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Yip, Amelia, Shelley McLeod, Andrew McRae i Bin Xie. "Influence of publicly available online wait time data on emergency department choice in patients with noncritical complaints". CJEM 14, nr 04 (lipiec 2012): 237–46. http://dx.doi.org/10.2310/8000.2012.120601.

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ABSTRACTObjectives:Increased emergency department (ED) wait times lead to more patients who leave without being seen and decreased patient satisfaction. Many EDs post estimated wait times either online or in the ED to guide patient expectations. The objectives of this study were to assess patients' awareness of online wait time data and to investigate patients' willingness to use this information when choosing between two academic EDs in London, Ontario.Methods:A prospective study was conducted over a 2-month period in a tertiary ED with online available wait times. Patients over 18 years of age assigned a Canadian Triage and Acuity Scale (CTAS) score of 3, 4, or 5 were approached by trained research assistants to complete a 15-item paper-based questionnaire. Multivariable logistic regression models were used to determine factors independently associated with the outcomes.Results:A total of 1,211 patients completed the survey. Of these, 109 (9%) were aware that ED wait time information was available on the Internet; 544 (45%) reported that they would use the available data to make a decision on which ED to visit, and 536 (44%) indicated that they were more likely to go to the ED with a shorter wait time. Age, gender, household income, education, and Internet access were not associated with awareness of online ED wait times. Participants less than 40 years of age were more likely to use online wait time information.Conclusion:There is low awareness of the availability of ED wait time data published online in the study locaton. Future research may include the delivery of a public awareness strategy for ED wait time data and a re-evaluation of ED use and patient satisfaction following this.
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Brière, Raphaëlle, Rogeh Habashi, Shaila Merchant, Lina Cadili, Zainab Alhumoud, Rebecca Lau, Nada Gawad i in. "2023 Canadian Surgery Forum01. Evaluation of physicians’ practices and knowledge regarding the treatment of acute uncomplicated diverticulitis03. What is the effect of rurality on outcomes for parathyroidectomy in a large North American jurisdiction?05. Characteristics of opioid providers for patients undergoing same-day breast surgery in Ontario, Canada06. Improving the management and outcomes of complex non-pedunculated colorectal polyps at a regional hospital in British Columbia10. Actinomycosis presenting as an anterior abdominal mass after laparoscopic cholecystectomy12. Prioritizing melanoma surgeries to prevent wait time delays and upstaging of melanoma during the COVID-19 pandemic13. Trust me, I know them: assessing interpersonal bias in general surgery residency interviews14. Current state of female and BIPOC representation in Canadian academic surgical societies15. Harnessing a province-wide network of surgical excellence and diverse talents for the continuous improvement of surgical care in BC16. Massive stone or is it glass: a curious case of porcelain gallbladder17. Choosing your endoscopist: a retrospective single-centre cohort study18. The local experience with endoscopic ampullectomy for noninvasive ampullary lesions at a single tertiary care centre19. Defining appropriate intraoperative patient blood management strategies in noncardiac surgery: the Ottawa Intraoperative Transfusion Consensus20. Postoperative gastrointestinal dysfunction after neuromuscular blockade reversal with sugammadex versus cholinesterase inhibitors in patients undergoing gastrointestinal surgery: a systematic review and meta-analysis21. Factors influencing recurrence in medial breast cancer after skin-sparing mastectomy and immediate breast reconstruction22. What is the role of fit in medical education? A scoping review23. The obesity paradox revisited: Is obesity still a protective factor for patients with severe comorbidities or in high-risk operations?24. Planetary health education for residents — an integrative approach through quality improvement25. A rare case of concurrent primary malignancies: adrenal cortical carcinoma and metastatic colon cancer26. Effect of video-based self-assessment on intraoperative skills: a pilot randomized controlled trial28. A cost–utility study of elective hemorrhoidectomies in Canada30. Opioid-free hernia repair using local anesthetic: an assessment of postoperative pain and recovery31. Mitigating the environmental burden of surgical and isolation gowns33. The evolution and contributions of theCanadian Journal of Surgery: a bibliometric study34. Clinical and oncologic outcomes of patients with rectal cancer and past radiotherapy for prostate cancer: a case–control study35. Antibiotic prophylaxis and mechanical bowel preparation in elective colorectal surgery: a survey of Quebec general surgeons36. Identifying core deficiencies and needs in the surgical knot-tying curriculum: a single-centre qualitative analysis37. Spleen-preserving surgery for symptomatic benign splenic cyst: video case report38. Learning to manage power differentials and navigate uncertainty: a qualitative interview study about decision-making in surgery39. Surgical education checklist: a novel tool to improve uptake of Competence By Design in a residency program and surgical resident experience40. A comparative evaluation of management strategies and patient outcomes for acute appendicitis in the post-COVID era41. External benchmarking of colorectal resection outcomes using ACS-NSQIP: accurately categorizing procedures at risk of morbidity42. Role of thymectomy in surgical treatment of secondary and tertiary hyperparathyroidism43. Starting position during colonoscopy: a systematic review and meta-analysis of randomized controlled trials44. Enhanced Recovery After Surgery protocols following emergency intra-abdominal surgery reduces length of stay and postoperative morbidity: a systematic review and meta-analysis45. Competencies, privileging and geography: preparing general surgery residents for rural practice in British Columbia46. Holographic surgical skills training: Can we use holograms to teach hand ties and is it comparable to in-person learning?47. The association between gender and confidence in UBC general surgery residents48. Quality improvement in timeliness of EPA completion in general surgery residency49. Gastrointestinal system surgical outcomes in the highly active antiretroviral therapy (HAART)-era HIV-positive patient: a scoping review50. Joint rounds as a method to partner surgical residency programs and enhance global surgical training52. Preoperative frailty and mortality in medicare beneficiaries undergoing major and minor surgical procedures53. What’s going on out there? Evaluating the scope of rural general surgery in British Columbia54. Short-stay compared with long-stay admissions for loop ileostomy reversals: a systematic review and meta-analysis55. General surgeons’ right hemicolectomy costs proficiency and preferences56. Staple line with bioabsorbable reinforcement for gastropexy in hiatal hernia repair57. Impact of enhanced recovery pathways on patient-reported outcomes after abdominal surgery: a systematic review58. Evaluation of outcomes between rural, northern/remote, and urban surgical patients diagnosed with moderate to severe acute pancreatitis: a retrospective study59. Outcome of preoperative percutaneous drainage of intraabdominal abscess versus initial surgery in patients with Crohn disease60. Preliminary analysis: dexamethasone-supplemented TAP blocks may reduce opioid requirements after colorectal surgery: a multi-centre randomized controlled trial61. Preoperative skin preparation with chlorhexidine alcohol versus povidone–iodine alcohol for the prevention of surgical site infections: a systematic review and meta-analysis of randomized controlled trials62. “Why didn’t you call me?” Factors junior learners consider when deciding whether to call their supervisor63. Cost savings associated with general surgical consultation within remote Indigenous communities in Quebec: a costing evaluation64. Right lateral decubitis patient position during colonoscopy increases endoscopist’s risk of musculoskeletal injury65. Reducing re-visit to hospital rates among pediatric post-appendectomy patients: a quality-improvement project66. Exploring gender diversity in surgical residency leadership across Canada67. Operating room sustainability project: quantifying the surgical environmental footprint for a laparoscopic cholecystectomy in 2 major surgical