11 research outputs found
Ethics Consultation Services: The Scenario
No full textThis chapter aims to provide a review of the state of the art of the ethical consultation services. In particular, we present a map of the most important traditions, discussing the different conceptions and the different roles they give to the counsellors. Then, we show the place of our ethical counselling methodology within this scenario
CANCER DURING PREGNANCY: A FRAMEWORK FOR ETHICAL CARE
No full textCancer affects about 1 in 1000 pregnancies, which is estimated to account for approximately 5000 pregnancies in Europe each year. Despite affluent availability of clinical practice guidelines for cancer management in the course of pregnancy, there is very little ethical guidance consolidated for everyday use. Therefore, the aim of this work is to construct a framework, which would serve healthcare professionals as a reference tool when addressing ethical issues in cancer care during pregnancy.
The framework is constructed around relational approach to respect for patient’s autonomy and ethics of care. It combines classical biomedical ethics principles and relational approaches to patient care. It emphasizes the importance of recognising the patient as another human being with her views on life, relationships and wishes, as well as forming a relationship between the patient and healthcare team, which is known as relational ethics.
However, respect for individual autonomy is not discarded entirely. First and foremost, evidence-based information disclosure is essential to personalised patient care. The latter invites to integrate technical aspects of personalised medicine with relational approach to patient care. Furthermore, protection of the vulnerable also serves as a safeguard ensuring that patient is not compelled to choices that are not her own.
Overall, this framework is expected to serve as a tool supporting ethical decision-making in cancer care during pregnancy. It can also be utilised by a variety of patient counselling services
Setting up an ethical oncofertility practice in developing countries
No full textFertility preservation for cancer patients is a relatively new field in medicine which requires
interdisciplinary approach. Improving therapies and rising survival rates require to consider patient’s
quality of life after cancer is cured which is relevant personal issue regardless of the individual income and the level of development of the country of origin. Fertility preservation offers possible solution but also raises ethical questions. We provide a summary of ethical principles embodied in professional guidelines together with options and restrictions to access fertility preservation in developing countries. We also make a suggestion that oncofertility counselling could be a pillar to address fertility preservation issues in cancer patients. Our proposed decisional support model is patient centred and focuses on patient values, personal philosophy and view of life emphasizing sensitivity to individual patient’s needs and wishes. Some fertility preservation concerns in oncology might be addressed mirroring already available expertise while some others will call for innovative and region specific solutions. Therefore, in addition to our proposal we also provide a list of organisations working in oncofertility field
Potential Pitfalls in the Evaluation of Ethics Consultation: The Case of Ethical Counseling
No full textWe discuss our account of ethical counseling in comparison with the American ethical consultation
Oocyte cryopreservation beyond cancer : tools for ethical reflection
No full textPurpose: This article offers physicians a tool for structured ethical reflection on challenging situations surrounding oocyte cryopreservation in young healthy women. Methods: A systematic literature review offers a comprehensive overview of the ethical debate surrounding the practice. Ethical Counseling Methodology (ECM) offers a practical approach for addressing ethical uncertainties. ECM consists of seven steps: (i) case presentation; (ii) analysis of possible implications; (iii) presentation of ethical question(s); (iv) explanation of ethical terms; (v) presentation of the ethical arguments in favor of and against the procedure; (vi) examination of the individual patient’s beliefs and wishes; and (vii) conclusive summary. Results: The most problematic aspects in the ethical debate include the distinction between medical and non-medical use of oocyte cryopreservation, safety and efficiency of the procedure, and marketing practices aimed at healthy women. Female empowerment and enhanced reproductive choices (granted oocyte cryopreservation is a safe and efficient technique) are presented as ethical arguments supporting the practice, while ethical reservations towards oocyte cryopreservation are based on concerns about maternal and fetal safety and wider societal implications. Conclusions: Oocyte cryopreservation is gaining popularity among healthy reproductive age women. However, despite promised benefits it also involves risks that are not always properly communicated in commercialized settings. ECM offers clinicians a tool for structured ethical analysis taking into consideration a wide range of implications, various ethical standpoints, and patients’ perceptions and beliefs
Fertility preservation in cancer patients : The global framework
No full textCancer treatment is the most frequent cause of reduced fertility in cancer patients, with up to 80% of survivors affected. None of the established or experimental fertility preservation methods can assure parenthood, rather they may provide a future opportunity to overcome treatment induced sterility. Around 70-75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. Lack of time and knowledge about existing options, delay in potentially useful treatment, patient's age, partnership status, existing children, sexual orientation and socioeconomic situation are the main barriers to effective fertility preservation. Patient's fears, expectations and priorities shaped by personal values have to be addressed in the framework of medical necessities, realistic survival probabilities, socio-cultural environment and resources availability. We call for a need of patient centred fertility counselling within a framework that should include patients understanding of medical aspects of their cancer, realistic fertility preservation options, preferences based on personal values and goals. Optional support services could also include legal guidance, psychological and spiritual support and financial counselling
Routine psychosocial care in infertility and medically assisted reproduction - a guide for fertility staff: External Review Report
No full text
Sodium, Potassium and Iodine Intake in an Adult Population of Lithuania
No full textHypertension is a leading risk factor for cardiovascular events and death. A reduction in salt intake is among the most cost-effective strategies to reduce blood pressure and the risk of cardiovascular diseases. Increasing potassium lowers blood pressure and is associated with lower cardiovascular risk. Adequate iodine intake is important to prevent iodine deficiency disorders. Salt iodization is a key strategy to prevent such deficiency. In Lithuania, no surveys have been performed to directly assess sodium, potassium and iodine consumption. The aim of the present study was to measure sodium, potassium and iodine intake in a randomly selected adult Lithuanian adult population using 24 h urine collections, and to assess knowledge, attitudes and behavior towards salt consumption. Salt and potassium intakes were estimated in 888 randomly selected participants by 24 h urine sodium and potassium excretion and 679 individuals provided suitable 24 h urine samples for the analysis of iodine excretion. Average salt intake was 10.0 (SD 5.3) g/24 h and average potassium intake was 3.3 (SD 1.3) g/24 h. Only 12.5% of participants consumed less than 5 g/24 h of salt. The median value of urinary iodine concentration (UIC) was 95.5 μg/L. Our study showed that average salt intake is twice as high as the maximum level recommended by the World Health Organization while potassium and iodine intakes in Lithuania are below the recommended levels
