PubMed Health⌕ Search

Biomedical subjects

B Spielman

Publications and source records attributed to B Spielman.

15 recordsLinked to original sources
PubMed1995

Beyond Pittsburgh: protocols for controlled non-heart-beating cadaver organ recovery.

Much of the ethical debate about controlled non-heart-beating cadaver (NHBC) organ recovery has focused on the University of Pittsburgh Medical Center (UPMC) protocol. Some commentators have voiced serious reservations about the ethical acceptability of that protocol; others have argued that the protocol contains sufficiently stringent ethical safeguards to warrant a limited and carefully monitored trial at UPMC. UPMC is not the only organization pursuing controlled NHBC organ procurement, however. The study of organ procurement organizations described in this article suggests that controlled NHBC organ procurement is a practice that, if not yet widespread, is certainly no longer isolated to a few organizations in which it is carefully monitored. Rather, it is being carried out under a variety of circumstances, many of which are less carefully constrained ethically than at the University of Pittsburgh Medical Center. The next stage of the ethical debate should focus on issues that are arising in a variety of settings as the practice spreads.

Academic Medical Centers↗
PubMed1992

Expanding the boundaries of informed consent: disclosing alcoholism and HIV status to patients.

Since informed consent became legally required in the therapeutic setting, the risks physicians were to disclose have been limited to the risks of particular procedures. Two recent court decisions in which disclosure of surgeons' alcoholism and positive human immunodeficiency virus status was required may begin to erode that limit. The grounds for this expansion of disclosure requirements were inherent in the 20-year-old "materiality" standard for disclosure; nevertheless, the change they signal is profound. These cases may signal a trend that, in the long term, could result in a shift in physician-patient communication and a significant loss of privacy for physicians.

Alcoholism↗
PubMedDate not supplied

Discussing organ donations with patients.

BACKGROUND: The gap between the demand and supply of organs has prompted examination of health care professionals' roles in organ retrieval. This study examines Illinois family physicians' advisory roles as reflected in their beliefs and conversations with patients about cadaveric organ donation. METHODS: A 50-item questionnaire was mailed to a random sample of 500 members of the Illinois Academy of Family Physicians. A total of 272 usable surveys were returned. RESULTS: The majority (67%) of the respondents believe that individuals' wishes to donate should prevail even when patients' families prefer not to donate. Yet, in conversations with patients, most of these physicians recommend only that patients sign driver's license donor cards (81%) and have discussions with family members (57%), methods that do not ensure that individuals' donative wishes will be carried out. Few physicians encourage completion of a health care power of attorney, the method most likely to ensure respect for patient wishes when an individual's desire to donate is specified. DISCUSSION: Family physicians could more effectively help patients implement their desires to donate if they would become more familiar with and include in their discussions the potential role of health care powers of attorney.

Adult↗