centres68. ERCP under general anesthesia compared with conscious sedation (EUGACCS) study69. Complications requiring intervention following gastrostomy/gastrojejunostomy tube insertion: a retrospective analysis70. Equity, diversity and inclusion (EDI) in underrepresented in medicine (URiM) residents: Where are we and what now?71. Association between complications and death within 30 days after general surgery procedures: a Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) substudy72. What is the long-term impact of gastrograffin on adhesive small bowel obstruction? A systematic narrative review73. TRASH-CAN: Trainee-Led Research and Sudit for Sustainability in Healthcare Canada74. Representation and reporting of sociodemographic variables in BREAST-Q studies: a systematic review75. A scoping review: should tap water instead of sterile water be used for endoscopy of the colon and rectum?76. Laparoscopic revision of Nissen fundoplication with EndoFLIP intraoperative assistance: a video presentation77. Environmental sustainability in the operating room: perspectives and practice patterns of general surgeons in Canada78. The impact of COVID-19 on medical students applying to general surgery in the CaRMS matching process79. Novel approach to laparoscopic gastrostomy tube placement80. Using prucalopride for prevention of postoperative ileus in gastrointestinal surgery: a systematic review and meta-analysis of randomized controlled trials81. Assessment of environmental and economic sustainability of perioperative patient warming strategies83. Development of a Canadian colorectal robotic surgery program: the first three years84. Patient safety and quality improvement lessons from review of Canadian thyroid and parathyroid surgery malpractice litigation case law01. Changes in sarcopenia status predict survival among patients with resectable esophageal cancer02. The feasibility of near-infrared fluorescence-guided robotic-assisted minimally invasive esophagectomy using indocyanine green dye03. Does patient experience with robotic thoracic surgery influence their willingness to pay for it?04. Artificial intelligence–augmented endobronchial ultrasound-elastography is a useful adjunct for lymph node staging for lung cancer05. Preoperative mediastinal staging in early-stage lung cancer: targeted nodal sampling is not inferior to systematic nodal sampling06. The application of an artificial intelligence algorithm to predict lymph node malignancy in non-small cell lung cancer07. Pneumonectomy for non-small cell lung cancer: long-term overall survival from a 15-year experience09. Primary spontaneous pneumothorax occurred in pectus excavatum patients10. Optimizing management for early-stage esophageal adenocarcinoma: longitudinal results from a multidisciplinary program11. Needle decompressions in post-traumatic tension pneumothorax: boon or bane12. 10-year follow-up of endoscopic mucosal resection versus esophagectomy for esophageal intramucosal adenocarcinoma in the setting of Barrett esophagus: a Canadian experience13. Outcomes after thoracic surgery for malignancy in patients with severe and persistent mental illness15. Stage II/III esophageal cancer patients with complete clinical response after neoadjuvant chemoradiotherapy: a Markov decision analysis16. Development of a surgical stabilization of rib fractures program at a Level I trauma centre in Qatar: initial report17. Screening Criteria Evaluation for Expansion in Pulmonary Neoplasias (SCREEN) II18. Multi-centre study evaluating the risks and benefits of intraoperative steroids during pneumonectomy19. Prediction of esophageal cancer short-term survival using a pretreatment health-related quality of life measure20. Evaluating the impact of virtual care in thoracic surgery: patients’ perspective21. Virtual thoracic surgical outpatient encounters are non-inferior to in-person visits for overall patient care satisfaction in the post-COVID-19 era22. Concurrent minimally invasive esophagectomy and laparoscopic right hemicolectomy23. Assessing the impact of robotic-assisted thoracic surgery on direct carbon dioxide emissions — a retrospective analysis of a prospective cohort24. Young’s modulus of human lung parenchyma and tumours25. Thoracic surgery trauma: nail gun v. SVC26. Thymomatous myasthenia gravis after total thymectomy at a tertiary care surgical centre: a 15-year retrospective review27. Effectiveness of 18F-FDG-PET/CT in the stage diagnosis of non-small cell lung cancer (NSCLC): a diagnostic test accuracy systematic review and meta-analysis01. Emergency colon resection in the geriatric population: the modified frailty score as a risk factor of early mortality02. Laparoscopic ovarian transposition prior to pelvic radiation in young female patients with anorectal malignancies: a systematic review and meta-analysis of prevalence03. Using preoperative C-reactive protein levels to predict anastomotic leaks and other complications after elective colorectal surgery: a systematic review and meta-analysis04. Perioperative intravenous dexamethasone for patients undergoing colorectal surgery: a systematic review and meta-analysis05. Population-based study comparing time from presentation to diagnosis and treatment between younger and older adults with colorectal cancer06. The role of warmed-humidified CO2insufflation in colorectal surgery: a meta-analysis07. Total abdominal colectomy versus diverting loop ileostomy and antegrade colonic lavage for fulminantClostridioidescolitis: analysis of the national inpatient sample 2016–201908. Cutting seton for the treatment of cryptoglandular fistula-inano: a systematic review and meta-analysis09. Prognostic value of routine stain versus elastic trichrome stain in identifying venous invasion in colon cancer10. Anastomotic leak rate following the implementation of a powered circular stapler in elective colorectal surgeries11. Surgical technique and recurrence of Crohn disease following ileocolic resection12. Implementation of synoptic reporting for endoscopic localization of complex colorectal neoplasms: Can we reduce rates of repeat preoperative colonoscopy?13. Effects of diet and antibiotics on anastomotic healing: a mouse model study with varied dietary fibre and fat, and preoperative antibiotics14. Assessment of rectal surgery–related physical pain and conditioning: a national survey of Canadian rectal surgeons15. Does specimen extraction incision and transversus abdominis plane block affect opioid requirements after laparoscopic colectomy?16. Colorectal and therapeutic GI working together: What is the role for TAMIS for benign lesions?17. Impact of the COVID-19 pandemic on readmission rates following colorectal surgery18. More than the sum of its parts: the benefits of multidisciplinary conferences extend beyond patient care19. Multidisciplinary conference for rectal cancer — measuring patient care impact20. Patient outcomes in emergency colorectal cancer resections: a 15-year cohort analysis21. Enhanced Recovery after Surgery (ERAS) protocols in colorectal cancer resection: a 15-year analysis of patient outcomes22. Laparoscopic to open conversion in colorectal cancer resection: a 15-year analysis of postoperative outcomes23. Management of postoperative ileus in colorectal cancer resections: a 15-year evaluation of patient outcomes24. Timing of ostomy reversal and associated outcomes: a systematic review25. Fragility of statistically significant outcomes in colonic diverticular disease randomized trials26. Postoperative day 1 and 2 C-reactive protein values for predicting postoperative morbidity following colorectal surgery27. Bariatric surgery before colorectal surgery reduces postoperative morbidity and health care resource utilization: a propensity score matched analysis28. Ileocolic Crohn disease: a video vignette of the Kono-S anastomosis29. Association between patient activation and postoperative outcomes in rectal cancer survivors30. Understanding surgeon and nurse perspectives on the use of patient-generated data in the management of low anterior resection syndrome31. Characteristics of interval colorectal cancer: a Canadian retrospective population-level analysis from Newfoundland and Labrador32. Current rectal cancer survivorship care: unmet patient needs and fragmented specialist and family physician care33. Local excision for T1 rectal cancer: a population-based study of practice patterns and oncological outcomes34. Can nonoperative management of acute complicated diverticulitis be successfully treated with a future hospital at home program? A retrospective cohort study35. Does patient activation impact remote digital health follow-up and same-day discharge after elective colorectal surgery36. Parastomal hernia prevention, assessment and management: best practice guidelines37. Anastomotic