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At least 343 records · Page 19Linked to original sources
PubMed2003

End-of-life issues and spiritual histories.

BACKGROUND: Patients facing end-of-life issues have spiritual concerns that may have an impact on their medical decision-making. METHODS: To determine whether physicians address spiritual concerns in this context, we reviewed the charts of 92 elderly hospitalized patients facing decisions regarding resuscitation status or feeding tube placement. RESULTS: The average age of the participants was 72.4 years and 51% of them were female. Only 6.5% of the patients had spiritual histories documented in their charts; 29% had either a spiritual history or some mention of chaplain or psychiatrist involvement. CONCLUSION: Spiritual concerns of many patients facing end-of-life decisions are not being addressed.

Aged↗
PubMed1998

Honoring Jehovah's Witnesses' advance directives in emergencies: a response to Drs. Migden and Braen.

Jehovah's Witnesses refuse blood transfusions out of obedience to the Bible's command to all Christians to abstain from blood. The Witnesses take this scriptural injunction seriously and, of their own initiative, execute advance medical directive cards to communicate their refusal to medical personnel in the event of their incapacity. In portraying the Witnesses' refusal of blood as the uninformed result of their subjugation by the Watchtower Society, Migden and Braen distort the facts about Jehovah's Witnesses, the basis for their refusal of blood, and their use of the blood refusal card. Further, not only does Migden and Braen's analysis subordinate patient values to professional preference in all cases, but the heightened scrutiny protocol they propose is useless because it cannot possibly be implemented in the hypothetical they posit. Finally, their legal analysis is not well founded and practitioners who choose to follow it will do so at their peril.

Advance Directives↗
PubMed2005

In the world of Dolly, when does a human embryo acquire respect?

For most of the 20th century, it was possible to regard fertilisation as the identifiable point when life begins, because this moment could be defined unequivocally and was thought to be the single most essential biological step in the establishment of a new human entity. Since the successful reproductive cloning of Dolly and other mammals, it is clear that any human cell has the potential to supply the full genome of an embryo, and hence a person, without going through fertilisation. At what point in time do such embryos acquire the respect accorded to human beings? The authors argue that the time of implantation is the most useful point at which the potential and the intention to create a new person are translated into reality, because from that point a new life develops. Implantation differentiates a somatic cell in culture (which is not due respect) from a human entity that has acquired its own identity and developmental potential. The authors examine the value of quickening or viability as alternative developmental stages in the process of acquiring respect for the Dolly embryo.

Animals↗
PubMed2001

Human embryonic stem cell therapy.

The author presents an overview (completed on September 15, 2001) of three issues involved in the ethics of human embryonic stem cell therapy: the ethical implications of some of the scientific issues involved, the specific ethical issues of the moral standing of the early human embryo and the problem of cooperation, and a consideration of two public policy issues: should the research go forward, and what kind of health care system should the United States adopt. The author argues that the public policy questions are the most important agenda.

Catholicism↗
PubMed1990

Ethics of practice among Christian psychologists: a pilot study.

Christian psychologists have questioned whether the code of ethics proposed by secular psychology is sufficient for the practitioner who is a Christian. However, little descriptive data exist on the ethical beliefs and behaviors of Christian psychologists. Survey data were obtained from 69 Christian clinicians indicating the frequency with which they engaged in 83 behaviors and the degree to which they believed the behaviors were ethical. Responses were tabulated for each option and on each behavior. Of the 83 items, four occurred in the practices of over 90% of the respondents, while six never occurred, the latter being mostly sexually related items. Agreement on ethics was found with 13 of the items, while nine behaviors, several of which involved financial issues, proved to be difficult ethical judgments. The data indicate that Christian psychologists are effectively understanding and implementing the ethical guidelines of the American Psychological Association although guidance may be needed regarding finances and homosexuality.

Christianity↗
PubMed2003

What is meant by telling the truth: Bonhoeffer on the ethics of disclosure.

