PubMed Health⌕ Search

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.

At least 1,027 records · Page 57Linked to original sources
PubMed1997

Beyond autonomy.

Explore the source record for details and available documents.

Adolescent↗
PubMed2006

[Assessment of chronic pain as a disability in patients with spinal cord injuries].

OBJECTIVES: To evaluate pain and its impact on daily life activities in patients with spinal cord injuries. METHODS: Patients with chronic pain associated with spinal cord injuries were mailed 2 questionnaires: the multidimensional pain inventory for spinal cord injury, which includes a visual numeric scale for pain; and the quality of life questionnaire SF-36. RESULTS: Twenty-two of the 28 patients (women 9, men 19) who were mailed the questionnaires responded. The location of pain was, in decreasing order: lower limbs, upper limbs, trunk. The clinical type of pain was usually neuropathic, and the mean pain intensity was 7.2+/-2.16. Eleven patients experienced sleep disturbances. In 17 patients, daily activities were limited because of pain (not counting 2 patients who were unable to answer because of hospitalization). Among 6 working patients (of 22), 5 experienced limitations in their job because of pain. SF-36 scores, which reflect psychological and physical health, were well below those of the general population. DISCUSSION-CONCLUSION: Despite the small size of our population and lack of a French-language validation of the questionnaire, these preliminary results point out the important interference of chronic pain in functional autonomy and quality of life in patients with spinal cord injuries.

Activities of Daily Living↗
PubMed2001

Historical and philosophical reflections on patient autonomy.

Contemporary American medical ethics was born during a period of social ferment, a key theme of which was the espousal of individual rights. Driven by complex cultural forces united in the effort to protect individuality and self-determined choices, an extrapolation from case law to rights of patients was accomplished under the philosophical auspices of 'autonomy.' Autonomy has a complex history; arising in the modern period as the idea of self-governance, it received its most ambitious philosophical elaboration in Kant's moral philosophy. In examining the Kantian construction, it is evident that neither his universal moral imperative nor his rigorous application of self-legislated ethical action can sustain our own notions of moral agency in a pragmatic, pluralistic society. But the Kantian position is useful in highlighting that self-governance is not equivalent to 'autonomy,' and this distinction defines the limits of autonomy in the clinical setting. A critique of Engelhardt's idea of 'principle of permission' is used to illustrate autonomy's eclipse as a governing principle for medical ethics.

Bioethical Issues↗
PubMed2002

Elderly residents' participation and autonomy within a geriatric ward in a public institution.

In this study the importance of the concept of autonomy among residents in geriatric institutions was investigated. By granting the residents more autonomy, their satisfaction increased, their daily routine changed, and their participation in social activity increased. Correlation was found between the degree of autonomy and the degree of the participation in different activities within the ward. The conclusion reached is that the residents' quality of life improves with more autonomy within the institution's framework.

Age Factors↗
PubMed2004

Legal harmonization and reproductive tourism in Europe.

Legislation of ethical issues illustrates the uneasy mix of ethics and politics. Although the majority has the political right to express its moral views in the law, a number of important ethical values like autonomy, tolerance and respect for other people's opinions urge the majority to take the minorities' position into account. Ignoring pluralism in society will inevitably lead to reproductive tourism. Although European legislation and harmonization in the domain of medically assisted reproduction is presented as a partial solution to this phenomenon, it is argued that European legislation should be avoided as much as possible. Regulation of these private ethical matters should be left to the national parliaments. A soft or compromise legislation will keep reproductive travelling to a minimum. Reproductive tourism is a safety valve that reduces moral conflict and expresses minimal recognition of the others' moral autonomy.

Abortion, Induced↗
PubMed2002

Three patients who asked that life support be withheld or withdrawn in the surgical intensive care unit.