leak rates in circular powered staplers versus manual circular staplers in left sided colorectal anastomoses: a systematic review38. The Gips procedure for pilonidal disease: a video presentation39. Local recurrence-free survival after transanal total mesorectal excision: a Canadian institutional experience40. The impact of operative approach for obese colorectal cancer patients: analysis of the national inpatient sample (2015–2019)41. Safety and feasibility of discharge within 24 hours of colectomy: a systematic review and meta-analysis42. Laparoscopic lateral lymph node dissection for an advanced rectal cancer: a video abstract43. “Dear diary”: challenges in adopting routine operative recording in surgical training44. Rectal cancer in the very young (age < 40) — more treatment, worse survival: a population-based study45. Surveillance following treatment for stage I–III rectal cancer in Ontario — a population-based descriptive study46. A 15-year institutional experience of trananal endoscopic microsurgery for local excision of benign and malignant rectal neoplasia47. Robotic approach to reoperative pelvic surgery48. A mucosa-adherent bacterium impairs colorectal anastomotic healing by upregulating interleukin-17: the role of low-grade inflammation as a driver of anastomotic leak49. High uptake of total neoadjuvant therapy for rectal cancer in Canada despite surgeon concerns for possible overtreatment and treatment-related toxicity50. Safety and feasibility of discharge within 24 hours of ileostomy reversal: a systematic review and meta-analysis51. Safety and efficacy of intravenous antifibrinolytic use in colorectal surgery: systematic review and meta-analysis52. Impact of ileal pouch anal anastomosis on fertility in female patients with uulcerative colitis: a systemic review53. Modulation of the gut microbiota with fermentable fibres and 5-aminosalicylate to prevent peri-anastomotic and metastatic recurrence of colorectal cancer54. Patients with locally advanced rectal cancer and a non-threatened circumferential resection margin may go straight to surgery and avoid radiation toxicities: the QuickSilver Trial55. Colonoscopies during the COVID-19 pandemic recovery period: Are we caught up on colorectal cancer detection and prevention? A single-institution experience56. Interim results of a phase II study evaluating the safety of nonoperative management for locally advanced low rectal cancer57. Assessing a tailored curriculum for endoscopic simulation for general surgery residency programs in Canada58. Modified Frailty Index for patients undergoing surgery for colorectal cancer: analysis of the National Inpatient Sample (2015–2019)59. Reducing postoperative bloodwork in elective colorectal surgery: a quality-improvement initiative60. A Nationwide Readmission Database (NRD) analysis assessing timing of readmission for complications following emergency colectomy: why limiting follow-up to postoperative day 30 underserves patients61. The same but different: clinical and Enhanced Recovery After Surgery outcomes in right hemicolectomy for colon cancer versus ileocecal resection in Crohn disease01. How reliable are postmastectomy breast reconstruction videos on YouTube?02. Knowledge, perceptions, attitudes, and barriers to genetic literacy among surgeons: a scoping review03. Exploring neutrophil-to-lymphocyte ratio as a predictor of postoperative breast cancer overall survival04. High β integrin expression is differentially associated with worsened pancreatic ductal adenocarcinoma outcomes05. Epidemiology of undifferentiated carcinomas06. An evidence-based approach to the incorporation of total neoadjuvant therapy into a standardized rectal cancer treatment algorithm07. Pushing the boundaries: right retroperitoneoscopic adrenalectomy after laparoscopic right nephrectomy08. The role of caspase-1 in triple negative breast cancer, the immune tumour microenvironment and response to anti-PD1 immunotherapy09. Perioperative neutrophil-to-lymphocyte ratio is associated with survival in patients undergoing colorectal cancer surgery10. Achievement of quality metrics in older adults undergoing elective colorectal cancer surgery11. Opportunities to improve the environmental sustainability of breast cancer surgical care12. Does margin status after biopsy matter in melanoma? A cohort study of micro- and macroscopic margin status and their impact on residual disease and survival13. Demonstration of D2 Lymph node stations during laparoscopic total gastrectomy14. Incidence of metastatic tumours to the ovary (Krukenberg) versus primary ovarian neoplasms associated with colorectal cancer surgery15. Spatial biomarkers in cancer16. How informed is the consent process for complex cancer resections?17. Adjuvant radiation therapy among immigrant and Canadian-born/long-term resident women with breast cancer18. Human peritoneal explant model reveals genomic alterations that facilitate peritoneal implantation of gastric cancer cells19. Preoperative breast satisfaction association with major complications following oncologic breast surgery20. Impact of geography on receipt of medical oncology consultation and neoadjuvant chemotherapy for triple negative andHER2positive breast cancer21. Comparison of radiation, surgery or both in women with breast cancer and 3 or more positive lymph nodes22. Impact of synoptic operative reporting as a quality indicator for thyroid surgery: a Canadian national study01. The Toronto management of initially unresectable liver metastases from colorectal cancer in a living donor liver transplant program02. Dissection of a replaced right hepatic artery arising from the superior mesenteric artery during a laparoscopic Whipple03. Implementing the HIBA index: a low-cost method for assessing future liver remnant function04. Oncologic outcomes after surgical resection versus thermoablation in early-stage hepatocellular carcinoma: a systematic review of randomized controlled trials with meta-analysis05. Robotic pancreatic necrosectomy and internal drainage for walled-off pancreatic necrosis06. Predicting diabetes mellitus after partial pancreatectomy: PRIMACY, a pilot study07. Bleed and save: patient blood management in hepatectomy08. Defining standards for hepatopancreatobiliary cancer surgery in Ontario, Canada: a population-based cohort study of clinical outcomes09. Laparoscopic choledochoduodenostomy for recurrent choledocholithiasis10. A comparison of daytime versus evening versus overnight liver transplant from a single Canadian centre11. Pilot study validating the line of safety as a landmark for safe laparoscopic cholecystectomy using indocyanine green and near-infrared imagine12. Effect of transversus abdominis plane catheters on postoperative opioid consumption in patients undergoing open liver resections — a single-centre retrospective review13. Comparing the RETREAT score to the Milan criteria for predicting 5-year survival in post-liver transplant hepatocellular carcinoma patients: a retrospective analysis14. Characterizing the effect of a heat shock protein-90 inhibitor on porcine liver for transplantation using ex-vivo machine perfusion15. Modulation by PCSK9 of the immune recognition of colorectal cancer liver metastasis17. Implementation of a preoperative ketogenic diet for reduction of hepatic steatosis before hepatectomy19. Trends in the incidence and management of hepatocellular carcinoma in Ontario20. Canadian coaching program leads to successful transition from open to laparoscopic hepatopancreatobiliary surgery21. The impact of a positive pancreatic margin analyzed according to LEEPP on the recurrence and survival of patients with pancreatic head adenocarcinoma22. Armed oncolytic virus VSV-LIGHT/TNFSF14 promotes survival and results in complete pathological and radiological response in an immunocompetent model of advanced pancreatic cancer23. Comparing the efficacy of cefazolin/metronidazole, piperacillin-tazobactam, or cefoxitin as surgical antibiotic prophylaxis in patients undergoing pancreaticoduodenectomy: a retrospective cohort study01. Not just jumping on the bandwagon: a cost-conscious establishment of a robotic abdominal wall reconstruction program in a publicly funded health care system02. Shouldice method brief educational video03. Laparoscopic recurrent hiatal hernia repair with mesh gastropexy04. Robotic transabdominal preperitoneal Grynfeltt lumbar hernia repair with mesh01. Substance abuse screening prior to bariatric surgery: an MBSAQIP cohort study evaluating frequency and factors associated with screening02. MBSAQIP risk calculator use in elective bariatric surgery is uncommon, yet associated with reduced odds of serious complications: a retrospective cohort analysis of 210 710 patients03. Short-term outcomes of concomitant versus delayed revisional bariatric surgery after adjustable gastric band removal04. Safety and outcomes of bariatric surgery in patients with inflammatory bowel disease: a systematic review and meta-analysis08. Prescription drug usage as measure of comorbidity resolution after bariatric surgery — a population-based cohort study09. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review10. Bariatric surgery reduces major adverse kidney events in patients with chronic kidney disease: a multiple-linked database analysis in Ontario11. Inter-rater reliability of indocyanine green fluorescence angiography for blood flow visualization in laparoscopic Roux-en-Y gastric bypass12. Characterization of small bowel obstructions following elective bariatric surgery13. Revision of bariatric surgery for gastroesophageal reflux disease: characterizing patient and procedural factors and 30-day outcomes for a retrospective cohort of 4412 patients14. Duodenal-jejunal bypass liners are superior to optimal medical management in ameliorating metabolic dysfunction: a systematic review and meta-analysis15. Characteristics and outcomes for patients undergoing revisional bariatric surgery due to persistent obesity: a retrospective cohort study of 10 589 patients01. Collateral damage: the impact of the COVID-19 pandemic on the severity of abdominal emergency surgery at a regional hospital02. Pseudoaneurysms after high-grade penetrating solid organ injury and the utility of delayed CT angiography03. Pseudoaneurysm screening after pediatric high-grade solid organ injury04. Witnessed prehospital traumatic arrest: predictors of survival to hospital discharge05. A tension controlled, noninvasive device for reapproximation of the abdominal wall fascia in open abdomens08. Delayed vs. early laparoscopic appendectomy (DELAY) for adult patients with acute appendicitis: a randomized controlled trial09. Days at home after malignant bowel obstructions: a patient-centred analysis of treatment decisions10. Polytrauma and polyshock: prevailing puzzle11. National emergency laparotomy audit: a 9-year evaluation of postoperative mortality in emergency laparotomy13. A comparison of stress response in high-fidelity and low-fidelity trauma simulation14. ASA versus heparin in the treatment of blunt cerebrovascular injury — a systematic review and meta-analysis15. Comparison of complication reporting in trauma systems: a review of Canadian trauma registries16. Benefits of the addition of a nurse practitioner to a high-volume acute care surgery service: a quantitative survey of nurses, residents and surgery attendings17. Examining current evidence for trauma recurrence preventions systems18. Disparities in access to trauma care in Canada: a geospatial analysis of Census data19. Fast-track pathway to accelerated cholecystectomy versus standard of care for acute cholecystitis: the FAST pilot trial20. Using the modified Frailty Index to predict postoperative outcomes in patients undergoing surgery for adhesive small bowel obstruction: analysis of the National Inpatient Sample, 2015–201921. Adequacy of thromboprophylaxis in trauma patients receiving conventional versus higher dosing regimens of low-molecular-weight heparin: a prospective cohort study22. The hidden epidemiology of trauma in Nunavik: a comparison of trauma registries as a call to action23. Mapping surgical services in rural British Columbia: an environmental scan". Canadian Journal of Surgery 66, nr 6 Suppl 1 (8.12.2023): S53—S136. http://dx.doi.org/10.1503/cjs.014223.

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Zhou, Yonghe, HaDi MaBouDi, Chaoyang Peng, Hiruni Samadi Galpayage Dona, Selene Gutierrez Al-Khudhairy, Lars Chittka, Cwyn Solvi i Fei Peng. "Bumblebees display stimulus-specific persistence behaviour after being trained on delayed reinforcement". Behavioral Ecology and Sociobiology 78, nr 1 (27.12.2023). http://dx.doi.org/10.1007/s00265-023-03414-7.

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Abstract In uncertain environments, animals often face the challenge of deciding whether to stay with their current foraging option or leave to pursue the next opportunity. The voluntary decision to persist at a location or with one option is a critical cognitive ability in animal temporal decision-making. Little is known about whether foraging insects form temporal expectations of reward and how these expectations affect their learning and rapid, short-term foraging decisions. Here, we trained bumblebees on a simple colour discrimination task whereby they entered different opaque tunnels surrounded by coloured discs (artificial flowers) and received reinforcement (appetitive sugar water or aversive quinine solution depending on flower colour). One group received reinforcement immediately and the other after a variable delay (0–3 s). We then recorded how long bees were willing to wait/persist when reinforcement was delayed indefinitely. Bumblebees trained with delays voluntarily stayed in tunnels longer than bees trained without delays. Delay-trained bees also waited/persisted longer after choosing the reward-associated flower compared to the punishment-associated flower, suggesting stimulus-specific temporal associations. Strikingly, while training with delayed reinforcement did not affect colour discrimination, it appeared to facilitate the generalisation of temporal associations to ambiguous stimuli in bumblebees. Our findings suggest that bumblebees can be trained to form temporal expectations, and that these expectations can be incorporated into their decision-making processes, highlighting bumblebees’ cognitive flexibility in temporal information usage. Significance statement The willingness to voluntarily wait or persist for potential reward is a critical aspect of decision-making during foraging. Investigating the willingness to persist across various species can shed light on the evolutionary development of temporal decision-making and related processes. This study revealed that bumblebees trained with delays to reinforcement from individual flowers were able to form temporal expectations, which, in turn, generalised to ambiguous stimuli. These findings contribute to our understanding of temporal cognition in an insect and the potential effects of delayed rewards on foraging behaviour.
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Hitchman, Kyle J., Albert T. Anastasio, Anthony N. Baumann, Sarah E. Welch, Kempland C. Walley i Christopher S. Klifto. "Examining One-Star Reviews in Orthopaedic Hand Surgeons in Large U.S. Cities". Journal of Wrist Surgery, 31.01.2024. http://dx.doi.org/10.1055/s-0044-1779446.

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Abstract Introduction Physician-review websites are a commonly used resource by patients when choosing a surgeon. While data exist regarding some surgical specialties, no study has examined negative one-star reviews for orthopaedic-trained hand surgeons. The goal of this study was to investigate one-star reviews regarding orthopaedic-trained hand and upper extremity surgeons in the 10 largest cities in the United States to determine the associated factors behind unsatisfied patients to improve patient care. Methods Patient reviews and narratives of orthopaedic-trained hand surgeons were collected from the 10 largest cities in the United States using Vitals.com. One-star reviews (out of a five-star maximum) with comments were identified and classified as operative or nonoperative. These reviews were further subclassified based on the nature of the comment. Results A total of 830 one-star reviews with 1,662 complaints were included in this study. Of these complaints, 557 (33.5%) were from patients who received operative care and 1,105 (66.5%) were from nonoperative care patients. Nonoperative patient one-star reviews had a significantly higher proportion of complaints related to bedside manners (37.6 to 19.6%, p < 0.001), not enough time spent with the provider (18.1 to 4.5%, p < 0.001), and wait time (13.3 to 3.2%, p < 0.001) as compared with operative patient one-star reviews. Operative patient one-star reviews had a higher proportion of complaints related to disagreement with the physician's decision or plan (15.6 to 10.2%, p = 0.002); uncontrolled pain (14.4 to 7.9%, p < 0.001); and medical staff or institution (17.2 to 12.9%, p = 0.018) as compared with nonoperative patients. Discussion Most one-star reviews regarding orthopaedic-trained hand surgeons referenced nonclinical components—bedside manner was the most common complaint. It was determined that surgical patients were less likely to leave a one-star review; however, if they did, the most common complaint was in reference to a disagreement with the physician's decision or uncontrolled pain postoperatively. Type of Study Outcomes 2c.
