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Amy L. McGuire Mark P. Aulisio F. Daniel Davis Cheryl Erwin Thomas D. Harter Reshma Jagsi 《The American journal of bioethics : AJOB》2020,20(7):15-27
Abstract The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient’s ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities. 相似文献
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Current external criticism of American schooling includes an assumption that content textbooks used in upper grades fail to challenge the abilities of pupils. To investigate this assumption, the multiformula readabilities of 111 content textbooks currently employed in grades six through nine in 30 middle or junior high schools were obtained. Five and six formula, same sample readability data were collected and analyzed by 37 teacher researchers. Two or more formulas placed 49% of these texts one or more grade levels above grade of use. The results also were analyzed in light of current concerns about the accuracy and use of readability formulas. Readability placements varied notably and significantly between‐texts and within‐texts for each content area and grade level of use. Significant mean differences occurred in grade placement by formulas differing in comprehension criteria and in word count procedures. Extending sample selection from three to six and nine within‐text samples did not change readability estimates notably or significantly. Teacher researcher procedural error occurred rarely. Teacher participants preferred the formulas combining realistic school estimates with efficiency in estimation. 相似文献
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