Moral Legitimacy: The Struggle Of Homeopathy in the NHS.

This article deploys a well-established theoretical model from the accountability literature to the domain of bioethics. Specifically, homeopathy is identified as a controversial industry and the strategic action of advocates to secure moral legitimacy and attract public funding is explored. The Glasgow Homeopathic Hospital (GHH) is used as the location to examine legitimizing strategies, from gaining legitimacy as a National Health Service (NHS) hospital in 1948, followed by maintaining and repairing legitimacy in response to government enquires in 2000 and 2010. An analysis of legitimizing strategies leads to the conclusion that advocates have been unsuccessful in maintaining and repairing moral legitimacy for homeopathy, thus threatening continued public funding for this unscientific medical modality. This is an encouraging development towards open and transparent NHS accountability for targeting limited public resources in pursuit of maximizing society's health and well-being. Policy implications and areas for future research are suggested.

Physician-owned hospitals, neurosurgeons, and disclosure: lessons from law and the literature.

Physician ownership of hospitals has been a subject of controversy for years. Opponents claim that physician ownership and the hospital profits that result from imaging, laboratory tests, and procedures create a conflict of interest for physicians in providing impartial patient care. Proponents argue that having an ownership stake in a hospital means that physicians can have control over all facets of the patient experience, which leads potentially to better patient satisfaction and outcomes. With passage of health reform legislation, physician-owned specialty hospitals have been under renewed attack and now face more restrictive limitations on their growth and expansion. The following review explores the history of physician-owned specialty hospitals, the controversy surrounding physician ownership, and the scope of neurosurgeon ownership in specialty hospitals and offers 2 models for disclosure of potential conflicts of interest.

How do hospitals deal with euthanasia requests in Flanders (Belgium)? A content analysis of policy documents.

OBJECTIVE: To describe the form and content of ethics policies on euthanasia in Flemish hospitals and the possible influence of religious affiliation on policy content. METHODS: Content analysis of policy documents. RESULTS: Forty-two documents were analyzed. All policies contained procedures; 57% included the position paper on which the hospital's stance on euthanasia was based. All policies described their hospital's stance on euthanasia in competent terminally ill patients (n=42); 10 and 4 policies, respectively, did not describe their stance in incompetent terminally and non-terminally ill patients. Catholic hospitals restrictively applied the euthanasia law with palliative procedures and interdisciplinary deliberations. The policies described several phases of the euthanasia care process--confrontation with euthanasia request (93%), decision-making process (95%), care process in cases of no-euthanasia decision (38%), preparation and performance of euthanasia (79%), and aftercare (81%)--as well as involvement of caregivers, patients, and relatives; ethical issues; support for caregivers; reporting; and practical examples of professional attitudes and communication skills. CONCLUSION: Euthanasia policies go beyond summarizing the euthanasia law by addressing the importance of the euthanasia care process, in which palliative care and interdisciplinary cooperation are important factors. PRACTICE IMPLICATIONS: Euthanasia policies provide tangible guidance for physicians and nurses on handling euthanasia requests.