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Losevich, Marina, Aigars Laizāns i Inga Kudeikina. "Aspects of Contractual Relations in Healthcare". SOCRATES. Rīgas Stradiņa universitātes Juridiskās fakultātes elektroniskais juridisko zinātnisko rakstu žurnāls / SOCRATES. Rīga Stradiņš University Faculty of Law Electronic Scientific Journal of Law 3, nr 24 (2022): 91–105. http://dx.doi.org/10.25143/socr.24.2022.3.091-105.
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The article aims to determine the scope and limitations of ethical duties and legal responsibilities of the medical practitioner within the professional-patient relationship (PPR), identify shortcomings of the legal framework and gaps in ethical principles, and propose solutions to them. It argues that in private law the healthcare shares many similarities with conractual law; therefore, the legal basis for physician-patient relationship is the special legal capacity of the contract parties and their free will, but ethical basis ‒ their good faith. One important finding is that physician right and obligation to refuse is an aspect of patient safety and quality of healthcare and has to be acknowledged by ethics and stipulated by law. In addition, it detects that medical professionals are ethically and legally vulnerable and need special protection. All this calls to carving out the proper place of medical practitioners’ professional autonomy and freedom in current legal regulation. Used materials include literature and scientific publications on clinical and research bioethics, contractual and medical law, regulatory enactments, court judgments. Methods used in the study include descriptive, analysis, synthesis, dogmatic, induction and deduction; legal interpretation methods such as grammatical and systemic. Keywords: patient’s rights, physician’s rights, physician’s autonomy, professional-patient relationship, right to refuse, medical liability
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Semenoh, Olena, i Olena Kravchenko. "PROFESSIONAL ETHICS IN LINGUA-CULTURAL DIMENSIONS: AMERICAN EXPERIENCE". Aesthetics and Ethics of Pedagogical Action, nr 16 (9.09.2017): 70–83. http://dx.doi.org/10.33989/2226-4051.2017.16.175981.
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The article outlines the concepts "nurse", "professional ethics of nurses." The professional ethics of nurses has been defined as a component of medical ethics which studies moral consciousness, moral and ethical aspects of professional activity, moral principles and values that regulate the moral relationship between s nurse and s patient, the patient's family, other members of the medical community and community. The analysis of foreign and Ukrainian experience of formation of nurses’ professional ethics gives grounds to characterize the quality as a set of interrelated cognitive, praxeological, communicative components; their presence allows to interact productively with the professional and social environment on the basis of professionally important ethical knowledge, skills, professional important qualities that are aimed at the effective organization of the medical-preventive process and the solution of professional tasks. The content of the professional ethics of a future nurse consists of ethical categories and professionally important ethical qualities such as: professional duty, responsibility, dignity, conscience, honor, respect, mercy, empathy, tolerance.The peculiarities of educational programs of future licensed younger nurses training (LPN) in the United States aimed at the formation of professional ethics have been outlined. A review of the linguistic- cultural aspect of the formation of nurses’ professional ethics at American higher education institutions has been conducted. The experience of classes on "Nursing Ethics", "Foreign Language" at Cherkasy Medical Academy has been presented; they are aimed at understanding the world of the profession, the culture of communication in medical community, ethical behavior, moral relations, prevention of conflict situations, and provision of psychological support.
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Leonova, Olga M., i Alexander N. Salnikov. "Historical aspects and organizational issues of deontology in dental institutions". Medicine and Physical Education: Science and Practice, nr 9 (2021): 39–44. http://dx.doi.org/10.20310/2658-7688-2021-3-1(9)-39-44.
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A large number of works are devoted to the problem of medical ethics and deontology. They mainly consider the relationship between a medical worker and a patient, a medical worker and society. The issue of adherence to medical deontology and ethics between doctors is not often raised in the professional literature. We considered issues of relationship of the health worker and patient, the personal qualities of the doctor and moral installations defining his behavior; relations with colleagues and rationing the vocational and ethical field of medicine in the form of a vocational and ethical code. The key principles of bioethics are the following: the principle of humanism, professionalism, the scientific nature of medical interventions, self-criticism. Modern successes in the field of science and technology, the transfer of their results to medical practice have determined the relevance of the relationship between the doctor and the patient from the point of view of law, morality and religious beliefs. This problem area is the subject of biomedical ethics, the task of which is to solve ethical problems closely related to medical practice and biomedical research. We defined modern medical ethics through correlation with the bioethical model.
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Znagovan, Alexandru. "Morality, ethics, and professional deontology: non-traditional sources of medico-pharmaceutical law". Moldovan Journal of Health Sciences 10, nr 1 (kwiecień 2023): 65–72. http://dx.doi.org/10.52645/mjhs.2023.1.10.
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Introduction. Moral, ethical, and professional deontological rules have a substantial impact on the social relations of legal regulation regarding liability for abuses and violations of citizens’ rights – people taking medication – patients as part of the health care system. The identification of the place and role of moral norms, ethics, and professional deontology, their quality as specific non-traditional primary sources in the development of the health care system, and the sub-branch of pharmaceutical law in the Republic of Moldova were the focus of the present study. Material and methods. The secondary descriptive synthesis study of normative-legal acts as primary specific non-traditional sources, viewed through the lens of the protection of the rights of the consumer of medicines, the patient – the ultimate beneficiary of the social relations in the field of health care – spanned the years 1991 to 2021. The most relevant sources subject to analysis are the Constitution of the Republic of Moldova, the Code of Ethics for doctors and pharmacists in the Republic of Moldova, laws, and sub-legislative acts, etc. The study is based on the use of several recognized techniques and methods of analysis: systemic approach, synthesis, logical-legal deduction, content and comparative analysis, etc. Results. Both the literature and recognized authors state that respect for moral, ethical, bioethical, and professional deontological norms in the field of health care has always been highly appreciated in society, which has led to the recognition of the nobility of medical and pharmaceutical activity. The results presented in this paper have made it possible to highlight aspects that recommend that the investigation of the role of legal regulation in medical and pharmaceutical activities also question the place and role of moral, ethical, and bioethical norms, as they generally have the same thematic orientation and influence on law, legislation, the practice of applying the law, and vice versa. Conclusions. The accomplished study allowed the identification of the dialectical and organic unity between moral, ethical, bioethical, and deontological sources with the rules of law - the moral-legal foundation of medico-pharmaceutical law. The consolidation of legal and moral norms demonstrates the structuring of the sub-branch of medico-pharmaceutical law. The analysis of the normative-legal acts in the Republic of Moldova confirms both the functionality of the „moral-ethics-deontology-law” system and the importance given to the protection of the rights of the consumer of medicines, the patient, as the ultimate beneficiary of social relations in the field of health care.
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Wang, Zekun, Zhaohua Deng i Xiang Wu. "Status Quo of Professional–Patient Relations in the Internet Era: Bibliometric and Co-Word Analyses". International Journal of Environmental Research and Public Health 16, nr 7 (2.04.2019): 1183. http://dx.doi.org/10.3390/ijerph16071183.
