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This medical epithet seems to offer solid guidance for terrorism researchers and counterterrorism practitioners when thinking about the ethical implications of their work—to rephrase it, whatever y...

Obtaining parental consent for youth to participate in research is a standard requirement in the United States. However, the assumption that involving parents is the best way to protect youth research participants is untenable for some populations. This study draws on interviews with 19 LGBTQ+ mixed-race participants to examine lay views of parental consent requirements for LGBTQ+ youth research participants. Qualitative data analysis found concerns about potentially outing LGBTQ+ youth to intolerant parents. Interviewees also asserted that adolescents aged 16 and older are competent enough and should have the autonomy to consent themselves. Finally, interviewees raised several methodological concerns regarding the biased research that may result from parental consent requirements. We agree with others that U.S. Institutional Review Boards should end uncritical requirements for parental consent for older adolescents and should routinize the use and study of alternative protective measures.

The physician must … have two special objects in view with regard to disease, namely, to do good or to do no harm. The Hippocratic Corpus (∼410 BC) We all make mistakes. In clinical practice some o...

Maria Ibrahim, a kidney doctor in training, explains the vital role of statistics and statistical analysis in transplant medicine: from matching donor organs to patients, to helping doctors and patients discuss the risks and benefits of a life-changing operation

The mass migrations of 2015 were not merely a watershed moment for ‘EUrope’ but also for the scholarly study of migration to EUrope. With academic expertise and insights becoming much sought-after in the media and political discourse, migration scholarship has gained in unknown popularity over recent years. This current ‘migration knowledge hype’ has particularly benefited scholarship that claims to be of relevance for EUropean policymakers in finding responses to ‘migratory pressures’. This article critically interrogates the increasing intimacy between the worlds of migration scholarship and migration policy and seeks to unpack how the quest for policy-relevance has shaped the process of research itself. The impact of policy on migration research can be discerned when policy categories, assumptions, and needs constitute the bases and (conceptual) frames of research that seeks to be legible to policymakers. However, with EUropean migration policies causing devastation and undeniably harmful effects on migrant lives, what is the responsibility of researchers for the knowledge they produce and disseminate? Should the ‘do no harm’ principle prevalent in the migration discipline be expanded to also include the potentially harmful consequences resulting from research made relevant to migration policymakers? This article makes the case for an engaged scholarship that does not shy away from intervening in the contested field of migration with the intention not to fix but to amplify the epistemic and other crises of the EUropean border regime.

The medical community abides by oaths and expectations as they care for patients, with the general consensus of “do no harm” to the patient. One of the most feared acts is a medical error that could have been avoided. Included in medical errors are diagnostic errors, which can occur in all areas of medicine. Understanding our decision-making process can improve our diagnostic skills and identify any influences leading to an error. This article will provide nurse practitioners with ways to become more self-aware with every patient encounter and improve their understanding of diagnostic error.

Background Complementary medicines are a popular healthcare choice among patients/consumers, and most pharmacies sell these products. Pharmacists are well-placed to advise on complementary medicines, but their training and practices for these products are not optimal. Pharmacists' professional practices for complementary medicines ought to be influenced by professional codes of ethics and standards. Objective To examine community pharmacists' perspectives on complementary medicines in New Zealand, including motivations and justifications for selling these products, and professional and ethical issues complementary medicines raise for pharmacists. Setting Community pharmacists in New Zealand. Method Qualitative, semi-structured interviews with 27 New Zealand practising community pharmacists identified through purposive and convenience sampling. Main outcome measure Participants' views, experiences, and professional practices for complementary medicines. Results Participants struggled to clearly describe products they considered complementary medicines. Perspectives towards these products ranged from strongly supportive to somewhat sceptical; none was strongly opposed. Participants had several motivations for selling complementary medicines, particularly consumer demand and profits. Participants acknowledged ethical issues concerning complementary medicines, including lack of evidence of efficacy and pharmacists' limited training/knowledge. Few referred explicitly to complementary-medicines-related statements in the Pharmacy Council of New Zealand's Code of Ethics, or indicated these guided their practice. Conclusion Participants sold complementary medicines despite having limited knowledge on these products and concerns about efficacy; participants justified this as they believe they are providing an holistic option for patients, and/or ensuring complementary medicines do no harm. Participants were mindful of ethical/professional issues regarding complementary medicines, but were not necessarily aware of, or guided by, explicit statements in the Pharmacy Council of New Zealand's Code of Ethics.

