Base de dados : MEDLINE
Pesquisa : E02.906 [Categoria DeCS]
Referências encontradas : 231 [refinar]
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[PMID]:28903155
[Au] Autor:Radix A; Davis AM
[Ad] Endereço:Callen Lorde Community Health Center, New York, New York.
[Ti] Título:Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons.
[So] Source:JAMA;318(15):1491-1492, 2017 Oct 17.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Disforia de Gênero/tratamento farmacológico
Hormônios Esteroides Gonadais/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Disforia de Gênero/diagnóstico
Hormônio Liberador de Gonadotropina/uso terapêutico
Seres Humanos
Consentimento Informado por Menores
Competência Mental
Encaminhamento e Consulta
Procedimentos de Readequação Sexual
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (Gonadal Steroid Hormones); 33515-09-2 (Gonadotropin-Releasing Hormone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.13540


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[PMID]:28716460
[Au] Autor:Chipkin SR; Kim F
[Ad] Endereço:University of Massachusetts School of Public Health and Health Sciences, Amherst; Valley Medical Group, Amherst, Mass. Electronic address: schipkin@umass.edu.
[Ti] Título:Ten Most Important Things to Know About Caring for Transgender Patients.
[So] Source:Am J Med;130(11):1238-1245, 2017 Nov.
[Is] ISSN:1555-7162
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Transgender people have a gender that is not in agreement with their birth sex. Previous barriers, including lack of provider knowledge, have created significant healthcare disparities for this population. Recent societal changes are increasing the numbers of transgender people seen by primary care practitioners. Ten key principles are provided to help primary care practitioners create more welcoming environments and provide quality care to transgender patients. Overall, all members of the healthcare team (primary and specialty) need to become aware of the transition process and maintain communication regarding risks, benefits, and goals. Transwomen (aka male to female) can be treated with estrogens, antiandrogens, or a combination. Benefits include change in fat distribution, skin softening, and breast development. Significant risks for thrombosis from estrogens have been linked to genetic mutations, smoking, prolonged inactivity, and hormone formulation. Oral administration may provide increased risk over peripheral administration. Transmen (aka female to male) can be treated with peripheral testosterone preparations. Benefits include deepening of voice and development of facial and body hair with variable changes in muscle mass. Risks from testosterone appear to be less common than from estrogen. Laboratory monitoring can guide treatment decisions and provide early detection of some complications. Monitoring of "existing" anatomy (either hormonally or surgically created or removed) is an important component of healthcare for transgender patients. Primary care providers also should be aware of resources in their community and online, which can help patients optimize their transition.
[Mh] Termos MeSH primário: Terapia de Reposição Hormonal
Procedimentos de Readequação Sexual
Pessoas Transgênero/psicologia
[Mh] Termos MeSH secundário: Inteligência Emocional
Disparidades em Assistência à Saúde
Terapia de Reposição Hormonal/efeitos adversos
Terapia de Reposição Hormonal/métodos
Seres Humanos
Atenção Primária à Saúde/métodos
Relações Profissional-Paciente
Medição de Risco
Procedimentos de Readequação Sexual/métodos
Procedimentos de Readequação Sexual/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE


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[PMID]:28486372
[Au] Autor:Maxwell S; Noyes N; Keefe D; Berkeley AS; Goldman KN
[Ad] Endereço:Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York.
[Ti] Título:Pregnancy Outcomes After Fertility Preservation in Transgender Men.
[So] Source:Obstet Gynecol;129(6):1031-1034, 2017 Jun.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transgender individuals, individuals whose gender identity does not align with their sex assigned at birth, undergoing gender-affirming hormonal or surgical therapies may experience loss of fertility. Assisted reproductive technologies have expanded family-building options for transgender men who were assigned female at birth. CASES: Three transgender men underwent oocyte cryopreservation before gender-affirming hormonal therapy. One patient underwent fertility preservation as an adolescent. Two adult patients had children using their cryopreserved oocytes, with the pregnancies carried by their sexually intimate partners. CONCLUSION: Transgender men with cryopreserved gametes can build families in a way that affirms their gender identity. Obstetrician-gynecologists should be familiar with the fertility needs of transgender patients so appropriate discussions and referrals can be made.
[Mh] Termos MeSH primário: Preservação da Fertilidade
Procedimentos de Readequação Sexual/métodos
Pessoas Transgênero
[Mh] Termos MeSH secundário: Adolescente
Criopreservação
Feminino
Seres Humanos
Masculino
Recuperação de Oócitos
Guias de Prática Clínica como Assunto
Gravidez
Resultado da Gravidez
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002036


