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D Schiedermayer

Publications and source records attributed to D Schiedermayer.

18 recordsLinked to original sources
PubMed2000

Pseudoascites in the clinical setting: avoiding unwarranted and futile paracenteses.

Ascites is diagnosed on physical exam by findings of abdominal distension, bulging flanks, shifting dullness and a prominent fluid wave. However, as the following cases demonstrate, these signs may also be positive in pseudoascites due to thick layers of adipose tissue in the abdomen. A history of recent food binging and a lack of a prolonged prothrombin time should raise the index of suspicion for pseudoascites in a patient with a protuberant abdomen. In light of equivocal physical signs, physicians may employ ultrasonography to prevent patients with pseudoascites from suffering multiple futile attempts at paracentesis.

Adult↗
PubMed1998

A survey of competencies and concerns in end-of-life care for physician trainees.

A survey was developed to explore physician trainee competencies and concerns surrounding end-of-life care. Thirty-one medical students, interns, and residents from the Department of Internal Medicine completed the survey in August 1996. The survey instrument found differing levels of competence/concern among medical students, interns, and residents. Self-reported competence increased with level of training. All trainees indicated the least comfort around discussions of hydration and feeding withdrawal. Both residents and interns indicated concern about potential illegality, breach of ethics or potential malpractice when reviewing eight currently legal and ethical end-of-life scenarios involving pain management or treatment withdrawal. Pain management, ethical issues, and delirium were the top three topics for which residents indicated an interest in future educational sessions. Results from the survey will be used to guide the development of educational initiatives that address trainee concerns. The competence/concern survey adds an important dimension to understanding how best to incorporate end-of-life education into residency training programs.

Clinical Competence↗
PubMed1997

Holding Owen.

Explore the source record for details and available documents.

Aged↗
PubMed1994

Willingness to perform euthanasia. A survey of physician attitudes.

BACKGROUND: In the United States, few studies have examined important variables in physician attitudes toward the practice of euthanasia, such as the patient's underlying disease, mental capacity, and age, and the physician's specialty and religion. We administered a case-based survey to analyze the impact of such specific variables on physician attitudes toward the practice. METHODS: A four-section survey solicited (1) physician responses to three hypothetical cases in which patients requested euthanasia; (2) physicians' general opinions about euthanasia and how its legalization might affect them personally and professionally; and (3) demographic information. Analysis focused on physicians' characteristics as they related to their responses to the various aspects of euthanasia elicited in the survey. Univariate and multivariate analyses, using logistic regression, were performed. RESULTS: Completed and analyzable surveys were returned by 740 physicians. We found that physicians felt more comfortable with euthanasia requests from nondecisional, nonterminal patients who had left advance directives than they did with requests from decisional patients suffering from grave illnesses or injuries, or from decisional patients who had early signs of a progressive but nonlethal neurologic disease. We also found that physicians' specialties and religions correlated with their responses to the hypothetical cases and with their generalized attitudes toward euthanasia. CONCLUSIONS: Given the disparity in responding physicians' attitudes toward euthanasia, along with the fact that values based on religious affiliation or profession may underlie many physicians' opposition to the practice, we conclude that if euthanasia is to be legalized, safeguards protective of patients and physicians must be incorporated.

Adult↗
PubMed1994

Clinical practice in the post-consensus society: still an art, slow to change.

Practicing doctors see things differently from bioethicists, argues David L Schiedermayer, in his response to Cameron's essay. Patient autonomy and informed consent figure more importantly in ethical debate than they do in actual practice. Clinicians work with a practical ethic of beneficence that is directly related to diagnosis and treatment.

Attitude of Health Personnel↗