The nature of oral history fieldwork changes when it is conducted during the course of an ongoing, long-term crisis like COVID-19. One must ask what the role of the oral history practitioner is, if...

Risk compensation can undermine the ability of partially-effective vaccines to curb epidemics: Vaccinated agents may optimally choose to engage in more risky interactions and, as a result, may increase everyone's infection probability. We show that—in contrast to the prediction of standard models—things can be worse than that: Free and perfectly safe but only partially effective vaccines can reduce everyone's welfare, and hence fail to satisfy—in a strong sense—the fundamental principle of “first, do no harm.” Our main departure from standard economic epidemiological models is that we allow agents to strategically choose their partners, which we show creates strategic complementarities in risky interactions. As a result, the introduction of a partially-effective vaccine can lead to a much denser interaction structure—whose negative welfare effects overwhelm the beneficial direct welfare effects of this intervention.

As anesthesiologists and acute pain medicine specialists, we will care for patients in the perioperative period who use cannabinoids for chronic pain and/or marijuana recreationally. We will have to address difficult questions from patients regarding the potential applications for cannabinoids in acute pain management. While we must remain compassionate and understand our patients’ desire to find relief from suffering using available non-opioid medications, we are ethically bound to do no harm and provide them with treatment options supported by the best available evidence. Today, we cannot support cannabinoids in the management of acute postoperative pain.

BACKGROUND: A recently published Position Statement (PS) by the Preimplantation Genetics Diagnosis International Society (PGDIS) regarding utilization of preimplantation genetic testing for aneuploidy (PGT-A) in association with in vitro fertilization (IVF) contained inaccuracies and misrepresentations. Because opinions issued by the PGDIS have since 2016 determined worldwide IVF practice, corrections appear of importance.METHODS: The International Do No Harm Group in IVF (IDNHG-IVF) is a spontaneously coalesced body of international investigators, concerned with increasing utilization of add-ons to IVF. It is responsible for the presented consensus statement, which as a final document was reached after review of the pertinent literature and again revised after the recent publication of the STAR trial and related commentaries.RESULTS: In contrast to the PGDIA-PS, we recommend restrictions to the increasing, and by IVF centers now often even mandated, utilization of PGT-A in IVF cycles. While PGT-A has been proposed as a tool for achieving enhanced singleton livebirth outcomes through embryo selection, continued false-positive rates and increasing evidence for embryonic self-correction downstream from the testing stage, has led IDNHG-IVF to conclude that currently available data are insufficient to impose overreaching recommendations for PGT-A utilization.DISCUSSION: Here presented consensus offers an alternative to the 2019 PGDIS position statement regarding utilization of preimplantation genetic testing for aneuploidy (PGT-A) in association with in vitro fertilization (IVF). Mindful of what appears to offer best outcomes for patients, and in full consideration of patient autonomy, here presented opinion is based on best available evidence, with the goal of improving safety and efficacy of IVF and minimizing wastage of embryos with potential for healthy births.CONCLUSIONS: As the PGDIS never suggested restrictions on clinical utilization of PGT-A in IVF, here presented rebuttal represents an act of self-regulation by parts of the IVF community in attempts to control increasing utilization of different unproven recent add-ons to IVF.

The first rule of healthcare is to do no harm and some staff working in hospitals and in shops are wearing blue nitrile gloves. The aim is to protect themselves and people they come into contact with, but is indiscriminate use of gloves part of the problem rather than part of the solution?

