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2.
J Law Med Ethics ; 51(3): 672-683, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38088597

RESUMO

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.


Assuntos
Lesões Encefálicas , Instituições Acadêmicas , Humanos
3.
JAMA Intern Med ; 183(4): 283-284, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36848080

RESUMO

This Viewpoint suggests that professional societies should continue to advocate for equitable access for patients to all necessary medical care including abortion care.


Assuntos
Aborto Induzido , Gravidez , Feminino , Humanos , Sociedades Médicas
4.
Cell Rep Med ; 3(8): 100719, 2022 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-35977463

RESUMO

In the past two years, in 25 US states, bills have been introduced to restrict access to gender-affirming medical care for minors. Some have already become law. We show how these bills, while purporting to "protect" trans youth, are really an assault on their ability, along with their parents' and physicians', to make healthcare choices and to receive medically necessary care. We discuss the evidence-based guidelines for the care of these patients, the positions taken by major medical societies against these bills, and the landscape of legal challenges that are being brought against these enacted laws.


Assuntos
Pessoas Transgênero , Adolescente , Atenção à Saúde , Identidade de Gênero , Instalações de Saúde , Humanos , Política
8.
AMA J Ethics ; 22(3): E209-216, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32220267

RESUMO

This article canvasses laws protecting clinicians' conscience and focuses on dilemmas that occur when a clinician refuses to perform a procedure consistent with the standard of care. In particular, the article focuses on patients' experience with a conscientiously objecting clinician at a secular institution, where patients are least likely to expect conscience-based care restrictions. After reviewing existing laws that protect clinicians' conscience, the article discusses limited legal remedies available to patients.


Assuntos
Consciência , Legislação Médica , Médicos , Recusa em Tratar , Ética Médica , Humanos , Organizações , Médicos/ética , Médicos/legislação & jurisprudência , Recusa em Tratar/ética , Recusa em Tratar/legislação & jurisprudência
11.
J Law Med Ethics ; 48(4_suppl): 146-154, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33404303

RESUMO

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of laws intended to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies.


Assuntos
Armas de Fogo/legislação & jurisprudência , Violência com Arma de Fogo/prevenção & controle , Papel do Médico , Prática Profissional/ética , Prática Profissional/legislação & jurisprudência , Ferimentos por Arma de Fogo/prevenção & controle , Aconselhamento , Responsabilidade pela Informação , Humanos , Notificação de Abuso , Estados Unidos/epidemiologia
12.
J Law Med Ethics ; 48(4_suppl): 142-145, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33404307

RESUMO

Physicians play a critical role in preventing and treating firearm injury, although the scope of that role remains contentious and lacks systematic definition. This piece aims to utilize the fundamental principles of medical ethics to present a framework for physician involvement in firearm violence. Physicians' agency relationship with their patients creates ethical obligations grounded on three principles of medical ethics - patient autonomy, beneficence, and nonmaleficence. Taken together, they suggest that physicians ought to engage in clinical screening and treatment related to firearm violence. The principle of beneficence also applies more generally, but more weakly, to relations between physicians and society, creating nonobligatory moral ideals. Balanced against physicians' primary obligations to patient agency relationships, general beneficence suggests that physicians may engage in public advocacy to address gun violence, although they are not ethically obligated to do so. A fourth foundational principle - justice - requires that clinicians attempt to ensure that the benefits and burdens of healthcare are distributed fairly.


Assuntos
Ética Médica , Armas de Fogo/ética , Defesa do Paciente/normas , Saúde Pública/normas , Ferimentos por Arma de Fogo , Beneficência , Humanos , Autonomia Pessoal , Relações Médico-Paciente/ética , Justiça Social
13.
Semin Perinatol ; 42(8): 525-530, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30415764

RESUMO

CRISPR-based therapeutics have the potential to revolutionize the treatment of hereditary diseases, but current efforts to translate research to the bedside face significant technical, regulatory, and ethical hurdles. In this article, we discuss an underappreciated application of CRISPR: diagnostic testing, and argue that: (1) CRISPR diagnostics are poised to disrupt diagnostic practices including perinatal screening and (2) since CRISPR diagnostics pose minimal technical, regulatory and ethical hurdles (unlike CRISPR therapeutic uses) they are likely to be clinically relevant before CRISPR-based therapies, and thus warrant medical community's attention.


Assuntos
Sistemas CRISPR-Cas , Edição de Genes/métodos , Marcação de Genes/métodos , Técnicas de Diagnóstico Molecular/métodos , Perinatologia/métodos , Prevenção Secundária/métodos , Edição de Genes/tendências , Marcação de Genes/tendências , Humanos , Técnicas de Diagnóstico Molecular/tendências , Perinatologia/tendências , Sistemas Automatizados de Assistência Junto ao Leito
15.
Semin Perinatol ; 42(8): 515-521, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30420296

RESUMO

CRISPR gene editing is poised to transform the therapeutic landscape for diseases of genetic origin. The ease and agility by which CRISPR can make specific changes to DNA holds great promise not only for the treatment of heritable diseases, but also their prevention through germline editing. CRISPR-based therapeutic strategies are currently under development for numerous monogenic diseases. These strategies range from proof of concept studies demonstrating pre-fertilization gamete editing to recently initiated clinical trials for postnatal ex vivo therapies. The promise of CRISPR's human genome editing potential has captivated the public's attention. It is of paramount importance that medical professionals who work with patients who may have or carry a monogenic heritable disease understand CRISPR technology in order to have informed and compassionate discussions with their patients. Understanding CRISPR means understanding its evolving therapeutic applications' nuances, limitations, and barriers to access as well as the regulatory landscape they inhabit. In this piece we provide a review of the promises and pitfalls of CRISPR germline gene editing and their implications for patient decision-making throughout various stages of the reproductive process.


Assuntos
Sistemas CRISPR-Cas , Medo , Edição de Genes/métodos , Predisposição Genética para Doença/genética , Terapia Genética/tendências , Esperança , Saúde Reprodutiva , Tomada de Decisões , Medicina Baseada em Evidências , Edição de Genes/tendências , Humanos
16.
J Law Med Ethics ; 46(3): 602-609, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30336104

RESUMO

This article examines five different Medical-Legal Partnerships (MLPs) associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, and best practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the "L" has been lacking and is overdue.


Assuntos
Pessoal de Saúde , Relações Interprofissionais , Advogados , Determinantes Sociais da Saúde , Serviços de Saúde Comunitária/organização & administração , Connecticut , Nível de Saúde , Humanos , Ambulatório Hospitalar/organização & administração , Patient Protection and Affordable Care Act , Pobreza
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