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Results for “Personal Autonomy”

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PubMed1994

The relationship of sociotropy and autonomy to symptoms, cognition and personality in depressed patients.

A growing body of research suggests that the two personality characteristics of sociotropy and autonomy confer vulnerability to depression in response to interpersonal or achievement-related events. This study examined the relationships of these characteristics to severity of symptoms, measures of negative cognition, neuroticism and extraversion in a sample of 118 unipolar depressed patients. Sociotropy was found to be associated with self-reported depressive symptoms independently of anxiety level, with frequency of negative automatic thoughts, with dysfunctional attitudes and neuroticism. It was more strongly related to dysfunctional attitudes reflecting a need for social approval than to those reflecting perfectionism. Autonomy was not associated with self-reported symptoms of depression or of anxiety. It was, however, associated with low extraversion and significantly more associated with perfectionism than social approval. The results support the need for further research to examine the precise roles of a number of psychological factors in the vulnerability to interpersonal life events but also suggest limitations in the relevance of the construct of autonomy to depression.

Achievement↗
PubMed2003

Anorexia nervosa and refusal of naso-gastric treatment: a response to Heather Draper.

Imposing artificial feeding on people with anorexia nervosa may be unethical. This seems to be Heather Draper's suggestion in her article, 'Anorexia Nervosa and Respecting a Refusal of Life-Prolonging Therapy: A Limited Justification.' Although this is an important point, I shall show that the arguments supporting this point are flawed. Draper should have made a brave claim: she should have claimed that people with anorexia nervosa, who competently decide not to be artificially fed, should be respected because everybody is entitled to exercise their autonomy, not only 'in the middle' of their life, but also at the end of it, or when their own life is at stake, because autonomy also extends to the most difficult moments of our life, and, ultimately, 'stretches [...] far out into the distance' at the end of it. I explain why Draper should have made the brave claim, and why she has not made it. I conclude that a defence of people's entitlement to competently refuse artificial feeding cannot rest upon the arguments developed by Draper. Whether or not we should respect competent refusal of artificial feeding depends on the normative strength that we are ready to ascribe to the principle of autonomy, to the moral relevance that we ascribe to the circumstances in which a person's autonomy is exercised, and, perhaps, eventually, on our sense of compassion.

Anorexia Nervosa↗
PubMed1993

Reproductive autonomy and evolutionary biology: a regulatory framework for trait-selection technologies.

The Constitution protects, in some measure, each person's autonomy in making basic decisions about family, parenthood, and procreation. This Article examines the extent to which courts should protect from government intrusions a parent's access to technologies that influence specific characteristics of offspring. Beginning with Supreme Court opinions that articulate constitutional and social values regarding reproductive autonomy, the Article explores how important new insights from evolutionary biology may supplement an understanding of human procreation. Specifically, the Article explains how trait selection can constitute an important part of larger "reproductive strategies" that powerfully affect an individual's "inclusive fitness" (itself a measure of reproductive success). It concludes that access to trait-selection technologies should receive the same federal protection from government intrusions as that afforded access to abortion. It proposes the first limit to that protection, however, when a parent seeks to select for a trait, or to use a technique, that would be clearly and significantly damaging to the future child. The Article subsequently divides the use of trait-selection technologies (TSTs) into eight contexts and proposes a preliminary framework by which a regulatory system could legitimately distinguish among them.

Biological Evolution↗
PubMedDate not supplied

Worshiping autonomy.

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Beneficence↗
PubMed2004

Homosexuality, ethics and identity synthesis.

Implicit metaphysical assumptions concerning the nature of sexual orientation are reflected in the language used to frame ethical debates concerning "reorientation" therapies. An alternative metaphysical construal is presented concerning sexual orientation and sexual identity development and synthesis. This alternative construal allows for humility concerning what we know and do not know about sexual orientation, underscores the client's self-determination and autonomy, and demonstrates regard for personal and religious valuative frameworks. Rather than focusing on therapies aimed specifically at sexual reorientation, clinicians would do well to provide clients with informed consent and to facilitate identity development and synthesis in keeping with their clients' requests for professional services.

Behavior Therapy↗
PubMed1983

The doctor-patient relationship.

This essay focuses on the doctor-patient relationship as a measure of ethical behavior by the physician. The perspective is derived from commitment as a religious humanist to the Judaic heritage, and experience in hospitals. The ethical responsibility to be competent professionally is presupposed. Emphasis is placed on the need of the physician to respect the autonomy of the patient as person, thus to limit the paternalism inherent in the physician's position, and to re-enforce this with compassion. Judaic sources supporting such conduct are cited. Exception is taken to decisions by civil and rabbinic judges which disregard the intimacy of the doctor-patient relationship.