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Sleiman, Jean-Pierre. "Generative artificial intelligence and large language models for digital banking: First outlook and perspectives". Journal of Digital Banking, 1.09.2023. http://dx.doi.org/10.69554/cnmi7720.

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After several years of steady progress, the Generative artificial intelligence (AI) and large language models (LLMs, their applications to text) fields have accelerated tremendously since the end of 2022 and the public launch of ChatGPT. This is due to record-breaking model sizes and performances in the last couple of months, triggering unprecedented adoption curves from end users across the world. Even though regulators reacted fast, sharing their first recommendations, auditing emerging players, amending their AI regulation drafts or launching dedicated working groups, these efforts will require several months or years to come to fruition. There are multiple reasons for this. LLMs are complex technological objects made of gigantic foundational models trained on enormous quantities of texts, coupled with dedicated interfaces and action agents. They present a huge potential to perform high varieties of tasks with very high quality but also important risks in terms of costs, content accuracy, transparency, data privacy, security and ethics. Finally, the current ecosystem of stakeholders is very dynamic but also immature. In this uncertain context, the digital banking industry has been reacting ambivalently, with major players banning employee access to ChatGPT and publicly communicating on new LLM initiatives at the same time. This can be explained by the huge potential offered by these technologies to transform their business, coupled with many open questions in terms of technological set-up, usage, compliance and profitability. As these technologies seem to be too transformative for the industry incumbents to just wait and see, they should start creating the right conditions to learn how to use them, by identifying relevant use cases, choosing adapted and simple solutions, designing relevant user experiences, building the right teams, environment, data sets and operating model, and actively engaging in regulatory conversations.
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Zimmerman, Anne. "Forced Organ Harvesting". Voices in Bioethics 9 (21.03.2023). http://dx.doi.org/10.52214/vib.v9i.11007.

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Photo by 187929822 © Victor Moussa | Dreamstime.com INTRODUCTION The nonconsensual taking of a human organ to use in transplantation medicine violates ethical principles, including autonomy, informed consent, and human rights, as well as criminal laws. When such an organ harvesting is not just nonconsensual, but performed in a way that causes a death or uses the pretense of brain death without meeting the criteria, it also violates the dead donor[1] rule.[2] The dead donor rule is both ethical and legal. It prevents organ retrieval that would predictably cause the death of the organ donor.[3] Retrieval of a vital organ is permissible only after a declaration of death.[4] Forced organ harvesting may breach the dead donor rule as it stands. A reimagined, broader dead donor rule could consider a larger timeframe in the forced organ harvesting context. In doing so, the broad dead donor rule could cover intent, premeditation, aiding and abetting, and due diligence failures. A broad definition of forced organ harvesting is ‘‘the removal of one or more organs from a person by means of coercion, abduction, deception, fraud, or abuse of power. . .’’[5] A more targeted definition is “[t]he killing of a person so that their organs may be removed without their free, voluntary and informed consent and transplanted into another person.”[6] In the global organ harvesting context, forced organ harvesting violates the World Health Organization (WHO) Guiding Principle 3, which says “live organ donors should be acting willingly, free of any undue influence or coercion.”[7] Furthermore, WHO states live donors should be “genetically, legally, or emotionally” attached to the recipient. Guiding Principle 1 applies to deceased donors, covers consent, and permits donation absent any known objections by the deceased.[8] Principle 7 says, “Physicians and other health professionals should not engage in transplantation procedures, and health insurers and other payers should not cover such procedures if the cells, tissues or organs concerned have been obtained through exploitation or coercion of, or payment to, the donor or the next of kin of a deceased donor.”[9] There are underground markets in which organ hunters prey on the local poor in countries with low wages and widespread poverty[10] and human trafficking that targets migrants for the purpose of organ harvesting.[11] This paper explores forced harvesting under the backdrop of the dead donor rule, arguing that a human rights violation so egregious requires holding even distant participants in the chain of events accountable. By interfering with resources necessary to carry out bad acts, legislation and corporate and institutional policies can act as powerful deterrents. A broader dead donor rule would highlight the premeditation and intent evidenced well before the act of organ retrieval. I. Background and Evidence In China, there is evidence that people incarcerated for religious beliefs and practices (Falun Gong) and ethnic minorities (Uyghurs) have been subjects of forced organ harvesting. A tribunal (the China Tribunal) found beyond a reasonable doubt that China engaged in forced organ harvesting.[12] Additionally, eight UN Special Rapporteurs found a system of subjecting political prisoners and prisoners of conscience to blood tests and radiological examinations to determine the fitness of their organs.[13] As early as 2006, investigators found evidence of forced organ harvesting from Falun Gong practitioners. [14] Over a million Uyghurs are in custody there, and there is ample evidence of biometric data collection.[15] An Uyghur tribunal found evidence of genocide.[16] “China is the only country in the world to have an industrial-scale organ trafficking practice that harvests organs from executed prisoners of conscience.”[17] Witnesses testified to the removal of organs from live people without ample anesthesia,[18] summonses to the execution grounds for organ removal,[19] methods of causing death for the purpose of organ procurement,[20] removing eyes from prisoners who were alive,[21] and forcing live prisoners into operating rooms.[22] The current extent of executions to harvest organs from prisoners of conscience in China is unknown. The Chinese press has suggested surgeons in China will perform 50,000 organ transplants this year.[23] Doctors Against Forced Organ Harvesting (DAFOR) concluded, “[f]orced organ harvesting from living people has occurred and continues to occur unabated in China.”[24] China continues to advertise in multiple languages to attract transplant tourists.[25] Wait times for organs seem to remain in the weeks.[26] In the United States, it is common to wait three to five years.[27] II. The Nascent System of Voluntary Organ Donation in China In China, throughout the 1990s and early 2000s, the supply of organs for transplant was low, and there was not a national system to register as a donor. A 1984 act permitted death row prisoners to donate organs.[28] In 2005, a Vice Minister acknowledged that 95 percent of all organ transplants used organs from death row prisoners.[29] In 2007 the planning of a voluntary system to harvest organs after cardiac death emerged. According to a Chinese publication, China adopted brain death criteria in 2013.[30] There had been public opposition due partly to cultural unfamiliarity with it.[31] Cultural values about death made it more difficult to adopt a universal brain death definition. Both Buddhist and Confucian beliefs contradicted brain death.[32] Circulatory death was traditionally culturally accepted.[33] The Ministry of Health announced that by 2015 organ harvesting would be purely voluntary and that prisoners would not be the source of organs.[34] There are cultural barriers to voluntary donation partly due to a Confucian belief that bodies return to ancestors intact and other cultural and religious beliefs about respect for the dead.[35] An emphasis on family and community over the individual posed another barrier to the Western approach to organ donation. Public awareness and insufficient healthcare professional knowledge about the process of organ donation are also barriers to voluntary donation.