael R. E. "Consent." In Medical Radiology, 17–20. Berlin, Heidelberg: Springer Berlin Heidelberg, 2007. http://dx.doi.org/10.1007/978-3-540-33255-8_4.

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Goold, Imogen, and Jonathan Herring. "Consent." In Great Debates in Medical Law and Ethics, 27–49. London: Macmillan Education UK, 2014. http://dx.doi.org/10.1007/978-1-137-32747-5_2.

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Coccia, F., and J. S. Freedman. "Consent in Interventional Radiology." In Medical Radiology, 19–24. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/174_2011_531.

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Charles, Adrian. "Consent for Medical Autopsy." In Practical Manual of Fetal Pathology, 19–25. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-42492-3_3.

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Eldo, Frezza. "Consent and Conflict of Interest." In Medical Ethics, 65–72. Boca Raton : Taylor & Francis, 2019.: Productivity Press, 2018. http://dx.doi.org/10.4324/9780429506949-9.

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Wear, Stephen. "The Informed Consent Event." In Clinical Medical Ethics, 84–107. Dordrecht: Springer Netherlands, 1993. http://dx.doi.org/10.1007/978-94-015-8122-6_7.

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Wear, Stephen. "Exceptions to Informed Consent." In Clinical Medical Ethics, 134–46. Dordrecht: Springer Netherlands, 1993. http://dx.doi.org/10.1007/978-94-015-8122-6_9.

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Samanta, Jo, and Ash Samanta. "Capacity and consent to medical treatment." In Medical Law, 131–82. London: Macmillan Education UK, 2015. http://dx.doi.org/10.1007/978-1-137-03826-5_4.

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White, Lynn J. "Informed consent for EMS research." In Emergency Medical Services, 410–14. Chichester, UK: John Wiley & Sons, Ltd, 2015. http://dx.doi.org/10.1002/9781118990810.ch119.

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Wear, Stephen. "The Enterprise of Informed Consent." In Clinical Medical Ethics, 147–50. Dordrecht: Springer Netherlands, 1993. http://dx.doi.org/10.1007/978-94-015-8122-6_10.

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Conference papers on the topic "Medical consent"

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Henley, Jessica, and Simon Kirby. "Robotic Surgery – Implications for Informed Consent." In The Hamlyn Symposium on Medical Robotics: "MedTech Reimagined". The Hamlyn Centre, Imperial College London London, UK, 2022. http://dx.doi.org/10.31256/hsmr2022.17.

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Informed consent can be a complicated medico-legal process to ensure that a patient understands the risks involved with medical treatment or procedure. Surgeons in particular continue to face legal liability on the claim that informed consent was not properly achieved before surgery, which is likely to be further complicated by evolving technological advances in medicine [1],[2]. Robotic surgery introduces ambiguity for physicians to achieve informed consent. In addition to explaining the procedure according to the plan, the physician must describe the risk inherent to the technology that could create risk during the procedure. In the relatively new and ever-progressing world of surgical robotics, the surgeon may not have a complete understanding of what can go wrong based on their knowledge of the technology. This ambiguity leaves room for legal vulnerability for both the physician and the patient in achieving informed consent, as well as ambiguity in who can be held responsible. With the development and implementation of surgical robotics, no standardized protocol or training has been developed for how to approach informed consent discussions with patients. This poster considers the implications of surgical robotics on informed consent.
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"How to Collect Consent for an Anonymous Medical Database." In International Conference on Health Informatics. SCITEPRESS - Science and and Technology Publications, 2014. http://dx.doi.org/10.5220/0004902404050412.

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Appenzeller, Arno, Thomas Kadow, Erik Krempel, and Jürgen Beyer. "CPIQ - A Privacy Impact Quantification for Digital Medical Consent." In PETRA '21: The 14th PErvasive Technologies Related to Assistive Environments Conference. New York, NY, USA: ACM, 2021. http://dx.doi.org/10.1145/3453892.3461653.

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Mancy, L., and S. Maria Celestin Vigila. "Consent based Access Control Mechanism for Encrypted Medical Image." In 2019 2nd International Conference on Intelligent Computing, Instrumentation and Control Technologies (ICICICT). IEEE, 2019. http://dx.doi.org/10.1109/icicict46008.2019.8993395.

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Geller, Simon, Sebastian Müller, Simon Scheider, Christiane Woopen, and Sven Meister. "Value-based Consent Model: A Design Thinking Approach for Enabling Informed Consent in Medical Data Research." In 15th International Conference on Health Informatics. SCITEPRESS - Science and Technology Publications, 2022. http://dx.doi.org/10.5220/0010828000003123.

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Zivojinovic, Dragica. "CONSENT OF THE LEGAL REPRESENTATIVE AND ASSENT OF PERSONS INCAPABLE OF GIVING INFORMED CONSENT TO PARTICIPATE IN MEDICAL RESEARCH." In SGEM 2014 Scientific SubConference on POLITICAL SCIENCES, LAW, FINANCE, ECONOMICS AND TOURISM. Stef92 Technology, 2014. http://dx.doi.org/10.5593/sgemsocial2014/b21/s5.073.

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Bonnici, Christian J. "An extended conceptual model of consent for information systems." In 2013 IEEE 26th International Symposium on Computer-Based Medical Systems (CBMS). IEEE, 2013. http://dx.doi.org/10.1109/cbms.2013.6627780.

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Alshevsky, Vladimir. "Problems of informed consent in domestic medicine." In Issues of determining the severity of harm caused to human health as a result of the impact of a biological factor. ru: Publishing Center RIOR, 2020. http://dx.doi.org/10.29039/conferencearticle_5fdcb03a27a5f7.62532593.

