Arts and Humanities Commons^™

When Can Physicians Say “No” To Families And Patients?, Charles Weijer

Charles Weijer

No abstract provided.

Providing Research Results To Participants: Attitudes And Needs Of Adolescents And Parents Of Children With Cancer, Conrad Fernandez, Jun Gao, Caron Strahlendorf, Albert Moghrabi, Rebecca Pentz, Raymond Barfield, Justin Baker, Darcy Santor, Charles Weijer, Eric Kodish

Charles Weijer

PURPOSE: There is an increasing demand for researchers to provide research results to participants. Our aim was to define an appropriate process for this, based on needs and attitudes of participants.

METHODS: A multicenter survey in five sites in the United States and Canada was offered to parents of children with cancer and adolescents with cancer. Respondents indicated their preferred mode of communication of research results with respect to implications; timing, provider, and content of the results; reasons for and against providing results; and barriers to providing results.

RESULTS: Four hundred nine parents (including 19 of deceased children) and 86 …

Care Of An Unresponsive Patient With A Poor Prognosis, Arthur Slutsky, Leonard Hudson, Nancy Dubler, Charles Weijer, Mark Tonelli

Charles Weijer

No abstract provided.

The Limits Of Consent: A Socio-Ethical Approach To Human Subject Research In Medicine, Oonagh Corrigan, John Mcmillan, Kathleen Liddell, Martin Richards, Charles Weijer

Charles Weijer

Since its inception as an international requirement to protect patients and healthy volunteers taking part in medical research, informed consent has become the primary consideration in research ethics. Despite the ubiquity of consent, however, scholars have begun to question its adequacy for contemporary biomedical research. This book explores this issue, reviewing the application of consent to genetic research, clinical trials, and research involving vulnerable populations. For example, in genetic research, information obtained from an autonomous research participant may have significant bearing on the interests of family members who have not consented to the study. This casts doubt on the adequacy …

Ethics And Schizophrenia, A. Rudnick, Charles Weijer

Charles Weijer

No abstract provided.

The Return Of Research Results To Participants: Pilot Questionnaire Of Adolescents And Parents Of Children With Cancer, Conrad Fernandez, Darcy Santor, Charles Weijer, Caron Strahlendorf, Albert Moghrabi, Rebecca Pentz, Jun Gao, Eric Kodish

Charles Weijer

PURPOSE: The offer to return research results to participants is increasingly recognized as an ethical obligation, although few researchers routinely return results. We examined the needs and attitudes of parents of children with cancer and of adolescents with cancer to the return of research results.

METHODS: Seven experts in research ethics scored content validity on parent and adolescent questionnaires previously developed through focus group and phone interviews. The questionnaires were revised and provided to 30 parents and 10 adolescents in a tertiary care oncology setting.

RESULTS: The content validity index for individual questions and the overall questionnaires scored as 0.86 …

Disclosure Of Research Result To Research Participants: Needs And Attitudes Of Adolescents And Parents, Conrad Fernandez, Shaureen Taweel, Eric Kodish, Charles Weijer

Charles Weijer

BACKGROUND: Researchers have a moral responsibility to offer to return research results to participants, but the needs and attitudes of parents and adolescents with cancer in paediatric oncology regarding the issue are relatively unknown.

OBJECTIVES: To explore the needs of potential research participants or their guardians with respect to the offer of a return of research results. METHODS: A questionnaire was used in a focus group and in telephone interviews with eight adolescents and 12 parents of children with cancer. The participants were asked to respond to the questions and to comment on the inclusiveness of the questionnaire.

RESULTS: The …

A Death In The Family: Reflections On The Terri Schiavo Case, Charles Weijer

Charles Weijer

No abstract provided.

Is Clinical Research And Ethics A Zero-Sum Game?, Charles Weijer

Charles Weijer

No abstract provided.