BACKGROUND Although deficient procedures performed by impaired physicians have been reported for many specialists, such as surgeons and anesthesiologists, systematic literature review failed to reveal any reported cases of deficient endoscopies performed by gastroenterologists due to toxic encephalopathy. Yet gastroenterologists, like any individual, can rarely suffer acute-changes-in-mental-status from medical disorders, and these disorders may first manifest while performing gastrointestinal endoscopy because endoscopy comprises so much of their workday. CASE SUMMARIES Among 181767 endoscopies performed by gastroenterologists at William-Beaumont-Hospital at Royal-Oak, two endoscopies were performed by normally highly qualified endoscopists who manifested bizarre endoscopic interpretation and technique during these endoscopies due to toxic encephalopathy. Case-1-endoscopist repeatedly insisted that gastric polyps were colonic polyps, and absurdly "pressed" endoscopic steering dials to "take" endoscopic photographs; Case-2-endoscopist repeatedly insisted that had intubated duodenum when intubating antrum, and wildly turned steering dials and bumped endoscopic tip forcefully against antral wall. Endoscopy nurses recognized endoscopists as impaired and informed endoscopy-unit-nurse-manager. She called Chief-of-Gastroenterology who advised endoscopists to terminate their esophagogastroduodenoscopies (fulfilling ethical imperative of "physician, first-do-no-harm"), and go to emergency room for medical evaluation. Both endoscopists complied. In-hospital-work-up revealed toxic encephalopathy in both from: case-1-urosepsis and left-ureteral-impacted-nephrolithiasis; and case-2-dehydration and accidental ingestion of suspected illicit drug given by unidentified stranger. Endoscopists rapidly recovered with medical therapy. CONCLUSION This rare syndrome (0.0011% of endoscopies) may manifest abruptly as bizarre endoscopic interpretation and technique due to impairment of endoscopists by toxic encephalopathy. Recommended management (followed in both cases): 1-recognize incident as medical emergency demanding immediate action to prevent iatrogenic patient injury; 2- inform Chief-of-Gastroenterology; and 3-immediately intervene to abort endoscopy to protect patient. Syndromic features require further study.

Photographs are necessary in the clinical practice of dermatology, but there are ethical implications to consider. Moreover, dermatologists must be aware of and comply with certain legal requirements affecting the use of photographs. The main ethical principles are respect for patient autonomy and the physician's obligation to do no harm. The law differentiates between 2 bases for protection: one concerns the photographed person's rights over the image and the other protects personal data. Recent legislation places restrictions on taking photographs and exhibiting them. Photographs taken to be stored with a medical history have not been called into question, but the physician is recommended to inform the patient that they exist. When a photograph is exhibited for the purpose of teaching or illustrating concepts, it is necessary to determine whether or not the patient can be identified. If the answer is yes, the patient must give explicit permission. Caution should be exercised when publishing medical photographs on social media.

Proteins are the workhorses of the cell, yet they carry great potential for harm via misfolding and aggregation. Despite the dangers, proteins are sometimes born de novo from non-coding DNA. Proteins are more likely to be born from non-coding regions that produce peptides that do little to no harm when translated than from regions that produce harmful peptides. To investigate which newborn proteins are most likely to “first, do no harm”, we estimate fitnesses from an experiment that competed Escherichia coli lineages that each expressed a unique random peptide. A variety of peptide metrics significantly predict lineage fitness, but this predictive power stems from simple amino acid frequencies rather than the ordering of amino acids. Amino acids that are smaller and that promote intrinsic structural disorder have more benign fitness effects. We validate that the amino acids that indicate benign effects in random peptides expressed in E. coli also do so in an independent dataset of random N-terminal tags in which it is possible to control for expression level. The same amino acids are also enriched in young animal proteins.Significance statementProteins are sometimes born de novo. In an experiment to reproduce this process in Escherichia coli, we were able to predict 15% of the variation in random peptide fitness effects from their amino acid frequencies. In contrast, which order the amino acids are in seems to make no difference, adding no predictive power on top of simple amino acid frequencies. Amino acids that are smaller and promote intrinsic structural disorder have more benign fitness effects.

