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Biomedical subjects

C J Dougherty

Publications and source records attributed to C J Dougherty.

At least 19 recordsLinked to original sources
PubMed1995

Ethics in nursing practice: confidentiality for women and their children with HIV/AIDS.

HIV-positive women and their children experience substantial problems brought about by the illness itself and service-delivery issues. Significant ethical concerns are raised when providing care to this patient population, and the ramifications of compromises in patient confidentiality are extremely serious. All practicing nurses should be familiar with the issues and potential solutions.

Adult↗
PubMed1994

Quality-adjusted life years and the ethical values of health care.

This paper defines the QALY, the quality-adjusted life year, and examines the ethical dimensions of its potential uses in health care, with special reference to rehabilitation. The implications of QALYs are analyzed with respect to three central ethical values in health care: freedom, happiness and fairness. QALYs may be useful in expanding patient freedom and in securing greater social happiness in the allocation of resources. However, QALYs raise important problems of fairness and have a bias toward curative interventions.

Ethical Theory↗
PubMed1993

Bad faith and victim-blaming: the limits of health promotion.

Two models of the relationship between individual behaviour and health status are examined. On the Freedom Model, the individual is presumed to be capable of free choices including many that have important health consequences. Freedom entails accountability. Thus individuals can be held responsible for health conditions that result from choices they have made. To hold otherwise--to refuse to acknowledge the freedom and responsibilities of individuals--is bad faith. On the Facticity Model, behaviour is a result of facts--genetic and environmental--beyond an individual's control. There is little or no freedom; people are the bodies and roles they inherit. Important among these facts is socio-economic position since it determines much of behaviour and resulting health status. Many people who are poor and lack education also suffer from poor health. To blame their poor health on their behaviour is to blame people already victimized by their circumstances. The relationships of these two models to health promotion are explored. Though conflicting in theory, some justice can be done to each model in the practical world of health promotion by appealing to the freedom in individuals in health education and to the facts that shape individuals in other health promotion and health care contexts.

Adult↗
PubMed1993

Our bodies, our families. The family's role in organ donation.

The 1968 Uniform Anatomical Gift Act--in keeping with a legal (and medical) concern for individual autonomy--bypassed the family in establishing the legal requirements for cadaveric organ donation, but current practice wisely recognizes a role for families in the decision making.

Advance Directives↗
PubMed1991

Whistleblowing in the OR: the ethical implications.

1. Whistleblowing highlights the positive social behavior that is intended to benefit others while concealing what is sometimes considered disloyal behavior. 2. Loyalty is one of the most important ethical values, but failure to recognize the limits of loyalty can lead to seriously unethical outcomes. 3. It is critical that the nurse contemplating whistleblowing exhaust all internal resources to resolve the wrongdoing before going outside the organization.

Ethics, Nursing↗
PubMed1990

The costs of commercial medicine.

The purpose of this paper is to review the rising influence of commercialism in American medicine and to examine some of the consequences of this trend. Increased competition subverts physician collegiality, draws hospitals into for-profit ownership and behavior, and leads clinical investigators into secrecy and possibly into bias and abuse. Medicine faces a deprofessionalization evidence in loss of control over the clinical setting and over self-regulation. Health care becomes a commodity relying on cultivation of desires instead of satisfaction of needs, even as many basic needs go unmet. Patients become consumers empowered with lawsuits and the connection of medicine to the relief of suffering is attenuated. Medical encounters are increasingly impersonal, dominated by specialization, technology, and bureaucracy. Patients are losing their physician-advocates to new conflicts of interests, physicians are losing their impulse to charity, and trust in the doctor-patient relationship and in medicine generally is eroding.

Commerce↗
PubMed1987

Body futures: the case against marketing human organs.

Creation of a market for the buying and selling of human organs for transplantation, even if it did allow supply to match demand, would be a serious mistake. Even if the market were fairly constructed, it might not dramatically increase the supply of transplantable organs, since donations likely would decrease if selling were allowed. Such a market would create a relative disadvantage for the poor, who would feel disproportionately greater pressure to sell their organs than would the wealthy. The possibility of realizing a profit from the organs of the dead could provide an incentive for murder or for doing less than we might to save lives. An organ market, where parts of a person are viewed as commodities, could lead to a general cheapening and coarsening of human relationships. Any organ selling system would create an economic relationship between buyer and seller, rather than a charitable one, raising quality control problems. The economic system, would drive out the volunteer donor system, sapping the altruistic bond that draws people together. Finally, an organ market presents a metaphysical threat in that it demeans our bodies to the status of articles to trade. An alternative to the current voluntary donor system and an organ market is to presume passive consent to organ donation with the right to informed refusal. Unless a record of the decedent's opposition to organ removal exists, the next of kin objects on being informed of the intent to remove organs, or the decedent was a member of a group known to oppose organ removal, we should presume a person's willingness to donate organs after death to save another person's life.

Commerce↗