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Biomedical subjects

E E Shelp

Publications and source records attributed to E E Shelp.

13 recordsLinked to original sources

The infrastructure of religious communities: a neglected resource for care of people with AIDS.

The AIDS Interfaith Council of Houston, sponsored by the Foundation for Interfaith Research and Ministry, recruits, trains, and coordinates volunteers for home-based care for adults and children with AIDS (acquired immunodeficiency syndrome). The program provides compassionate, non-judgmental care for the sick and respite support for the primary care provider. Care is provided by highly motivated, trained volunteers. The respite care team model also represents a support system to complement medical management and other health care services for people with AIDS. With the expanding number of cases and the growing preference for clients to remain at home, such a model will become increasingly important as people continue to live longer with AIDS.

Acquired Immunodeficiency Syndrome↗

Denial in clinical medicine. A reexamination of the concept and its significance.

It is argued that, due to the diversity of meanings attaching to the term "denial" considerable imprecision exists in the clinical use both of the term itself and of its associated concepts. An obvious danger in this situation is that the term should be rendered unserviceably vague. Less obvious dangers include infringements of patients' rights and a tendency to foster paternalistic decision making. Amending the term's clinical usage is made with recommendations.

Attitude of Health Personnel↗

Courage: a neglected virtue in the patient-physician relationship.

The contribution that the virtues can make to the moral life in general and to the moral community constituted in the patient-physician relationship more specifically is gaining increased scholarly attention. This paper explores the meaning and relevance of the virtue of courage for patients and physicians. Courage is presented as a virtue for physicians in addition to the excellences of competence and compassion and a virtue for patients in addition to the excellences of compliance and gratitude. In agreement with Alasdair MacIntyre, courage is held to be necessary, at times, to our expression of care and concern for one another. The patient-physician relationship is shown to be a context in which care and concern is expressed, a context in which courage can be a relevant virtue. Certain conditions are listed as necessary to courage: freedom, fear, risk, uncertainty, an endangered good and a morally worthy end. Equivalents to these necessary conditions are discussed and held to be potentially present in patient-physician encounters. Physicians are pictured as a 'sustaining presence' who have duties toward patients of 'encouragement' that can be fulfilled in ways relative to the requirements of each circumstance. Patients are held to have a duty to learn about the nature of human existence and to develop the character necessary to its negotiation. Patients and physicians can be agents of courage who come together in a context of care and concern where certain goods are preserved even, at times, in the midst of loss. Thus, courage is presented as a relevant and important moral virtue for the patient-physician relationship in which those qualities that define who we are as a moral community are expressed and sustained.

Moral Obligations↗

Missed physical diagnosis: conceptual and moral comments on the psychiatrist-patient relationship.

Diagnosis is an important element in the therapeutic alliance. It informs treatment and management decisions in the interests of the patient. The relative and discretionary factors in diagnosis are prominent in psychiatry. The problematic nature of psychiatric diagnoses and the difficulty in demarcating physical from psychic disorders suggests an approach to patients with psychiatric symptoms that is alert to possible somatic causes. The well-being of the patient is primary in the therapeutic exchange. Thus, the moral principle to "do no harm" prevails. The potential costs to patients from missed physical diagnosis counsels an open attitude by psychiatrists in the diagnostic process. There are moral, scientific, and professional reasons to support this approach. Ultimately, the good of the patient and the good of the profession require it.

Diagnosis↗

Courage and tragedy in clinical medicine.

The relationship between medical clinicians and patients is described as potentially tragic in nature and a context in which courage can be a relevant virtue. Danger, risk, uncertainty, and choice are presented as features of clinical relationships that also function as necessary conditions for courage. The clinician is seen as a 'sustaining presence' who has duties of 'encouragement' with respect to patients. The patient is seen to have a duty to learn the condition of human existence which can be discovered in clinical relations and to develop the virtues necessary to a fitting negotiation of human life. Case examples of courage on the parts of the principal participants in the clinical encounter are provided. In addition, several goods for clinicians and patients as objects of courage are identified.

Attitude of Health Personnel↗

Students' attitudes to ethics in the medical school curriculum.

A survey of 106 medical students assessing their interest in and attitudes to medical ethics in the curriculum is reported by the authors. Results indicate that 64 per cent of the students rated the importance of medical ethics to good medical care as high or critical and 66 per cent desired to learn more about the topic. However, in reports of patient encounters identifying ethical issues, less than six per cent of the students reported a frequency of more than one such patient encounter per week. The students also demonstrated a greater awareness of more obvious ethical issues than of more subtle, less publicised issues. When asked how medical ethics should be taught, the students clearly affirmed a desire for an integrated exposure to the subject throughout the medical curriculum. Possible implications of these findings for medical education are discussed.

Attitude of Health Personnel↗