IntroductionFactitious hematemesis is the bleeding type of Munchausen’s syndrome together with dual diagnosis of school refusal is rarely reported in the literature. It is a condition in which the ...patient intentionally produces symptoms to assume a sick role and gain medical attention. Underdiagnosis of this disorder results in the unnecessary use of medical resources, i.e. unnecessary medical tests and evaluations.ObjectivescaseWe present this rare case of a patient with chronic factitious disorder who presented to the emergency with hematemesis. The 12 year old male patient grade 6 student presented with curious history of hematemesis just before the entrance of school and in the new school premises since 2 years resulting in school refusal and multiple doctor shopping. The patient underwent laboratory tests (such as the examination of sputum specimens, urinalysis, complete blood evaluations) and diagnostic studies (fiberoptic bronchoscopy with bronchoalveolar lavage, computerized tomography and radiography of the chest, bronchial arteriography, endocopic studies etc), because he continually presented with hematemesis, in order to spot and discover the nature of the bleeding. Since such examinations failed (a few of them-namely fiberoptic bronchoscopies--were even performed when he was coughing up blood) and psychiatric consultations revealed the presence of psychologically traumatic events in the patient’s history which could explain the psychopathic traits of her personality (in fact she was aggressive and unstable in interpersonal relations), a diagnosis of factitious hematemesis in Munchausen’s syndrome was made.MethodsThe typical characteristics that should prompt the physician to include Munchausen syndrome in the diagnosis include deliberately lying, repeatedly coming to the clinic/hospital with similar complaints in a short span of time, taking excessive drugs (especially insulin and warfarin) to induce side-effects, recurrent abdominal pain, scars on limbs, and rheumatologic and hematological disorders.ResultsWe recommend that physicians all across the globe should report more cases of Munchausen syndrome. More research is required in this arena to understand the cultural, social, and psychological aspects of Munchausen syndrome and to find out which treatment strategy can be most beneficial for such patientsConclusionsMunchausen syndrome is a diagnostic dilemma that needs to be given adequate medical and social attention by encouraging further research and spreading awareness not only amongst the general population but also health care providers. With proper evaluation, diagnosis, and psychotherapy, the disease will not remain a diagnostic dilemma and would be easier to control and treat. This case report will contribute towards the awareness of physicians about Munchausen syndrome and the strategies to diagnose and treat it.Disclosure of InterestNone Declared
Purpose
This paper aims to convey the different ways in which HR managers can prepare their staff for the return to business travel.
Design/methodology/approach
The author has based her findings on ...years of firsthand experience in the field of business travel expense management.
Findings
This paper proposes that HR teams should shape travel policy for success and maintain clear communication with teams, which are the surefire ways to prepare teams for the return of business travel.
Originality/value
This paper provides value for HR managers who are dealing with employees who are perhaps anxious about making business trips for the first time since the pandemic.
During the COVID-19 pandemic, the media have repeatedly praised healthcare workers for their 'heroic' work. Although this gratitude is undoubtedly appreciated by many, we must be cautious about ...overuse of the term 'hero' in such discussions. The challenges currently faced by healthcare workers are substantially greater than those encountered in their normal work, and it is understandable that the language of heroism has been evoked to praise them for their actions. Yet such language can have potentially negative consequences. Here, I examine what heroism is and why it is being applied to the healthcare workers currently, before outlining some of the problems associated with the heroism narrative currently being employed by the media. Healthcare workers have a clear and limited duty to treat during the COVID-19 pandemic, which can be grounded in a broad social contract and is strongly associated with certain reciprocal duties that society has towards healthcare workers. I argue that the heroism narrative can be damaging, as it stifles meaningful discussion about what the limits of this duty to treat are. It fails to acknowledge the importance of reciprocity, and through its implication that all healthcare workers have to be heroic, it can have negative psychological effects on workers themselves. I conclude that rather than invoking the language of heroism to praise healthcare workers, we should examine, as a society, what duties healthcare workers have to work in this pandemic, and how we can support them in fulfilling these.
NEGLIGENCE AND AI'S HUMAN USERS Selbst, Andrew D
Boston University law review,
09/2020, Letnik:
100, Številka:
4
Journal Article
Recenzirano
Negligence law is often asked to adapt to new technologies. So it is with artificial intelligence ("AI"). Though AI often conjures images of autonomous robots, especially autonomous vehicles, most ...existing AI technologies are not autonomous. Rather, they are decision-assistance tools that aim to improve on the inefficiency, arbitrariness, and bias of human decisions. Decision-assistance tools are frequently used in contexts in which negligence law or negligence analogues operate, including medicine, financial advice, data security, and driving (in partially autonomous vehicles). Users of these tools interact with AI as they would any other form of technological development-by incorporating it into their existing decision-making practices. Accordingly, it is important to understand how the use of these tools affects the duties of care required by negligence law and people's ability to meet them. This Article takes up that discussion, arguing that AI poses serious challenges for negligence law's ability to continue compensating the injured. By inserting a layer of inscrutable, unintuitive, and statistically derived code in between a human decisionmaker and the consequences of her decisions, AI disrupts our typical understanding of responsibility for choices gone wrong. This Article argues that AI's unique nature introduces four complications into negligence: 1) the inability to predict and account for AI errors; 2) physical or cognitive capacity limitations at the interface where humans interact with AI; 3) the introduction of AI-specific software vulnerabilities into decisions not previously mediated by software; and 4) distributional concerns based on AI's statistical nature and potential for bias. In those contexts where we rely on current negligence law to compensate for injuries, AI's use will likely result in injured plaintiffs regularly losing out, as errors cease being the fault of the operator and become statistical certainties embedded within the technology. With most new technologies, negligence law adapts over time as courts gain familiarity with the technology's proper use. But the unique nature of AI suggests that this may not occur without legislation requiring AI to be built interpretably and transparently, at a minimum, and that other avenues of regulation may be better suited to preventing uncompensated losses by injured parties.