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Background: Incidents of violence against medical staff have increased in intensity, showing the deteriorating relationship between doctors and patients in China over the past few years. In addition, professional–patient relations have been significantly affected in the Internet era in China, which has attracted great attention from many scholars. This study aims to analyze the research status of professional–patient relations in the Internet era in China and further reveal its research pattern and trends. Methods: This study collected journal articles published during the past 21 years from the Wanfang Data Knowledge Service Platform. Then, bibliometric analysis was carried out, including publication growth, core author and collaborative degree, highly cited papers, journal distribution, and institution distribution analyses. We also analyzed the subject heading–source literature matrix and co-occurrence matrix of keywords through hierarchical cluster, social network, and strategic diagram analyses. Results: The number of articles has continually risen since 1998, which follows the growth law of literature. Furthermore, the distribution of these studies obeys Bradford’s law of scattering, and mainly concentrates on the fields of medicine and health technology. The distribution of high-frequency keywords follows Zipf’s law. Conclusions: We identified eight focal research directions, namely: website building (especially for professional–patient interaction), telemedicine, professional–patient communication and network public opinion, professional–patient contradiction and health education, new media, follow-up interaction platform, healthcare reform and computer network, and medical ethics.
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Sergeev, V. V., i I. A. Shmelev. "The combination of moral and law norms in regulation of medical activity". Problems of Social Hygiene, Public Health and History of Medicine 31, nr 1 (15.12.2023): 88–92. http://dx.doi.org/10.32687/0869-866x-2023-31-1-88-92.
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The article considers proposals developed according results of the study and targeted on improving social regulation of medical activities on basis of complex institutional approach. The complexity of approach lies in the fact that in regulation of public relations in health care opposition between norms of law and norms of morality is not allowed because in medicine they inter-condition and inter-complement each other. The institutional aspect of approach is reflected in tight interaction of moral and legal foundations, as well as in mechanisms of implementation of social standardization of specific sphere of medical activity. The formalized model of integrated institutional approach is presented. The importance of bioethics, in which principle of inter-complementarity of morality and law is realized to its maximum extent is emphasized. The significance of structural principles of bioethics that characterize totality of stable relationships of subjects of medical intervention is highlighted. The emphasis is made on interrelation between principles of bioethics and medical ethics, on norms of medical ethics, that largely determine content of professional duty of physician. The norms of medical ethics are grouped into three systems: “doctor-patient”, “doctor-colleague” and “doctor-society” that are contained in international ethical documents and “The Code of Professional Ethics for Physicians” of the Russian Federation. The importance of internal and external mechanisms of implementation of complex social regulation of medical activity is marked.
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Pinto Marques, A. Franklim. "A profession, a (bio)ethics. A conceptual vision". Anales de la Real Academia Nacional de Farmacia 89, nr 89(02) (30.06.2023): 177–89. http://dx.doi.org/10.53519/analesranf.2023.89.02.04.
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The pharmaceutical profession has a unique scope of intervention in the area of health, where the pharmacist can be found in all domains related to access to health care, at its most varied levels. All this scope is based on a broad academic training, where scientific knowledge and expertise confer skills that are directly reflected on the pharmaceutical profession and practice. The professional practice of the pharmacist is very diverse and can be observed in various circumstances, from direct contact with the patient, with the person, as in community pharmacy, hospital pharmacy, clinical analysis laboratory, palliative or continuous care, in nursing homes, to in more reserved situations, such as in the laboratory or in scientific and clinical research. This wide range of activity of the pharmacist, supported by individual labor relations or integrated into multidisciplinary health teams, requires from him an assertive behavior and a (bio)ethical awareness that allows him to respond to the different demands he faces in his daily life. It is important, therefore, to reflect on the concepts and assumptions that ethics or bioethics have in the professional life of pharmacist, in the area of health and life sciences, and in the personal life of each one.
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Al-Balushi, Amal A. "In the Era of Social Media: Is it time to establish a code of online ethical conduct for healthcare professionals?" Sultan Qaboos University Medical Journal [SQUMJ] 20, nr 1 (9.03.2020): 25. http://dx.doi.org/10.18295/squmj.2020.20.01.004.
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Social media is becoming an invasive part of the lives of many professionals including those in the healthcare field. One of the countless implications of such an invasion is how the healthcare professional’s engagement with social media affects the traditional doctor-patient relationship. The online presence of professionals should be carefully self-monitored as it affects the individual’s reputation and society’s perception of their profession. Therefore, the contents of public and personal accounts must differ according to their purpose. In the public eye, conflicts of interest must be declared and scientifically-based medical advice should be clearly differentiated from experience-based advice, personal opinions or commercial advertisements. Online doctorpatient relationships risk the privacy of patients as well as the personal privacy of the healthcare professional. Personal accounts created for friends and family should be kept separate from public accounts created for educational, professional or commercial purposes. Published educational material should be clearly differentiated from commercial material so that it is easier for the public to make an informed decision. This paper proposes a code of online ethical conduct to be implemented in Oman.Keywords: Codes of Ethics; Social Media; Health Personnel; Privacy; Confidentiality; Conflict of Interest; Physician-Patient Relations; Oman.
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Kaya, Ayla, i İlkay Boz. "The development of the Professional Values Model in Nursing". Nursing Ethics 26, nr 3 (20.09.2017): 914–23. http://dx.doi.org/10.1177/0969733017730685.
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One of the most important criteria for professionalism is accumulation of knowledge that is usable in professional practice. Nursing models and theories are important elements of accumulating nursing knowledge and have a chance to guarantee the ethical professional practice. In recent years, there has been an increase in the use of models in nursing research and newly created terminology has started to be used in nursing. In this study, a new model, termed as the Professional Values Model, developed by the authors was described. Concepts comprising the conceptual framework of the model and relations between the concepts were explained. It is assumed that awareness about concepts of the model will increase not only the patients’ satisfaction with nursing care, but also the nurses’ job satisfaction and quality of nursing care. Contemporary literature has been reviewed and synthesized to develop this theoretical paper on the Professional Values Model in nursing. Having high values in nursing increases job satisfaction, which results in the improvement of patient care and satisfaction. Also, individual characteristics are effective in the determination of individual needs, priorities, and values. This relation, proved through research about the Professional Values Model, has been explained. With development of these concepts, individuals’ satisfaction with care and nurses’ job satisfaction will be enhanced, which will increase the quality of nursing care. Most importantly, nurses can take proper decisions about ethical dilemmas and take ethical action when they take these values into consideration when giving care. The Professional Values Model seems suitable for nurse managers and it is expected that testing will improve it. Implementation of the Professional Values Model by nurse managers may increase motivation of nurses they work with. It is suggested that guidance by the Professional Values Model may help in enhancement of motivation efforts of the nurse managers and therefore should be taken into account.
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FAVACHO, Natasha Costa. "MEDICAL PROPAGANDA". RCMOS - Revista Científica Multidisciplinar O Saber 1, nr 2 (22.01.2024): 20–45. http://dx.doi.org/10.51473/rcmos.v1i2.2021.29.