This article explores Dietrich Bonhoeffer's writings on truth telling with reference to the problem of medical error in the US, the UK, and other developed nations, with particular attention to physicians' resistance to disclosing their own mistakes to injured patients and their families. The brief essay 'What is Meant by "Telling the Truth"?' and its historical context--Bonhoeffer's imprisonment and interrogation in 1943--is proposed as a text for medical ethicists and others seeking to overcome the barrier of the 'hidden curriculum' within the culture of medicine, which encourages medical students and physicians to conceal their errors and to fear disclosure.

Attitude of Health Personnel↗
PubMed2003

Clinical pastoral education and post privacy legislation: an Australian perspective.

Recently introduced privacy legislation in Australia has required that professional associations approaching education from the perspective of human cases review their standards and develop new policies and procedures to protect the privacy of individuals. In this article, the author explores the disruption created for Clinical Pastoral Education by the introduction of these privacy laws, demonstrates that it is possible to be loyal to both a commitment to privacy and learning from "living human documents," develop strategies for changing the educational culture, and establish new procedures, strategies, and policy.

Australia↗
PubMed2004

Grounding research and medical education about religion in actual physician-patient interaction: church attendance, social support, and older adults.

This article reviews the relation between social support and elder health, the social-support dimensions of religion, the relation between church attendance and elder health, the place of religion in the biopsychosocial model of medicine, and medical education's position on physician-patient communication about religion. It then examines the emergence of the topic of religion in actual visits. Data are 71 videotaped and transcribed, chronic-routine visits between 12 internal medicine physicians and their older patients. Religion was raised as a topic in 9 visits (13%). In every case, the topic was initiated by patients. The most frequent topic was church attendance (7 of 9 topics), which patients typically used as a contextualizing framework to relate and describe somatic problems. In no cases did physicians make efforts to support or facilitate patients' church attendance, as is advocated by medical education. Implications for medical education and the biopsychosocial model are discussed.

Aged↗
PubMedDate not supplied

Blood transfusion and Jehovah's Witnesses: the legal and ethical issues.

A critical incident is any event that had an effect, or could have had an effect, on the welfare of a patient. Patients must be treated with respect by staff who demonstrate that they are sensitive to individual needs, values, beliefs and cultural background. This article will examine the legal and ethical issues relevant to the right of an unconscious Jehovah's Witness in an intensive care unit (ICU) to refuse a blood transfusion. The concepts of consent, capacity to consent, necessity to act, advance directives, decision making, consequences of failing to obtain consent, ethical principles, human rights and the best interests of the patient will be explored, in the light of relevant statute and case law, in order to demonstrate some of the legal and ethical complexities within acute healthcare delivery.

Accidental Falls↗
PubMed1994

Induced delivery of anencephalic fetuses: a response to James L. Walsh and Moira M. McQueen.

James Walsh and Moira McQueen accurately conclude that the early delivery of anencephalic fetuses is morally acceptable, but the reasoning they use to reach that conclusion is flawed. First, the principle of double effect does not require a weighing of good and evil, but rather seeks a sufficient reason for tolerating the physical evil indirectly intended. Second, the principle of double effect requires a clear distinction between physical and moral causality. Third, the Catholic moral tradition will not admit direct and intended killing of the innocent. Rather, early delivery of anencephalic fetuses is permissible because of the pathology associated with delivery of anencephalic fetuses at full term. Thus, the early delivery of an anencephalic infant is acceptable if the purpose of the moral act is avoiding a pathological condition on the part of the mother.

Anencephaly↗
PubMed2002

Conjoined twins and Catholic moral analysis: extraordinary means and casuistical consistency.

eThis article draws upon the Roman Catholic distinction between "ordinary" and "extraordinary" means of medical treatment to analyze the case of "Jodie" and "Mary," the Maltese conjoined twins whose surgical separation was ordered by the English courts over the objection of their Roman Catholic parents and Cormac Murphy-O'Connor, the Roman Catholic Cardinal Archbishop of Westminister. It attempts to shed light on the use of that distinction by surrogate decision makers with respect to incompetent patients. In addition, it critically analyzes various components of the distinction by comparing the reasoning used by Catholic moralists in this case with the reasoning used in other cases that raise similar issues, including women facing crisis pregnancies who prefer abortion to adoption and the Indiana "Baby Doe" case.

Abortion, Induced↗