PubMed Health⌕ Search

Biomedical subjects

C J Dougherty

Publications and source records attributed to C J Dougherty.

29 records · Page 2Linked to original sources
PubMedDate not supplied

Competency after a suicide attempt: an ethical reflection.

The provision of critical care services can be complicated by ethical problems involving competency. When a patient's competency is in doubt there is conflict between the principles of autonomy and paternalism. The authors describe an ethical situation involving attempted suicide and administration of chemical restraints where the patient's competency was in doubt.

Adult↗
PubMedDate not supplied

The right choice. Two approaches to determining right and wrong.

What if your superior sent you on a recruiting trip and told you to misrepresent the institution, if necessary, to get more nursing staff? What would you do? Finding ways to do what is right is a challenge. But determining what is right is a prior and often a more difficult task, involving a choice of ethical perspectives. One perspective is utilitarianism--a form of consequentialism, whereby acts are right or wrong depending on their consequences. A second ethical approach is a respect-for-persons position, a form of deontology which holds that we have a duty to refrain from certain acts that are inherently disrespectful of persons. The utilitarian way to determine right from wrong is to look at an action's implications for people's happiness or unhappiness. Lies might be justified on a case-by-case basis if they tend to produce more happiness than any other option. An ethical alternative is a respect-for-persons view. Three broad tests can be applied to judge whether an action is respectful of persons: the tests of autonomy, promise keeping, and reciprocity.

Choice Behavior↗
PubMedDate not supplied

The excesses of individualism. For meaningful healthcare reform, the United States needs a renewed sense of community.

In the United States at the end of the twentieth century, the balance of values tilts too far toward the individual and away from the community. What is needed is a renewed sense of community that enhances the lives of individuals as it serves the common good. The first step toward creating a new balance is a critique of the present imbalance, which is shaped by excessive forms of individualism that affect every aspect of our healthcare delivery system. Technological individualism occurs when the value of technology is measured only by its service to the individual. The results are a technological imperative, unreasonable expectations on the part of the community, distorted judgement on the statistical likelihoods of individual outcomes, fragmentation of care, and a reliance on rescue medicine. A psychosocial individualism has misshapen our attitudes about ourselves and our communities, bringing with it a deepening sense of alienation. The results in U.S. healthcare include commercialization, exclusion of the poor, a litigious provider-patient relationship, declining respect for life, and a sense of community that excludes other generations and nations. Libertarian individualism has created political isolation and prevents the evolution of democratic decision making and real partnerships in healthcare. The results are an unpooling of insurance risk, an interpretation of freedom that is inimical to family and community ties, hostility to government, a view of healthcare as a commodity, and deprofessionalization of the medical professions. Healthcare reform must seek to change what medical technology does for us, repair the psychosocial harms healthcare individualism has produced, and promote citizen participation in the healthcare system in new and important ways.

Abortion, Legal↗
PubMedDate not supplied

How to avoid flying blind. To truly improve U.S. healthcare, leaders must consider seven moral values.

To genuinely improve U.S. healthcare, we must base it on seven moral values familiar to Americans: Preserving individual dignity. Patients have a right to information about their medical condition and a right to participate in decisions about treatment. Society should make a basic package of healthcare available to all who need it. Caring for patients' welfare. As providers are obliged to have compassion for patients' suffering, they should also put patients' interests above their own and avoid conflicts of interest. Protecting the least well-off. Many who are poor, less educated, or members of racial or ethnic minorities bear disproportionate burdens of morbidity and mortality. They should receive care that compensates for those disadvantages. Seeking the common good. Our society has a strong disposition toward excessive individualism. We need greater emphasis on public health and preventive measures, as well as more opportunities for the public to help shape the healthcare system. Containing the healthcare costs. Waste is offensive both economically and morally. We can contain costs only by grappling explicitly with the need for healthcare rationing, which should be applied according to ethical criteria. Retaining a sense of responsibility. Society can help renew a sense of responsibility b anchoring it in the concept of subsidiarity, according to which the best government is the least government necessary to perform its appropriate tasks. Establishing high standards of quality. Providers should pursue excellence as measured by improved medical outcomes, uniform use of appropriate procedures, and increased consumer satisfaction. Quality-of-life judgments can be useful in making healthcare decisions, especially for persons who are dying.

Altruism↗