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Objectives: This study evaluates, firstly, the distinction between the terms advertising and propaganda and its application to medical activity, justifying the choice of the term "propaganda" in the title of this article. In a second moment, the research approaches the normative framework that allows the Federal and Regional Medical Councils to regulate the limits and restitions to advertisement by doctor and to adopt the appropriate measures and sanctions in case of violation of legal and ethical norms in doctor-patient relations. Afterwards, the normative and deontological diplomas, their respective permissions and prohibitions of conduct of the medical professional when advertising on social networks are analyzed. Finally, the practices of use of social networks by doctors are outlined in accordance with medical ethics and the law, reaching the conclusion that it is fully possible for doctors to advertise on social media, provided that the legal and deontological parameters of the profession are followed. Methods: This article analyzes the possibility of medical professionals to use advertising tools in social networks, through bibliographic research of texts contained in works on Medical Law and legal analysis about the legal and deontological norms that govern medical activity in Brazil. The Boolean indicators used for research of the titles were "and" and "or", from the following descriptors: "Propaganda", "Advertising" and "Social Networking" and " Physician-Patient Relations", all extracted from DeSC.
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Pukhova, E. P., O. Yu Kutumova i D. O. Trufanov. "Attitude of patients and doctors of government health care system to the basic principles of medical ethics". Research and Practical Medicine Journal 8, nr 1 (10.03.2021): 97–108. http://dx.doi.org/10.17709/2409-2231-2021-8-1-10.
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Currently, researchers face with various situations related to the moral situation in healthcare. This article is based on the results of a sociological reasearch conducted by specialists of the Krasnoyarsk Regional Center for Health and Medical Prevention in 2015–2019.Given the relevance of this topic, researchers compare the opinions of modern doctors and patients to ethical principles. Purpose of the study. To study the attitude of modern doctors and patients of medical institutions to the classical norms of medical ethics. Materials and methods. For the selection of respondents was used the representative sample based on gender and age of respondents (for the selection of patients), and by specialty of a medical workers (for doctors). Information collected by survey. Descriptive statistics were used to interpret the results, statistically significant differences between the rates were determined by Fischer`s exact test. Results. The results indicate that there are statistically significant differences in the attitude of doctors and patients to some classic norms of medical ethics. In general, doctors often have an unambiguous opinion about the principles of bioethics; patients are more lenient about the principles of bioethics. However, sometimes patients are more categorical about some aspects of the principles of bioethics. In particular, these include the ambiguous opinions of doctors regarding the judgment that “if the doctor realizes that the patient has been harmed as a result of unlawful acts, he must report this to the internal affairs bodies”, as well as the opinions of doctors about the admissibility of accepting gifts from the patient. Conclusions. The classical principles of bioethics preserve functionality and form the necessary attitude of doctors and patients to the ethical foundations of the doctor’s professional activities. Nevertheless, some aspects of these relationships are partially dysfunctional and can become a source of negative behavior in the system of relations between a doctor and a patient.
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Masrizal, Marzuki, Syahrul Awali, Azmi Yudha, Maria Ulfa i Nurul Aida. "Code of Ethics for Teachers in Islamic Education Perspective Muhammad Athiyah Al-Abrasyi". Britain International of Linguistics Arts and Education (BIoLAE) Journal 1, nr 2 (30.11.2019): 199–209. http://dx.doi.org/10.33258/biolae.v1i2.87.
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Education can be simply interpreted as an effort to shape human personality in accordance with the values and codes of ethics contained in society and the country. One of the most important components in the learning process is educators and students. Along with the times, there is a shift in the pattern of teacher and student relations; economic values have driven many policies, the appreciation of students towards teachers has decreased, the price of teacher's work is higher, and the teacher's appreciation for him has been lower. Considering the urgency of the teacher's role in the education process, many scholars wrote about the obligations, traits or tasks that the teacher and students had to have. Based on this background, the writer formulates the problem of the teacher's code of ethics in the perspective of Islamic education, Muhammad Athiyah Al-abrasyi. This research is a qualitative descriptive study with the type of library research. The results of this study include personal and professional aspects. The code of ethics of teachers in Islamic education proposed by Muhammad Athiyah al-Abrasyi includes: 1. The code of ethics of teachers relating to themselves; a. Be zuhud, b. Clean from sin and reprehensible qualities. 2. The teacher's code of ethics relating to students and fellow teachers; a. Be wise and firm, b. Forgiving and patient, c. Having dignity and self-esteem, d. Loving students is like loving their own children, e. Knowing students' habits. 3. Code of ethics for teachers related to their duties; a. Sincere at work, b. Mastering the field of study, c. Be able to create active communication between educators and students.
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Krishna, Lalit Kumar Radha, Sumytra Menon i Ravindran Kanesvaran. "Applying the welfare model to at-own-risk discharges". Nursing Ethics 24, nr 5 (16.12.2015): 525–37. http://dx.doi.org/10.1177/0969733015617340.
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“At-own-risk discharges” or “self-discharges” evidences an irretrievable breakdown in the patient–clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician’s duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent to invoke an at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care’s use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient’s decision-making capacity and raises questions as to the patient’s decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient’s welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient’s specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for assessing the validity of at-own-risk discharge requests on a case-by-case basis.
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Elder, Ruth, John Price i Gail Williams. "Differences in Ethical Attitudes Between Registered Nurses and Medical Students". Nursing Ethics 10, nr 2 (marzec 2003): 149–64. http://dx.doi.org/10.1191/0969733003ne590oa.
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In this study we compared the ethical attitudes of a group of experienced, predominantly female, registered nurses (n = 67) with those of a group of final year, mixed sex, medical students (n = 125). The purpose was to determine the basis of differences in attitudes that could lead to ethical disagreements between these two groups when they came to work together. A questionnaire developed to explore ethical attitudes was administered and the responses of the two groups were compared using t-tests. Because of the preponderance of females among the nurses an analysis of variance of the gender-adjusted scores for each group was also carried out. On comparing the responses, the nurses differed significantly from the medical students in a number of ethical domains. A potential source of conflict between these two groups is that the nurses were inclined to adopt the perspective of patients but the medical students identified with their profession. When corrected for the effects of gender, the differences persisted, indicating that it was discipline that determined the differences. We recommend that students of nursing and medicine receive ethics education together, and that more open dialogue between doctors and nurses with respect to their different ethical viewpoints is needed in the work setting. This article will be of interest to educators of students of medicine and nursing, as well as to doctors and nurses who are eager to improve their professional relations and thereby improve patient care.
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Wlodarczyk, Dorota, i Magdalena Lazarewicz. "Frequency and burden with ethical conflicts and burnout in nurses". Nursing Ethics 18, nr 6 (5.10.2011): 847–61. http://dx.doi.org/10.1177/0969733011408053.
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Many studies examine a stressors-professional burnout (PB) relation, but only few consider the role of ethical conflicts (ECs) in this context. The aim of this study was to characterize ECs' frequency and level of burden with them among nurses and to establish the relations between ECs' frequency, burden and PB. One hundred nurses participated in this study. ECs' frequency and burden were tested with an originally developed questionnaire. PB was examined with Maslach Burnout Inventory. Most frequent ECs concerned a nurse-patient relationship. PB was positively related to ECs' frequency ( r = .54; p = .001) and burden ( r = .22; p = .03). Frequency of specific conflict did not imply burden with it and vice versa. ECs' frequency seems more important for PB than a level of burden with them. The most frequent and the most burdening conflicts may lead to development of PB but the less frequent and less burdening ones are also dangerous.
