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CMAJ : Canadian Medical Association... Jun 2014
Review
Topics: Biomedical Research; Canada; Disclosure; Ethics, Medical; Humans; Incidental Findings
PubMed: 24688013
DOI: 10.1503/cmaj.140136 -
International Journal of Environmental... Sep 2021The purpose of this study is to examine the relationship between foreign investors and voluntary disclosure. Focusing on voluntary disclosure of carbon emissions...
The purpose of this study is to examine the relationship between foreign investors and voluntary disclosure. Focusing on voluntary disclosure of carbon emissions information and using South Korean firms from 2014 to 2019, we found that foreign investors are likely to voluntarily release information on carbon emissions. Thus, foreign investors play a role in controlling the information gap in a capital market. We also discuss the effect of environmental, social, and governance activities on the relationship between foreign investors and voluntary disclosure. We infer that the analysis result shows that foreign investors motivate firms to improve the environment to prepare for future environmental risks. Our study also suggests solving environmental problems actively, such as responding to climate change, by presenting a direction for policymaking on sustainable management.
Topics: Carbon; Climate Change; Disclosure; Internationality; Republic of Korea
PubMed: 34639399
DOI: 10.3390/ijerph181910097 -
Korean Journal of Medical Education Mar 2022We aimed to develop a program for error disclosure for emergency medicine (EM) residents to determine its effects.
PURPOSE
We aimed to develop a program for error disclosure for emergency medicine (EM) residents to determine its effects.
METHODS
Fifteen EM residents participated in 2020. The program included two-error disclosure sessions using standardized patients (SPs), a didactic lecture, and debriefing. The Kirkpatrick model was used to evaluate this program. Satisfaction scores and narrative reactions were collected (level 1). Residents were asked to choose their actions and explain reasons for the representative error cases before and after the program (level 2). After 2 months, they were asked to write their experiences of disclosing errors to real patients (level 3). The differences in the disclosing communication scores allocated by the SPs were compared between the senior and junior residents.
RESULTS
The residents' satisfaction scores were high. Before the program, some residents chose not to disclose errors when there were no harmful sequelae at the time of the incident. After the program, opinions changed, and the residents thought that all errors should be disclosed. Before the program, most residents disclosed the errors to patients first; after the program, they would report to the hospital first to receive guidance. After 2 months, five residents reported disclosing errors to real patients. The senior residents' total scores and the scores for "prevention of future errors" were higher.
CONCLUSION
The residents showed confidence in error disclosure while maintaining rapport with the real patient, and some were satisfied with their disclosure approach. Our error disclosure program for EM residents had a positive effect on their behavior and attitude toward error disclosure.
Topics: Communication; Disclosure; Emergency Medicine; Humans; Internship and Residency; Medical Errors; Truth Disclosure
PubMed: 35255612
DOI: 10.3946/kjme.2022.215 -
PLoS Computational Biology Oct 2015
Topics: Algorithms; Disclosure; Guideline Adherence; Guidelines as Topic; Quality Control; Research; Scientific Misconduct
PubMed: 26426757
DOI: 10.1371/journal.pcbi.1004388 -
Revista Medica de Chile Sep 2016For several years and in many different ways, medical errors have been studied. As expected, the majority of efforts have been directed to prevent clinical errors during... (Review)
Review
For several years and in many different ways, medical errors have been studied. As expected, the majority of efforts have been directed to prevent clinical errors during the different phases of health care. Nevertheless, less attention has been given to what happens when a negative effect has already occurred. The present work describes the doubts and difficulties that doctors deal with when facing an error and to describe the communicational tools that the literature offers to cope with them. The definition of medical error was the starting point that was used to later analyze the evidence about what, why and how to inform medical errors from an ethical and technical point of view. In the light of new legal exigencies, communicational and health protocols are revised, distinguishing those that are used for conveying bad news and medical errors. The importance of the ethical and communicational formation of the professionals is emphasized, identifying certain hindering aspects of the medical culture. This culture promotes an idea of the doctor as a professional who knows everything, does not make mistakes and acts in isolation. These do not reflect personal attributes in the professional and in the health team, required for a good professional practice.
Topics: Chile; Disclosure; Humans; Medical Errors; Physician-Patient Relations
PubMed: 28060981
DOI: 10.4067/S0034-98872016000900013 -
Policy, Politics & Nursing Practice Aug 2020The purpose of this article is to analyze radon awareness and disclosure policy proposed during the 2018 Kentucky General Assembly using Kingdon's Multiple Stream...
