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Biomedical subjects

S D Edwards

Publications and source records attributed to S D Edwards.

32 records · Page 2Linked to original sources
PubMed1997

The moral status of intellectually disabled individuals.

The moral status accorded to an individual (or class of individuals) helps to account for the weight of the moral obligations considered due to an individual (or class of individuals). Strong arguments can be given to indicate that the moral status accorded, justly or unjustly, to individuals with intellectual disabilities is less than that accorded to those considered intellectually able. This paper suggests that such a view of the moral status of intellectually disabled individuals derives from individualism. Ontological and normative components of individualism are identified. It is shown that individualistic, ontological criteria for personhood compromise the integrity of "dependent" individuals. And it is shown that the normative component of individualism further compromises the integrity of intellectually disabled individuals. An alternative view of the self is outlined in which dependence features centrally. It is tentatively suggested that such a view of the self may prove more congenial to enhancing the moral status of individuals with intellectual disabilities.

Ego↗
PubMed1997

Dismantling the disability/handicap distinction.

This paper discusses the distinction between disability and handicap as it is proposed by the World Health Organization (WHO) in their publication International Classification of Impairments, Disabilities and Handicaps (WHO, 1993 (first published, 1980)). Following criticism of this an attempt to salvage the distinction by Nordenfelt (1993, 1983) is discussed. It is argued that neither the WHO nor Nordenfelt are successful in their attempts to preserve the distinction between disability and handicap in a theoretically well-motivated manner. Contrary to the WHO, it is argued that what they term 'disabilities' and 'handicaps' both have external causes. And contrary to Nordenfelt's position it is shown that "basic actions" do not provide a firm theoretical foundation for the concept of disability. Moreover, the criticisms of these two sets of views reveal that attempts to describe the phenomenon of disablement which focus on the individual suffer from a serious methodological shortcoming.

Persons with Disabilities↗
PubMed1996

What are the limits to the obligations of the nurse?

This paper enquires into the nature and the extent of the obligations of nurses. It is argued that nurses appear to be obliged to undertake supererogatory acts if they take clause one of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) Code of Professional Conduct seriously (as, indeed, they are required to do). In the first part of the paper, the nature of nursing obligations is outlined, and then the groups and individuals to whom nurses have obligations are identified. Following a brief discussion of the moral foundation of the nurse's obligations to her/his employer, a common conflict of obligations is identified. Then a distinction is drawn between ordinary and extraordinary moral standards. Appreciation of this is necessary for an understanding of the criterion of what constitutes a supererogatory act. By the definition of supererogatory acts proposed below, it is suggested that actions such as whistleblowing satisfy that definition.

Beneficence↗
PubMed1993

Transurethral needle ablation (TUNA) of the prostate using low-level radiofrequency energy: an animal experimental study.

Transurethral needle ablation of the canine prostate using low level radiofrequency energy was examined for efficacy and safety in a two-stage experimental study. Eleven mongrel dogs were treated via the bladder neck and prostatic urethra using a specially designed catheter through which needle antennas were advanced into the prostatic tissue. A radiofrequency energy source was connected to the catheter and used to create tissue ablation. In the first 5 dogs this was found to be feasible. Necrotic lesions were created around the needle antennas. Typically, lesions were 1 cm in diameter and conical in shape. The actual size of the lesion was directly related to power level used, time of ablation and length of needle deployment. In the next 6 dogs temperatures were simultaneously measured in the prostatic urethra and rectum. The dogs were sacrificed 0, 2, 2, 14, 28 and 30 days following the experiments and the bladder, prostate and anterior rectal wall were removed en bloc and examined macroscopically and histopathologically for any changes. It was found that urethral temperatures increased to 46.1 degrees C on the average while rectal temperature did not rise during the entire experiment. The lesions found in the prostate were similar to those found in the first 5 dogs. No macroscopic or histopathologic changes were noted at the bladder base, anterior rectal wall or in the distal prostatic urethra. It was concluded that prostatic tissue ablation in the canine model can be achieved safely and could justify the start of human trials.

Animals↗
PubMed1993

Needle ablation using radio frequency current as a treatment for benign prostatic hyperplasia: experimental results in ex vivo human prostate.

Transurethral needle ablation of the prostate using low level radiofrequency (RF) energy was investigated in a human ex vivo model. RF power applications at a variety of power levels for various treatment times elicited marked thermal lesions of consistent sizes in prostatic adenomas. Tissue temperature was found to be the fundamental lesioning parameter. Lesions were created whenever tissue temperature exceeded 45 degrees C. Lesion size correlated with RF power delivery and electrode length. Monitoring of the tissue impedance assisted in controlling efficacious lesioning. RF power applications of 5-7.5 W for 3 min are suggested as the 'ideal' setting to treat human prostatic adenomas, taking into consideration the lesion size and time to achieve ablative temperatures.

Aged↗
PubMed1993

Transurethral needle ablation (TUNA): thermal gradient mapping and comparison of lesion size in a tissue model and in patients with benign prostatic hyperplasia.