[36] Although the Chinese government claims its current system is voluntary and no longer exploits prisoners,[37] vast evidence contradicts the credibility of the voluntary transplant program in China.[38] III. Dead Donor Rule: A Source of Bioethical Debate It seems tedious to apply this ethical foundation to something as glaring as forced organ harvesting. But the dead donor rule is a widely held recognition that it is not right to kill one person to save another.[39] It acts as a prohibition on killing for the sake of organ retrieval and imposes a technical requirement which influences laws on how death is declared. The dead donor rule prevents organ harvesting that causes death by prohibiting harvesting any organ which the donor agreed to donate only after death prior to an official declaration of death. There is an ongoing ethical debate about the dead donor rule. Many in bioethics and transplant medicine would justify removing organs in specific situations prior to a declaration of death, abandoning the rule.[40] Some use utilitarian arguments to justify causing the death of someone who is unconscious and on life support irreversibly. Journal articles suggest that the discussion has moved to one of timing and organ retrieval.[41] Robert Truog and Franklin Miller are critics of the dead donor rule, arguing that, in practice, it is not strictly obeyed: removing organs while a brain-dead donor is still on mechanical ventilation and has a beating heart and removing organs right after life support is removed and cardio-pulmonary death is declared both might not truly meet the requirement of the dead donor rule, making following the rule “a dubious norm.”[42] Miller and Truog question the concept of brain death, citing evidence of whole body integrated functions that continue indefinitely. They challenge cardio-pulmonary death, asserting that the definition includes as dead, those who could be resuscitated. Their hearts could resume beating with medical intervention. Stopping life support causes death only in those whose lives are sustained by it. Some stipulate that the organ retrieval must not itself cause the death. Some would rejigger the cause of death: Daniel Callahan suggests that the underlying condition causes the death despite removal of life support.[43] But logically, a person could continue life support and be alive, so clearly, removing life support does cause death. Something else would have caused brain death or the circumstance that landed the person on mechanical ventilation. To be more accurate, one could say X caused the irreversible coma and removing life support caused the death itself. Miller and Truog take the position that because withdrawal of life support does cause death, the dead donor rule should be defunct as insincere. To them, retrieving vital organs from a technically alive donor should be permissible under limited conditions. They look to the autonomous choices of the donor or the surrogate (an autonomy-based argument). They appreciate the demand for organs and the ability to save lives, drawing attention to those in need of organs. Live donor organ retrieval arguably presents a slippery slope, especially if a potential donor is close to death, but not so close to label it imminent. They say physicians would not be obligated to follow the orders of a healthy person wishing to have vital organs removed, perhaps to save a close friend or relative. Similarly, Radcliffe-Richards, et al. argue that there is no reason to worry about the slippery slope of people choosing death so they can sell their vital organs, whether for money for their decedents or their creditors.[44] The movement toward permissibility and increased acceptance of medical aid in dying also influence the organ donation arena. The slippery slope toward the end of life has potential to become a realistic concern. Older adults or other people close to death may want to donate a vital organ, like their heart, to a young relative in need. That could greatly influence the timing of a decision to end one’s life. IV. Relating the Dead Donor Rule to Forced Organ Harvesting There is well documented evidence that in China organs have been removed before a declaration of death.[45] But one thing the dead donor rule does not explicitly cover is intent and the period prior to the events leading to death. It tends to apply to a near-death situation and is primarily studied in its relationship to organ donation. It is about death more than it is about life. Robertson and Lavee investigated data on transplantation of vital organs in China and they document cases where the declaration of death was a pretense, insincere, and incorrect. Their aim was to investigate whether the prisoners were in fact dead prior to organ harvesting.[46] (The China Tribunal found that organs have been removed from live prisoners and that organ harvesting has been the cause of death.) They are further concerned with the possible role of doctors as executioners, or at least as complicit in the execution as the organ harvesting so closely follows it. V. A Broader Dead Donor Rule A presumed ethical precursor to the dead donor rule may also be an important ethical extension of the rule: the dead donor rule must also prohibit killing a person who is not otherwise near death for the purpose of post-death organ harvesting. In China, extra-judicial killings of prisoners of conscience are premeditated ― there is ample evidence of blood tests and radiology to ensure organ compatibility and health.[47] To have effective ethical force, the dead donor rule should have an obvious application in preventing intentional killing for an organ retrieval, not just killing by way of organ retrieval. When we picture the dead donor rule, bioethicists tend to envision a person on life support who will either be taken off it and stop breathing or who will be declared brain dead. But the dead donor rule should apply to healthy people subject to persecution at the point when the perpetrator lays the ground for the later killing. At that point, many organizations and people may be complicit or unknowingly contributing to forced organ harvesting. In this iteration of the dead donor rule, complicity in its violations would be widespread. The dead donor rule could address the initial action of ordering a blood or radiology test or collecting any biometric data. Trained physicians and healthcare technicians perform such tests. Under my proposed stretch of the dead donor rule, they too would be complicit in the very early steps that eventually lead to killing a person for their organs. I argue these steps are part of forced organ harvesting and violate the dead donor rule. The donor is very much alive in the months and years preceding the killing. A conspiracy of indifference toward life, religious persecution, ethnic discrimination, a desire to expand organ transplant tourism, and intent to kill can violate this broader dead donor rule. The dead donor rule does not usually apply to the timing of the thought of organ removal, nor the beginning of the chain of events that leads to it. It is usually saved for the very detailed determination of what may count as death so that physicians may remove vital and other organs, with the consent of the donor.[48] But I argue that declaring death at the time of retrieval may not be enough. Contributing to the death, even by actions months or years in advance, matter too. Perhaps being on the deathbed awaiting a certain death must be distinguished from going about one’s business only to wind up a victim of forced organ harvesting. Both may well be declared dead before organ retrieval, but the likeness stops there. The person targeted for future organ retrieval to satisfy a growing transplant tourism business or local demand is unlike the altruistic person on his deathbed. While it may seem like the dead donor rule is merely a bioethics rule, it does inform the law. And it has ethical heft. It may be worth expanding it to the arena of human trafficking for the sake of organ removal and forced organ harvesting.[49] The dead donor rule is really meant to ensure that death was properly declared to protect life, something that must be protected from an earlier point. VI. Complicity: Meaning and Application Human rights due diligence refers to actions that people or institutions must take to ensure they are not contributing to a human rights violation. To advise on how to mitigate risk of involvement or contribution to human rights violations, Global Rights Compliance published an advisory that describes human rights due diligence as “[t]he proactive conduct of a medical institution and transplant-associated entity to identify and manage human rights risks and adverse human rights impacts along their entire value and supply chain.”