The purpose of this article is to analyze radon awareness and disclosure policy proposed during the 2018 Kentucky General Assembly using Kingdon's Multiple Stream Framework. Radon gas is the second leading cause of lung cancer. Exposure to radon occurs largely in the home. The proportion of homeowners who have completed radon testing remains low, and home radon testing is voluntary in most states. The Environmental Law Institute recommends states enact policies to promote radon awareness and testing. The most common radon awareness policy mandates radon disclosure during a real estate transaction. A bill to mandate radon disclosure during a real estate transaction was proposed during the 2018 Kentucky General Assembly but was met with opposition and was not filed. As a policy alternative, an administrative regulation to amend the was proposed to the Kentucky Real Estate Commission. Administrative regulations set forth by government regulatory agencies are equally enforceable and may be a more politically feasible alternative to enacting public policy. Nurses are positioned to promote the health of patients and populations. Nurses advocating for radon control legislation and/or administrative regulations may push radon control policy higher on the governmental decision agenda leading to policy change to decrease the development of lung cancer.
Topics: Disclosure; Environmental Policy; Guidelines as Topic; Health Policy; Humans; Kentucky; Lung Neoplasms; Politics; Public Policy; Radon
PubMed: 32393114
DOI: 10.1177/1527154420923728 -
American Journal of Human Genetics Nov 2020The analogy between genomics and imaging has been an important touchstone in the debate on how secondary findings should be handled in both clinical and research...
The analogy between genomics and imaging has been an important touchstone in the debate on how secondary findings should be handled in both clinical and research genomics contexts. However, a critical eye is needed to understand whether an analogy like this one provides an adequate basis for policymaking in genomics. Genomics and imaging are undoubtedly similar in certain ways, but whether that similarity is adequate to justify adopting identical policies is a task that requires further analysis. This is highlighted by the fact that secondary findings are produced in other domains of medicine and public health, such as newborn screening programs, routine laboratory panels, and antibiotic sensitivity testing, and that the practices for handling secondary findings in each of these areas are different. These examples demonstrate that medicine has no single comprehensive policy or set of practices for managing secondary findings. Analogies to imaging, newborn screening, routine testing panels, and antibiotic sensitivity testing all lead to different policy options for genomics. In this piece we argue that analogies are a powerful way of driving policy discussions by rendering two different areas of medical practice similar, but an overdependence on a single analogy risks limiting policy discussions in potentially deleterious ways.
Topics: Diagnostic Imaging; Disclosure; Genetic Testing; Genomics; Health Policy; Humans; Incidental Findings; Infant, Newborn; Policy Making; Public Health; Sequence Analysis, DNA
PubMed: 33157006
DOI: 10.1016/j.ajhg.2020.08.024 -
BMJ Open Oct 2018To analyse the section of Disclosure UK that pertains to healthcare professionals (HCPs) in order to provide insight into the database's structure and content and...
Disclosure of payments by pharmaceutical companies to healthcare professionals in the UK: analysis of the Association of the British Pharmaceutical Industry's Disclosure UK database, 2015 and 2016 cohorts.
OBJECTIVES
To analyse the section of Disclosure UK that pertains to healthcare professionals (HCPs) in order to provide insight into the database's structure and content and suggest ways to improve its transparency.
DESIGN AND PARTICIPANTS
Cohort study of drug companies and HCPs in the 2015 and 2016 versions of Disclosure UK.
RESULTS
Companies report transfers of value (ToVs) to named HCPs or, where an HCP declines to consent, in aggregate. Only a limited number of variables describe the recipient HCP and the ToV, precluding refined analyses. In 2015, 107 companies reported 54 910 ToVs worth ₤50 967 728. In 2016, 109 companies reported ToVs but spending decreased by 7.3%. The spending was concentrated: the top 10 spenders reported about 50% of the total value, with consultancy-related payments comprising over 70%, and the rest being costs for events. In 2015, 55.5% (30 478) of ToVs worth ₤24 428 619 (47.9%) were disclosed at the individual HCP level, increasing to 64.5% (32 407) and ₤28 145 091 (59.2%) in 2016. Despite increased individual-level disclosure in 2016, the median number of ToVs reported by each company at the individual level was only 57.7%, with 25% of companies reporting less than 38.6%. We found little agreement (62%-48% in 2015 and 46%-30% in 2016) between HCP consent rates that we calculated based on information in the database and those provided by companies.