Abortion, Therapeutic↗
PubMed2006

Justified paternalism: the nature of beneficence in the care of dementia patients.

The issue of patient autonomy in cases of permanent dementia has recently received a great deal of philosophical attention. Specifically, many have worried about ethical issues surrounding advance directives in which people specify how they shall be treated when they are no longer competent to make their own medical decisions. Ronald Dworkin has been a staunch defender of what he calls precedent autonomy in these cases, believing persons have a right to control, to some degree, how their lives will end, despite the common intuition that the principle of beneficence requires us to improve the experiential quality of patients' lives. Objections have been brought against Dworkin on a number of fronts, including worries about personal identity theory and informed consent. Here, I offer an objection to Dworkin's assessment of the nature of paternalism as it relates to cases of permanent dementia.

Advance Directive Adherence↗
PubMedDate not supplied

Autonomy and paternalism: partners or rivals?

This article is concerned with the ethical relationship between autonomy and paternalism. In the health care setting both clients and professionals can be profoundly affected by the way in which this relationship is interpreted and this article sets out to explore this phenomenon. It began by offering some well established definitions of autonomy and paternalism and goes on to examine the two principles in detail as they relate to persons in good health and to those in ill health. Finally an attempt made to answer the question of whether the two concepts are in conflict or partnership.

Ethics, Nursing↗
PubMed2003

The female smoker: from addiction to recovery.

Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Big tobacco's well-timed marketing strategies skillfully link cigarette use to typical female values: independence, self-reliance, weight control, stress management, social progress and popularity, personal attractiveness, autonomy, self-fulfillment, youth, happiness, personal success, health, and active, vigorous, and strenuous lifestyles. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. Smoking is a critical hazard for women in their reproductive years, particularly when they are pregnant. The US Public Health Service 2000 Clinical Practice Guideline provides helpful guidance and sound general recommendations for the treatment of women of all ages for tobacco use and dependence. Women and girls who smoke represent diverse subgroups of the population with unique issues and needs. The 2001 Surgeon General's Report on Women and Smoking stresses the importance of multistrategy programs for treating female smokers. This approach includes antitobacco media campaigns, increases in tobacco prices, promotion of nonsmoking in public places, curbs on tobacco advertising and promotion, enforcement of legislation to reduce youth access to tobacco products, and effective tobacco use treatment programs.

Adolescent↗
PubMed2003

[Ethical aspects of biological sample banks].

Numerous activities in the domain of epidemiology require the constitution or the use of biological sample banks. Such biobanks raise ethical issues. A number of recommendations are applicable to this field, in France and elsewhere. Major principles applicable to biobanks include the respect of person's autonomy, the respect of human body, the respect of confidentiality. These principles are translated into practices through the following procedures: relevant information to the persons regarding their sample management prior to informed consent, opinion of an independent ethics committee, actual implementation of conditions for protecting samples and data. However, although those principles may appear quite simple and obvious, in the context of a largely international practice of research and given the large variety of biobanks, it is not always obvious for researchers to find their way. The attitudes vary between countries, there are numerous texts for various types of biobanks, the same texts raise different interpretations in different institutions, there are new ethical opinions expressed, and mainly the novelty of questions raised by the uses of samples that are possible today, especially in genetics, and were not foreseeable at the time of sampling make the field difficult in practice. This article reviews the types of biobanks, the relevant ethical issues. It also underlines the still unclear or ambiguous situations using some examples of practical situations.

Bioethical Issues↗
PubMedDate not supplied

[Beyond autonomy].

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Patient Rights↗
PubMedDate not supplied

State interests in terminating medical treatment.

Judicial reasoning in termination of treatment decisions has neglected valid state interests in the preservation of life and the ethical integrity of medicine. Courts must balance these interests against individual liberty, rather than assuming that patient autonomy is absolute.

Cultural Diversity↗
PubMed1989

The incompetent developmentally disabled person's right of self-determination: right-to-die, sterilization and institutionalization.

The developmentally disabled, specifically those mentally incompetent from birth, are entitled to a full panoply of constitutional rights and protections. These rights include the right to terminate life-sustaining treatment, the right of procreative integrity and the right not to be involuntarily institutionalized. However, the mentally incompetent developmentally disabled are generally unable to exercise these rights. This Note asserts first that proper procedural safeguards are necessary to guarantee the exercise of these constitutional rights by the incompetent disabled individual. Second, the Note focuses upon how best to preserve the disabled person's autonomy. The Note subsequently rejects the substituted judgment standard as a legal fiction, and endorses the best interest test which necessarily comports with the evidence, and properly accounts for the disabled person's incompetency.

Humans↗