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 163 records · Page 9Linked to original sources
PubMed2003

[Quality of life at the end of live: experiences, models and perspectives].

The present paper gives an overview of theoretical concepts and empirical research on the issue of quality of life at the end of life with a focus on psychological concepts of lifelong development. Faced with severe illness, it seems that in old age the quality of life strongly depends on the individuals' potentials for developmental change. In addition, particular qualities of the spatial, social, and care context, taking the psychosocial, spiritual and practical competences and needs of the patients and their relatives into account, seem to lead to a higher degree of self determination and well-being. Empirical findings on the predictors of quality of life and of a "good death" are reported. Implications for an adequate care context at the end of life and research needs are discussed.

Adaptation, Psychological↗
PubMed2006

[Enhancement between self-realization and self-deception].

DEFINITION OF THE PROBLEM: Is it morally responsible to enhance human beings technically? To answer this question three problems will be analyzed: 1) Do we destroy human nature if we allow enhancement? 2) Can enhancement lead to a loss of autonomy and personality? 3) What are the differences between enhancement of adults and enhancement of children? Arguments and conclusion: I will defend a certain kind of moderate liberalism in order to solve these problems. I will focus on the question whether reversible enhancements must be evaluated differently from irreversible enhancements. Arguments from J. Habermas against enhancement of children will be rejected. Under certain conditions enhancement is not morally unacceptable but it must be ensured that these conditions are fulfilled.

Adult↗
PubMed2005

The right to withdraw consent to research on biobank samples.

Ethical guidelines commonly state that research subjects should have a right to withdraw consent to participate. According to the guidelines we have studied, this right applies also to research on biological samples. However, research conducted on human subjects themselves differs in important respects from research on biological samples. It is therefore not obvious that the same rights should be granted research participants in the two cases. This paper investigates arguments for and against granting a right to withdraw consent to research on biobank samples. We conclude that (1) there are no explicit arguments for such a right in the guidelines we have studied, (2) the arguments against such a right are inconclusive, (3) considerations of autonomy, privacy, personal integrity, and trust in medical research provide sufficient reasons for granting a right to withdraw consent to research on biobank samples, (4) in certain cases, research participants should be allowed to waive this right.

Biological Specimen Banks↗
PubMed2004

Informed consent and the use of placebo in Poland: ethical and legal aspects.

The concept of informed consent was one of the most fruitful ideas that deeply changed the relationships between physicians and their patients from paternalism to respect for the personal autonomy of subjects needing professional medical care. The great progress in medicine, also involving the pharmaceutical industry, has created an increasing need to perform different clinical and experimental trials. The evolution of clinical research in the last decades has influenced strongly the design of these studies. One of the most important changes in this field has been the use of placebo groups in double-blind controlled studies. The controversies have involved not only the use of placebo when standard or proven treatment was available, but also some specific problems concerning the procedure of obtaining informed consent in such trials. This paper briefly presents the evolution of informed consent in Poland as well as different ethical and legal problems concerning informed consent and the use of placebo controls in clinical trials.

Controlled Clinical Trials as Topic↗
PubMed1985

Building an effective doctor-patient relationship: from patient satisfaction to patient participation.

In this paper, the authors argue that patient satisfaction is an insufficient measure of the quality of the doctor-patient relationship. While shown to have a salutary effect on patient anxiety concerning illness and treatment, the only other significant outcome associated with levels of satisfaction is utilization behavior. This is not surprising, the authors argue, since prevailing conceptualizations of patient satisfaction fail to incorporate measures of patient participation in the therapeutic process. Evidence suggests that by encouraging patients to take an active role in their health care physicians can increase the effectiveness of their therapeutic activities. A method for involving patients is through incorporating their preferences into the physician's decision-making processes. An example of physician decision making which incorporates patient preferences is provided.

Attitude to Health↗
PubMed1991

Smoking and sedentary behavior as related to work organization.

There is little research which has investigated whether working life may affect health behaviors. However, there is data suggesting that smoking as well as leisure activities are affected during times of stress. Both theoretical work and research suggests that work may socialize people such that the use of leisure time for active pursuits, including exercise, may be contingent upon jobs which promote interaction, learning, and activity on the job. In investigating whether the psychosocial structure of work might affect smoking and sedentary behavior, a subsample (n = 7.201) of a representative sample of the Swedish population aged 16-65 years was selected for study. Reports on job characteristics and health behaviors were obtained in personal or telephone interviews and a logistic regression analysis was performed. In general, job demands like shift work, piece work, hazardous exposure, and physical load tended to be associated with smoking and sedentary behavior, whereas job resources, including personal autonomy, were predictive of regular exercise, but unrelated to smoking behavior. Correlational patterns varied somewhat between sexes. The implications of these findings with respect to work organization, considerations in epidemiological research, and the conduct of health promotion programs are discussed.

Health Behavior↗
PubMed1992

African women and AIDS: negotiating behavioral change.