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Strauss, Ronald P., John A. Van Aalst, Lynn Fox, Margot Stein, Michael Moses i Cynthia H. Cassell. "Flood, Disaster, and Turmoil: Social Issues in Cleft and Craniofacial Care and Crisis Relief". Cleft Palate-Craniofacial Journal 48, nr 6 (listopad 2011): 750–56. http://dx.doi.org/10.1597/09-255.
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Objective To examine social issues in the conduct of cleft and craniofacial care through relief programs in disrupted crisis contexts. Method Social, health policy, and ethical analyses. Results At best, craniofacial team care is multidisciplinary, coordinated, and sustained, requiring a long-term relationship between team members, patients, and families. Disasters and societal turmoil interrupt such relationships, causing craniofacial care to become a secondary concern. Providing craniofacial team care in a crisis setting requires rebuilding disrupted coordination and communication. Crisis relief care involves a complex set of expectations and responsibilities and raises issues such as (1) quality assurance, infection control, appropriate standards of care, and follow-up care/continuity; (2) equity of access to services and clinical ethics in the context of war and/or deprivation; (3) training of visitors in the local nation or site; (4) disciplinary composition of teams, interprofessional communication/rivalry, and credentials of clinicians; (5) ownership of the site and local visitor relations; (6) fundraising and marketing strategies; and (7) ethical issues in the doctor-patient relationship. Conclusions Specific ethical standards for international cleft and craniofacial care delivery also apply to domestic and global crisis relief contexts. Guidance on issues related to professional experience, informed consent, and continuity of care will help care providers address social and ethical issues raised in crisis relief programs. This paper proposes that the Position Paper of the American Cleft Palate-Craniofacial Association (ACPA) on International Treatment Programs should be used as a template to develop and disseminate a set of standards that apply to crisis relief.
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Sitepu, Febrina Lorence. "Legal Review Doctor’s Professional Liability Insurance To Patients". Journal of Law Science 2, nr 1 (30.01.2020): 34–42. http://dx.doi.org/10.35335/jls.v2i1.1613.
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The cause of disputes that occur between patients and doctors is often due to an alleged medical malpractice carried out by doctors in carrying out their duties as providers of health services to patients, and resulting in losses for patients. Through professional liability insurance, doctors can transfer all risks of a patient's lawsuit against him to the insurer by paying a certain premium, and the insurer provides compensation to the patient who filed the lawsuit. As for the problem in this thesis is how the professional obligations of doctors in providing services to patients and the possibility of malpractice as the basis for the existence of medical professional liability insurance,The research method used in the preparation of this thesis is the normative juridical method. The normative juridical research method is used in this study to conduct searches on legal norms, as well as to obtain data and information contained in various literatures in libraries, research journals, newspapers, magazines, internet sites and so on. Doctors' professional obligations in providing services to patients are regulated in the Indonesian Medical Code of Ethics (KODEKI) and Law No. 29 of 2004 concerning Medical Practice. Broadly speaking, the doctor's professional obligations to the patient are: protecting the life of human beings, being sincere and using all their knowledge and skills for the benefit of the patient, keeping everything he knows about a patient even after the patient dies, performing emergency assistance as a duty. humanity, as well as increase knowledge and follow the development of medical science or dentistry. Medical malpractice is a doctor's behavior that is not right, which violates morals and laws. This malpractice occurs due to negligence in carrying out the practice of the medical profession. Legal liability insurance arises in connection with legal aspects in society where it is possible to sue other parties as individuals or business entities for careless actions or negligence. Arrangements for legal relations between doctors and insurance companies are specifically regulated in insurance policies. The policy is used as evidence that there has been an insurance agreement between the insurer (insurance company) and the insured (doctor). In addition, the regulation of legal relations between doctors and insurance companies is also regulated in the Commercial Code, the Civil Code, and Law no. 23 of 1992. The forms of risk that can be transferred by the doctor as the insured with the insurance company as the insurer are: bodily injury to the patient caused by the actions of the insured that occur in the area of ??coverage during the validity of the policy, actions taken by authorized health workers who are not doctors or doctors teeth that help the insured, events that result in loss and claims from patients, professional liability insurance only applies to compensation for losses that are determined to be located in the country of address of the insured party. So there are several ways to settle disputes over these claims, namely: through peaceful means, through arbitration institutions, through court processes. bodily injury to the patient caused by the actions of the insured that occurred in the coverage area during the validity of the policy, actions taken by authorized health workers who were not doctors or dentists who assisted the insured, events that resulted in losses and claims from patients, liability insurance the medical profession only applies to compensation for losses that are determined to be located in the country of address of the insured party. So there are several ways to settle disputes over these claims, namely: through peaceful means, through arbitration institutions, through court processes. bodily injury to the patient caused by the actions of the insured that occurred in the coverage area during the validity of the policy, actions taken by authorized health workers who were not doctors or dentists who assisted the insured, events that resulted in losses and claims from patients, liability insurance the medical profession only applies to compensation for losses that are determined to be located in the country of address of the insured party. So there are several ways to settle disputes over these claims, namely: through peaceful means, through arbitration institutions, through court processes. events that result in losses and claims from patients, medical professional liability insurance only applies to compensation for losses that are determined to be located in the country of address of the insured party. So there are several ways to settle disputes over these claims, namely: through peaceful means, through arbitration institutions, through court processes. events that result in losses and claims from patients, medical professional liability insurance only applies to compensation for losses that are determined to be located in the country of address of the insured party. So there are several ways to settle disputes over these claims, namely: through peaceful means, through arbitration institutions, through court processes. Based on these explanations and conclusions, the author suggests that professionals should take professional legal liability insurance, especially for doctors to take medical professional liability insurance. It is recommended that efforts to introduce medical professional liability insurance products be increased to protect patients and doctors in the event of medical malpractice. The amount of premium should be adjusted to the condition of doctors and patients in Indonesia. In accordance with the development and progress of the medical profession, the Government should immediately stipulate a provision regarding the medical professional standard.
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Sanderson, Christine, Linda Sheahan, Slavica Kochovska, Tim Luckett, Deborah Parker, Phyllis Butow i Meera Agar. "Re-defining moral distress: A systematic review and critical re-appraisal of the argument-based bioethics literature". Clinical Ethics 14, nr 4 (7.11.2019): 195–210. http://dx.doi.org/10.1177/1477750919886088.
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The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation.
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Choi, Woosok. "Understanding the Complementary Relation between Duty Ethics and Virtue Ethics for Medical Practitioners*". Korean Journal of Medical Ethics 23, nr 1 (marzec 2020): 39–56. http://dx.doi.org/10.35301/ksme.2020.23.1.39.
