| 1. |
- Brynolf, Anne, et al.
(författare)
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Virtual colleagues, virtually colleagues : physicians’ use of Twitter: a population-based observational study
- 2013
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Ingår i: BMJ Open. - London : BMJ House. - 2044-6055. ; 3:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter.Design Population-based cross-sectional observational study.Setting The social networking site Twitter (Swedish-speaking users, n=298819).Population Physicians and medical students (Swedish-speaking users, n=237) active on the social networking site Twitter between July 2007 and March 2012.Main outcome measure Postings that reflect unprofessional behaviour and ethical breaches among physicians and medical students.Results In all, 237 Twitter accounts were established as held by physicians and medical students and a total of 13 780 tweets were analysed by content. In all, 276 (1.9%) tweets were labelled as ‘unprofessional’. Among these, 26 (0.2%) tweets written by 15 (6.3%) physicians and medical students included information that could violate patient privacy. No information on the personal ID number or names was disclosed, but parts of the patient documentation or otherwise specific indicatory information on patients were found. Unprofessional tweets were more common among users writing under a pseudonym and among medical students.Conclusions In this study of physicians and medical students on Twitter, we observed potential violations of patient privacy and other breaches of medical ethics. Our findings underline that every physician and medical student has to consider his or her presence on social networking sites. It remains to be investigated if the introduction of social networking site guidelines for medical professionals will improve awareness.
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| 2. |
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| 3. |
- Kristoffersson, Ulf, et al.
(författare)
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Nya rön om fragil X-syndromet komplicerar genetisk vägledning. Sjukdomsgenen orsakar fler symtom än vad som tidigare varit känt
- 2005
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Ingår i: Läkartidningen. - 0023-7205. ; 102:44, s. 3232-3236
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish Medical Society’s Delegation for Medical Ethics held in October 2004 a workshop on the new ethical implications on genetic counselling in families where a premutation or mutation in the FMR1 gene was found. New research has revealed that premutation carrier women have an increased risk of premature ovarian failure, and, thus, their fertile sisters may be mutation carriers with an increased risk of having a child with the fragile X syndrome. Premutation carrier males have after the age of 50 an increased risk of developing ataxia and cognitive dysfunctions. Accordingly, their daughters have a high risk of having a child with the fragile X syndrome. The ethical aspects of these issues were discussed at the workshop with suggestions on the way forward.
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| 4. |
- Lerner, Henrik, et al.
(författare)
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Veterinary surgeons attitudes towards physician-assisted suicide: an empirical study of Swedish experts on euthanasia
- 2011
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Ingår i: JOURNAL OF MEDICAL ETHICS. - : BMJ Publishing Group. - 0306-6800 .- 1473-4257. ; 37:5, s. 295-298
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Tidskriftsartikel (refereegranskat)abstract
- Aim To examine the hypothesis that knowledge about physician-assisted suicide (PAS) and euthanasia is associated with a more restrictive attitude towards PAS. Design A questionnaire about attitudes towards PAS, including prioritisation of arguments pro and contra, was sent to Swedish veterinary surgeons. The results were compared with those from similar surveys of attitudes among the general public and physicians. Participants All veterinary surgeons who were members of the Swedish Veterinary Association and had provided an email address (n=2421). Main outcome measures Similarities or differences in response pattern between veterinary surgeons, physicians and the general public. Results The response pattern among veterinary surgeons and the general public was almost similar in all relevant aspects. Of the veterinarians 75% (95% CI 72% to 78%) were in favour of PAS, compared with 73% (95% CI 69% to 77%) among the general public. Only 10% (95% CI 5% to 15%) of the veterinary surgeons were against PAS, compared with 12% (95% CI 5% to 19%) among the general public. Finally, 15% (95% CI 10% to 21%) of veterinarians were undecided, compared with 15% (95% CI 8% to 22%) among the general public. Physicians had a more restrictive attitude to PAS than the general public. Conclusions Since veterinary surgeons have frequent practical experience of euthanasia in animals, they do have knowledge about what euthanasia really is. Veterinary surgeons and the general public had an almost similar response pattern. Accordingly it seems difficult to maintain that knowledge about euthanasia is unambiguously associated with a restrictive attitude towards PAS.
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| 5. |
- Lynoe, Niels, et al.