[50] Many people and organizations enable forced organ harvesting. They may be unwittingly complicit or knowingly aiding and abetting criminal activity. For example, some suppliers of medical equipment and immunosuppressants may inadvertently contribute to human rights abuses in transplantation in China, or in other countries where organs were harvested without consent, under duress, or during human trafficking. According to Global Rights Compliance, “China in the first half of 2021 alone imported ‘a total value of about 24 billion U.S. dollars’ worth of medical technology equipment’, with the United States and Germany among the top import sources.”[51] The companies supplying the equipment may be able to slow or stop the harm by failing to supply necessary equipment and drugs. Internal due diligence policies would help companies analyze their suppliers and purchasers. Corporations, educational institutions, and other entities in the transplantation supply chain, medical education, insurance, or publishing must engage in human rights due diligence. The Global Rights Compliance advisory suggests that journals should not include any ill-gotten research. Laws should regulate corporations and target the supply chain also. All actors in the chain of supply, etc. are leading to the death of the nonconsenting victim. They are doing so while the victim is alive. The Stop Forced Organ Harvesting Act of 2023, pending in the United States, would hold any person or entity that “funds, sponsors, or otherwise facilitates forced organ harvesting or trafficking in persons for purposes of the removal of organs” responsible. The pending legislation states that: It shall be the policy of the United States—(1) to combat international trafficking in persons for purposes of the removal of organs;(2) to promote the establishment of voluntary organ donation systems with effective enforcement mechanisms in bilateral diplomatic meetings and in international health forums;(3) to promote the dignity and security of human life in accordance with the Universal Declaration of Human Rights, adopted on December 10, 1948; and(4) to hold accountable persons implicated, including members of the Chinese Communist Party, in forced organ harvesting and trafficking in persons for purposes of the removal of organs.[52] The Act calls on the President to provide Congress a list of such people or entities and to sanction them by property blocking, and, in the case of non-US citizens, passport and visa denial or revocation. The Act includes a reporting requirement under the Foreign Assistance Act of 1961 that includes an assessment of entities engaged in or supporting forced organ harvesting.[53] The law may have a meaningful impact on forced organ harvesting. Other countries have taken or are in the process of legal approaches as well.[54] Countries should consider legislation to prevent transplant tourism, criminalize complicity, and require human rights due diligence. An expanded dead donor rule supports legal and policy remedies to prevent enabling people to carry out forced organ harvesting. VII. Do Bioethicists Mention Human Rights Abuses and Forced Organ Harvesting Enough? As a field, bioethics literature often focuses on the need for more organs, the pain and suffering of those on organ transplant waitlists, and fairness in allocating organs or deciding who belongs on which waitlist and why. However, some bioethicists have drawn attention to forced organ harvesting in China. Notably, several articles noted the ethical breaches and called on academic journals to turn away articles on transplantation from China as they are based on the unethical practice of executing prisoners of conscience for their organs.[55] The call for such a boycott was originally published in a Lancet article in 2011.[56] There is some acknowledgement that China cares about how other countries perceive it,[57] which could lead to either improvements in human rights or cover-ups of violations. Ill-gotten research has long been in the bioethics purview with significant commentary on abuses in Tuskegee and the Holocaust.[58] Human research subjects are protected by the Declaration of Helsinki, which requires acting in the best interests of research subjects and informed consent among other protections.[59] The Declaration of Helsinki is directed at physicians and requires subjects enroll in medical research voluntarily. The Declaration does not explicitly cover other healthcare professionals, but its requirements are well accepted broadly in health care. CONCLUSION The dead donor rule in its current form really does not cover the life of a non-injured healthy person at an earlier point. If it could be reimagined, we could highlight the link between persecution for being a member of a group like Falun Gong practitioners or Uyghurs as the start of the process that leads to a nonconsensual organ retrieval whether after a proper declaration of death or not. It is obviously not ethically enough to ensure an execution is complete before the organs are harvested. It is abuse of the dead donor rule to have such a circumstance meet its ethical requirement. And obviously killing people for their beliefs or ethnicity (and extra-judicial killings generally) is not an ethically acceptable action for many reasons. The deaths are intentionally orchestrated, but people and companies who may have no knowledge of their role or the role of physicians they train or equipment they sell are enablers. An expanded dead donor rule helps highlight a longer timeframe and expanded scope of complicity. The organ perfusion equipment or pharmaceuticals manufactured in the United States today must not end up enabling forced organ harvesting. With an expanded ethical rule, the “donor is not dead” may become “the donor would not be dead if not for. . .” the host of illegal acts, arrests without cause, forced detention in labor camps, extra-judicial killings, lacking human rights due diligence, and inattention to this important topic. The expanded dead donor rule may also appeal to the bioethics community and justify more attention to laws and policies like the Stop Forced Organ Harvesting Act of 2023. - [1] The word “donor” in this paper describes any person from whom organs are retrieved regardless of compensation, force, or exploitation in keeping with the bioethics literature and the phrase “dead donor rule.” [2] Robertson, M.P., Lavee J. (2022). Execution by organ procurement: Breaching the dead donor rule in China. Am J Transplant, Vol.22,1804– 1812. doi:10.1111/ajt.16969. [3] Robertson, J. A. (1999). Delimiting the donor: the dead donor rule. Hastings Center Report, 29(6), 6-14. [4] Retrieval of non-vital organs which the donor consents to donate post-death (whether opt-in, opt-out, presumed, or explicit according to local law) also trigger the dead donor rule. [5] The Stop Forced Organ Harvesting Act of 2023, H.R. 1154, 118th Congress (2023), https://www.congress.gov/bill/118th-congress/house-bill/1154. [6] Do No Harm: Mitigating Human Rights Risks when Interacting with International Medical Institutions & Professionals in Transplantation Medicine, Global Rights Compliance, Legal Advisory Report, April 2022, https://globalrightscompliance.com/project/do-no-harm-policy-guidance-and-legal-advisory-report/. [7] WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation, as endorsed by the sixty-third World Health Assembly in May 2010, in Resolution WHA63.22 https://apps.who.int/iris/bitstream/handle/10665/341814/WHO-HTP-EHT-CPR-2010.01-eng.pdf?sequence=1. [8] WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation (2010). [9] WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation (2010). [10] Promchertchoo, Pichayada (Oct. 19, 2019). Kidney for sale: Inside Philippines’ illegal organ trade. https://www.channelnewsasia.com/asia/kidney-for-sale-philippines-illegal-organ-trade-857551; Widodo, W. and Wiwik Utami (2021), The Causes of Indonesian People Selling Covered Kidneys from a Criminology and Economic Perspective: Analysis Based on Rational Choice Theory. European Journal of Political Science Studies, Vol 5, Issue 1. [11] Van Reisen, M., & Mawere, M. (Eds.). (2017). Human trafficking and trauma in the digital era: The ongoing tragedy of the trade in refugees from Eritrea. African Books Collective. [12] The Independent Tribunal into Forced Organ Harvesting from Prisoners of Conscience in China (China Tribunal) (2020). https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf [13] UN Office of the High Commissioner, Press Release, China: UN