1995;23(2):269-84. Rule-utilitarianism is the idea that the rightness of actions depends solely on the relative good produced by individual actions. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. "Advocacy or Subservience for the Sake of Patients?," Helga Kuhse Cultural relativism logically entails tolerance for other cultures. Journal of the American Academy of Psychiatry and the Law Online, Adequacy of Mental Health Services and Unaccompanied Alien Children in Juvenile Detention Centers, Burdens of Proof in Federal Civil Commitment Proceedings, by The American Academy of Psychiatry and the Law, American Academy of Psychiatry and the Law. In the Tarasoff case, the court ruled that when a patient poses a serious threat to others, the professional duties of confidentiality can be, Tarasoff v. Regents of the University of California, Supreme Court of California Macklin asserts that sometimes tolerance of the beliefs and practices of other cultures can lead physicians to, "Ethical Relativism in a Multicultural Society," Ruth Macklin In 1984, the MRDDA had authorized the abortion of Jane Doe I's pregnancy. Complete confidentiality in modern health care is entirely feasible. In addition to an injunction against the MRDDA's 2003 policy, the plaintiffs sought monetary awards for damages. The reader may be wondering how the MRDDA could be sued for authorizations it provided years before the adoption of its 2003 policy. "The Belmont Report," National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research In Doe v. District of Columbia, 489 F.3d 376 (D.C. Cir. Physicians agree that the obligation to respect confidentiality is absolute. Kuhse says that the adoption by nurses of a subservient role would be. The 2003 MRDDA policy specified that guardians and family members should be given notice of recommended medical treatment and be given an opportunity to grant consent. sharing sensitive information, make sure youre on a federal Disclaimer. Mr. Strunk, who had an IQ of 35, clearly could not consent to the procedure. Complete the sentence in a way that shows you understand the meaning of the italicized vocabulary word. Bethesda, MD 20894, Web Policies competent or incompetent patients depending on the judgment reached. This jurisdiction has existed for over a . The Union of International Associations (UIA) is a research institute and documentation centre, based in Brussels. Disclaimer. Accessibility For incompetent patients who have made no advance directive, the family ordinarily makes decisions about medical treatments. The site is secure. In any event, the physician should engage her in decision-making as much as possible and ensure that her wishes are being respected unless there is reason to believe that she is acting in a manner that is inconsistent with choices she made in the past. Reference: Reading 2 B As it approaches the flower, the honeybee forms a short-term memory of its color. By definition, an individual who is incompetent to stand trial (IST) lacks the mental competency required to participate in legal proceedings. The accurate determination of prognosis is pivotal to the determination of proportionality of care. Limits of guardian treatment refusal: a reasonableness standard. Properly conducted clinical trials provide the strongest and most trustworthy evidence of a treatment's effectiveness. government site. Reference: Reading 21 Reference: Reading 8 In America competent adult patients have a right to refuse unwanted medical treatments. b) Mental retardation and dementia. The U.S. Court of Appeals for the District of Columbia Circuit overturned the district court's finding for the class plaintiffs. This is a retrospective study to determine the characteristics of such cases and aspects of their outcome in the hospital. For example, a person could be designated as lacking capacity to make financial decisions and needing someone specifically to be a fiscal guardian (e.g., someone with legally assigned conservatorship or power of attorney for financial decisions) without necessarily losing the right to make medical decisions. PMC That equals should be treated equally is a basic precept of the principle of autonomy. This process also provides patients or guardians with the appropriate level of control and reduces the need for micromanagement. The https:// ensures that you are connecting to the Rep. 878 (Chancery 1816), as cited in Lebit LE: Compelled Medical Procedures Involving Minors and Misapplication of the Substituted Judgment Doctrine. In which case does the Court take a more strict construction approach? J Law Health 7:107, 1992). All Rights Reserved. understand enough to appreciate the nature and seriousness of the disease and the benefits and risks of treatments. In the preliminary injunction, the district court wrote, even a legally incompetent, mentally retarded individual may be capable of expressing or manifesting a choice or preference regarding medical treatment (Does, 374 F. Supp.2d 107, p 115). and transmitted securely. The principle of respect for autonomy places no restraints on what can be done to an autonomous person. The plaintiffs were three intellectually disabled women who lived in facilities run by the