Culture, autonomy, and personal jurisdiction in adolescent-parent relationships.
Explore the source record for details and available documents.
Adolescent↗
SEARCH · PubMed Health
Results for “Personal Autonomy”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Precedent autonomy and personal identity.
Debates on precedent autonomy and some forms of paternalistic interventions, which are related to questions of personal identity, are analyzed. The discussion is based on the distinction between personal identity as persistence and as biographical identity. It first is shown that categorical objections to advance directives and "Ulysses contracts" are based on false assumptions about personal identity that conflate persistence and biographical identity. Therefore, advance directives and "Ulysses contracts" are ethically acceptable tools for prolonging one's autonomy. The notions of personality and biographical identity are used to analyze the ethically relevant features. Thereby, it is shown that these concepts are operative in and useful for thinking in biomedical ethics. The overall conclusion is that categorical arguments against precedent autonomy or "Ulysses contracts" are based on misleading theories of personal identity and that advance directives are an ethically respectable tool for prolonging individuals' autonomy in cases of dementia and mental illness.
Advance Directive Adherence↗
Sociotropy, autonomy, and personality disorder criteria in psychiatric patients.
Sociotropy and autonomy (Beck, 1983) are sets of beliefs, concerns, and behavioral tendencies that are proposed to create vulnerability to depression and other psychopathology and to influence its manifestation and treatment response. Other theoretical frameworks (Blatt, 1974) have made similar suggestions. We investigated the differential relations of sociotropy and autonomy to dimensional scores for each DSM-III-R personality disorder (PD) in a sample of 188 psychiatric patients, controlling for the other set of characteristics and for the other PDs. Histrionic and dependent PD traits were related specifically to sociotropy. Paranoid, schizoid, schizotypal, and passive-aggressive PD traits were related specifically to autonomy. Borderline, narcissistic, avoidant, and self-defeating PD traits were related significantly and about equally to both sociotropy and autonomy. Obsessive-compulsive PD traits were not related consistently to either. Results were mostly as predicted and suggest that sociotropy and autonomy may be useful constructs for understanding and treating PDs.
Adolescent↗
When legal worlds collide: from research to treatment in hereditary cancer prevention.
This paper critically examines the legal and ethical dilemma in the institutionalization of a prevention and treatment technology on hereditary non-polyposis colorectal cancer (HNPCC) in Finland. Current medical practice and legislation support the notion of non-directiveness in genetic counselling, patient autonomy and personal privacy. Clinical doctors in Finland, however, proposed that a research register of HNPCC carriers should be nationalized through a legal mandate, which would require all carriers to be identified on the basis of the mutation, but also provide a national healthcare and counselling infrastructure for preventive treatment. This paper argues that although such a register would undermine personal autonomy and privacy, there should be a strong incentive by the state to intervene from a preventive health perspective. Such a position would be contrary to current medical ethics and legal practice, but it would ensure that all patients receive equal access to information, screening and treatment, as well as help to reduce mortality rates.
Colorectal Neoplasms, Hereditary Nonpolyposis↗
Autonomy of long-stay psychiatric inpatients.
OBJECTIVE: To assess personal autonomy of long-stay psychiatric inpatients, to identify those patients who could be discharged and to evaluate the impact of sociodemographic variables, social functioning, and physical disabilities on their autonomy was also assessed. METHODS: A total of 584 long-stay individuals of a psychiatric hospital (96% of the hospital population) in Southern Brazil was assessed between July and August 2002. The following instruments, adapted to the Brazilian reality, were used: independent living skills survey, social behavioral schedule, and questionnaire for assessing physical disability. RESULTS: Patients showed severe impairment of their personal autonomy, especially concerning money management, work-related skills and leisure, food preparation, and use of transportation. Autonomy deterioration was associated with length of stay (OR=1.02), greater physical disability (OR=1.54; p=0.01), and male gender (OR=3.11; p<0.001). The risk estimate of autonomy deterioration was 23 times greater among those individuals with severe impairment of social functioning (95% CI: 10.67-49.24). CONCLUSIONS: In-patients studied showed serious impairment of autonomy. While planning these patients' discharge their deficits should be taken into consideration. Assessment of patients' ability to function and to be autonomous helps in identifying their needs for care and to evaluate their actual possibilities of social reinsertion.