human Rights experts alarmed by ‘organ harvesting’ allegations (UN OTHCHR, 14 June 2021), https://www.ohchr.org/en/press-releases/2021/06/china-un-human-rights-experts-alarmed-organ-harvesting-allegations. [14] David Matas and David Kilgour, Bloody Harvest. The killing of Falun Gong for their organs (Seraphim Editions 2009). [15] How China is crushing the Uyghurs, The Economist, video documentary, July 9, 2019, https://youtu.be/GRBcP5BrffI. [16] Uyghur Tribunal, Judgment (9 December 2021) (Uyghur Tribunal Judgment) para 1, https://uyghurtribunal.com/wp-content/uploads/2022/01/Uyghur-Tribunal-Judgment-9th-Dec-21.pdf. [17] Ali Iqbal and Aliya Khan, Killing prisoners for transplants: Forced organ harvesting in China, The Conversation Published: July 28, 2022. https://theconversation.com/killing-prisoners-for-transplants-forced-organ-harvesting-in-china-161999 [18] Testimony demonstrated surgeries to remove vital organs from live people, killing them, sometimes without ample anesthesia to prevent wakefulness and pain. China Tribunal (2020), p. 416-417. https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf; Robertson MP, Lavee J. (2022), Execution by organ procurement: Breaching the dead donor rule in China. Am J Transplant, Vol.22,1804– 1812. doi:10.1111/ajt.16969. [19] Doctors reported being summoned to execution grounds and told to harvest organs amid uncertainty that the prisoner was in fact dead. China Tribunal (2020), p. 52-53. [20]In testimony to the China Tribunal, Dr. Huige Li noted four methods of organ harvesting from live prisoners: incomplete execution by shooting, after lethal injection prior to death, execution by removal of the heart, and after a determination of brain death prior to an intubation (pretense of brain death). China Tribunal (2020), pp. 54-55. https://chinatribunal.com/wp-content/uploads/2020/03/ChinaTribunal_JUDGMENT_1stMarch_2020.pdf [21] A former military medical student described removing organs from a live prisoner in the late 1990s. He further described his inability to remove the eyes of a live man and his witnessing another doctor forcefully remove the man’s eyes. China Tribunal (2020), p. 330. [22] In 2006, a nurse testified that her ex-husband, a surgeon, removed the eyes of 2,000 Falun Gong practitioners in one hospital between 2001 and 2003. She described the Falun Gong labor-camp prisoners as being forced into operating rooms where they were given a shot to stop their hearts. Other doctors removed other organs. DAFOH Special Report, 2022. https://epochpage.com/wp-content/uploads/sites/3/2022/12/DAFOH-Special-Report-2022.pdf [23] Robertson MP, Lavee J. (2022), Execution by organ procurement: Breaching the dead donor rule in China. Am J Transplant, Vol.22,1804– 1812. doi:10.1111/ajt.16969. [24] DAFOH Special Report, 2022. https://epochpage.com/wp-content/uploads/sites/3/2022/12/DAFOH-Special-Report-2022.pdf; DAFOH’s physicians were nominated for a Nobel Prize for their work to stop forced organ harvesting. Šućur, A., & Gajović, S. (2016). Nobel Peace Prize nomination for Doctors Against Forced Organ Harvesting (DAFOH) - a recognition of upholding ethical practices in medicine. Croatian medical journal, 57(3), 219–222. https://doi.org/10.3325/cmj.2016.57.219 [25] Robertson and Lavee (2022). [26] Stop Organ Harvesting in China, website (organization of the Falun Dafa). https://www.stoporganharvesting.org/short-waiting-times/ [27] National Kidney Foundation, The Kidney Transplant Waitlist – What You Need to Know, https://www.kidney.org/atoz/content/transplant-waitlist [28] Wu, Y., Elliott, R., Li, L., Yang, T., Bai, Y., & Ma, W. (2018). Cadaveric organ donation in China: a crossroads for ethics and sociocultural factors. Medicine, 97(10). [29] Wu, Elliott, et al., (2018). [30] Su, Y. Y., Chen, W. B., Liu, G., Fan, L. L., Zhang, Y., Ye, H., ... & Jiang, M. D. (2018). An investigation and suggestions for the improvement of brain death determination in China. Chinese Medical Journal, 131(24), 2910-2914. [31] Huang, J., Millis, J. M., Mao, Y., Millis, M. A., Sang, X., & Zhong, S. (2012). A pilot programme of organ donation after cardiac death in China. The Lancet, 379(9818), 862-865. [32] Yang, Q., & Miller, G. (2015). East–west differences in perception of brain death: Review of history, current understandings, and directions for future research. Journal of bioethical inquiry, 12, 211-225. [33] Huang, J., Millis, J. M., Mao, Y., Millis, M. A., Sang, X., & Zhong, S. (2015). Voluntary organ donation system adapted to Chinese cultural values and social reality. Liver Transplantation, 21(4), 419-422. [34] Huang, Millis, et al. (2015). [35] Wu, X., & Fang, Q. (2013). Financial compensation for deceased organ donation in China. Journal of Medical Ethics, 39(6), 378-379. [36] An, N., Shi, Y., Jiang, Y., & Zhao, L. (2016). Organ donation in China: the major progress and the continuing problem. Journal of biomedical research, 30(2), 81. [37] Shi, B. Y., Liu, Z. J., & Yu, T. (2020). Development of the organ donation and transplantation system in China. Chinese medical journal, 133(07), 760-765. [38] Robertson, M. P., Hinde, R. L., & Lavee, J. (2019). Analysis of official deceased organ donation data casts doubt on the credibility of China’s organ transplant reform. BMC Medical Ethics, 20(1), 1-20. [39] Miller, F.G. and Sade, R. M. (2014). Consequences of the Dead Donor Rule. The Annals of thoracic surgery, 97(4), 1131–1132. https://doi.org/10.1016/j.athoracsur.2014.01.003 [40] For example, Miller and Sade (2014) and Miller and Truog (2008). [41] Omelianchuk, A. How (not) to think of the ‘dead-donor’ rule. Theor Med Bioeth 39, 1–25 (2018). https://doi-org.ezproxy.cul.columbia.edu/10.1007/s11017-018-9432-5 [42] Miller, F.G. and Truog, R.D. (2008), Rethinking the Ethics of Vital Organ Donations. Hastings Center Report. 38: 38-46. [43] Miller and Truog, (2008), p. 40, citing Callahan, D., The Troubled Dream of Life, p. 77. [44] Radcliffe-Richards, J., Daar, A.S., Guttman, R.D., Hoffenberg, R., Kennedy, I., Lock, M., Sells, R.A., Tilney, N. (1998), The Case for Allowing Kidney Sales, The Lancet, Vol 351, p. 279. (Authored by members of the International Forum for Transplant Ethics.) [45] Robertson and Lavee, (2022). [46] Robertson and Lavee, (2022). [47] China Tribunal (2020). [48] Consent varies by local law and may be explicit or presumed and use an opt-in or opt-out system and may or may not require the signoff by a close family member. [49] Bain, Christina, Mari, Joseph. June 26, 2018, Organ Trafficking: The Unseen Form of Human Trafficking, ACAMS Today, https://www.acamstoday.org/organ-trafficking-the-unseen-form-of-human-trafficking/; Stammers, T. (2022), "2: Organ trafficking: a neglected aspect of modern slavery", Modern Slavery and Human Trafficking, Bristol, UK: Policy Press. https://bristoluniversitypressdigital.com/view/book/978144736. [50] Do No Harm: Mitigating Human Rights Risks when Interacting with International Medical Institutions & Professionals in Transplantation Medicine, Global Rights Compliance, Legal Advisory Report, April 2022, https://globalrightscompliance.com/project/do-no-harm-policy-guidance-and-legal-advisory-report/. [51] Global Rights Compliance, p. 22. [52] The Stop Forced Organ Harvesting Act of 2023, H.R. 1154, 118th Congress (2023). https://www.congress.gov/bill/118th-congress/house-bill/1154. [53] The Stop Forced Organ Harvesting Act of 2023, H.R. 1154, 118th Congress (2023), https://www.congress.gov/bill/118th-congress/house-bill/1154. [54] Global Rights Compliance notes that Belgium, France (passed law on human rights due diligence in the value supply chain), United Kingdom, United States, Canada, Australia, and New Zealand have legal approaches, resolutions, and pending laws. p. 45. [55] For example, Caplan, A.L. (2020), The ethics of the unmentionable Journal of Medical Ethics 2020;46:687-688. [56] Caplan, A.L. , Danovitch, G., Shapiro M., et al. (2011) Time for a boycott of Chinese science and medicine pertaining to organ transplantation. Lancet, 378(9798):1218. doi:10.1016/S0140-6736(11)61536-5 [57] Robertson and Lavee. [58] Smolin, D. M. (2011). The Tuskegee syphilis experiment, social change, and the future of bioethics. Faulkner L. Rev., 3, 229; Gallin, S., & Bedzow, I. (2020). Holocaust as an inflection point in the development of bioethics and research ethics. Handbook of research ethics and scientific integrity, 1071-1090. [59] World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, and amended multiple times, most recently by the 64th WMA General Assembly, Fortaleza, Brazil, October 2013. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
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