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[PMID]:28402247
[Au] Autor:Baker KE
[Ad] Endereço:From the Johns Hopkins Bloomberg School of Public Health, Baltimore; and the Center for American Progress, Washington, DC.
[Ti] Título:The Future of Transgender Coverage.
[So] Source:N Engl J Med;376(19):1801-1804, 2017 May 11.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Cobertura do Seguro/legislação & jurisprudência
Seguro Saúde/legislação & jurisprudência
Procedimentos de Readequação Sexual/economia
Pessoas Transgênero
[Mh] Termos MeSH secundário: Feminino
Disforia de Gênero/economia
Disforia de Gênero/psicologia
Disforia de Gênero/terapia
Seres Humanos
Cobertura do Seguro/economia
Masculino
Cirurgia de Readequação Sexual/economia
Cirurgia de Readequação Sexual/legislação & jurisprudência
Sexismo/legislação & jurisprudência
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1702427


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[PMID]:28382847
[Au] Autor:Joseph A; Cliffe C; Hillyard M; Majeed A
[Ad] Endereço:1 Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK.
[Ti] Título:Gender identity and the management of the transgender patient: a guide for non-specialists.
[So] Source:J R Soc Med;110(4):144-152, 2017 Apr.
[Is] ISSN:1758-1095
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In this review, we introduce the topic of transgender medicine, aimed at the non-specialist clinician working in the UK. Appropriate terminology is provided alongside practical advice on how to appropriately care for transgender people. We offer a brief theoretical discussion on transgenderism and consider how it relates to broader understandings of both gender and disease. In respect to epidemiology, while it is difficult to assess the exact size of the transgender population in the UK, population surveys suggest a prevalence of between 0.2 and 0.6% in adults, with rates of referrals to gender identity clinics in the UK increasing yearly. We outline the legal framework that protects the rights of transgender people, showing that is not legal for physicians to deny transgender people access to services based on their personal beliefs. Being transgender is often, although not always, associated with gender dysphoria, a potentially disabling condition in which the discordance between a person's natal sex (that assigned to them at birth) and gender identity results in distress, with high associated rates of self-harm, suicidality and functional impairment. We show that gender reassignment can be a safe and effective treatment for gender dysphoria with counselling, exogenous hormones and surgery being the mainstay of treatment. The role of the general practitioner in the management of transgender patients is discussed and we consider whether hormone therapy should be initiated in primary care in the absence of specialist advice, as is suggested by recent General Medical Council guidance.
[Mh] Termos MeSH primário: Identidade de Gênero
Pessoas Transgênero
Transexualismo
[Mh] Termos MeSH secundário: Feminino
Disforia de Gênero
Clínicos Gerais
Seres Humanos
Masculino
Preconceito
Procedimentos de Readequação Sexual/métodos
Medicina Estatal
Pessoas Transgênero/legislação & jurisprudência
Pessoas Transgênero/psicologia
Pessoas Transgênero/estatística & dados numéricos
Transexualismo/epidemiologia
Transexualismo/psicologia
Transexualismo/terapia
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170407
[St] Status:MEDLINE
[do] DOI:10.1177/0141076817696054