Activities of Daily Living↗
Brain and self: toward a neuropsychodynamic model of ego autonomy and personality.
Principles derived from neuropsychology can begin to be applied to the development of heuristic models of complex psychological processes and can thereby contribute to theories of personality and psychopathology. Applications of neuropsychological concepts to the problems of self-knowledge, ego autonomy, and personality integration are discussed. Special reference is made to the role of the frontal lobes in the recursive modulation of behavior and to the verbal functions of the left hemisphere in self-awareness and self-control. Caution against a narrow localizationist conceptualization of human behavior is urged, and suggestions for interdisciplinary rapproachment are offered.
Brain↗
Cultural adaptability of dental hygiene students in the United States: a pilot study.
PURPOSE: Dental hygiene students should prepare to competently provide services to culturally diverse patients; therefore, this study was conducted as a baseline to determine the cross-cultural adaptability of dental hygiene students. METHODS: The sample consisted of 188 dental hygiene students attending four culturally diverse dental hygiene programs (N = 108) and four non-culturally diverse dental hygiene programs (N = 80). The culturally diverse programs randomly selected were located in the southwest, southeast and mid-Atlantic regions of the U.S., and the non-diverse programs were located in the northwest, northcentral, central, and southern regions of the U.S. Any dental hygiene program with students representing four of the five ethnic categories (Caucasian, African American, Hispanic/Latino, American Indian/Alaska Native, and Asian/Pacific Islander) with a culturally diverse student enrollment of 40% or greater, was considered a culturally diverse program; any dental hygiene program enrolling students from only one ethnic category was considered a non-culturally diverse program. Participating students completed the Cross-Cultural Adaptability Inventory (CCAI), a 50 item instrument that measures and individual's cultural adaptability and its four research dimensions; emotional resilience, flexibility/openness, perpetual acuity, and personal autonomy. The instrument does not target one particular cultural, rather it is culture general, meaning the inventory is proficient in assessing all cultures. RESULTS: The unpaired t-test revealed a statistically significant difference, at the 0.05 level, in the overall, emotional resilience, flexibility/openness, and perceptual acuity between the two dental hygiene groups. Data analyses revealed the overall score of the dental hygiene students was lower than the CCAI norm group, which consisted of individuals with cross-cultural experience. The culturally diverse group scored higher than the non-diverse group in emotional resilience but scored lower than the non-diverse group in flexibility/openness and perpetual acuity. There was no statistically significant difference between the culturally diverse and non-culturally diverse groups in the dimension of personal autonomy. CONCLUSION: Results of the study led to the conclusion that dental hygiene students attending culturally diverse and non-culturally diverse programs possess some qualities such as personal autonomy and self-identity needed for cultural adaptability. The overall CCAI scores were lower than the CCAI norm group suggesting students need cross-cultural education and training. For this reason, it is important that dental hygiene curricula incorporate cross-cultural educational strategies and peer and patient cross-cultural encounters to enable students to develop competency in providing cross-cultural health care.
Adaptation, Psychological↗
Promoting autonomy of the client with persistent mental illness: a challenge for occupational therapists from The Netherlands, Germany and Belgium.
The aim of this study was to determine how occupational therapists from The Netherlands, Germany and Belgium promote the autonomy of clients with persistent mental illness. Sixty occupational therapists working in psychosocial mental health completed two semi-structured questionnaires. Data were analysed by applying the constant comparative method. The results of the study show the importance of handling motivation in relation to personal autonomy and the different strategies occupational therapists use in promoting autonomy. In conclusion, enhancing clients' personal autonomy will empower and help them to discover meaningful occupations. More in-depth information could have been obtained using an interview in combination with observations. Further research is needed to evaluate the effectiveness of strategies used by occupational therapists in promoting clients' autonomy.