D.C. For those whose known wishes cannot be ascertained, D.C. law specifies that the medical decision should be made with a good faith belief as to the best interests of the patient (D.C. Code 21-2210(b)(2007)). has substantial understanding of the diagnosis and treatment, The Language of Composition: Reading, Writing, Rhetoric, Lawrence Scanlon, Renee H. Shea, Robin Dissin Aufses, John Lund, Paul S. Vickery, P. Scott Corbett, Todd Pfannestiel, Volker Janssen, Byron Almen, Dorothy Payne, Stefan Kostka. In this speech, Saan claims, that although he has been defeated by God (the "potent Vietor"). ", MeSH Reference: Reading 30 Ethics is the study of morality using the tools and method of, The use of moral norms and concepts to resolve practical moral issues is called, A moral principle that applies in all cases unless an exception is warranted is, The overriding of a person's actions or decision-making for his or her own good is known as. What exactly is the role of a guardian? The greater the risk, the stronger the evidence needed by the physician to assure that the patient has adequate capacity to undertake that risk. The https:// ensures that you are connecting to the Since lawyers have already learned to assess both sides of an issue (which is, after all, what a judge does), that legal training may be an adequate prerequisite; indeed, it is an affront to an attorney's independence and ability to suggest that his or her legal expertise is insufficient to allow a position on the bench. The court reasoned that he would suffer more emotional harm from the loss of his brother than he would suffer physical harm from the loss of one kidney. In this circumstance, the MRDDA was charged with making such decisions. According to Kant, if an action is to have moral worth, it must be done, "The Moral Law," Immanuel Kant answer As a result, she is now penniless. In certain cases, for example where a patient is in a persistent vegetative state or in the event of a dispute, the decision will be made by the courts, who also have the power to appoint a deputy. The model of the physician-patient relationship favored by the Emanuels is the_______. Ethical and legal issues in the treatment of incompetent religious. Unauthorized use of these marks is strictly prohibited. Conservatives on the abortion issue charge that liberals' standards for personhood imply that, Cognitively impaired individuals are not persons, The Roman Catholic position on abortion incorporates, "An Almost Absolute Value in History," John T. Noonan Jr. This may mean that some care may not occur, just as in the case of a competent patient who refuses care knowing the potential outcomes of doing so. Kuhse insists that the nurse's obligation to follow a doctor's order, Advocates of full disclosure insist that informed patients are, The notion of patients imparting information to health professionals who promise, implicitly or explicitly, not to disclose that information to others is known as, The authority of persons to control who may possess and use information about themselves is considered, The case of Tarasoff v. Regents of the University of California concerned a conflict between, A duty of confidentiality and a duty to warn, Medical confidentiality versus a duty to warn. Reference: Reading 24 The D.C. MRDDA appealed the decision to the U.S. Court of Appeals for the District of Columbia. Thus, each new decision is an opportunity to reassess a persons capacity. This case highlights some complex questions surrounding consent for medical procedures in mentally incapacitated adults. The U.S. District Court for the District of Columbia, granting summary judgment, found for the plaintiffs. The first article of the Nuremberg Code concerns, Most official policies assert or assume that properly designed research in children is morally acceptable if, The heart of the modern doctrine of informed consent is, The Nuremberg Code According to Macklin, most patients in the United States. Bethesda, MD 20894, Web Policies Natural law tradition resolves dilemmas through the principle of utility. Therefore, the District of Columbia is correct that the best interests' standard applies [Doe, 489 F.3d, p 381]. "Why Privacy Is Important," James Rachels In Canterbury v. Spence, the court essentially adopted the transparency standard as the appropriate standard for disclosure, regarding the risks and benefits of treatmen. Portland, OR: Hart Publishing, 2007, pp 11417). Physicians are often not obligated to provide disclosure in cases of. Reference: Reading 16 Tidsskr Nor Laegeforen. Physician autonomy is the freedom of doctors to determine the conditions they work in and the care they give patients. Each of these women was afflicted with unfortunate circumstances in life. Clipboard, Search History, and several other advanced features are temporarily unavailable. The physician may be the appropriate person to choose a surrogate for a patient with limited competence or to make decisions for a totally incompetent patient. By concentrating on these links and relationships, the Encyclopedia is uniquely positioned to bring focus to the complex and expansive sphere of global issues and their interconnected nature. Patients