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This paper examines the ethics of medical professionals and argues that both duty ethics and virtue ethics are required of them. It is argued that Aristotle’s virtue ethics, which emphasizes practical excellence, does not conflict with Kant’s duty ethics, which holds that ethical conduct is justified on the basis of universal rules; instead, these two approaches to ethics are in fact complementary. The validity of this argument is found in the writings of E. Pellegrino, who believes that medical practitioners are necessarily ethical and that ethical practice is based on two things. First, according to Pellegrino, physicians must respond to the suffering of patients. The reason for this comes from our duty to uphold the dignified right of all human beings to be respected without exception and also from Kant’s categorical imperative, which demands that people be treated as ends-in-themselves rather than simply means to an end. Second, if the dignity of all human beings is important, then the dignity, not only of patients, but also that of medical practitioners, must be upheld. Pellegrino proposes virtue ethics, which requires excellence for the purpose of goodness, as a way of preserving human dignity. Thus, the relationship between physicians and patients should be embodied in the best practical wisdom on the basis of defending universal rules. It is the attitude of the practitioner to respond to the needs of the patient, and this response must be implemented with practical wisdom and respect between the practitioner and the patient. In the end, the professional ethics of Pellegrino is a virtue ethic that embraces duty ethics. According to Pellegrino, a physician’s medical practice is a defense of human dignity and a realization of a better life for individuals and communities. Thus, what is required of medical practitioners is both the categorical imperative and practical wisdom (phron?sis).
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Odozor, Uche S., Helen N. Obilor, Olasupo O. Thompson i Ngozi S. Odozor. "A Rationalist Critique of Sally Gadow’s Relational Nursing Ethics". UJAH: Unizik Journal of Arts and Humanities 22, nr 1 (8.07.2021): 27–54. http://dx.doi.org/10.4314/ujah.v22i1.2.
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The ethic of care proposed by Carol Gilligan in late twentieth century instantly elicited a wide range of adaptations and elaborations in numerous disciplines, under the banner of ‘relational ethics’. Sally Gadow’s ‘relational narrative’ is one of these adaptations. Like Gilligan, Gadow aims to dismantle ethical rationalism or universalism, wherein the foregoing mainstream nursing practice had purportedly focused on applying existing philosophical theories of ethics to all conceivable clinical situations. For Gadow, every moral engagement, such as that between a nursing professional and a patient, comes with inherent unique features that render impotent any attempt at universalisation. Each clinical encounter is rather defined by the ability of the professional to engage the client in an intimate, caring relationship that enables healing to take place. Against this backdrop, this paper argues that the theory of Relational Narrative, particularly as conceptualised and articulated by Sally Gadow, cannot be carried through without making some rationalist assumptions, because professionalism in nursing practice is by definition, a deeply embedded ingredient of rational reflection. Furthermore, nursing professionals can make progress or impact only by having recourse to the code of ethics; also, direct application of Gadow’s theory puts the nurse in a dilemma when it comes to dealing with patients suffering from chronic contagious diseases, such as the Ebola or the coronavirus disease (COVID-19). Finally, juxtaposing Gadow’s work with the ideas of the earlier scholars she criticises unsparingly, the paper found that traces of universalist, rationalist assumptions abound in her thought precisely because of the wealth of influence she has garnered from philosophers and psychologists; influences going as far back as Descartes and Kant, down to Rawls and Kohlberg. The data used for this study came from library and archival materials, as well as from internet resources.
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Sledge, Renata, Dixie Meyer, Max Zubatsky, Katie Heiden-Rootes, Marie Philipneri i Teri Browne. "A Systematic Literature Review of Relational Autonomy in Dialysis Decision Making". Health & Social Work 47, nr 1 (15.12.2021): 53–61. http://dx.doi.org/10.1093/hsw/hlab042.
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Abstract Nephrology interdisciplinary guidelines, professional codes of ethics, principle-based ethical standards, and literature promote patient autonomy and self-determination through shared decision making as ethical practice. Healthcare professionals are accountable for practice that is mindful of the impact of cultural diversity and community on the values and beliefs of the patient, an important part of shared decision making (SDM). Despite previous research regarding dialysis decision making, relational autonomy in chronic kidney disease (CKD) and end-stage kidney disease SDM conversations is not well understood. This systematic literature review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework for identifying peer-reviewed literature on SDM for CKD. The findings were summarized into four broad themes: (1) promoting autonomy is a foundation of medical caring; (2) providers have a responsibility to respond to their asymmetrical social power; (3) autonomy is situated within the context of the patient; and (4) dialogue is a tool that negotiates clinical recommendations and patient goals. The caring practices of promoting autonomy with a dialogical resolution of a conflict acknowledging the interdependence of the parties and the patient’s social–relational situatedness support a perspective of relational autonomy in dialysis decision-making practice and research.
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Jacobs, Gaby. "Patient autonomy in home care: Nurses’ relational practices of responsibility". Nursing Ethics 26, nr 6 (7.05.2018): 1638–53. http://dx.doi.org/10.1177/0969733018772070.
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Background: Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. Aim: To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course (‘learning circle’) for home care nurses, including participant observations and focus groups. The theoretical notion of ‘relational agency’ and the moral concept of ‘practices of responsibility’ were used to conduct a narrative analysis on the nurses’ stories about autonomy. Participants: Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Findings: Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients’ strengths and collaboration with patients and informal caregivers. Discussion: On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. Conclusion: The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.
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Pezdek, Krzysztof, i Robert Dobrowolski. "The Ethical Code of Conduct for Physiotherapists—An Axiological Analysis". International Journal of Environmental Research and Public Health 20, nr 2 (12.01.2023): 1362. http://dx.doi.org/10.3390/ijerph20021362.
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The goal of the article is an axiological analysis of the Ethical Code of Conduct for Physiotherapists. The basic ethical values constituting the axiological basis of physiotherapy are care, professionalism, responsibility, fairness, professional integrity, respect for a patient/client’s dignity and autonomy. Those values have been selected from the theory and practice of physiotherapy, but also from socio-cultural conditions influencing the relations and interdependencies between physiotherapists and other professional groups or society as a whole. Those values can exist as qualities of a subject (a physiotherapist) or as functions realised by them (acting for the welfare of a patient/client, society, profession). Some of the analysed values have been directly enumerated in the Ethical Code of Conduct for Physiotherapists, while others must be deduced from the rules included in this document. The analysed values should be internalised by the physiotherapists during their training and professional practice.
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Menezes, Márcia Mendes, Luciana Colares Maia, Caroline Urias Rocha, Cristina Andrade Sampaio i Simone de Melo Costa. "Ethical Conflicts Experienced by Medical Students". Revista Brasileira de Educação Médica 41, nr 2 (czerwiec 2017): 327–35. http://dx.doi.org/10.1590/1981-52712015v41n2rb20160072.