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[PMID]:28191651
[Au] Autor:Sharif A; Malhotra NR; Acosta AM; Kajdacsy-Balla AA; Bosland M; Guzman G; Prins GS; Abern MR
[Ad] Endereço:Department of Pathology, University of Illinois at Chicago, Chicago, Illinois.
[Ti] Título:The Development of Prostate Adenocarcinoma in a Transgender Male to Female Patient: Could Estrogen Therapy Have Played a Role?
[So] Source:Prostate;77(8):824-828, 2017 Jun.
[Is] ISSN:1097-0045
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prostate adenocarcinoma (PCa) is a rare diagnosis in the male to female transgender (MtFT) population with only a few case reports published in the current medical literature. Long standing beliefs of androgen suppression conferring a protective effect against prostate cancer development have been challenged by the literature citing adenocarcinoma development in the prostate of rodent models following combined estrogen and testosterone treatment. MATERIALS AND METHODS: We herein present a MtFT patient who presented with high grade PCa following 20 years of exogenous estrogen therapy. RESULTS: Immunohistochemical (IHC) localization of estrogen receptor alpha (ER-α) and progesterone receptor (PR) demonstrated positive staining in stromal cells; while, androgen receptor (AR) demonstrated positive staining in malignant glands and weak scattered staining in adjacent stroma. CONCLUSION: This pattern of staining raises concern for a possible contributing role of exogenous estrogen therapy in tumorigenesis. As awareness of gender dysphoria and acceptance of gender reassignment surgery has seen a recent increase, the unique needs of this population must be recognized. Prostate 77:824-828, 2017. © 2017 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Adenocarcinoma
Terapia de Reposição de Estrogênios
Estrogênios
Prostatectomia/métodos
Neoplasias da Próstata
Procedimentos de Readequação Sexual/métodos
[Mh] Termos MeSH secundário: Adenocarcinoma/sangue
Adenocarcinoma/etiologia
Adenocarcinoma/patologia
Adenocarcinoma/cirurgia
Terapia de Reposição de Estrogênios/efeitos adversos
Terapia de Reposição de Estrogênios/métodos
Estrogênios/administração & dosagem
Estrogênios/efeitos adversos
Estrogênios/metabolismo
Feminino
Seres Humanos
Imuno-Histoquímica
Laparoscopia/métodos
Efeitos Adversos de Longa Duração/diagnóstico
Efeitos Adversos de Longa Duração/etiologia
Masculino
Meia-Idade
Gradação de Tumores
Estadiamento de Neoplasias
Antígeno Prostático Específico/análise
Neoplasias da Próstata/sangue
Neoplasias da Próstata/etiologia
Neoplasias da Próstata/patologia
Neoplasias da Próstata/cirurgia
Procedimentos Cirúrgicos Robóticos/métodos
Testosterona/metabolismo
Pessoas Transgênero
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Estrogens); 3XMK78S47O (Testosterone); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170214
[St] Status:MEDLINE
[do] DOI:10.1002/pros.23322