A Critical History Of Individual And Collective Ethics In The Lineage Of Lellouch And Schwartz, Charles Heilig, Charles Weijer

Charles Weijer

The notions of individual and collective ethics were first explicitly defined in the biostatistical literature in 1971 to motivate a mathematical solution to a posed ethical dilemma. This paper reviews key antecedents to these concepts and traces explicit references to them over time, primarily in the biostatistical literature. Following a historical exposition of these texts, a critical thematic analysis shows the following: the normative force of these concepts has not been adequately argued. Individual and collective ethics do not solve the problem of how to use accumulating data to inform ethical action. The notions of the "individual" and the "collective" …

Disclosure Of The Right Of Research Participants To Receive Research Results: An Analysis Of Consent Forms In The Children's Oncology Group, Conrad Fernandez, Eric Kodish, Shaureen Taweel, Susan Shurin, Charles Weijer

Charles Weijer

BACKGROUND: The offer of return of research results to study participants has many potential benefits. The current study examined the offer of return of research results by analyzing consent forms from 2 acute lymphoblastic leukemia studies of the 235 institutional members of the Children's Oncology Group.

METHODS: Institutional review board (IRB)-approved consent forms from 2 standard-risk acute lymphoblastic leukemia studies (Children's Cancer Group [CCG] 1991 and Pediatric Oncology Group [POG] 9407) were analyzed independently by 2 reviewers.

RESULTS: The authors received replies from 202 of the 235 institutions that were contacted (85%). One hundred eighty-one institutions had CCG 1991 (n …

Ethical Issues In Palliative Care Research, Neil Macdonald, Charles Weijer

Charles Weijer

No abstract provided.

Hospital Policy On Appropriate Use Of Life-Sustaining Treatment, Peter Singer, Geoff Barker, Kerry Bowman, Christine Harrison, Philip Kernerman, Judy Kopelow, Neil Lazar, Charles Weijer, Stephen Workman

Charles Weijer

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate.

DESIGN: Case study.

SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining Treatment.

PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal …

Misrepresenting Research: Commentary, Charles Weijer

Charles Weijer

No abstract provided.

Family Duty Is More Important Than Rights, Charles Weijer

Charles Weijer

No abstract provided.

An Historical Take On The Physician's Charter, Nuala Kenny, Charles Weijer

Charles Weijer

No abstract provided.

Legal And Ethical Issues In Geriatric Medicine, Heather Macdonald, Charles Weijer, Peter Singer

Charles Weijer

No abstract provided.

Voting Ourselves Rights: A Critique Of The Canadian Medical Association Charter For Physicians, Nuala Kenny, Charles Weijer, Francoise Baylis

Charles Weijer

No abstract provided.

Getting Doctors To Listen: Ethics And Outcomes Data In Context, Charles Weijer

Charles Weijer

No abstract provided.

Medical Futility: Physicians, Not Patients, Call The Shots, Charles Weijer

Charles Weijer

No abstract provided.

Monitoring Informed Consent In An Oncology Study Posing Serious Risk To Subjects, Myrian Skrutkowski, Charles Weijer, Stan Shapiro, Abraham Fuks, Adrian Langleben, Benjamin Freedman

Charles Weijer

No abstract provided.

Cpr For Patients In A Persistent Vegetative State?, Charles Weijer

Charles Weijer

No abstract provided.

Self Interest Is Not The Sole Legitimate Basis For Making Decisions, Charles Weijer

Charles Weijer

No abstract provided.

A Study In Contrasts: Eligibility Criteria In A Twenty-Year Sample Of Nsabp And Pog Clinical Trials, Abraham Fuks, Charles Weijer, Benjamin Freedman, Stanley Shapiro, Myriam Skrutkowska, Amina Riaz

Charles Weijer

We studied changes in eligibility criteria--the largest impediment to patient accrual--in two samples of clinical trials. Trials from the NSABP (National Surgical Adjuvant Breast and Bowel Program) and POG (Pediatric Oncology Group) were analyzed. After eliminating duplications, the criteria in each protocol were enumerated and classified according to a novel schema. NSABP trials contained significantly more criteria than POG trials, and added precision criteria (making study populations homogeneous) at a faster rate than POG studies. The difference between NSABP studies (explanatory trials) and POG studies (pragmatic trials) suggest that large numbers of eligibility criteria are not necessary for quality studies. …

Democracy In Medicine?, Charles Weijer

Charles Weijer

No abstract provided.

Learning From The Dutch: Physician-Assisted Death, Slippery Slopes And The Nazi Analogy, Charles Weijer

Charles Weijer

No abstract provided.

Euthanasia, Assisted Suicide And The Family Physician, Charles Weijer

Charles Weijer

No abstract provided.