(författare)
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An overview of the scientific controversy regarding the diagnostic accuracy of Shaken baby syndrome
- 2023
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Ingår i: Medicine and Law Journal. - New York : William S. Hein & Co., Inc.. - 0723-1393 .- 2471-836X. ; 42:4, s. 763-780
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Tidskriftsartikel (refereegranskat)abstract
- The process used to diagnose Shaken Baby Syndrome (SBS), a subgroup of Abusive Head Trauma (AHT) without signs of relevant trauma, is not reliable and remains uncertain. There is insufficient scientific evidence for any doctor or medical expert to conclude that if a child has three medical findings, the “triad”, then the infant must have been shaken or abused. All studies showing a ‘strong’ association between the triad and the diagnostic accuracy of the SBS diagnosis rely on circular reasoning., There is insufficient scientific evidence that the isolated triad can predict traumatic shaking, as there is a high risk of bias. There is an ongoing scientific controversy within the area. The aim of the present article is to facilitate a better understanding of this scientific controversy for those who are not themselves medical scientists -, such as lawyers, prosecutors, and judges. The legal and medical consequences of the current scientific controversy is that an incorrect diagnosis may delay the correct diagnosis, harm the infant and its family, and jeopardis e rule of law.
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| 6. |
- Lynoe, Niels, et al.
(författare)
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Do child abuse pediatricians search for a "pediatric Vulcan planet"? : Comparison of controversies about the Vulcan-must-exist-theory and the Infant-must-have-been-shaken-theory
- 2020
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Ingår i: Journal of Research in Philosophy and History. - : Scholink. - 2576-2451 .- 2576-2435. ; 3:2, s. 162-193
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Tidskriftsartikel (refereegranskat)abstract
- We argue that there are similarities between the Vulcan-must-exist-theory, derived from the Original Unrestricted Newtonian Gravitational (OUNG) theory, on the one hand, and on the other hand the infant-must-have-been-shaken-theory, derived from the Original Unrestricted Abusive Head Trauma (OUAHT) theory.Although the Vulcan-must–exist-theory was apparently supported by observations over a period of 50 years, after the introduction of Einstein’s general relativity theory in 1915 and its corroboration in 1919, the alleged planet was subsequently neither observed nor needed.In analogy with the Einstein/Vulcan reasoning, we suggest that the introduction of the non-shaken baby theory by Geddes et al. in 2001-2004 indicates that in cases where an infant displays no external signs of trauma, the infant-must-have-been-shaken-theory is no longer needed.Moreover we argue that the two new theories -Einstein’s and Geddes et al.’s- have relevant similarities in terms of the effect on the respective original, unrestricted theory. Just as acceptance of Einstein’s general relativity theory led to the abandonment of the Vulcan-must-exist-theory, it is reasonable to claim that the infant-must-have-been-shaken-theory should also be abandoned. We finally argue that while the consequences of abandoning the Vulcan-must-exist-theory were restricted to some scientific and astronomical issues, the infant-must-have-been-shaken-theory has not yet been abandoned because of the societal and legal consequences.
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| 7. |
- Lynoe, Niels, et al.
(författare)
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Heed or disregard a cancer patient's critical blogging? : An experimental study of two different framing strategies
- 2016
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Ingår i: BMC Medical Ethics. - : Springer Science and Business Media LLC. - 1472-6939. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: We have examined healthcare staff attitudes of toward a blogging cancer patient who publishes critical posts about her treatment and their possible effect on patient-staff relationships and treatment decisions.Methods: We used two versions of a questionnaire containing a vignette based on a modified real case involving a 39-year-old cancer patient who complained on her blog about how she was encountered and the treatment she received. Initially she was not offered a new, and expensive treatment, which might have influenced her perception of further encounters. In one version of the vignette, the team decides to put extra effort into both encounters and offers the expensive new cancer treatment. In the other version, the team decides to follow the clinic's routine to the letter. Subsequently, blog postings became either positive or negative in tone. We also divided participants into value-neutral and value-influenced groups (regarding personal values) by asking how their trust in healthcare would be affected if the team's suggestion were followed.Results: A total of 56 % (95 % CI: 51-61) of the respondents faced with a team decision to 'do something-extra' in encounters would act in accordance with this ambition. Concerning treatment, 32 % (95 % CI: 28-38) would follow the team's decision to offer a new and expensive treatment. A large majority of those who received the "follow-routine" version agreed to do so in encountering [94 % (95 % CI: 91-97)]. Similar proportions were found regarding treatment [86 % (95 % CI: 82-90)]. A total of 83 % (95 % CI: 76-91) of the value-neutral participants who received the "do-something-extra" version stated that they would act as the team suggested regarding encounters, while 57 % (95 % CI: 47-67) would do so in regard to treatment. Among the value-influenced participants who received the "do-something-extra" version, 45 % (95 % CI: 38-51) stated that they would make an extra effort to accommodate the patient and her needs, while the proportion for treatment was 22 % (95 % CI: 16-27). Among those who had received the "follow-routine" version, a large majority agreed, and no difference was indicated between the value-neutral and the value-influenced participants.Conclusion: The present study indicates that healthcare staff is indeed influenced by reading a patient's critical blog entries, largely regarding encounters, but also concerning treatment is concerned. Value-neutral healthcare personnel seem to exhibit a pragmatic attitude and be more inclined to heed and respond to a patient whose criticism may well be warranted. The study also indicates that healthcare staff is partly positive or negative to future blogging patients depending on how the issue has been framed. For future research we suggest as a bold hypothesis that the phrase "clinical routine" might conceal power aspects masquerading as adopted ethical principles.