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[PMID]:28141788
[Au] Autor:Fernández Rodríguez M; Guerra Mora P; Martín Sánchez E; Grupo GIDSEEN
[Ad] Endereço:Unidad de Tratamiento de Identidad de Género del Principado de Asturias (UTIGPA). Hospital San Agustín de Avilés. Asturias. España.
[Ti] Título:[Characteristics of Adolescents with Gender Dysphoria Referred to the Gender Identity Treatment Unit].
[Ti] Título:Lesiones mortales de tráfico en España relacionadas con el trabajo según el motivo del desplazamiento y según sexo (2010-2013)..
[So] Source:Rev Esp Salud Publica;91, 2017 Feb 01.
[Is] ISSN:2173-9110
[Cp] País de publicação:Spain
[La] Idioma:spa
[Ab] Resumo:OBJECTIVE: The demand for treatment among people with gender dys-phoria has increased during the last years. The aim of the present research was to carry out an analysis of the demand of the teenagers that requested consultation at the UTIGPA (Gender Identity Treatment Unit of Principality of Asturias) as they presented complains of gender dysphoria. METHODS: The sample included 20 minors that were treated between March 2007 and December 2015. The clinical history was made to collect informa-tion. It was made descriptive analysis and the reason sex/gender was used. RESULTS: The 20 teenagers represented the 14,6% of the whole sample (of 137 demands). The age average was 15,20 years (SD=1,473) and the range of years was between 12-17. The reason sex/gender was 1/1 (10 into the man to woman group and 10 into the woman to man group). At the arrival at the Treatment Unit, 100% of the individuals lived with their nuclear or extended family and in the 60% of the cases, their parents were separated. 70% of the cases were referred from mental health services. 10% hadn´t got any past medical history and 35% had never received any prescription for a psychopharmacological treatment. 95% hadn't done any hormonal self-treatment. 100% defined themselves as heterosexual. 25% requested exclusively for psychological interventions and 75% asked for medical treatments. CONCLUSIONS: The profile of the minor was a teenager of approximately 15 years old that was referred from mental health services. Contrary to the fin-dings of other national and international researches, the rate sex/gender was equated in our research. The minor had got a past medical history and their prio-rity request was for medical treatments, both hormonal and surgical therapies.
[Mh] Termos MeSH primário: Disforia de Gênero
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos
Serviços de Saúde para Pessoas Transgênero
Pessoas Transgênero
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Disforia de Gênero/diagnóstico
Disforia de Gênero/psicologia
Disforia de Gênero/terapia
Seres Humanos
Masculino
Anamnese
Encaminhamento e Consulta
Procedimentos de Readequação Sexual
Espanha
Pessoas Transgênero/psicologia
Pessoas Transgênero/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE


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[PMID]:28135582
[Au] Autor:Sumia M; Lindberg N; Työläjärvi M; Kaltiala-Heino R
[Ad] Endereço:Tampere University Hospital, Department of Adolescent Psychiatry, Box 2000, 33521, Tampere, Finland.
[Ti] Título:Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment.
[So] Source:J Adolesc;56:34-39, 2017 Apr.
[Is] ISSN:1095-9254
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We studied current (GIDYQ-A) and recalled (RCGI) childhood gender identity among 719 upper secondary school students 401 girls, mean age 17.0 (SD = 0.88) years old and 318 boys, mean age 17.2 (SD = 0.86 years old in Finland. We also compared these dimensions of identity in community youth to same dimensions among adolescent sex reassignment (SR) applicants. Most community youth scored high on the normative, cis-gender end of gender experience (median score 4.9 for boys and 4.9 for girls) and recalled fairly gender typical childhood behaviours and experiences. The girls displayed more gender non-conformity in childhood. Among the boys 2.2% and among the girls 0.5% displayed potentially clinically significant gender dysphoria on the GIDYQ-A. The community youth differed clearly from adolescent SR applicants on current and recalled childhood gender identity (SR applicants were 47, 6 natal boys and 41 natal girls, average ages were 16.4 years old (SD = 0.93) and girls were on average 16.8 years old (SD = 1.0).
[Mh] Termos MeSH primário: Disforia de Gênero/epidemiologia
Identidade de Gênero
Estudantes/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Comportamento do Adolescente
Feminino
Finlândia/epidemiologia
Seres Humanos
Masculino
Procedimentos de Readequação Sexual/psicologia
Procedimentos de Readequação Sexual/estatística & dados numéricos
Estatísticas não Paramétricas
Inquéritos e Questionários
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170131
[St] Status:MEDLINE


