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Biomedical subjects

Shimon Glick

Publications and source records attributed to Shimon Glick.

13 recordsLinked to original sources
PubMed2006

Euthanasia: an overview and the jewish perspective.

BACKGROUND: End-of-life care poses fundamental ethical problems to clinicians. Defining euthanasia is a difficult and complex task, which causes confusion in its practical clinical application. Over the course of history, abuse of the term has led to medical atrocities. Familiarity with the relevant bioethical issues and the development of practical guidelines might improve clinical performance. OBJECTIVE: To define philosophical concepts, to present historical events, to discuss the relevant attitudes in modern bioethics and law that may be helpful in elaborating practical guidelines for clinicians regarding euthanasia and end-of-life care. Concepts found in the classic sources of Jewish tradition might shed additional light on the issue and help clinicians in their decision-making process. METHODS: An historical overview defines the concepts of active versus passive euthanasia, physician-assisted suicide and related terms. Positions found in classical Jewish literature are presented and analyzed with their later interpretations. The relevance and application in modern clinical medicine of both the general and Jewish approaches are discussed. RESULTS: The overview of current bioethical concepts demonstrates the variety of approaches in western culture and legal systems. Philosophically and conceptually, there is a crucial distinction between active and passive euthanasia. The legitimacy of active euthanasia has been the subject of major controversy in recent times in various countries and religious traditions. CONCLUSION: The historical overview and the literature review demonstrate the need to provide clearer definitions of the concepts relating to euthanasia, for in the past the term has led to major confusion and uncontrolled abuse. Bioethical topics should, therefore, be included in medical training and continuing education. There are major debates and controversies regarding the current clinical and legal approaches. We trust that classical Jewish sources might contribute to the establishment of clinical definitions, meaningful approaches and practical guidelines for clinicians.

Attitude to Health↗
PubMed2006

Truth-telling in a culturally diverse world.

Until recently physicians have been reluctant to disclose a poor prognosis to patients for fear of harming them with the bad news and/or taking away their will to live. In the last decades we have seen a reversal of practice among Western physicians, and most doctors readily disclose to their patients the full extant of their disease. This change is probably due to the emphasis on patient autonomy in the doctor-patient relationship and the lack of evidence that hearing the bad news impacts significantly on patient outcomes. This emphasis on complete honesty with patients might not reflect the practice in non-Western cultures. In disclosing a poor prognosis to a patient the physician must do so with cultural sensitivity, compassion and letting the patient decide how much he or she wants to know.

Cultural Diversity↗
PubMed2005

The care of patients with dementia: a modern Jewish ethical perspective.

Patients with dementia and their families can face many difficult and agonizing ethical dilemmas over the course of the illness. An awareness of the Jewish ethical response to some of these issues can help clinicians in treating patients of the Jewish faith and also serve as an example of how one ethical system addresses these questions. The Jewish response is grounded in a profound respect and value for human life in all its forms and man's responsibility to preserve it, but Judaism rejects unproven therapies and recognizes the limitations of modern medicine. Jewish law also codifies normative obligations that children have toward their elderly parents. With these principles in the forefront, this article analyzes a Jewish ethical response to various problems in the care of the demented patient such as truth telling, transfer to a nursing home, artificial nutrition, and end-of-life care, taking into account modern concepts of the doctor-patient relationship and ancient Jewish tradition.

Aged↗
PubMed2004

A physician charter on medical professionalism: a challenge for medical education.

The European Federation of Internal Medicine, The American College of Physicians-American Society of Internal Medicine, and the American Board of Internal Medicine recently developed a Charter on Medical Professionalism that they hope will be accepted by physicians around the world. The charter is based on three principles: the primacy of patient welfare, patient autonomy, and social justice. We believe that each of these principles has relevance to medical education and practical implications. Based on the obligations of the charter, we believe that medical educators should consider the attribute of altruism in making admission decisions, enhance moral development in medical schools, develop a curriculum in quality improvement, explore further the use of patient simulation, and renew their efforts to incorporate knowledge of the basic sciences into clinical training. Furthermore, we believe they should ensure that students protect patient confidentiality, ensure role-model appropriate interactions with pharmaceutical companies, teach students how gender, race, and socioeconomic status have an impact on health care, require electives in underserved areas, and incorporate the charter into courses on medical ethics. Medical educators must also ensure that the curriculum and learning climate at their institutions support the values articulated in the charter.

Journal Article↗
PubMed2003

Simulation-based medical education: an ethical imperative.

Medical training must at some point use live patients to hone the skills of health professionals. But there is also an obligation to provide optimal treatment and to ensure patients' safety and well-being. Balancing these two needs represents a fundamental ethical tension in medical education. Simulation-based learning can help mitigate this tension by developing health professionals' knowledge, skills, and attitudes while protecting patients from unnecessary risk. Simulation-based training has been institutionalized in other high-hazard professions, such as aviation, nuclear power, and the military, to maximize training safety and minimize risk. Health care has lagged behind in simulation applications for a number of reasons, including cost, lack of rigorous proof of effect, and resistance to change. Recently, the international patient safety movement and the U.S. federal policy agenda have created a receptive atmosphere for expanding the use of simulators in medical training, stressing the ethical imperative to "first do no harm" in the face of validated, large epidemiological studies describing unacceptable preventable injuries to patients as a result of medical management. Four themes provide a framework for an ethical analysis of simulation-based medical education: best standards of care and training, error management and patient safety, patient autonomy, and social justice and resource allocation. These themes are examined from the perspectives of patients, learners, educators, and society. The use of simulation wherever feasible conveys a critical educational and ethical message to all: patients are to be protected whenever possible and they are not commodities to be used as conveniences of training.

Computer Simulation↗
PubMed2002

[Child abuse--undiagnosed].

We present the case of a 2 1/2 year old child brought to the emergency room by his mother, a nurse at that hospital, and her companion, because of a fractured clavicle. Over the next 14 days the child was seen by a variety of physicians in different sites (3 different emergency rooms, pediatricians' offices, orthopedic clinics) for various injuries. Each individual injury was treated separately, and the diagnosis of a battered child syndrome was not entertained. The child was not undressed completely and numerous clues to the diagnosis went undetected. A greater sensitivity to the diagnosis of child abuse is essential. More careful history-taking, more thorough physical examination and better interinstitutional communication are essential if child abuse is to be detected in its earliest phases.

Battered Child Syndrome↗