Trends in the incidence of HIV/AIDS infection among women in Sub-Saharan Africa suggest this population is increasingly at risk. Many of the same factors that have predisposed rural African women to ill health in the past now increase their vulnerability to AIDS, including poverty and malnutrition, uncontrolled fertility, and complications of childbirth. As men travel out from rural communities to urban centers in search of employment, their sexual contacts multiply; many will acquire the HIV virus and carry it back to infect wives at home. Women, too, are leaving rural areas for the promise of a better life in cities and commercial centers along the way. Their struggle for economic survival and personal autonomy has led many to form relationships with new sexual partners, with a consequent increase in HIV seroprevalence among women once considered at low risk of infection. This paper argues that AIDS prevention campaigns have not yet taken into account the cultural, social, and economic constraints on most African women's ability to comply with advice to limit partners and use condoms. The author proposes a research agenda to explore the meaning of AIDS and AIDS prevention in the sociocultural context of women's lives. A better understanding of how women, themselves, perceive and respond to current attempts to prevent the transmission of AIDS is an increasingly critical factor in the intervention process. Most important, it is a necessary first step toward their effective participation with men in the development of culturally relevant strategies for protecting themselves and their families.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Gender differences in occupational mobility and structure of employment in the British Civil Service.

In all industrialized societies health status in adults has been found to vary with social position. Attempts to explain this are usually grouped under headings of artefact, material, lifestyle and selective mobility of the healthiest. Such attempts have to date been unsuccessful in fully accounting for this relationship, and whilst they have merit have left unconsidered the effects of the process whereby social stratification occurs. The present study is a prelude to subsequent studies that will endeavour to distinguish between three separate influences on health--the effects of current social position, the long term effects stemming from one's initial class position, and the effects of the processes governing mobility. The purpose of our present investigation is to describe patterns of occupational mobility, that will enable us to identify possible predictors of subsequent mobility and therefore to indicate to what extent mobility might be a process governed by social rules. The work presented in this paper comprises part of the Whitehall II study of occupational, social and lifestyle influences upon health in a Civil Service population. Using multiple regression techniques almost half the variation in mobility is modelled in terms of educational level, fathers' social class, gender, marital status, age on entry into the Civil Service, length of time in Civil Service employment and grade of entry into the Civil Service. Using estimates derived from this model it is suggested that a number of sub-groups within the Civil Service suffer adverse mobility (mobility appears particularly restricted for women and for those entering the Civil Service above 30 years of age). The results obtained suggest that the issue of obstructed opportunity at the workplace could become a focus for fruitful investigation, linking issues of personal autonomy, expectations and control to health. A number of methodological problems in this kind of work are considered together with discussion of how the model can be used to increase our understanding of mobility.

Adult↗
PubMed1993

The hoarding habit, countertransference, and consultation anthropology in a Peruvian psychiatric hospital.

The 'hoarding habit' is the practice of collecting a large number of mostly useless objects by psychiatric patients. Countertransference consists of distorted perceptions by psychotherapists in their study of individuals, or social scientists in their study of human groups, which interfere with the pursuit of their therapeutic or research goals. A case is here presented from observations made by the author in one pavilion of the Hospital Victor Larco Herrera in Lima, Peru, of a 'bag man' who persisted in carrying his 'hoard' with him in large market bags. The practice of hoarding is related to the culture and social structure of the hospital, patients' use of physical space, the existence of trade networks, the smuggling of alcohol, and patients' needs to retain a feeling of selfness and personal autonomy as well as to maintain ties with the external world. In all these senses the hoarding habit is overdetermined: it is both a symptom of pathology and a sign of healthy functioning. However, its clinical construction may be expanded by an observer who can function as a 'culture broker' and who may be able to apply the dialectic of pathology and health to the operation of psychiatric services for more therapeutic ends. However, the observer, in a consultation capacity, is advised to go beyond the study of transference and countertransference in his or her subjects to focus on his/her own countertransference in order to consult more effectively.

Anthropology, Cultural↗
PubMed2006

The antecedents and consequences of autonomous self-regulation for college: a self-determination theory perspective on socialization.

Using self-determination theory, two studies investigated the relations among perceived need support from parents, their adolescents' autonomous self-regulation for academics, and the adolescents' well-being. Study 1 indicated that perceived need support from parents independently predicted adolescents' well-being, although when mothers' and fathers' data were examined separately, the relation was stronger for mothers than for fathers. In Study 2, autonomous self-regulation for planning to attend college was a significant partial mediator of the relation of adolescents' perceived need support to well-being. Thus, perceived need support from parents does seem important for the development of adolescents' autonomous self-regulation and well-being.

Adolescent↗
PubMedDate not supplied

Protecting elders: regulating intergenerationally transmitted debt in Australia.

Australia, like other western nations, is facing the prospect that in the decades ahead the overall population will age dramatically. This article considers legal issues associated with the aged and intergenerationally transmitted debt. It will be argued that the present legal regulation of guarantees is a complex amalgam of case law, statute and finance industry self-regulatory codes which does not necessarily or adequately take into account the particular vulnerabilities of the aged and the very old or the intergenerational pressures which they may confront. It may be necessary to take significant steps to protect vulnerable elders while still recognizing their rights to exercise personal autonomy. Some proposals for reform are made.