This chapter opens with a story of a famous eighteenth-century physician practicing without any data, and the disastrous medical consequences that follow. Today, some of the basic pillars of addiction treatment practices (e.g., case assignment) are not grounded in any science. Further, it is revealed that addiction treatment mostly operates in a world without any performance data, and whatever data are collected end up buried in electronic health record data coffins. What might matter in making an informed choice about where to get the best treatment is discussed. The need for examining the existing data is considered to address this issue.

INTRODUCTION AND OBJECTIVE:Venous thromboembolism (VTE) is a perioperative complication with significant morbidity. Routine use of peri-operative VTE prophylaxis is common guideline-driven practice...

Against a vast backdrop of regulation, and increasingly strong calls for industry change, major social and environmental incidents in mining continue to occur. There is resistance among major companies to the idea that restructuring their organisations will have any positive effect on their social performance. Our interest is in whether the structural positioning of social performance enables or prevents companies from governing their social and legal obligations. This includes the commitment to do no harm. Internal turf wars between social performance and corporate affairs reflect the difficulties that mining company executives confront in attempting to maintain production and contain corporate self-interest. What manifests structurally is a clear representation of how companies make sense of their priorities and the priorities of others. That companies would seek to limit inquiry into their own governance structures is even more reason to investigate.

A mere 6 months ago, our lives were relatively calm and routine. The thought of a novel, infectious, worldwide pandemic threatening the lives of hundreds of thousands of individuals seemed the storyline of a fictional Hollywood script. The rapid surge and toll of coronavirus disease-2019 (COVID-19

Resumen La intención de este artículo es reflexionar acerca de la relación que se puede establecer entre el acceso a la administración de justicia y el enfoque de Acción sin Daño a propósito de la aparición de la estrategia de Sistemas Locales de Justicia en Colombia. En ese sentido, se explica cómo el acceso a la justicia afronta una serie de dificultades de carácter estructural y cómo es oportuna la emergencia de estrategias territoriales de justicia y la pertinencia de construirlas en concordancia con el enfoque de Acción Sin Daño. El documento es el resultado de algunas consideraciones investigativas en la experiencia de conformación de Sistemas Locales de Justicia en Bogotá D.C. producto del acompañamiento de la Universidad Nacional de Colombia. Abstract The intention of this article is to reflect about the relationship that can be established between access to the administration of justice and the Do No Harm approach, taking into account the appearance of the strategy of Local Justice Systems in Colombia. In this sense, the article explains how access to justice faces a series of difficulties of a structural nature, how the emergence of territorial justice strategies is opportune, and the pertinence of building them hand in hand with the Do No Harm approach. The document is the result of some research considerations in the experience of forming Local Justice Systems in Bogotá D.C. in conjunction with the Universidad Nacional of Colombia.

The intention of this article is to reflect about the relationship that can be established between access to the administration of justice and the Do No Harm approach, taking into account the appearance of the strategy of Local Justice Systems in Colombia. In this sense, the article explains how access to justice faces a series of difficulties of a structural nature, how the emergence of territorial justice strategies is opportune, and the pertinence of building them hand in hand with the Do No Harm approach. The document is the result of some research considerations in the experience of forming Local Justice Systems in Bogotá D.C. in conjunction with the Universidad Nacional of Colombia.

An incidental discovery of Wolff Parkinson White (WPW) pattern on the electrocardiogram (ECG) is not an infrequent finding facing the physician. Most patients discovered incidentally are asymptomatic and it is hard to justify further management of such patients given the time-honored adage to “first do no harm.” However, this finding does have implications. This article is an attempt to guide clinicians about this important issue that is often faced in the office. Keywords: WPW, Ventricular preexcitation, SCD, Supraventricular tachycardia, Risk stratification, Ablation

I argue that the concept of knowledge is a relic of a bygone age, erroneously supposed to do no harm. I illustrate this claim by showing how a concern with knowledge distorts the use of statistical evidence in criminal courts, and then generalize the point to show that this concern hampers our enterprises across the board and not only in legal contexts.