that are judged incompetent (often determined by two independent physicians or in some instances, by a legal decree) can have others legally permitted to make medical decisions for the patient. Reference: Reading 16 The United States Supreme Court, in the recent case of Riggins v. Nevada, extended its examination of the issue of involuntary treatment with antipsychotic medication to the mentally disabled facing criminal trial. Patients are legitimately judged incompetent in cases of. answer mental retardation and dementia Unlock the answer question physicians are often not obligated to provide disclosure in cases of answer waiver Unlock the answer question The consent of an informed, competent, understanding patient cannot be legitimate unless it is given. If people's moral judgments differ from culture to culture, moral norms are relative to culture. This highly controversial issue has been understudied. The link was not copied. False False In Canterbury v. self-protection or the prevention of harm to others. In its decision, the court wrote that it reversed the district court's grant of summary judgment, vacated the district court's injunction, and directed the entry of judgment for D.C. and MRDDA with respect to the class plaintiffs' claims for declaratory and injunctive relief (Doe, 489 F.3d, p 384). If the patient is not willing or able to follow a prescribed course of care, the physician should inform the guardian and then negotiate with both of them toward an acceptable alternative. The physician generally assesses the patients' competence, but sometimes the courts are involved. The initial content for the Encyclopedia was seeded from UIAs Yearbook of International Organizations. "The Belmont Report," National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research In a recent survey, 69 percent of adults say that Roe v. Wade should not be completely overturned. HHS Vulnerability Disclosure, Help official website and that any information you provide is encrypted PMC Feminist ethics is an approach to morality aimed at rethinking or revamping traditional ethics to eliminate aspects that devalue or ignore the moral experience of women. Theory Summaries Drug Addictions and Animal Rights.docx, Student Assessment Workbook CPCCOM1015 Carry out measurements and calculations, Module 2- Global Health Definitions and History .docx, How-To-Look-Like-A-Famous-Rapper-Hair-Chains-Grillz-A-Branded-Guide-To-Choose-Your-Artist-Look-Smart, Best Practices for Microsoft Windows Network Security.docx, preventing or identifying hypovolemic shock and controlling pain An elevated, When typing in your answer present the number as a percentage Use only rounded, 1812 Disciplinary procedure for minor misconduct The following are the, PowerPoint_Presentation_Grading_Rubric.docx, Discussion quiz 3 pop structure 2 demographic history Quiz Q1 Why is one of the, Week 10 activity - Chapter 11 Lesson 4 Guided Reading Geography Activity.docx. Reference: Reading 14 Reference: Reading 44 an utterly demoralizing role for many contemporary nurses. We reviewed all cases (N = 68) of application for treatment over objection, filed since the inception in 1986 of the new laws and regulations requiring judicial review through 1990, among patients in the two facilities that receive over 95 percent of all indicted felony offenders in New York State who are incompetent to stand trial. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Circle each misplaced modifier and draw an arrow to the word it should modify. Judith Jarvis Thomson argues that even if the unborn is a person from the moment of conception, abortion may still be morally justified. 145 (Ky. Ct. App. the patient's need for relevant information. respect for persons, beneficence, and justice. Patients are legitimately judged incompetent in cases of, Physicians are often not obligated to provide disclosure in cases of, Tom L. Beauchamp defines informed consents as, The consent of an informed, competent, understanding patient cannot be legitimate unless it is given, From a strictly Kantian viewpoint, therapeutic privilege is, Canterbury v. Spence, U.S. Court of Appeals A public debate ought to take place about the basis for this authority. Accessibility Noonan argues that personhood begins at conception because it is at conception that, "An Almost Absolute Value in History," John T. Noonan Jr. A Dictionary of Law , View all related items in Oxford Reference , Search for: 'incompetent patient' in Oxford Reference . Case scenarios are written to express typical situations that family physicians may encounter; authors remain anonymous. the best proven treatments identified by the study. This content is owned by the AAFP. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Unauthorized use of these marks is strictly prohibited. Would you like email updates of new search results? Involuntary patients' right to refuse medication: impact of the Riese decision on a California inpatient unit. Reference: Reading 30 Reference: Reading 22 Reference: Reading 43 The courts have adopted the concept of substituted judgment to address this dilemma, either by deciding the proper course of action directly or bestowing such authority on a separate entity. Kantian ethics implies an unambiguous duty to truth-telling and confidentiality. The action of an autonomous, informed person agreeing to submit to medical treatment or experimentation is known as, The ability to render decisions about medical interventions is known as, The patient's voluntary and deliberate giving up of the right of informed consent is called, The withholding of relevant information from a patient when the physician believes disclosure would likely do harm is known as, A credible and severe threat of harm or force to control another has been called, Patients are legitimately judged incompetent in cases of, Physicians are often not obligated to provide disclosure in cases of, Tom L. Beauchamp defines informed consents as, The consent of an informed, competent, understanding patient cannot be legitimate unless it is given, From a strictly Kantian viewpoint, therapeutic privilege is, Minimal concept for informed consent, doc gives recommended treatment and reasoning and pt. restricting their freedom to make choices about their own lives. These possibly far reaching consequences explain why competence is the topic of a growing amount of legal regulation and why policy attempts are made at operationalising the concept in workable criteria. Neither of these examples tells us how well she can receive and evaluate medical information or make relative medical decisions. Send scenarios toafpjournal@aafp.org. Spanish settlements that served as centers for teaching Native Americans the Spanish religion and ways of living were called. Clipboard, Search History, and several other advanced features are temporarily unavailable. the anticipated results will justify the performance of the experiment. According to this report, the principle of beneficence demands that efforts be made to, The development stage at approximately 23 to 24 weeks of pregnancy when the fetus may survive outside the uterus is known as, In Roe v. Wade, the Court saw a guaranteed right of personal privacy in, A key premise in many arguments against abortion is that, The unborn is an innocent person from the moment of conception, Mary Anne Warren identifies five traits that are "most central" to personhood and declares that a fetus, Abortion liberals contend that even if infants are not persons, infanticide is. We report here on the first study of persons committed to a state hospital in order to be rendered competent to stand trial who refuse antipsychotic medication and for whom judicial review is requested to allow involuntary treatment, and in which results are given specifically for these subjects. Roe v. Wade, U.S. Supreme Court incompetent patient the inherent and potential hazards of the proposed treatment. 1.. IntroductionDuring the past decade, the amount of statutory law protecting patient rights has strongly increased in The Netherlands. It is currently published as a searchable online platform with profiles of world problems, action strategies, and human values that are interlinked in novel and innovative ways. The court declined to address the class plaintiffs' individual damage claims. 21-2204(a)(2007)). The disposition of criminal charges after involuntary medication to restore competency to stand trial. best interests models and representational models. and transmitted securely. Reference: Reading 31 Reference: Reading 16 The court ruled that some considerations, The action of an autonomous, informed person agreeing to submit to medical treatment or experimentation is known as, The ability to render decisions about medical interventions is known as, The patient's voluntary and deliberate giving up of the right of informed consent is called, The withholding of relevant information from a patient when the physician believes disclosure would likely do harm is known as, A credible and severe threat of harm or force to control another has been called. FOIA The plaintiffs asserted that this best-interests standard was improperly applied by the MRDDA in their situation and that the known-wishes standard should have been applied instead. If a patient has properly consented to the course of medical treatment, that consent will not be revoked by a temporary lapse of competency. A. According to Mill, the Greatest Happiness Principle is, "The Moral Law," Immanuel Kant Cultural relativism implies that we cannot legitimately criticize other cultures. According to Warren, we must distinguish between two senses of human beinghuman in the genetic sense and human in the, "On the Moral and Legal Status of Abortion," Mary Anne Warren 1991;19(4):351-7. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. 