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At least 1,009 records · Page 56Linked to original sources
PubMed1998

Ethical dimensions of ultrasound screening for fetal anomalies.

The ethical dimensions of the debate on routine ultrasound are analyzed. The central role of the informed consent process, based on a respect for the autonomy of the pregnant woman, is presented. Failure to offer quality ultrasound in clinical settings where it is available restricts access to pregnant women to the diagnosis of fetal anomalies and therefore restricts access to the options of abortion and fetal therapy. We show that beneficence- and justice-based considerations do not supersede respect for autonomy.

Congenital Abnormalities↗
PubMed2006

Dignity under threat? A study of the experiences of older people in the United Kingdom.

Theoretical accounts have offered a general understanding of the social significance and importance of dignity and suggest that older age may threaten dignity by structuring and limiting the opportunities for participation and/or social recognition. Micro-sociological research has shown how older people negotiate their identity, in the face of its erosion by the aging body and disability and the domination of health and social care workers. These theoretical approaches inform the study presented here, which explores the meaning and experience of dignity for older people in their daily lives. Older people's accounts were elicited through a series of focus groups with participants living in England and Wales. Participants were selected according to predefined criteria to represent a range of different socio-economic and ethnic backgrounds, levels of fitness, and home circumstances. Personal identity and autonomy were the aspects of dignity most meaningful to the participants, and discussions tended to focus mainly on when personal identity and autonomy were threatened or violated in the context of the provision of health and social care. The authors discuss the extent to which older people's discourse on dignity resonates with the theoretical discourse.

Aged↗
PubMedDate not supplied

Cosmetic treatment, autonomy, and risks: "if you don't do it, I'll go to a dentist who will".

Patient requests and treatment goals may exceed the limits of professional practice and may have an adverse effect on health. When doctors encounter these types of requests, they first must decide whether the patient has the capacity to consent to such care. In the case of child patients, no such capacity exists and surrogate consent to care must be, in the opinion of the doctor, in the child's best interests. Parents who request potentially harmful procedures for a child with no hope for any health care benefit should be refused politely. Adult patients who request harmful elective procedures for themselves also should be educated and helped to fully understand why the request represents substandard treatment. The long-term consequences of these requests must be detailed clearly for these patients. Elective cosmetic treatment that will lead to long-term adverse effects on function and health raises serious ethical concerns in which the principle of nonmaleficence likely will trump the patient's autonomy.

Adolescent↗
PubMed1992

Ethical considerations in living organ donation and a new approach. An Advance-Directive Organ Registry.

Living organ donation should be recognized as an ethical compromise to the principle of nonmaleficence (doing no harm), given the risks healthy donors are allowed to assume. Living organ donation should be reserved for situations in which there is no acceptable alternative. Increasing the availability of cadaveric organs is most desirable, since it would decrease (although probably not eliminate) the need for living organ transplantation and would provide organs (ie, hearts) that could not otherwise be obtained. We propose the development of an incentive-based Advance-Directive Organ Registry, in which all adults are encouraged to register their advance directive regarding organ donations. Those individuals agreeing to permit usable organs to be taken at the time of death would receive priority for organs generated by the program, should a transplant become necessary when there is a shortage of organs. The proposed Advance-Directive Organ Registry is firmly founded on the principles of autonomy, beneficence, and justice.

Advance Directives↗
PubMedDate not supplied

Self-determination as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptualization of self-determination from the perspectives of motivation, skills enhancement and positive youth development. Self-determination, as a positive youth development construct in the Hong Kong Positive Youth Development Program (P.A.T.H.S.), refers to young people's ability to set goals and make choices according to his/her own thinking. In accordance with adolescents' developmental needs, the key components which cultivate self-determination in this Curriculum include self-awareness, goal setting, problem solving and choice making. Eight Units are devised which target at cultivating self-determination as a positive youth construct. In addition, other Units which targets at fostering bonding, social, emotional, cognitive competence, self-efficacy and self-identity also reinforce the cultivation of self-determination. This paper also includes strategies which schools may adopt to foster an autonomy supportive learning environment.

Adolescent↗
PubMed1986

Patient autonomy, informed consent, and the reality of critical care.

The realities of serious illness and critical care environments often complicate our efforts to evaluate treatment refusal according to the doctrine of informed consent. However, health professionals must strive to use informed consent as the ultimate standard for both treatment and nontreatment decisions, by making continual efforts to communicate with patients, share information, and enhance their sense of autonomy and control.

Aged↗
PubMed1993

Healing the self. The moral meaning of relationships in rehabilitation.

Ethical issues in rehabilitation include both clinical dilemmas and broader philosophic issues about the goals of rehabilitation and the nature of the provider-patient relationship. Two philosophic issues are explored in this paper. One involves the social conceptions of the human good that necessarily underlie rehabilitative care and provide its ethical context. The second is the way in which the clinical reality of rehabilitation challenges the ideals of autonomy and individualism central to mainstream bioethics. This paper argues that only with a moral vocabulary of relationships and transformative healing, rather than with a vocabulary of individualistic autonomy, can rehabilitation convincingly express its social goals and professional mission in an era of scarce resources.

Ethics, Professional↗