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Biomedical subjects

M B Kapp

Publications and source records attributed to M B Kapp.

At least 37 records · Page 2Linked to original sources
PubMed1998

"A place like that": advance directives and nursing home admissions.

Decisions about admitting a mentally incapacitated person to a nursing home raise a variety of difficult legal, ethical, and public policy issues. A strategy for anticipating and addressing this contingency prospectively, by encouraging execution of formal advance planning directives while the individual is still capable, may mitigate some of the dilemmas associated with these issues. The author discusses the contours and feasibility of such a strategy, analyzing nursing home admission on one's behalf and for refusing such admission, or placing explicit conditions on such admission, in advance of the time that the actual decision must be made.

Advance Directives↗
PubMed1998

"Courtroom whores"?--or why do attorneys call us?: findings from a survey on attorneys' use of mental health experts.

Mental health professionals who serve as expert witnesses are repeatedly characterized as (in the words of one recent author) "Whores of the Court." However, scholars have published little systematically gathered data about why attorneys seek mental health opinions and the criteria they use for selecting experts. We investigated these issues using a mailed survey of attorneys and judges. A slight majority of attorney respondents had requested mental health professionals' opinion in the previous year. The most important factors in selecting experts were their knowledge, ability to communicate, and local reputation; national reputation and scholarly writings were least important. Forty-nine percent of the responding attorneys said that receiving a favorable opinion was a "very important" or "essential" consideration, although this did not necessarily mean they wanted a dishonest opinion. Our findings suggest that most forensic work is performed by mental health professionals who are chosen because of their knowledge, communication skills, and local reputations.

Adult↗
PubMed1997

Who is responsible for this? Assigning rights and consequences in elder care.

In the context of providing health and human services for older individuals, modern American culture often depends on formally asserting and battling over a clashing array of rights among respective combatants as a first resort at problem-solving. A substantial impediment exists in our cultural environment that discourages families and professionals, and the agencies that employ them, from recognizing and respecting the rights of older persons in a less adversarial and more subtle, sensitive, and flexible manner. This article discusses this barrier, illustrating it in several aging-related settings, and suggests a paradigm for addressing the situation. Then, several current challenges to the rethinking of rights and responsibilities in geriatric and gerontological practice are acknowledged.

Aged↗
PubMed1996

Physical restraint use in critical care: legal issues.

Landmark federal legislation and several other social and clinical forces have induced nursing homes to reduce their use of physical or mechanical restraints on their residents during the past decade. Attention is being paid to the overuse of restraining devices and methods in acute care hospitals, including critical care units, and the need to develop strategies for their reduction or elimination. One of the most serious barriers to accomplishing this objective is anxiety on the part of health professionals and administrators about potential legal liability for patient injury. This article discusses the potential legal implications of physical restraint reduction in hospitals, with special emphasis on the critical care context. It places risks in realistic perspective, ultimately arguing that developing suitable alternatives to restraint use in most cases best serves the legal--as well as the clinical, ethical, and financial--interests of all concerned parties.

Aged↗
PubMed1996

Therapeutic jurisprudence and end-of-life medical care: physician perceptions of a statute's impact.

OBJECTIVE: Assess the perceptions of Ohio physicians regarding the impact of their state's 1990 advance directive legislation on their medical practices when decisions need to be made and implemented concerning use of life-prolonging medical interventions, and to draw public policy. DESIGN: A mailed survey to physicians, to be completed and returned anonymously. The form contained ten questions to be answered according to a five-point Likert scale, a request for demographic information, and an opportunity to write additional comments on the form. SETTING: Surveys mailed to every physician on the Wright State University continuing medical education mailing list who had designated a specialty in internal medicine, family practice, or surgery. MAIN OUTCOME MEASURES: Physicians' perceptions of the impact of Ohio's advance directive legislation on their communication with patients and families, anxieties about legal liability associated with end-of-life care, and willingness to limit life-prolonging medical interventions in specific situations. RESULTS: Mixed. While many physicians reported enhancements in relationships, communication, and willingness to respect patient and family wishes due to the statute, others reported an opposite effect. For many physicians, the statute made little impact on their practices. CONCLUSIONS: The Ohio statute could benefit from rewriting, but there are inherent problems with advance directive laws. Professional education about death and dying issues and the chance for physicians to practice end-of-life treatment techniques are essential.

Advance Directives↗