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ABSTRACT The current study aimed to identify and analyze the prevalence of ethical conflicts experienced by medical students. This study is a cross-sectional and analytical research that was conducted in a public school in the state of Minas Gerais, Brazil. The instrument used for the data collection was a self-administered questionnaire. The data collected were presented in absolute and percentage values. For the analytical statistical treatment of the data, the level of significance was considered p <0.05. The outcome variables were: Experiences of ethical conflicts in interpersonal relations within the medical course and Ethical conduct in health care. The identification of the prevalence of ethical conflicts in the undergraduate program adopted the perspective of different interpersonal relations (academic-teaching, academic-academic, academic-employee, academic-patient, teacher-teacher, teacher-patient, teacher-employee and employee-patient). (Importance of identifying themselves to the health services user and requesting consent to perform the physical examination, assistance without the supervision of the teacher, issuance of health documents without the signature of the professional responsible and use of social networks to share data Of patient). It was verified the association of the outcome variables with sex, year of graduation and course evaluation. A total of 281 undergraduate students enrolled in all undergraduate courses in Medicine of both sexes, with a predominance of female (52.7%). The students reported having experienced conflicting situations in interpersonal relations with teachers (59.6%), provided assistance without proper supervision of a teacher (62.6%), reported having issued health documents without the accompaniment of teachers (18, 5%). The highest frequency was observed among those enrolled in the most advanced years of the undergraduate program (p <0.05). The use of social networks for the purpose of sharing patient data (25.1%) was prevalent in the most advanced years of medical graduation and among those who evaluated the course as regular (p <0.05). It is concluded that undergraduate medical students experienced ethical conflicts during their medical training, with a prevalence of conflicts in the advanced years of the course. From this perspective, it is necessary to provide a space for discussion and collective reflection on the ethical problems experienced by students, during their graduation in Medicine, in order to build a professional ethical practice.
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Gherman, Cristian, Ovidiu Chiroban i Dan Perju-Dumbrava. "THE ETHICS OF THE RELATION BETWEEN THE CONVICTED PATIENT AND THE PHYSICIAN". Medicine and Pharmacy Reports 89, nr 4 (28.10.2016): 474–79. http://dx.doi.org/10.15386/cjmed-628.
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Backgrounds and aims: Approaching the convicted patient is a topical issue in terms of alignment with EU provisions and recommendations, more so in the context of year by year increase in the number of convicts and consequently, prison patients. The prison patient exhibits increased vulnerability in regard to the rest of the convicts due to his/her medical status overlapping personality changes induced, while coping with a new environment. This represents a challenge for the physicians involved in the expertise process, which must act objectively within the limits and by the principles of professional ethics, while confronting a patient influenced by the prison environment.Methods: We studied the existing legal and ethical framework concerning the expertise in view of sentence postponement/interruption on medical grounds and made a comparison between the theoretical information available and the “real life” situations encountered in our experience at the Institute of Legal Medicine Cluj-Napoca. Following this step we tried to establish some principles needed to optimize health care in the penitentiary system by detecting and sanctioning situations of deceptive behavior, doubled or not by simulation and over-simulation.Results: Convicts present pathologies documented in medical records, but accuse new symptoms that could suggest a new pathological condition. During the expertise, convicted patients emphasize their symptoms and/or claim new symptoms unrelated to their documented medical condition. Convicts submit repeated requests for which treatment solutions within the NAP healthcare system had been already formulated.Conclusion: The patient must be properly informed about the steps to be taken and duration expected in performing a legal medicine expertise in pursuit of sentence postponement or interruption for the treatment of a medical condition that cannot be properly addressed within the NAP sanitary system. Information should come from authorized sources. Efforts to determine unauthorized sources (mainly "experienced" detainees with records of unsubstantiated demands) are surely beneficial.
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Waisel, David B., Giulia Lamiani, Norma J. Sandrock, Robert Pascucci, Robert D. Truog i Elaine C. Meyer. "Anesthesiology Trainees Face Ethical, Practical, and Relational Challenges in Obtaining Informed Consent". Anesthesiology 110, nr 3 (1.03.2009): 480–86. http://dx.doi.org/10.1097/aln.0b013e318197ff46.
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Background Categorizing difficulties anesthesiologists have in obtaining informed consent may influence education, performance, and research. This study investigated the trainees' perspectives and educational needs through a qualitative analysis of narratives. Methods The Program to Enhance Relational and Communication Skills-Anesthesia used professional actors to teach communication skills and relational abilities associated with informed consent. Before attending the program, participants wrote about a challenging informed consent experience. Narratives were analyzed by two researchers following the principles of grounded theory. The researchers independently read the narratives and marked key words and phrases to identify reoccurring challenges described by anesthesiologists. Through rereading of the narratives and discussion, the two researchers reached consensus on the challenges that arose and calculated their frequency. Results Analysis of the 39 narratives led to the identification of three types of challenges facing anesthesiologists in obtaining informed consent. Ethical challenges included patient wishes not honored, conflict between patient and family wishes and medical judgment, patient decision-making capacity, and upholding professional standards. Practical challenges included the amount of information to provide, communication barriers, and time limitations. Relational challenges included questions about trainee competence, mistrust associated with previous negative experiences, and misunderstandings between physician and patient or family. Conclusions The ethical, practical, and relational challenges in obtaining informed consent colored trainees' views of patient care and affected their interactions with patients. Using participant narratives personalizes education and motivates participants. The richness of narratives may help anesthesiologists to appreciate the qualitative aspects of informed consent.
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Miksa, Joanna. "Transhumanism as a Challenge to the Medical Doctor-Patient Relation". Acta Universitatis Lodziensis. Folia Philosophica. Ethica-Aesthetica-Practica, nr 32 (30.12.2018): 47–69. http://dx.doi.org/10.18778/0208-6107.32.04.
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In this paper I undertake to analyze the way in which the arrival of HETs may influence the therapeutic relationship between the medical doctor and the patient. I begin with presenting he notion of transhumanism, insisting especially on the fact that some of the technologies that can be classified as HETs are already in use. As a result, the traditionally difficult task of defining health and a disease is becoming even more complicated. This circumstance poses the risk that medical doctors in their relationship with the patient, because of the possibilities offered by new technologies, will oscillate in their professional practice between helping the patient to recover and satisfying needs that are not justified by the considerations of health. I will try to show how the therapeutic relationship between the medical doctor and the patient may be transformed because of new technologies by using the example of IVF procedure applied to postmenopausal patients. In order to understand why the relationship between the medical doctors and their patients is so vulnerable in the context of transhumanism, I propose to re-analyze the most basic notions which help us understand the nature of the therapeutic relationship: the status of medicine as contrasted with technology, basic principles of medical ethics, the notion of a disease and an illness.
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Santos, Amanda Larissa Souza dos, Rafaella Ayanne Alves dos Santos, Adriana Maria Pereira da Silva, Jamille Dias Leal i Viviane Euzébia Pereira Santos. "Systematization of nursing care: the kaleidoscope of nurses in a teaching hospital". Revista de Enfermagem UFPE on line 5, nr 7 (12.08.2011): 1613. http://dx.doi.org/10.5205/reuol.1262-12560-1-le.0507201106.
