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T Nilstun

Publications and source records attributed to T Nilstun.

69 records · Page 4Linked to original sources

Medical and social paternalism. Regulation of and attitudes towards compulsory psychiatric care.

In Sweden, recommendations and reforms in psychiatric care have increasingly stressed respect for patient autonomy and justice with less emphasis on medical and social paternalism. This is the official policy. But what are the attitudes of the people involved in or affected by compulsory psychiatric care? To answer this question, the attitudes of committed and voluntarily admitted patients, their relatives, psychiatric staff, health and welfare personnel of primary care and a sample of the general public were studied in 2 Swedish counties. Strong support for medical and social paternalism was reported, and according to most of the people asked, doctors, not legal authorities, should decide about commitment. These attitudes are discordant with the recent legislative changes in Sweden.

Adolescent↗

Theory and methods for research on ethical issues in dementia care.

Swedish research on ethical issues in dementia care is almost exclusively done by nursing scientists. Many of these studies are rightfully acclaimed as exemplary research. But the strong focusing on the nurse and her relation to the patient tends to bias the ethical issues--the attitudes of other persons involved or affected are also in need of investigation. Further, there is a predilection for content analysis at the expense of causal analysis. In this paper an eclectic approach to the study of ethical issues in dementia care is advocated. More interdisciplinary communication and co-operation is also needed--especially between nursing scientists and moral philosophers. To facilitate such communication and co-operation a model for analysis of ethical issues is presented and discussed. To illustrate my ideas I use three articles by researchers from the department of advanced nursing in Umeå: Ekman & Norberg (1988), Norberg & Asplund (1990) and Akerlund & Norberg (1989-90).

Behavioral Research↗

Epidemiology and moral philosophy.

To an increasing extent ethical controversies affect and sometimes obstruct public health work and epidemiological research. In order to improve communication between the concerned parties a model for identification and analysis of ethical conflicts in individual-based research has been worked out in co-operation between epidemiologists and moral philosophers. The model has two dimensions. One dimension specifies relevant ethical principles (as beneficence, non-maleficence, autonomy and justice). The other dimension specifies the groups of persons involved in the conflict under consideration (for example: the study-population, individuals who may benefit from the results, the researchers and their personnel, the community at large). The model has been applied to the problem of legitimacy of case-register research and to problems in psychiatric health services research as well as epidemiological research.

Autopsy↗

Longitudinal studies on environmental factors and disease. A model for analysis of ethical conflicts.

The use of individual-based data in research has recently come in for much discussion. The basic issue of the discussion is how to balance between different legitimate interests: the interest in improving knowledge on matters important to human health and the interest in respecting individual autonomy. In this paper we will use a model for description and analysis of ethical conflicts in individual-based research. The model consists of two dimensions: the first specifies the persons involved in the conflict, the second specifies the relevant ethical principles. We have chosen the case of the Rönnskär study as an example. For illustration we distinguish between: no study, a study without informed consent and a study with informed consent. In the Rönnskär study the decision between the three situations rests upon an assessment of the conflict between two obligations: to improve the working environment and to respect autonomy.

Conflict, Psychological↗