Aged↗
PubMed2006

Justice and equality in mental health law: the European experience.

This is the text of a lecture delivered at the World Conference of the International Academy of Law and Mental Health in Sydney in September 2003 on the occasion of the award to the author of the Prix Philippe Pinel. Its theme is the potential of the European Convention on Human Rights to secure the human rights of people with mental disorders and disabilities, viewed in the context of the legislation on mental health and mental incapacity in England and Wales. Its conclusion is that the Convention is better at protecting them from unwanted or unnecessary treatment and care than it is at securing for them equal access to the treatment and care they want or need. The lecture has been updated to reflect developments in the United Kingdom since 2003.

Civil Rights↗
PubMed2004

Governing street-based injecting drug users: a critique of heroin overdose prevention in Australia.

This article provides a critical analysis of existing approaches to the prevention of heroin overdose in Australia. It draws on almost 2 years of ethnographic research with street-based injecting drug users (IDUs), street-based sex workers and service providers in Melbourne, Australia's second largest city, and on recent anthropological and sociological work on governmentality. The substantive sections of the article argue: (1) that heroin overdose prevention in Australia contains implicit or explicit assumptions of rationality and personal autonomy, continues to emphasise individual behaviour change and inscribes a self-disciplined, self-aware, self-regulating subject; and (2) that the social, cultural and economic realities--the 'lived experience'--of street-based IDUs and sex workers may undermine or hinder the successful adoption of overdose prevention strategies. The paper concludes by arguing that the 'chaotic' practices of street-based IDUs and sex workers arise in response to particular 'risk environments', and that individually focused overdose prevention strategies, while an important first step, need to be complemented by measures addressing the macro- and micro-aspects of risk environments.

Adult↗
PubMed2003

Development and characteristics of a well-being enhancing psychotherapeutic strategy: well-being therapy.

This article describes the main characteristics and technical features of a novel psychotherapeutic strategy, well-being therapy. This paper outlines the background of its development, the structure of well-being therapy, its key concepts and technical aspects. Well-being therapy is based on Ryff's multidimensional model of psychological well-being, encompassing six dimensions: autonomy, personal growth, environmental mastery, purpose in life, positive relations and self-acceptance. The goal of this therapy is improving the patients' levels of psychological well-being according to these dimensions, using cognitive-behavioral techniques. It may be applied as a relapse-preventive strategy in the residual phase of affective (mood and anxiety) disorders, as an additional ingredient of cognitive-behavioral packages, in patients with affective disorders who failed to respond to standard pharmacological or psychotherapeutic treatments and in body image disturbances. The clinical studies supporting its efficacy are illustrated.

Humans↗
PubMed2002

Temperament and character in couples with fertility disorders: a double-blind, controlled study.

OBJECTIVE: To evaluate the personality features of infertile patients. DESIGN: A double-blind, controlled study. SETTING: An outpatient facility for diagnosis and care of infertility. PATIENT(S): We assessed 142 infertile couples with obstetric-gynecologic clinical and instrumental examinations. The couples were divided into three groups: organic infertility, functional infertility, and infertility of uncertain origin. The third group was excluded. INTERVENTION(S): Organic infertility and functional infertility were ascertained with gynecologic and andrologic clinical examinations, seminal liquid examination, postcoital testing, progesterone assay, hysterosalpingography, biopsy of endometrium, and laparoscopy. Personality traits were assessed with the Temperament and Character Inventory (TCI). MAIN OUTCOME MEASURE(S): Results of the Temperament and Character Inventory. RESULT(S): Infertile women showed lower Cooperativeness than control women. Women with functional infertility had lower scores in Cooperativeness and Self-Directedness than women with organic infertility. Men belonging to the functional infertility group had a lower Novelty Seeking score than did those of the organic infertility group. Men and women in the functional infertility group showed higher Harm Avoidance than those in the organic infertility and control groups. CONCLUSION(S): The results emphasize that the study of personality in the diagnostic and therapeutic assessment of infertility might provide useful predictive elements for functional infertility.

Adult↗
PubMedDate not supplied

Assisted suicide: implications for nurses and nursing.

Assisted suicide is an issue of great importance to nurses. This issue reflects our values and beliefs as a society, calls for a clear and precise response as a profession, and challenges individual nurses to think about their own moral views. The history of the debate and the compelling moral arguments on both sides attest to the complexity of the issue and also suggest that it will not soon be resolved. The current position of the profession, as expressed in the ANA Code for Nurses and a specific position statement, were reviewed. The dilemma faced by the individual nurse who perceives an obligation to adhere to the guidelines specified by his or her profession's code and yet whose conscience dictates an act in violation of this code has been discussed as an instance of conscientious objection. While this analysis has been necessarily brief, it was intended to illustrate the importance of being clear about one's personal moral views and equally clear about one's duty to fulfil the obligations stemming from the profession's public statements. It is essential that the profession continue to explore the moral issues involved in requests for assistance in dying and provide additional guidelines for practicing nurses, with sound rationale for the profession's position.

American Nurses' Association↗