Journal of medical ethics
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Journal of medical ethics · Apr 2007
"Do-not-resuscitate" orders in patients with cancer at a children's hospital in Taiwan.
To quantify the use of do-not-resuscitate (DNR) orders in a tertiary-care children's hospital and to characterise the circumstances in which such orders are written. ⋯ From the study of patient deaths in this tertiary-care children's hospital, it was concluded that an explicit DNR order is now the rule rather than the exception, with more DNR orders being written for patients who have been ill longer, who have solid tumours, who are not in remission and who are in the ward.
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Journal of medical ethics · Mar 2007
Are the GFRUP's recommendations for withholding or withdrawing treatments in critically ill children applicable? Results of a two-year survey.
To evaluate feasibility of the guidelines of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French-speaking group of paediatric intensive and emergency care; GFRUP) for limitation of treatments in the paediatric intensive care unit (PICU). ⋯ GFRUPs procedure was applicable in most cases. The main difficulties were anticipating the correct date for the meeting and involving nurses in the procedure. Children for whom the procedure was interrupted because of clinical improvement and who survived in poor condition without a formal decision pointed out the need for medical criteria for questioning, which should systematically lead to a formal decision-making process.
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Journal of medical ethics · Mar 2007
Biography Historical ArticleEthical reflections on Edward Jenner's experimental treatment.
In 1798 Dr Edward Jenner published his famous account of "vaccination". Some claim that a Research Ethics Committee, had it existed in the 1790s, might have rejected his work. I provide the historical context of his work and argue that it addressed a major risk to the health of the community, and, given the devastating nature of smallpox and the significant risk of variolation, the only alternative preventative measure, Jenner's study had purpose, justification and a base in the practice of the day.