OBJECTIVE: To illustrate some of the difficulties encountered in the transition from restorative to palliative care and in the pursuit of patient autonomy in the intensive care unit. DESIGN: A review of the cases of three patients who asked that life support be withheld or withdrawn, and a discussion of the legal and ethical implications of these cases. SETTING: A surgical intensive care unit in an academically affiliated public hospital serving as a Level I trauma center. PATIENTS: Three adults with severe injuries who lacked legal surrogates and lost the ability to make medical decisions. INTERVENTIONS: Care from the attending surgery and consultative critical care services, in addition to consultations from the psychiatry service and the hospital ethics committee. MAIN RESULTS: All three patients died after life support was withheld or withdrawn, but not without conflicts among the various services. In two cases, decisions that the patients may or may not have agreed with were made for them by their physicians. In the third case, the patient was not consulted after his clinical situation changed. CONCLUSIONS: Patients' wishes change and are difficult to know, and even when they are known, physicians may have difficulty honoring them. Nevertheless, patient autonomy should be respected whenever possible in the intensive care unit.

Adult↗
PubMed2006

A self-determination multiple risk intervention trial to improve smokers' health.

BACKGROUND: Little is known about how interventions motivate individuals to change multiple health risk behaviors. Self-determination theory (SDT) proposes that patient autonomy is an essential factor for motivating change. OBJECTIVE: An SDT-based intervention to enhance autonomous motivation for tobacco abstinence and improving cholesterol was tested. DESIGN: The Smokers' Health Study is a randomized multiple risk behavior change intervention trial. SETTING: Smokers were recruited to a tobacco treatment center. PATIENTS: A total of 1.006 adult smokers were recruited between 1999 and 2002 from physician offices and by newspaper advertisements. INTERVENTIONS: A 6-month clinical intervention (4 contacts) to facilitate internalization of autonomy and perceived competence for tobacco abstinence and reduced percent calories from fat was compared with community care. Clinicians elicited patient perspectives and life strivings, provided absolute coronary artery disease risk estimates,enumerated effective treatment options, supported patient initiatives,minimized clinician control, assessed motivation for change, and developed a plan for change. OUTCOME MEASURES: Twelve-month prolonged tobacco abstinence, and change in percent calories from fat and low-density lipoprotein-cholesterol (LDL-C) from baseline to 18 months. RESULTS- Intention to treat analyses revealed that the intervention significantly increased 12-month prolonged tobacco abstinence (6.2% vs 2.4%; odds ratio [OR]=2.7, P=.01, number needed to treat [NNT] =26), and reduced LDL-C (-8.9 vs -4.1 mg/dL; P=.05). There was no effect on percent calories from fat. CONCLUSIONS: An intervention focused on supporting smokers'autonomy was effective in increasing prolonged tobacco abstinence and lowering LDL-C. Clinical interventions for behavior change may be improved by increasing patient autonomy and perceived competence.

Humans↗
PubMed2006

Relationship styles of self-focused autonomy, other-focused connection, and mutuality among Mexican American and European American college students.

The author examined relationship styles of self-focused autonomy (SFA), other-focused connection (OFC), and mutuality among 415 European and Mexican American young adults in 2 U.S. colleges. Mutuality was the most commonly reported style for both ethnic groups, although Mexican American men were more likely than the others to indicate that they had the SFA style. Mexican American participants perceived their fathers' styles as SFA more often than did the others regarding either of their parents' styles. Mutuality was associated with the best mental-health outcomes regardless of gender or ethnicity. The present results indicate that the cultural influences on autonomy and connection are complex and that collectivistic cultural contexts may sometimes promote autonomy concerns in men.

Adult↗
PubMedDate not supplied

Informed consent in dentistry: the impact of "Who pays the bills?".

This paper analyzes the concept of informed consent in dentistry from a bioethical and philosophical perspective. It is my contention that informed consent, as presently utilized in daily dental practice, might be illusory at best. After analysis of the concept in general to derive a philosophical underpinning, this basis is applied to alternate delivery systems including Medicaid, Capitation Programs, and the "overbilling" scenario. Then an approach that is respectful of the patient's autonomy and that can achieve a truly meaningful informed consent is suggested.

Beneficence↗