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| 8. |
- Lynoe, Niels, et al.
(författare)
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Is there a common denominator for Brief Resolved Unexplained Events, Sudden Infant Death Syndrome, and alleged Shaken Baby Syndrome?
- 2020
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Ingår i: Medical Hypotheses. - : Elsevier. - 0306-9877 .- 1532-2777. ; 144
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Tidskriftsartikel (refereegranskat)abstract
- We propose the medical hypothesis that a common denominator may be the precursor for Brief Resolved Unexplained Events (BRUE), cases of Sudden Infant Death Syndrome (SIDS) as well as to cases of alleged Shaken Baby Syndrome (SBS) without external signs of trauma. Although previous studies have emphasized differences, we have focused on the overarching common denominators of the three conditions in terms of mechanism theories. In consequence, fatal cases with subdural hemorrhage (SDH) classified as SBS could be classified as high risk BRUE with SDH. Fatal cases without SDH could be classified as SIDS. Non-fatal cases with SDH and retinal hemorrhages (RHs), currently classified as SBS, could be classified as BRUE with SDH and RHs, leaving a fourth group of BRUE without SDH and RHs. While both the BRUE and the SIDS diagnoses have been refined and developed, alleged abusive head trauma (AHT) cases with and without external signs of trauma have been indiscriminately combined. This is analogous to indiscriminately grouping together, e.g., headache due to a brain tumor or headache after head trauma. Alleged AHT cases with external signs of trauma and high velocity impact might be explained by the traditional AHT mechanism theories, whereas the one-third of all alleged AHT cases without external signs of trauma could be explained by the hypoxia cascade theory and/or other non-shaking theories.
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| 9. |
- Lynoe, Niels, et al.
(författare)
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Is there an association between infantile colic and subdural hemorrhage?
- 2020
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Ingår i: Medical Hypotheses. - : Elsevier. - 0306-9877 .- 1532-2777. ; 144
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Tidskriftsartikel (refereegranskat)abstract
- We present the hypothesis that subdural hemorrhages during childbirth might be associated with so-called three-month colic, whereby an infant cries intensively and repeatedly during its first three months. A traditional interpretation is that this infantile crying is associated with nutrition and is accordingly "a gut issue", but this is probably not the whole explanation. It has also been suggested that infantile crying can trigger a caregiver to shake the baby to make it stop crying, thereby inflicting a subdural hemorrhage. A mechanism-based argument supporting our hypothesis would be that the bilateral film-thin subdural hemorrhage associated with a high percentage of deliveries might cause meningeal irritation and in some cases also symptoms as inconsolable crying. An epidemiological argument is that infantile crying is more frequent among first-born, male and premature babies; these categories have also an increased incidence of subdural hemorrhage. Moreover, preventive programs for managing infantile crying have had no effect on the incidence of alleged shaken baby cases. As infantile crying is currently considered unexplained, it is reasonable to explore the proposed hypothesis and strategies which refute or corroborate it. We suggest that a cohort study of premature, first born and male babies with and without infantile crying are examined with brain MRI scan soon after delivery with clinically and MRI follow up during 3-6 months.
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