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Biomedical subjects

W J Winslade

Publications and source records attributed to W J Winslade.

At least 19 recordsLinked to original sources
PubMed2000

Sex offenders, sentencing laws and pharmaceutical treatment: a prescription for failure.

The phenomenon of adults who have sexual interests involving children as partners, or pedophiles, is considered among the most sociopathological of human conditions. Considerable literature is devoted to issues and problems associated with or related to pedophilia, including prevalence, etiology, treatment, and outcome studies. The sexual victimization of children, based upon data gathered from a number of sources, suggests an intractable problem that is national in scope. Recent manifestations of society's efforts to deal with the sexual victimization of children include the enactment of criminal sentencing laws that mandate the treatment of offenders with certain pharmaceutical agents, such as medroxy-progesterone acetate ("MPA"). Because sentencing laws as a rule vary widely from state to state, there is considerable variation as to who is subject to MPA treatment laws, and how such laws-including specific provisions, such as clinical criteria, if any, required for treatment; type and period of treatment plans; informed consent; etc-are implemented. Most important, these sentencing laws may have remarkably little relation to what is widely considered effective treatment for pedophilia disorders. We examine in detail the most recent sentencing laws pertaining to treatment of persons who have been convicted of sex offenses involving children as victims. Our critique may offer insight and suggestions as to how such sentencing laws can be more suitably tailored to the treatment needs of persons with pedophilia disorders.

Adult↗
PubMed1994

Privacy, confidentiality, and privilege in psychotherapeutic relationships.

The dilemma faced by mental health professionals in guaranteeing clients' privacy and confidentiality while complying with the legitimate requests of third parties for confidential information is addressed. How that dilemma is played out in relation to child-abuse reporting laws is examined in terms of the legal and ethical aspects of privacy, confidentiality, and privilege in mental health practice.

Adolescent↗
PubMed1994

Eavesdropping on the 50-minute hour: managed mental health care and confidentiality.

This article discusses managed care, recent case law developments, and the legal basis of confidentiality in the patient-therapist relationship. It discusses how managed care intrudes into the confidential treatment relationship with prospective and retrospective utilization reviews. Some of the areas adversely impacted include public policy, the patient-therapist relationship, and informed consent. In order to be a program in the interest of patients and not simply cost containment, managed care must accommodate patients' reasonable expectations of confidentiality. Suggestions are delineated for the protection of confidentiality by managed care, including expanding the duty of confidentiality to managed care, obligating managed care to secure patients' informational privacy, obtaining informed consent to disclose as little information as necessary, and involving the patient in the cost containment and quality assurance process.

Ambulatory Care↗
PubMed1991

Legal regulation of terminal care: options and obstacles.

The law regulates some aspects of medical practice and facilitates other aspects. Two laws in Texas that both facilitate and regulate medical care are the Texas Natural Death Act (TNDA) and the Durable Power of Attorney for Health Care (DPOAHC). The TNDA implements the treatment wishes of the patient who is terminally ill. The DPOAHC designates a proxy to make medical decisions for patients when they become incompetent. Because these laws can provide considerable help in caring for terminally ill or incompetent patients, physicians in Texas should understand these laws and use them in their practices.

Federal Government↗
PubMed1989

Suicide of AIDS patients in Texas: a preliminary report.

The incidence of suicide in patients with the diagnosis of acquired immunodeficiency syndrome (AIDS) in the state of Texas during the period between January 1986 and August 1987 was determined. AIDS patients were found to have a rate of suicide higher than expected when compared to the general population. The results of this study document this trend which has important implications in the care of the growing number of patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Rights, roles, and relationships in radiology.

Traditionally, radiologists report their findings to the referring physician. When a patient who understands the reason for the diagnostic examination asks the radiologist to disclose the results, in most cases the radiologist should not decline but should answer truthfully.

Ethics, Medical↗
PubMed1985

Informed consent in psychiatric research: preliminary findings from an ongoing investigation.

Preliminary findings from an investigation of informed consent processes in four psychiatric research projects (two being carried out at a university medical center and two at a public psychiatric hospital) are reported. Study methods include the systematic observation of investigator/subject information disclosure sessions using audio and videotape, as well as the use of standardized interaction rating forms and subject understanding interviews. In an attempt to determine if subjects' understanding of research can be improved through increased subject education, several modes of information disclosure are compared. Partial results from the public psychiatric hospital portion of the investigation suggest low subject understanding in many areas with subjects often demonstrating difficulty differentiating between treatment and biomedical research. Subjects' problematic understanding of research purposes and methodology was compounded by investigator disclosures which often emphasized the therapeutic, personalistic and nonresearch-oriented aspects of the project. Nevertheless, even when information disclosures were significantly improved, subject understanding in many cases continued to be low--suggesting that additional factors aside from the quality of investigator disclosure are involved in psychiatric subjects' comprehension and understanding of research. The implication of these findings for informed consent, regulation of biomedical research and the protection of human subjects are discussed.

Antidepressive Agents↗
PubMed1985

Psychotic patients' understanding of informed consent.

Courts have found psychiatric patients to have the qualified right to refuse treatment. Particularly problematic is whether newly admitted psychiatric patients can comprehend information and give informed consent. The authors examined the ability of voluntary and involuntary psychotic patients to understand information about antipsychotic medication, related this assessment to psychopathology, and evaluated factors involved in hypothetical acceptance or refusal of treatment. Although most patients stated they had understood informed consent material, objective ratings did not support this. Impaired understanding was significantly associated with thought disturbance but did not affect hypothetical acceptance or refusal of antipsychotics. Legal status was not a significant factor.

Adult↗