The Journal of clinical ethics
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Comment
Dying but not killing: donation after cardiac death donors and the recovery of vital organs.
Michael Potts, Paul A. Byrne, and David W. Evans are critical of donation after cardiac death (DCD). ⋯ Consistent with the "dead donor rule," DCD is not the cause of death. There are also procedural mechanisms to address the potential conflicts of interest that concern the authors. Rather than being prohibited, DCD may be an ethically justifiable exception to the rule that organ donors must be dead prior to organ recovery.
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Breaches of electronic medical records constitute a type of healthcare error, but should be considered separately from other types of errors because the national focus on the security of electronic data justifies special treatment of medical information breaches. Guidelines for protecting electronic medical records should be applied equally to paper medical records.
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Informed consent is the practical application of the principle of autonomy, and two of the five core features of informed consent are related to information. Researchers have reported on patients' expressed needs for information, such as their stated desires for the quantity of and the source of information. A separate body of research has examined patients' unexpressed needs for information from the perspective of cognitive psychology, such as the emotional tone and order of information. This article suggests that the autonomy of patients is best served by meeting their expressed and unexpressed information needs for in tandem.
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Practice Guideline
A physician's role following a breach of electronic health information.
The Council on Ethical and Judicial Affairs of the American Medical Association examines physicians' professional ethical responsibility in the event that the security of patients' electronic records is breached.
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The American Medical Association Council on Ethical and Judicial Affairs (CEJA) has written a position paper on physicians' ethical responsibilities in the event that the security of patients' electronic health information has been breached. The report offers compelling ethical and practical justifications for notification requirements and articulates guidelines for clinicians. ⋯ It outlines the new legal duty to disclose security breaches, established by the 2009 HITECH Act, which is only briefly mentioned in the report. The commentary also analyzes the CEJA recommendations in light of the legal mandate and suggests that the guidance would benefit from further clarification.