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Since 1993, the requirement to obtain informed consent from a patient before a medical intervention has not been properly implemented to date. This is partly due to the wording of a number of articles of the current Federal Law of November 21, 2011 № 323-FZ and orders of the Ministry of Health of the Russian Federation, which set the trend for profanity in informing the patient. Evasion of the doctor from proper informing the patient creates the prerequisites for the doctor to commit acts falling under the Criminal Code, as well as in civil proceedings.
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Li, Jingquan. "Open Medical Big Data and Open Consent and Their Impact on Privacy." In 2017 IEEE International Congress on Big Data (BigData Congress). IEEE, 2017. http://dx.doi.org/10.1109/bigdatacongress.2017.76.

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Assale, Michela, Erica Barbero, and Federico Cabitza. "Digitizing the Informed Consent: the Challenges to Design for Practices." In 2019 IEEE 32nd International Symposium on Computer-Based Medical Systems (CBMS). IEEE, 2019. http://dx.doi.org/10.1109/cbms.2019.00127.

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Reports on the topic "Medical consent"

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Barbour, Virginia, Muhammad Irfan, Deborah Poff, and Michael Wise. Journals’ Best Practices for Ensuring Consent for Publishing Medical Case Reports. Committee on Publication Ethics, December 2016. http://dx.doi.org/10.24318/cope.2019.1.6.

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Patel, Deep, Kenneth Graf, and David Fuller. Hip Surgical Preparation Educational Video. Rowan Digital Works, January 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1022.

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This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Catherine Fedorka, and David Fuller. Shoulder Surgical Preparation Educational Video. Rowan Digital Works, January 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1023.

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This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Julio Rodriguez, Vishal Khatri, and David Fuller. Spine Surgical Preparation Educational Video. Rowan Digital Works, January 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1021.

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This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Eric Freeland, and David Fuller. Foot and Ankle Surgical Preparation Educational Video. Rowan Digital Works, January 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1020.

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This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Alisina Shahi, and David Fuller. Hand and Wrist Surgical Preparation Educational Video. Rowan Digital Works, January 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1019.

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This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Edwards, Robert R., and Jr. Tmproving the Consult Management Process at David Grant Medical Center. Fort Belvoir, VA: Defense Technical Information Center, August 1998. http://dx.doi.org/10.21236/ada372308.

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Wiener, Joshua M., Mary E. Knowles, and Erin E. White. Financing Long-Term Services and Supports: Continuity and Change. RTI Press, September 2017. http://dx.doi.org/10.3768/rtipress.2017.op.0042.1709.

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This article provides an overview of financing for long-term services and supports (LTSS) in the United States, paying special attention to how it has changed and not changed over the last 30 years. Although LTSS expenditures have increased greatly (like the rest of health care), the broad outline of the financing system has remained remarkably constant. Medicaid—a means-tested program—continues to dominate LTSS financing, while private long-term care insurance plays a minor role. High out-of-pocket costs and spend-down to Medicaid because of those high costs continue to be hallmarks of the system. Although many major LTSS financing reform proposals were introduced over this period, none was enacted—except the Community Living Assistance Services and Supports Act, which was repealed before implementation because of concerns about adverse selection. The one major change during this time period has been the very large increase in Medicare spending for post-acute services, such as short-term skilled nursing facility and home health care. With the aging of the population, demand for LTSS is likely to increase, placing strain on the existing system.
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Zambrano, Omar, and Hugo Hernández. La clase media en Venezuela: Definición, caracterización y evolución reciente. Inter-American Development Bank, February 2021. http://dx.doi.org/10.18235/0003067.

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Venezuela experimenta la recesión económica más severa y prolongada de su historia económica moderna. El país ha perdido tres cuartas partes de su Producto Interno Bruto, produciendo, como consecuencia, una degradación extrema de las condiciones materiales de vida de sus habitantes. En este contexto, no existe una evaluación apropiada de los efectos que esta profunda crisis económica ha tenido sobre los indicadores socioeconómicos de las clases medias en Venezuela. Este documento técnico hace uso de las fuentes de microdatos disponibles para analizar empíricamente el tamaño y la evolución reciente de la clase media venezolana a la luz de la reciente crisis económica. En líneas generales, se corrobora una caída abrupta y sistemática tanto en el tamaño de la clase media venezolana, así como del poder de consumo de quienes todavía forman parte de ella. En 2020 se verifica que aproximadamente 9 de cada 10 familias que era considerada de clase media a principios de la década pasada, ya no lo es. Además, el análisis dinámico de los datos muestra evidencia de que una porción muy importante de familias de clase media ha perdido su estatus sobretodo en los últimos años, tendencia comprobada por la evolución indicadores no monetarios, relacionados con los niveles multidimensionales de bienestar y seguridad económica de las familias de estratos medios. Venezuela llegó a ser el hogar de la más grande, sólida y próspera clase media de la región, hoy en día, la situación ha cambiado radicalmente: una parte importante de el acervo de capacidades y capital humano de la clase media ha alimentado la ola de emigración de venezolanos de los últimos años, mientras la otra parte, la poción que permaneció en Venezuela, sufre la erosión de sus condiciones en el marco de la depresión económica y la crisis humanitaria. En general, existe amplio consenso sobre el efecto positivo que tiene la clase media sobre el bienestar, el crecimiento económico, la equidad y la estabilidad de las economías, en este sentido, la rehabilitación de la clase media venezolana deberá formar parte de cualquier programa de recuperación futura.
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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