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[PMID]:28081569
[Au] Autor:Beek TF; Cohen-Kettenis PT; Bouman WP; de Vries AL; Steensma TD; Witcomb GL; Arcelus J; Richards C; De Cuypere G; Kreukels BP
[Ad] Endereço:Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands.
[Ti] Título:Gender Incongruence of Childhood: Clinical Utility and Stakeholder Agreement with the World Health Organization's Proposed ICD-11 Criteria.
[So] Source:PLoS One;12(1):e0168522, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The World Health Organization (WHO) is revising the tenth version of the International Classification of Diseases and Related Health Problems (ICD-10). This includes a reconceptualization of the definition and positioning of Gender Incongruence of Childhood (GIC). This study aimed to: 1) collect the views of transgender individuals and professionals regarding the retention of the diagnosis; 2) see if the proposed GIC criteria were acceptable to transgender individuals and health care providers; 3) compare results between two countries with two different healthcare systems to see if these differences influence opinions regarding the GIC diagnosis; and 4) determine whether healthcare providers from high-income countries feel that the proposed criteria are clinically useful and easy to use. A total of 628 participants were included in the study: 284 from the Netherlands (NL; 45.2%), 8 from Flanders (Belgium; 1.3%), and 336 (53.5%) from the United Kingdom (UK). Most participants were transgender people (or their partners/relatives; TG) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both HCP and TG individuals. Participants completed an online survey developed for this study. Overall, the majority response from transgender participants (42.9%) was that if the diagnosis would be removed from the mental health chapter it should also be removed from the ICD-11 completely, while 33.6% thought it should remain in the ICD-11. Participants were generally satisfied with other aspects of the proposed ICD-11 GIC diagnosis: most TG participants (58.4%) thought the term Gender Identity Disorder should change, and most thought Gender Incongruence was an improvement (63.0%). Furthermore, most participants (76.1%) did not consider GIC to be a psychiatric disorder and placement in a separate chapter dealing with Gender and Sexual Health (the majority response in the NL and selected by 37.5% of the TG participants overall) or as a Z-code (the majority response in the UK and selected by 26.7% of the TG participants overall) would be preferable. In the UK, the majority response (35.8%) was that narrowing the GIC diagnosis was an improvement, while the NL majority response (49.5%) was that this was not an improvement. Although generally the results from HCPs were in line with the results from TG participants some differences were found. This study suggests that, although in an ideal world a diagnosis is not welcomed, several participants felt the diagnosis should not be removed. This is likely due to concerns about restricting access to reimbursed healthcare. The choice for positioning of a diagnosis of GIC within the ICD-11 was as a separate chapter dealing with symptoms and/or disorders regarding sexual and gender health. This was the overall first choice for NL participants and second choice for UK participants, after the use of a Z-code. The difference reflects that in the UK, Z-codes carry no negative implications for reimbursement of treatment costs. These findings highlight the challenges faced by the WHO in their attempt to integrate research findings from different countries, with different cultures and healthcare systems in their quest to create a manual that is globally applicable.
[Mh] Termos MeSH primário: Identidade de Gênero
Disfunções Sexuais Fisiológicas/classificação
Disfunções Sexuais Fisiológicas/diagnóstico
Pessoas Transgênero
Organização Mundial da Saúde
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Procedimentos de Readequação Sexual
Disfunções Sexuais Fisiológicas/fisiopatologia
Disfunções Sexuais Fisiológicas/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170802
[Lr] Data última revisão:
170802
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0168522


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[PMID]:28064252
[Au] Autor:McCullough LB
[Ad] Endereço:Weil Medical College of Cornell University, New York, New York, USA Laurence.McCullough@bcm.edu.
[Ti] Título:Philosophical Provocation: The Lifeblood of Clinical Ethics.
[So] Source:J Med Philos;42(1):1-6, 2017 Feb.
[Is] ISSN:1744-5019
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation. The papers in this clinical ethics issue of the Journal of Medicine and Philosophy provide just such philosophical provocation related to core topics in clinical ethics: the distinction between clinical practice and clinical research; telemedicine, or medicine at a distance; illness narratives; the concept of the placebo effect; and sex reassignment.
[Mh] Termos MeSH primário: Eticistas
Ética Clínica
Filosofia Médica
[Mh] Termos MeSH secundário: Pesquisa Biomédica/ética
Seres Humanos
Procedimentos de Readequação Sexual/ética
Telemedicina/ética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:E; IM
[Da] Data de entrada para processamento:170109
[St] Status:MEDLINE
[do] DOI:10.1093/jmp/jhw034



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