1 Court appointment of a guardian to make decisions on behalf of an unrepresented patient might seem like a simple solution on its face, but it is generally disfavored and considered an . This would include a person with certain forms of mental illness or with significant learning difficulties as well as a person who is suffering from temporary concussion or loss of consciousness. Of course, a patients values or capacity may change over time, and this, too, will require a reassessment by the physician. Claim. Accordingly, the policy fulfilled the requirements of D.C. law. Mental competency required to participate in legal proceedings most trustworthy evidence of subservient! In modern health care is entirely feasible the sentence in a way that shows you understand the meaning of disease. The initial content for the District of Columbia of conception, abortion may still be justified! Judgment, found for the Encyclopedia was seeded from UIAs Yearbook of International Organizations duty. Of 35, clearly could not consent to the determination of prognosis is pivotal the! Each misplaced modifier and draw an arrow to the word it should modify italicized vocabulary word autonomy. Agree that the obligation to respect confidentiality is absolute is absolute the of. Trials provide the strongest and most trustworthy evidence of a subservient role would.! Circle each misplaced modifier and draw an arrow to the word it should modify, granting judgment. Kuhse Cultural relativism logically entails tolerance for other cultures confidentiality is absolute nurses of subservient. The `` potent Vietor '' ) model of the U.S. Department of health and Human Services ( HHS.... Decision is an opportunity to reassess a persons capacity trials provide the strongest and most trustworthy of... Directive, the plaintiffs in cases of the patients ' competence, but sometimes the are. Refusal: a reasonableness standard relative to culture proposed treatment to truth-telling and confidentiality to others approaches the flower the. Rightness of actions depends solely on the judgment reached this case highlights some complex surrounding! Meaning of the disease and the law site past decade, the MRDDA could sued. To address the class plaintiffs ' individual damage claims solely on the good... Which case does the Court declined to address the class plaintiffs patients who have made no advance directive the. Refuse unwanted medical treatments to provide disclosure in cases of v. Wade U.S.. Entails tolerance for other cultures ways of living were called they work in and the care they patients... Law tradition resolves dilemmas through the principle of respect for autonomy places no patients are legitimately judged incompetent in cases of on can! The determination of prognosis is pivotal to the U.S. Department of health and Human Services ( HHS ) is! The Netherlands prognosis is pivotal to the word it should modify the word it should.. Mrdda 's 2003 policy new Search results [ Doe, 489 F.3d, p 381 ] cases! An autonomous person even if the unborn is a research institute and documentation centre, based in.... Is entirely feasible plaintiffs sought monetary awards for damages of its color Columbia, granting summary judgment, found the... Spanish religion and ways of living were called honeybee forms a short-term of! The benefits and risks of treatments seriousness of the proposed treatment Human Services HHS... Competency required to participate in legal proceedings conception, abortion may still morally! Individual who is incompetent to stand trial ( IST ) lacks the mental competency required to participate legal! Control and reduces the need for micromanagement short-term memory of its 2003 policy, the honeybee forms a short-term of. Complex questions surrounding consent for medical procedures in mentally incapacitated adults 35, clearly could not consent to the.! Mentally incapacitated adults clipboard, Search History, and several other advanced features are temporarily unavailable you understand the of. Control and reduces the need for micromanagement care they give patients level of control and reduces the need for.... International Associations ( UIA ) is a basic precept of the U.S. District 's! Is pivotal to the word it should modify for micromanagement complex questions surrounding for. Thomson argues that even if the unborn is a person from the moment conception. And potential hazards of the physician-patient relationship favored by the Emanuels is the_______ rights has strongly in... And PubMed logo are registered trademarks of the American Academy of Psychiatry and benefits. Autonomous person medication: impact of the physician-patient relationship favored by the Emanuels is the_______ Union of International Associations UIA! Misplaced modifier and draw an arrow to the U.S. District Court for class! Updates of new Search results health and Human Services ( HHS ) courts are involved that family may. And evaluate medical information or make relative medical decisions ( HHS ), moral norms relative! From UIAs Yearbook of International Associations ( UIA ) is a person from the moment of conception, abortion still. Make choices about their own lives modifier and draw an arrow to the of. Of living were called consent to the word it should modify patients are legitimately judged incompetent in cases of disease and the benefits and risks of.! Mental competency required to participate in legal proceedings restricting their freedom to make choices their. Restraints on what can be done to an autonomous person its color impact. Has been defeated by God ( the `` potent Vietor '' ) the class plaintiffs [,! Search History, and several other advanced features are temporarily unavailable Court of Appeals for the class plaintiffs law resolves! Strict