A new device has been development for treating benign prostatic hyperplasia (BPH) that is performed as an outpatient procedure. the device (transurethral needle ablation or TUNA) employs needles that deliver low-level radiofrequency (RF) power locally at high temperature to ablate hyperplastic prostate tissue. During the TUNA procedure the temperature proximal to the needle tips is measured with thermocouples within the needle's protective shields and urethral temperature is measured via a thermocouple contained within the catheter tip. Tissue impedance is also measured by the TUNA catheter since it is well known from other thermal treatment methods that thermal destruction of prostatic tissue depends upon a particular prostate's tissue composition and thermoregulation. Because of this variation in prostates, a nomogram guide for setting the TUNA device was created using a turkey breast tissue model. Lesion sizes created at particular settings in the turkey breast model were similar to those created at the same settings in patients with BPH. In addition, local thermal gradients within the TUNA lesions were visualized and mapped using an infrared thermal imaging system which demonstrated that central lesion temperature with the device is approximately 80-100 degrees C.

Catheter Ablation↗
PubMed1993

Transurethral needle ablation (TUNA): safety, feasibility, and tolerance of a new office procedure for treatment of benign prostatic hyperplasia.

Many attempts have been made to develop a method for treating benign prostatic hyperplasia (BPH) that is minimally invasive, efficacious, and low cost. The transurethral needle ablation (TUNA) device has recently been developed to treat BPH by selectively ablating hyperplastic prostatic tissue. A special catheter incorporates needles that deliver low-level radiofrequency power directly to a very localized area of the prostate. The needles have adjustable shields to protect the urethra if desired or necessary. It is positioned via transrectal ultrasound or direct vision. A pilot study was performed in patients to evaluate TUNA feasibility via histopathological measurement of thermal lesion size and TUNA safety by: (1) monitoring urethral and rectal temperatures; (2) assessing the ability to localize lesions, and (3) determining patient tolerance of the procedure without anesthesia. Twenty patients were treated using TUNA prior to scheduled retropubic prostatectomy. The surgical prostatic specimens were recovered from 1 day to 1 month after TUNA, were step-sectioned, and examined histologically. Patients were 68 years old on average with prostate weight varying from 14 to 88 g. The TUNA procedure averaged 27 min, 4 lesion treatments per prostate, and 4-15 W of power applied for 3 min. Proximal lesion temperature was about 40-50 degrees C with central lesion temperatures of about 80-100 degrees C. Urethral temperature averaged 37-42 degrees C and rectal temperature remained unchanged. Macroscopic examination of the specimens demonstrated localized lesions averaging 12 x 7 mm. Microscopic examination showed larger lesions of extensive coagulative necrosis averaging 30 x 15 mm. Specific immunohistochemical staining showed destruction of all tissue components.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

Traditional and modern medicine in South Africa: a research study.

This paper examines the relationship between traditional and modern medicine with reference to an experimental research study conducted in South Africa, which focused on interviews by traditional Zulu healers and modern clinical psychologists with the same group of psychiatric patients. Results indicated that while traditional and modern practitioners worked from different theoretical orientations, they were in significant agreement as to both diagnosis and treatment of patients when faced with the same limited choice of options. Furthermore, patients perceived both traditional and modern practitioners as being more or less equally helpful. Results are compared with those of other studies. Local and international implications for the relationship between traditional and modern medicine are discussed.

Humans↗
PubMed1985

Hypnotherapy as a treatment for enuresis.

The main objective of this study was to provide an adequately controlled experimental and clinical study to assess the efficacy of hypnotherapy in the treatment of nocturnal enuresis. Subjects were 48 nocturnal enuretic boys, aged 8-13 yr. Treatment consisted of six standardized sessions, one hourly session per subject per week. Results indicated that hypnotherapy was significantly effective over 6 months in decreasing nocturnal enuresis, compared with both pretreatment baseline enuresis frequency and no-treatment controls. It also suggested that trance induction was not a necessary prerequisite for success. Comparison with other methods of treatment provided evidence that hypnotherapy was an effective alternative or adjunctive form of treatment for enuresis.

Adolescent↗
PubMed1983

Deculturation as a precipitant of parasuicide in an Asian group.

The Durban Indian community has been described as an acculturating or a deculturating community. The processes of acculturation and deculturation are seen to lead to a transitional state of values and norms which causes psychological stresses within the community. Deviation from accepted cultural norms and concomitant interpersonal disputes were major precipitating factors in parasuicidal acts in 54 of a sample of 100 patients, reflecting the stresses of the transitional state of the community. Culturally deviant precipitating factors in the parasuicidal act were more common in females, in the younger age group, in patients of the Christian religion, and in upper- and middle-class patients.

Acculturation↗
PubMed1981

Parasuicide in the Durban Indian community.

Biographical and psychiatric factors in 100 patients referred to a department of psychiatry after a suicide attempt were surveyed. One of the major precipitants of parasuicide in the present study, and found in all cases, was an interpersonal dispute; this involved extended family in 63 cases and marital or romantic relationships in 81.

Adolescent↗
PubMedDate not supplied

Are nursing's 'extraordinary' moral standards realistic?

This paper discusses a hypothetical situation, taken from the author's book Nursing Ethics: a principle-based approach, in which a nurse feels pressured into working beyond his official span of duty. The nurse experiences a conflict between a number of obligations; to patients and clients, to his family and to himself. To which should he give greatest weight? Steven Edwards suggests the nurse's decision is a moral one, based on personal standards held by the nurse.

Ethics, Nursing↗