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Conflicts of Interest and Commitment
Published in Steven A. Wartman, Confluence of Policy and Leadership in Academic Health Science Centers, 2022
Raymond J. Hutchinson, Sanjay Saint, James O. Woolliscroft
Many factors challenge the successful implementation of proper COI policy at AHSCs. Some occur with any policy implementation, regardless of venue, and some are related to the specific nature of policy creation – for example, in areas that touch on personal behaviors and professional ethics. Most health-care administrators, providers, educators, and researchers take their professional responsibilities very seriously, striving to reduce undesirable biases in their work. In fact, many do not think that influences from their interactions with representatives, scientists, and leaders from biomedical industries impact their work negatively. Indeed, while it is known that reciprocity develops as a natural occurrence in the course of interpersonal collaborations, not much is known about how such reciprocity extends to the conduct of professional duties affecting third parties – for example, patients, students, trainees, the public. Therefore, it is often hard to convince professionals within the AHSC that their actions must be guided by a set of principles that they may feel they already adhere to without the need for third-party oversight.
Law, normative limits and women’s health
Published in Irehobhude O. Iyioha, Women’s Health and the Limits of Law, 2019
By building into a law incentives for compliance alongside punitive methods for non-compliance where necessary, legislators signal that a new legal norm, itself building upon the commonly accepted positive aspects of a system, aspires to improve a society and its women, rather than supplant in punitive ways that which a society has held true for ages. To explain this point, the criminal act of FGC provides a useful example. Current prohibitions against the practice are supported by sanctions, severe in many cases, which include financial penalties and jail terms. Substantive effectiveness in this particular case advances an approach that recognizes law’s inherent need to “appeal”213 to citizens’ expectations of legal correctness and their “self-interest”214 by crafting reciprocal incentives to change individual behaviour. By reciprocity in this context is meant the provision of a benefit for compliance. Substantive effectiveness thus advances the formation of law that iterates and acknowledges the benign (admittedly a value judgement) aspects of the rituals and practices that are celebrated alongside the FGC procedure, affirms the need for cultural subsistence for such practices, outlines the medical or scientific case for eradication of the surgical aspect of the practices, offers economic incentives for compliance215 (with compliance being monitored through medical visits as is the case in Canada and other Western countries), and caps it with penalties couched as the outcomes for contrary conduct.
Care Ethics and the Practice of Medicine
Published in Ruth E. Groenhout, Care Ethics and Social Structures in Medicine, 2018
Care theory, then, begins with the recognition that humans are irretrievably social beings, that our existence, our identity, and, a fortiori, our ethics, needs to be analyzed within a social framework. Further, that social framework is dependent on the provision of care for its very existence. Humans need care at most points in their lives, but they cannot survive without care at a number of significant junctures. Infancy and childhood are obvious cases, as are the many times when we face serious illness, disabling conditions, or other types of vulnerability. At each of those points in our lives, we depend on others to care for us, often in a way that precludes absolute reciprocity, while depending on a general willingness to participate in general structures of care. By absolute reciprocity I mean the ability to repay care received with care given to the specific agent who provided care in the first place. Generally, this is not how care works; those who receive from one person often give back to others and some who receive care never provide care in return, some because they are incapable, others because they are freeloaders, others because the mobility of the modern world takes them far away from their initial caregivers, and so on.
Telemental health policies for college students during COVID-19
Published in Journal of American College Health, 2023
Yash S. Huilgol, John Torous, Jessica A. Gold, Matthew L. Goldman
Some state governors have attempted to modify these orders temporarily through executive orders. However, establishing these changes permanently will require collaboration from legislatures, professional associations, and licensing boards to recognize interjurisdictional care for mental health. One example is the Psychology Interjurisdictional Compact (PSYPACT), which is an interstate compact among 14 states that enables mental health practice across state lines allowing for virtual care.15 Another is the Interstate Medical Licensure Compact (IMLCC), an agreement developed with the assistance of the Federal State Medical Boards (FSMB) that streamlines licensing procedures for physicians in 29 states.16 However, these reciprocity agreements were made prior to the widespread implementation of virtual care, as has been necessitated by the COVID-19 pandemic. Most licensure reciprocity was designed prior to the COVID-19 pandemic for provider-operated practices in multiple cities in close proximity (e.g., Augusta, Georgia and North Augusta, South Carolina), or for clinicians who practiced in-person in different states at different times, not at the same time.
A comparison of patients with opioid use disorder receiving buprenorphine treatment with and without peer recovery support services
Published in Journal of Substance Use, 2022
Sara Mills Huffnagle, Grace Brennan, Keegan Wicks, Denise Holden, Sarah Kawasaki
This study examines the differences in demographics and treatment engagement among individuals with OUD who received or did not receive PRSS upon initiation of OUD treatment at an outpatient opioid treatment program facility (OTP) at the Pennsylvania Psychiatric Institute in central Pennsylvania. IRB approval was obtained by Penn State Health. Some patients received OUD treatment, including medical and therapy appointments, in the OTP. Other patients received medical follow-up appointments at local primary care practices through buprenorphine-waivered providers who were affiliated with a local organization providing PRSS, herein referred to as the Recovery, Advocacy, Support, and Education (RASE) Project. While PRSS were not considered routine care at the OTP, established partnerships between the OTP and the RASE Project’s buprenorphine-waivered providers across several clinical sites allowed for the shared treatment of patients in need of OUD treatment at higher levels of care. These patients were often accompanied by a state-certified PRSS specialist during routine medical appointments with the OTP or a local primary care practice affiliated with the RASE Project (Kawasaki et al., 2019). For our study, each PRSS specialist was certified as a Certified Recovery Specialist (CRS) from the Pennsylvania Certification Board (PCB) and the International Certification & Reciprocity Consortium (IC&RC).
Thick trust, thin trust, social capital, and health outcomes among trans women of color in New York City
Published in International Journal of Transgender Health, 2022
Sel J. Hwahng, Bennett Allen, Cathy Zadoretzky, Hannah Barber Doucet, Courtney McKnight, Don Des Jarlais
This is how, then, that social capital “gets in the body” (Rostila, 2011) to influence an individual’s health. We posit that “opening up to social capital” thus occurs through trusting, which can be broken down as a series of: (1) risks; (2) vulnerabilities; and (3) reciprocities. Reciprocity implies some form of expectations being met, such as a mutual exchange of emotional risk-taking and vulnerability (as what often takes place in thick trust) or access to resources previously unavailable through networking, advocacy, or active requesting (as what often takes place in thin trust). A focus on thick and thin trust gets to the “heart of the matter” of social capital, and is at least partly responsible for why social capital matters with regard to health. As will be discussed in this article, participants in our study, with little access to material resources, were still able to successfully generate thick and thin trust capital for themselves.