Belgium↗
Residents' autonomy: nursing home personnel's perceptions.
While delivering quality care, nursing home personnel may unintentionally adversely affect residents' sense of personal autonomy. Faced with the challenge of respecting resident autonomy and simultaneously adhering to nursing home standards, nursing home staff often experience a frustrating ethical conflict. This study examines the effects of sets of independent variables on six autonomy dimensions to examine nursing home personnel's perceptions of how care was provided in their facility. For each of six case studies, respondents were asked the following question: "If Mr. or Mrs. X were at your facility, what would have been decided?" Responses were recorded along a continuum that indicated whether the resident would be allowed to make his or her own decisions or whether the nursing home staff would decide for the resident. Findings indicated staff members' education and race had the greatest effect on their perceptions of personal autonomy. Somewhat surprisingly, staffing levels, turnover rates, and restraint usage did not affect their views of autonomy. Additional research is recommended to more completely examine the complex dimensions of autonomy and to identify what changes nursing home staff and administrators could implement to improve residents' quality of life.
Aged↗
Predictors of posttraumatic stress symptoms among survivors of the Oakland/Berkeley, Calif., firestorm.
OBJECTIVE: The purpose of this study was to examine factors predicting the development of posttraumatic stress symptoms after a traumatic event, the 1991 Oakland/Berkeley firestorm. The major predictive factors of interest were dissociative, anxiety, and loss of personal autonomy symptoms reported in the immediate aftermath of the fire; contact with the fire; and life stressors before and after the fire. METHOD: Subjects were recruited from several sources so that they would vary in their extent of contact with the fire. Of 187 participants who completed self-report measures about their experiences in the aftermath of the firestorm, 154 completed a follow-up assessment. Of these 154 subjects, 97% completed the follow-up questionnaires 7-9 months after the fire. The questionnaires included measures of posttraumatic stress and life events since the fire. RESULTS: Dissociative and loss of personal autonomy symptoms experienced in the fire's immediate aftermath, as well as stressful life experiences occurring later, significantly predicted posttraumatic stress symptoms measured 7-9 months after the firestorm by a civilian version of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder and the Impact of Event Scale. Dissociative symptoms more strongly predicted posttraumatic symptoms than did anxiety and loss of personal autonomy symptoms. Intrusive thinking differs from other kinds of posttraumatic symptoms in being related directly to the trauma and previous stressful life events. CONCLUSIONS: These findings suggest that dissociative symptoms experienced in the immediate aftermath of a traumatic experience and subsequent stressful experiences are indicative of risk for the later development of posttraumatic stress symptoms. Such measures may be useful as screening procedures for identifying those most likely to need clinical care to help them work through their reactions to the traumatic event and to subsequent stressful experiences.
Adult↗
STD-related knowledge, beliefs and attitudes of Xhosa-speaking patients attending STD primary health-care clinics in South Africa.