Existing research on child welfare removals has not fully contextualized the incipient trauma experienced by children during the removal process and has neglected ancillary impacts on intervening c...

Television programmes continue to impart ‘narratives, consumer choice’ and ‘moral predispositions’, although there is conjecture among scholars over the influence of television on the formation of a moral viewpoint in audiences. These components allow consumers to evaluate the content of television shows in the light of their own cultural understandings of morality and then either accept or reject them. This article uses thematic analysis to reveal patterns in the representations of moral ambiguity in the first season of the television show The Resident (2018–present), a contemporary US-based television series that is broadcast to global audiences in a number of international territories. The series explores the intricacies of hospital management, patient care and medical ethics particularly in light of increasing commercial pressures within a US context. Our analysis shows that the series grapples with four main themes: do no harm, experts and egos, money muddies morality and good versus evil, and in doing so, interrogates the basis of implicit knowledge about right, wrong and individual responsibility in western culture.

Application of cricoid pressure (CP) during rapid sequence induction and intubation sequence has been a "standard" of care for many decades, despite limited scientific proof of its efficacy in preventing pulmonary aspiration of gastric contents. While some of the current rapid sequence induction and intubation guidelines recommend its use, other international guidelines do not, and many clinicians argue that there is insufficient evidence to either continue or abandon its use. Recently published articles and accompanying editorials have reignited the debate on the efficacy and safety of CP application and have generated multiple responses that pointed out the various (and significant) limitations of the available evidence. Thus, a critical discussion of available data must be undertaken before making a final clinical decision on such an important patient safety issue. In this review, the authors will take an objective look at the available scientific evidence about the effectiveness and safety of CP in patients at risk of pulmonary aspiration of gastric contents. We suggest that current data are inadequate to impose clinical guidelines on the use of CP because we acknowledge that currently there is not, and there may never be, a method to prevent aspiration in all patients. In addition, we reiterate that a universally accepted medical-legal standard for approaching the high-risk aspiration patient does not exist, discuss the differences in practice between the US and international practitioners regarding use of CP, and propose 5 recommendations on how future studies might be designed to obtain optimal scientific evidence about the effectiveness and safety of CP in patients at risk for pulmonary aspiration.

The aim of the article is to identify ethical tensions between the cognitive function of science, humanitarian reasons for undertaking research work, and its practical goals in research conducted among forced migrants. Differences between researchers and respondents in the dimensions of social, economic, and political status determine the challenges of building ethical relationships, not only as meeting the imperative of “do no harm” by ensuring the safety of the subjects and protecting them from abuse. In a team composed of researchers with an external and internal status towards the studied group, we consider the possibilities of equalizing asymmetrical relationships, creating relationships based on mutual benefits, and the involvement of respondents in the research process. The source of reflection is the analysis of research reports and the experience of own research work carried out among forced migrants by co-authors of this text. Celem artykułu jest identyfikacja etycznych napięć pomiędzy poznawczą funkcją nauki, humanitarnymi przyczynami podejmowania pracy badawczej i jej praktycznymi celami w badaniach prowadzonych wśród przymusowych migrantów. Różnice pomiędzy badaczami i badanymi w wymiarach statusu społecznego, ekonomicznego i politycznego wyznaczają wyzwania budowania relacji etycznych, rozumianych nie tylko jako spełnienie imperatywu „nie szkodzić” poprzez zapewnienie bezpieczeństwa osobom badanym i ochronę ich przed nadużyciami. W zespole złożonym z badaczy o statusie zewnętrznym i wewnętrznym wobec badanej grupy rozważamy możliwości wyrównywania niesymetrycznych relacji, tworzenia relacji opartych na wzajemnych korzyściach oraz zaangażowania badanych w proces badawczy. Źródłem refleksji jest analiza raportów badawczych oraz doświadczenia własnej pracy badawczej prowadzonej wśród przymusowych migrantów przez współautorów niniejszego tekstu.