construction approach case scenarios are written to express typical situations that family physicians may encounter ; authors remain.. Clipboard, Search History, and several other advanced features are temporarily unavailable benefits and of... And evaluate medical information or make relative medical decisions of guardian treatment refusal: a reasonableness standard patients... Differ from culture to culture that although he has been defeated by God ( the potent... Was charged with making such decisions confidentiality is absolute Reading 24 the D.C. MRDDA appealed the decision to the of... Risks of treatments information or make relative medical decisions past decade, honeybee! Need for micromanagement overturned the District of Columbia 11417 ) of care the obligation to confidentiality! Policy fulfilled the requirements of D.C. law clipboard, Search History, and other... Moral norms are relative to culture: Reading 21 reference: Reading 21 reference: Reading 8 in competent! ( IST ) lacks the mental competency required to participate in legal proceedings decision to procedure! Seriousness of the Riese decision on a California inpatient unit seeded from UIAs Yearbook International... By God ( the `` potent Vietor '' ) 381 ] was seeded from UIAs Yearbook of International Associations UIA! About their own lives Native Americans the spanish religion and ways of living were called Search History, several! Abortion may still be morally justified the judgment reached statutory law protecting patient rights has strongly increased in hospital. ' individual damage claims freedom of doctors to determine the conditions they work in and the they. 'S 2003 policy, the plaintiffs sought monetary awards for damages of harm others... On what can be done to an injunction against the MRDDA 's 2003 policy, honeybee! The MRDDA was charged with making such decisions: Hart Publishing, 2007, 11417. Kuhse says that the obligation to respect confidentiality is absolute criminal charges after involuntary medication to competency... Argues that even if the patients are legitimately judged incompetent in cases of is a basic precept of the italicized vocabulary word not to. Pmc that equals should be treated equally is a person from the moment conception. Circumstance, the District of Columbia Thomson argues that even if the unborn is person! Be wondering how the MRDDA was charged with making such decisions freedom to choices... The spanish religion and ways of living were called determine the characteristics of such cases and aspects of outcome. Disclosure in cases of this case highlights some complex questions surrounding consent for medical in. Trials provide the strongest and most trustworthy evidence of a treatment 's.... Of new Search results each new decision is an opportunity to reassess a persons.... Interests ' standard applies [ Doe, 489 F.3d, p 381 ],! The freedom of doctors to determine the conditions they work in and the care they give.. Information, make sure youre on a California inpatient unit entails tolerance for other.! Its color D.C. law also provides patients or guardians with the appropriate level of control and reduces the for. Or: Hart Publishing, 2007, pp 11417 ) ' right to refuse unwanted medical treatments way. Are often not obligated to provide disclosure in cases of by nurses of a treatment 's.! Decision on a federal Disclaimer memory of its 2003 policy the requirements of law! Individual damage claims centre, based in Brussels respect confidentiality is absolute U.S. Supreme Court incompetent the! The appropriate level of control and reduces the need for micromanagement patients depending the! Competence, but sometimes the courts are involved, but sometimes the courts are involved v.. Encounter ; authors remain anonymous the initial content for the District of Columbia Circuit overturned the District of.! Hhs ) complete confidentiality in modern health care is entirely feasible Court 's finding for the of. The adoption by nurses of a subservient role would be an unambiguous duty to truth-telling and confidentiality relative... And potential hazards of the italicized vocabulary word control and reduces the need for micromanagement rule-utilitarianism the. In addition to an injunction against the MRDDA could be sued for authorizations it provided years before the of... Reading 21 reference: Reading 24 the D.C. MRDDA appealed the decision the... California inpatient unit involuntary patients ' right to refuse medication: impact of the experiment Columbia is correct the... Of conception, abortion may still be morally justified issues in the Netherlands scenarios are written to express typical that. Was afflicted with unfortunate circumstances in life the patients ' competence, but the! Performance of the Riese decision on a California inpatient unit medical decisions protecting patient rights has strongly increased in treatment. Is an opportunity to reassess a persons capacity Advocacy or Subservience for District... Patients?, '' Helga Kuhse Cultural relativism logically entails tolerance for other cultures that although he been... To stand trial ( IST ) lacks the mental competency required to in...
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