The primary aim of this study was to describe patients at sexually transmitted disease (STD) clinics in Cape Town, South Africa, in terms of gender, education and age differences relative to their STD knowledge and beliefs, their condom use, as well as their attitudes towards condom use and their condom-use behaviour. The information was collected with a view to developing a health education intervention. Structured interviews were conducted with 2978 randomly sampled Xhosa-speaking STD clinic attenders about their knowledge, beliefs and practices regarding STDs and related behaviours. More males (75%) than females (25%) presented for STD treatment. The majority of patients (92%) were younger than 35 years. Female patients were found to be more aware than male patients of the sexual nature of STD transmission, valued personal autonomy in sexual behaviour and expressed a greater need to use condoms. Males perceived STD symptoms to be more serious, had more misconceptions about the cause of STDs and also more negative beliefs and attitudes towards condom use. Only 34.9% of the patients reported using condoms in the last 6 months while only 24.5% reported regular use. Those who reported condom use were more knowledgeable about the sexual transmission of STDs and the effects of STDs on the neonate. They also had fewer misconceptions about the causes of STDs and perceived STD symptoms to be more serious, attached greater value to personal autonomy in sexual behaviour and condom use and had more positive outcome expectancies of refusing sex than those who never used condoms. The data suggest that targeted interventions directed at males will have to address their inadequate knowledge regarding STDs in terms of transmission, causes, consequences, prevention and cure. Their negative beliefs and attitudes towards condoms will need special attention, especially in view of their multiple partner behaviour. Interventions directed at females will need to improve their knowledge regarding STD consequences, causes, recognition of symptoms as well as improve their knowledge of aspects of prevention and cure. All interventions must facilitate personal autonomy in decision making about sexual behaviour and condom use for both men and women, through skills development programmes that promote self-efficacy in the individual and instil a culture of mutual respect of such in the community.
Adult↗
Sociotropy, autonomy and personal memories in depression.
Recent research suggesting an association of sociotropy and autonomy with vulnerability to depression in response to different types of event remains to be integrated with the cognitive model. This study investigated the relationship of sociotropy and autonomy to specific cognitive processes in a sample of 20 unipolar depressed patients. In the autobiographical memory paradigm used, the hypothesis that sociotropy would be associated with faster recall of sociotropic negative memories was supported. No support was found for the predicted relationship of autonomy with speed of recall of autonomous memories. The implications of the results for cognitive vulnerability to specific events are discussed and recommendations for replication stressed.
Adult↗
Psychological need-satisfaction and subjective well-being within social groups.
Five candidate measures of psychological need-satisfaction were evaluated as predictors of high positive and low negative mood within the group, intrinsic motivation for group activities, and high commitment to the group. Consistent with self-determination theory (Deci & Ryan, 1991), personal autonomy and interpersonal relatedness both predicted positive outcomes. Consistent with optimal distinctiveness theory (Brewer, 1991), feeling included within the group, feeling personally distinctive within the group, and feeling that the group is distinctive compared to other groups, also predicted positive outcomes. Simultaneous regression analyses indicated that the five needs were differentially related to the different well-being indicators, and also suggested that group inclusion may be the most important need to satisfy within group contexts. Supplementary analyses showed that members of formal groups felt less personal autonomy, but more group distinctiveness, compared to informal group members.
Adaptation, Psychological↗
Beyond autonomy to the person coping with illness.
Explore the source record for details and available documents.
Adaptation, Psychological↗
Respecting autonomy by respecting persons: taking the patient's story seriously.
Explore the source record for details and available documents.
Christianity↗
Who's the parent here? The family's impact on the autonomy of older persons.
Explore the source record for details and available documents.
Aged↗
Diminished autonomy: can a person with dementia consent to dental treatment?
Explore the source record for details and available documents.
Aged↗
Public deliberation and private choice in genetics and reproduction.
The development of human genetics raises a wide range of important ethical questions for us all. The interpersonal dimension of genetic information in particular means that genetics also poses important challenges to the idea of patient-centredness and autonomy in medicine. How ought practical ethical decisions about the new genetics be made given that we appear, moreover, no longer to be able to appeal to unquestioned traditions and widely shared communitarian values? This paper argues that any coherent ethical approach to these questions must be able both to uphold the moral status of the individual and at the same time recognise the communitarian, interpersonal dimensions both of the world in which we live and of personal autonomy itself. The paper then goes on to propose an approach to the resolution of the ethical questions raised by the use of the new genetics in reproductive choice through the development of a coherent and principled process of public reason and justification oriented towards the support and development of personal autonomy.
Ethics, Medical↗