Should noninvasive ventilation be used with the do-not-intubate patient?
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Most of the large quantity of data on noninvasive ventilation (NIV) in acute respiratory failure is from patients who want all possible treatments and life-support. Few data are available on NIV in patients who have elected specific limits on life support and treatments (eg, patients with do-not-intubate [DNI] orders) and patients who are near the end of life and will receive comfort measures only (CMO). The most critical issue regarding NIV in DNI and CMO patients is informed consent. The patient must be informed of the risks and potential benefits of NIV, and must consent to NIV. We have few data on patients' attitudes about NIV at end of life. Data from cancer patients at end of life suggest that they want to maintain control over care decisions and may want treatment that delays death long enough that they can put their affairs in order. If informed consent and control of care decisions are assured, then NIV can be appropriate in DNI and CMO patients to reverse an acute respiratory failure that is not necessarily life-terminating, or to improve patient comfort, or to delay death. (+info)
A randomised trial of conventional versus BAUS procedure-specific consent forms for transurethral resection of prostate.
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Access to medications and medical care after participation in HIV clinical trials: a systematic review of trial protocols and informed consent documents.
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Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form.
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Elimination of requirement for prior signature consent and pre-and post-test counseling for HIV testing. Final rule.
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This document adopts, without change, the proposed rule published in the Federal Register on December 29, 2008, updating informed consent requirements related to testing for the Human Immunodeficiency Virus (HIV) for Veterans receiving health care from the Department of Veterans Affairs (VA). This final rule is in accordance with related provisions of the Veteran's Mental Health and Other Care Improvements Act of 2008. The final rule eliminates the regulatory requirement for written informed consent for HIV testing and specific pre- and post-test counseling of Veteran patients. VA will implement this rule through internal policy guidance specifying these requirements and how they apply to HIV testing. (+info)