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ABSTRACTObjective: to investigate nurses' knowledge regard to Nursing Care System (EAS). Method: a descriptive study from qualitative data was collected from semi-structured interviews. The sample consisted of 13 nurses from a teaching hospital, located in Petrolina. The study was approved by the Ethics Committee for Studies of Humans and Animals UNIVASF, according to opinion No. 96/2010. The statements were analyzed according to Bardin's Content Analysis. From the analysis of the interviews, categories and subcategories emerged: SAE knowledge, SAE and work organization. Results: nurses interviewed acquired knowledge about the SAE at graduation, where the process of learning nursing theory was not applied in field practice, leading to deficiency in their professional practice. However, most recognized the SAE as an important tool for improving nursing care, which enables the organization of care, autonomy, and professional development. Conclusion: it was realized through research, that nurses understand the importance of NCS and show interest in their applicability, however, cite several factors as obstacles to their use, such as lack of time, the field of theoretical process and extra work. Descriptors: knowledge; nurse-patient relations; nursing care; nursing process. RESUMOObjetivo: investigar o conhecimento dos enfermeiros em relação à Sistematização da Assistência de Enfermagem (SAE). Método: estudo descritivo com abordagem qualitativa cujos dados foram coletados a partir de entrevistas semi-estruturadas. A amostra foi composta por 13 enfermeiros de um Hospital de Ensino, localizado em Petrolina-PE. O estudo foi aprovado pelo Comitê de Ética em Estudos Humanos e Animais da UNIVASF, de acordo com o parecer nº 96/2010. As falas foram analisadas conforme Análise de Conteúdo de Bardin. A partir da análise das entrevistas, emergiram categorias e subcategorias: conhecimento sobre a SAE; SAE e a organização do trabalho. Resultados: os enfermeiros entrevistados adquiriram conhecimento sobre a SAE na graduação, onde o processo de enfermagem aprendido na teoria não era aplicado na prática de campo, acarretando deficiência na sua prática profissional. Porém, a maioria reconheceu a SAE como importante instrumento para melhoria da assistência de enfermagem, que possibilita a organização do cuidado, autonomia e valorização profissional. Conclusão: foi percebido com a pesquisa, que os enfermeiros compreendem a importância da SAE e demonstram interesse na sua aplicabilidade, no entanto, apontam diversos fatores como empecilhos para a sua utilização, tais como falta de tempo, de domínio do processo teórico e a sobrecarga de trabalho. Descritores: conhecimento; relações enfermeiro-paciente; cuidados de enfermagem; processos de enfermagem.RESUMENObjetivo: Investigar el conocimiento de las enfermeras sobre el Sistema de Atención de Enfermería (EAS). Método: Estudio descriptivo, con datos cualitativos se obtuvieron de entrevistas semi-estructuradas. La muestra estuvo constituida por 13 enfermeras de un hospital universitario, situado en Petrolina. El estudio fue aprobado por el Comité de Ética para el Estudio de los seres humanos y animales UNIVASF, de acuerdo a la opinión N º 96/2010. Las declaraciones fueron analizadas según el Análisis de Contenido de Bardin. A partir del análisis de las entrevistas, las categorías y subcategorías surgido: el conocimiento de la SAE, SAE y la organización del trabajo. Resultados: Las enfermeras entrevistadas conocimientos adquiridos acerca de la SAE en la graduación, donde el proceso de aprendizaje de la teoría de enfermería no se aplicó en la práctica de campo, lo que lleva a la deficiencia en su ejercicio profesional. Sin embargo, la mayoría reconoció la SAE como una herramienta importante para mejorar la atención de enfermería, que permite a la organización de la atención, la autonomía y desarrollo profesional. Conclusión: Se realiza a través de la investigación, que las enfermeras comprendan la importancia de la SAE y mostrar interés en su aplicación, sin embargo, citar varios factores como obstáculos para su uso, tales como la falta de tiempo, el campo del proceso teórico y extra trabajo. Descriptores: conocimiento; la relaciones enfermero-paciente; atención de enfermería; proceso de enfermería.
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Fontana, Rosane Teresinha, Mariliane Adriana Monteiro, Cristiana Fick i Francine Zorzo. "Therapeutic process and perspectives about the practice of equine-assisted therapy". Revista de Enfermagem UFPE on line 4, nr 2 (31.03.2010): 757. http://dx.doi.org/10.5205/reuol.936-7326-1-le.0402201038.
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ABSTRACTObjective: to identify the perspectives of therapists before the therapeutic process and their views about the practice of equine-assisted therapy. Methodology: exploratory study from qualitative approach, performed in a Therapeutic Center, where are therapists health and educations professionals and volunteers of Psychology, Nursing, Education and Physical Education undergraduates. Data collection was performed by a questionnaire with 15 professionals, after the approval by the Ethics Committee of the Regional Integrated University of Alto Uruguai and of Mission/Campus Santo Ângelo/RS (protocol 118-04/PPH/08). Results: data indicate promising prospects for professionals with work, especially because it is a new initiative designed to improve the quality of life for people with disabilities and special needs and to involve personal and professional growth, new learning and challenges to be overcome. Conclusion: we can observe satisfactory involvement of subjects in the therapeutic process with the prospect of exchanging knowledge and building new, and they are key actors in the therapeutic process of the practitioner. It is believed that such initiatives contribute to the promotion of health and creating healthy environments. Descriptors: therapy; patient care team; public health; equine-assisted therapy; delivery of health care; professional-family relations; nursing care.RESUMOObjetivo: identificar as perspectivas dos equoterapeutas diante do processo terapêutico e suas concepções acerca da prática da equoterapia. Metodologia: trata-se de uma pesquisa exploratória, de caráter qualitativo. Foi realizada em um Centro de Equoterapia, onde os equoterapeutas são profissionais de saúde e educação e voluntários dos cursos de Psicologia, Enfermagem, Pedagogia e Educação Física. A coleta de dados deu-se por meio de um questionário, oferecido a 15 profissionais. O projeto foi aprovado pelo Comitê de Ética da Universidade Regional Integrada do Alto Uruguai e das Missões/campus Santo Ângelo/RS, sob protocolo número 118-04/PPH/08. Resultados: os dados apontam perspectivas otimistas dos profissionais com o trabalho desenvolvido, especialmente porque se trata de uma nova iniciativa que pretende melhorar a qualidade de vida de portadores de deficiências e necessidades especiais, envolvem crescimento pessoal e profissional e novas aprendizagens, desafios a serem vencidos. Conclusão: pode-se observar envolvimento satisfatório dos sujeitos com o processo terapêutico com perspectivas de trocas de saberes e da construção de novos e, de que são atores importantes no processo terapêutico do praticante. Acredita-se que iniciativas desta natureza contribuem para a promoção da saúde e para a criação de ambientes saudáveis. Descritores: terapia; equipe de assistência ao paciente; saúde pública; terapia assistida por cavalos; assistência à saúde; relações profissional-família; cuidado de enfermagem.RESUMENObjetivo: identificar las perspectivas de terapeutas acerca del proceso terapéutico de La terapia asistida con caballos y sus puntos de vista acerca de la práctica. Metodología: este es un carácter exploratorio y cualitativo. Se celebró en un Centro de Equitación Terapéutica, donde terapeutas son profesionales de la salud y la educación y los voluntarios de cursos de Psicología, Enfermería, Educación y Educación Física. La recopilación de datos se realizó por medio de un cuestionario aplicado a quince profesionales. El proyecto fue aprobado por el Comité de Ética de la Universidad Regional Integrada del Alto Uruguay y de la Misiónes/ Campus Santo Ângelo/RS, con número de protocolo 118-04/PPH/08. Resultados: datos indican buenas perspectivas para los profesionales con el trabajo, especialmente porque es una nueva iniciativa destinada a mejorar la calidad de vida de las personas con discapacidades y necesidades especiales y la participación de crecimiento personal y profesional, el aprendizaje y nuevos desafíos por superar. Conclusión: se puede observar la participación satisfactoria de los sujetos en el proceso terapéutico con la posibilidad de intercambiar conocimientos y la creación de nuevos, y son actores clave en el proceso terapéutico. Se cree que estas iniciativas contribuyen a la promoción de la salud y la creación de ambientes saludables. Descriptores: terapia; grupo de atención al paciente; la salud pública; terapía asistida por caballos; prestación de atención de salud; relaciones profesional-familia; atención de enfermería.