CONCLUSIONS
Key deficiencies in Disclosure UK include: insufficient information on payments and recipients, a relatively low HCP consent rate for individual-level disclosure, differences in consent rates across companies and payment types, and reporting ambiguities or inconsistencies. We employ these findings to develop recommendations for improving transparency, including an easily interpretable consent rate statistic that allows for comparison across years, firms and countries. If deficiencies remain unresolved, the UK should consider introducing legislation requiring mandatory disclosure to allow for adequate tracking of industry payments.
Topics: Conflict of Interest; Databases as Topic; Disclosure; Drug Industry; Health Personnel; Humans; Societies, Pharmaceutical; United Kingdom
PubMed: 30344175
DOI: 10.1136/bmjopen-2018-023094 -
Annals of Internal Medicine Sep 2019One of the hallmarks of a trustworthy clinical guideline or guidance statement is a comprehensive process for disclosure of interests (DOI) and management of conflicts...
Disclosure of Interests and Management of Conflicts of Interest in Clinical Guidelines and Guidance Statements: Methods From the Clinical Guidelines Committee of the American College of Physicians.
One of the hallmarks of a trustworthy clinical guideline or guidance statement is a comprehensive process for disclosure of interests (DOI) and management of conflicts of interest (COIs). The American College of Physicians (ACP) Clinical Guidelines Committee (CGC) aims to disclose all health care-related interests and manage conflicts in a manner that is transparent, proportional, and consistent. Any person involved in the development of an ACP clinical guideline or guidance statement must disclose all financial and intellectual interests related to health care from the previous 3 years. Persons complete disclosures at the start of their participation and are required to update them over the course of their involvement with the CGC, including before each CGC meeting. A DOI-COI Review and Management Panel reviews the disclosures; flags potential conflicts; grades the COI as low-, moderate-, or high-level; and manages the person's participation accordingly. A high-level COI results in recusal from authorship, voting, and all committee discussions. Participants with a moderate-level COI are recused from authorship and voting for clinically relevant topics but may participate in all discussions. A low-level COI results in no role restrictions. All disclosures and COI management decisions are publicly reported.
Topics: Authorship; Conflict of Interest; Disclosure; Humans; Practice Guidelines as Topic; Publishing; Time Factors
PubMed: 31426089
DOI: 10.7326/M18-3279 -
BMC Medical Ethics May 2020Biomarker research is gaining increasing attention focusing on the preclinical stages of the disease. Such interest requires special attention for communication and...
BACKGROUND
Biomarker research is gaining increasing attention focusing on the preclinical stages of the disease. Such interest requires special attention for communication and disclosure in clinical contexts. Many countries give dementia a high health policy priority by developing national strategies and by improving guidelines addressing disclosure of a diagnosis; however, risk communication is often neglected.
MAIN TEXT
This paper aims to identify the challenges of disclosure in the context of dementia prediction and to find out whether existing clinical guidelines sufficiently address the issues of disclosing a dementia diagnosis and of disclosing the risk of developing dementia in asymptomatic and MCI stage. We will examine clinical guidelines and recommendations of three countries (USA, Canada and Germany) regarding predictive testing and diagnostic disclosure in dementia and Mild Cognitive Impairment (MCI) to show their potentials and limits. This will provide a background to address ethical implications of predictive information and to identify ways how to proceed further. We will start by examining the guidelines and recommendations by focusing on what there is already and what is missing regarding the challenges of disclosing dementia prediction and MCI. Then, we will highlight the novel ethical issues generated by the shift to identify preclinical stages of the disease by biomarkers. We will argue for the need to develop guidelines for disclosing a risk status, which requires different considerations then disclosing a diagnosis of dementia. Finally, we will make some suggestions on how to address the gap and challenges raised by referring to German Stakeholder Conference, which presents us a good starting point to the applicability of involving stakeholders.
CONCLUSIONS
This paper underlines the need to develop empirically based guidelines that address the ethical and social strategies for risk communication of dementia prediction by genetic as well as non-genetic biomarkers. According to our analysis, the guidelines do not address the new developments sufficiently. International efforts should aim for specific guidelines on counseling, communicating risk and disclosing results. We argue that guidelines on (risk) disclosure should be developed by involving various stakeholders and should be informed by socio-empirical studies involving laypersons' needs and wishes regarding risk communication.
Topics: Canada; Cognitive Dysfunction; Dementia; Disclosure; Germany; Humans
PubMed: 32393330
DOI: 10.1186/s12910-020-00476-4