PubMed Health⌕ Search

Biomedical subjects

Sylvia Hyland

Publications and source records attributed to Sylvia Hyland.

5 recordsLinked to original sources
PubMed2005

Is consent required for publication of medical errors?

Publication of information about medical errors is critical to error prevention and shared learning among health professionals and institutions. While some countries have error reporting systems in place, journal publications are still essential reference tools for learning about error, and editorial policies about when to publish errors are needed, as these provide important guidance to journal editorial boards. While there is a prima facie moral requirement to obtain consent to publish patient information, publication without patient consent may be justified if certain criteria are met. Justification will involve consideration of a variety of principles, rules and conditions grounded in ethics, law and policy. Except in exceptional circumstances of overriding importance to public health, a patient's personal information should not be published over the patient's refusal. But what constitutes "exceptional circumstances of overriding importance to public health"? We argue that medical error is one such circumstance and present an argument in favour of a specific policy stance on publication of medical errors.

Canada↗
PubMed2004

SARS and hospital priority setting: a qualitative case study and evaluation.

BACKGROUND: Priority setting is one of the most difficult issues facing hospitals because of funding restrictions and changing patient need. A deadly communicable disease outbreak, such as the Severe Acute Respiratory Syndrome (SARS) in Toronto in 2003, amplifies the difficulties of hospital priority setting. The purpose of this study is to describe and evaluate priority setting in a hospital in response to SARS using the ethical framework 'accountability for reasonableness'. METHODS: This study was conducted at a large tertiary hospital in Toronto, Canada. There were two data sources: 1) over 200 key documents (e.g. emails, bulletins), and 2) 35 interviews with key informants. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. RESULTS: Participants described the types of priority setting decisions, the decision making process and the reasoning used. Although the hospital leadership made an effort to meet the conditions of 'accountability for reasonableness', they acknowledged that the decision making was not ideal. We described good practices and opportunities for improvement. CONCLUSIONS: 'Accountability for reasonableness' is a framework that can be used to guide fair priority setting in health care organizations, such as hospitals. In the midst of a crisis such as SARS where guidance is incomplete, consequences uncertain, and information constantly changing, where hour-by-hour decisions involve life and death, fairness is more important rather than less.

Attitude of Health Personnel↗