Institutional review board reform.
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Ethics Committees, Research↗
Biomedical subjects
Donald S Kornfeld
Publications and source records attributed to Donald S Kornfeld.
Consultation-liaison psychiatry: contributions to medical practice.
Consultation-liaison psychiatry has recently been recommended for subspecialty status by the American Board of Psychiatry and Neurology with a name change to "psychosomatic medicine." Final approval by the American Board of Specialties is expected. Therefore, this is a propitious time to review what the author considers the significant contributions of consultation-liaison psychiatry to the practice of medicine, the education of its practitioners, and future opportunities and challenges. The articles mentioned have been published primarily in medical and surgical journals in which their authors believed they would have the greatest impact. Therefore, this is a body of work that is probably unknown to most psychiatrists outside of this field.
Cost-Benefit Analysis↗
Commentary on "A model policy addressing mistreatment of students.
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Education, Medical↗
Can we measure out a life in coffee spoons?
Public policy decisions in medicine and other fields necessitate careful weighing of choices and consequences. Cost-benefit analyses have been offered as one way to facilitate such decisions. In "Quantifying the value of human life," L. Eugene Arnold asserts that mathematical models such as his offer greater clarity in making public policy decisions than is possible with the "intuitive" or "emotional" approach. In our opinion, problems associated with this quantitative analysis demonstrate a need for caution in applying such mathematical models to public policy decisions....
Clozapine↗
Commentary on "Sedation before ventilator withdrawal.
In any important article in the field of clinical ethics, the focus should not be on the specific case example, but rather on the issues it presents for thought and discussion. Barbara Springer Edwards and Winston M. Ueno achieve this end admirably. They present a terminally ill patient who requested termination of ventilator support, despite the overwhelming odds that he would die as a result. The authors ask whether or not the physician acted appropriately in accommodating the patient's wish and in sedating him to decrease suffering in his last moments. They present compelling arguments that sedation was warranted in this case. They also note correctly that competent patients have the right to refuse treatment. However, in addition to the question of sedation, this case raises other important issues, specifically those related to pain management and depression in the terminally ill....
Depressive Disorder↗