El presente trabajo tiene como objetivo analizar el impacto que los nuevos desarrollos legislativos en el ámbito de los criterios ESG tienen en la normativa societaria. En concreto el trabajo analiza ...el posible cambio en la concepción del interés social como consecuencia de los desarrollos legislativos en materia de sostenibilidad, y en particular, los posibles cambios que dicha materia hayan podido producir en los deberes de carácter fiduciario. Para ello, resulta obligado no solo analizar la propuesta de directiva sobre diligencia debido, sino también el propio concepto de interés social y su relación con el deber de diligencia y el deber de lealtad.
Abstract
Every day in EDs, clinicians are faced with situations where they need to decide whether to detain a patient for assessment and treatment. For patients who meet the relevant criteria, ...provisions of mental health legislation can be used. For other patients, clinicians often rely on so‐called ‘duty of care’. This article briefly explores this complex area of law, including the relevant legislation, common law principles and grey areas. It also proposes an approach to decision‐making in this area.
Over a decade has passed since landmark Delaware corporate law decisions on oversight responsibility, and only a small handful of cases have survived a motion to dismiss. Scholars have puzzled over ...what it means to have the potential for corporate accountability lodged within the duty of good faith, but almost never brought to fruition in terms of trial liability.
Background:
Positioned at the frontlines of the battle against COVID-19 disease, nurses are at increased risk of contraction, yet as they feel obligated to provide care, they also experience ethical ...pressure.
Research question and objectives:
The study examined how Israeli nurses respond to ethical dilemmas and tension during the COVID-19 outbreak, and to what extent this is associated with their perceived risk and motivation to provide care?
Research design:
The study implemented a descriptive correlative study using a 53-section online questionnaire, including 4 open-ended questions.
Participants and research context:
The questionnaire was complete by 231 registered and intern nurses after being posted on nurses’ Facebook and WhatsApp groups, and through snowball sampling.
Ethical considerations:
The research was pre-approved by the ethics committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa, Israel.
Findings:
In all, 68.8% of the respondents had received some form of training about COVID-19. Respondents positioned themselves at perceived high risk levels for contracting the virus. About one-third feared going to work because of potential contraction and due to feeling inadequately protected. While 40.9% were scared to care for COVID-19 patients, 74.7% did not believe they have the right to refuse to treat certain patients. When asked about defining an age limit for providing patients with scarce resources (such as ventilation machines) in cases of insufficient supplies, respondents stated that the maximum age in such scenarios should be 84 (standard deviation (SD = 19) – yet most respondents (81.4%) believed that every patient has the right to receive optimal treatment, regardless of their age and medical background.
Discussion:
Correlating with their strong commitment to care, nurses did not convey intention to leave the profession despite their stress, perceived risk, and feelings of insufficient support and protection at work. The nurses did not hold a utilitarian approach to resource allocation, thereby acknowledging the value of all people and their entitlement to care, regardless of optimal outcomes.
Conclusion:
While experiencing significant personal risk and emotional burden, nurses conveyed strong dedication to providing care, and did not regret working in the nursing profession, yet they did seek a supportive climate for their needs and ethical concerns.
Artificial intelligence (AI) has risen to legal debate over legal liability in-volved in an incident. An intelligent machine can learn through experience and adapts its decisions accordingly. As ...such, if an intelligent machine’s be-haviour causes harm, the developer and the machine's owner may argue that the autonomous nature of AI systems has broken the causal link. The diffi-culty of determining who is liable for a harmful behaviour of an AI system is accentuated by the fact that tracing back the decision-making process of an AI system is not always possible. This paper aims to put forward a definition of a duty of care for developers and users of AI systems that could be the basis for the investigation of liability while seeking predictability of the allo-cation of legal liability in many cases involving AI incidents. The paper ex-amines some guidelines on ethics for AI to discern essential elements of the duty of care in the AI environment. The paper argues that a uniform minimum standard of care should be adopted internationally through model laws or even an international convention. A uniform standard of care should be enforced by State control rather than self-regulation by the AI industry. A licensing or certification requirement for AI products should be implemented to verify that the elements of the duty of care have been satisfied to control AI production and import/export relations. Violation of the standard of care can be an objective ground to negate or allocate negligence, especially when verifying errors in the design of the relevant software or if explaining the AI system's behaviour is not possible. A clear standard of care would, this paper assumes, help promote AI development and use and would not create imped-iments to investment in AI production.
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