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Heilman, Mary Kathleen Deutscher, i Tracy J. Trothen. "Conscientious objection and moral distress: a relational ethics case study of MAiD in Canada". Journal of Medical Ethics 46, nr 2 (6.12.2019): 123–27. http://dx.doi.org/10.1136/medethics-2019-105855.
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Conscientious objection has become a divisive topic in recent bioethics publications. Discussion has tended to frame the issue in terms of the rights of the healthcare professional versus the rights of the patient. However, a rights-based approach neglects the relational nature of conscience, and the impact that violating one’s conscience has on the care one provides. Using medical assistance in dying as a case study, we suggest that what has been lacking in the discussion of conscientious objection thus far is a recognition and prioritising of the relational nature of ethical decision-making in healthcare and the negative consequences of moral distress that occur when healthcare professionals find themselves in situations in which they feel they cannot provide what they consider to be excellent care. We propose that policies that respect the relational conscience could benefit our healthcare institutions by minimising the negative impact of moral distress, improving communication among team members and fostering a culture of ethical awareness. Constructive responses to moral distress including relational cultivation of moral resilience are urged.
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Susic, Esta, Ema Nicea Gruber i Blazenka Guberina Korotaj. "Training for Person Centered Medicine in a Forensic Hospital". International Journal of Person Centered Medicine 4, nr 3 (6.03.2015): 189–204. http://dx.doi.org/10.5750/ijpcm.v4i3.481.
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The education and training needed for health professionals performing person centered medicine in a prison hospital is presented. The health professionals involved work in the department for forensic psychiatry of a prison hospital and conduct mandatory psychiatric treatment during a person’s prison sentence using a bio-psycho-social model of treatment and rehabilitation. Such health professionals work with mentally ill people having partially diminished capacity who perpetrated criminal activities and were sentenced according to the Croatian Criminal Code or Criminal Procedures Act and the Law for the Protection of Persons with Mental Illness. Required professional skills include capabilities to provide person-centered psychiatric treatment aimed at reducing psychopathology, articulating theoretical concepts, therapeutic procedures, health professionals' roles and self-understanding, interpersonal issues, relations between patient/prisoner and health professional, ethical dilemmas, and challenges establishing partnerships. Since each patient is also a person serving a prison sentence, the health professional must also know the legislative framework, work as a civil servant, pass the State service examination and be part of a team with different types of other professionals, particularly social workers, occupational therapists, prison officers, court officers, and state officers. For health professionals to practice person centered medicine in a prison setting is a quite demanding and stressful challenge. It may be the hardest way to practice, but it is the right way to do it.
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Victor, Elizabeth, i Laura Guidry-Grimes. "Relational autonomy in action: Rethinking dementia and sexuality in care facilities". Nursing Ethics 26, nr 6 (18.07.2018): 1654–64. http://dx.doi.org/10.1177/0969733018780527.
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Background: Caregivers and administrators in long-term facilities have fragile moral work in caring for residents with dementia. Residents are susceptible to barriers and vulnerabilities associated with the most intimate aspects of their lives, including how they express themselves sexually. The conditions for sexual agency are directly affected by caregivers’ perceptions and attitudes, as well as facility policies. Objective: This article aims to clarify how to approach capacity determinations as it relates to sexual activity, propose how to theorize about patient autonomy in this context, and suggest some considerations for finding an ethically responsible and practically feasible way to respect the sexual rights of this population. Research Design: The focus is on residents with early to moderate dementia in states of daily dependency on professional caregivers. The article critically examines existing empirical research on sexuality among persons with dementia, caregivers’ attitudes, and institutional roadblocks to enabling residents’ sexuality. A relational lens and insights from disability studies are used in the philosophical analysis. Participants and Research Context: No research participants were part of this analysis. Ethical Considerations: This article offers a conceptual analysis and normative framework only. Findings: The analysis highlights the delicate balance that capacity assessments for sexual activity have to strike; while caregivers should protect those who cannot give adequate consent, the denial of sexuality among residents can cause deep, long-ranging harms. Sexual agency features into an ongoing sense of self for many individuals with dementia, and the imposition of inappropriate standards and expectations for sexual autonomy can lead to unwarranted obstacles to sexual activity. Discussion: Recommendations include developing clear and inclusive institutional policies and practices of care, providing education for caregivers on how to discuss and document residents’ sexual preferences over time, and taking advantage of ethics consultation services. Conclusion: This analysis establishes the need for more research and discussion on this sensitive topic. Future research should investigate the specific responsibilities of caregivers in furthering the sexual interests of residents, how exactly to modify existing capacity instruments, and how best to support historically marginalized patients in their sexual identities.
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Mashkova, K. V., M. V. Varlen, S. S. Zenin, A. L. Bartsits i G. N. Suvorov. "Self-Regulation of Relations in Information-Sharing on the Progress and Results of Genetic Studies: Problems of Professional and Ethical Requirements Development". Lex Russica, nr 6 (1.07.2019): 131–42. http://dx.doi.org/10.17803/1729-5920.2019.151.6.131-142.
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The paper deals with the problems of development of professional and ethical requirements in the field of information sharing about the progress and results of genetic research. The author substantiates the conclusion about the need to adopt such requirements at the level of self-regulatory organizations of geneticists These requirements should include the provisions on additional information, providing information about secondary and random test results in specific cases where the potential benefit for the patient is significant, but the additional load on the specialist is not too noticeable. The requirements should contain a list of specific genetic abnormalities and diseases related to random and secondary results of the study and reported regardless of the patient’s will, as well as the procedure and role of all involved parties (specialists and patients) in the process of disclosure of the results of the study.
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Liaw, Siaw-Teng, i Gregory Peterson. "Doctor and pharmacist — back to the apothecary!" Australian Health Review 33, nr 2 (2009): 268. http://dx.doi.org/10.1071/ah090268.
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The Australian National Medicines Policy embodies four tenets: availability, quality, safety and efficacy of medicines; timely access to affordable medicines; quality use of medicines (QUM); and a responsible and viable medicines industry. The promotion of QUM requires a multidisciplinary approach, including contributions from government, the pharmaceutical industry, health professionals, consumers and academia. However, there are significant tensions and unintended effects associated with the multidisciplinary approach, especially with the relationships between prescribers and dispensers of medicines. The general practitioner and the pharmacist share a common ancestor ? the apothecary. The separation of dispensing from prescribing, which began in medieval Europe and 19th century England, reframed and confined the patient?doctor relationship to one of diagnosis, prescription and non-drug management. The role of pharmacists was limited to dispensing, though the present trend is for their responsibilities to be widened. Historical antecedents, the contribution of an increasing number of actors to the costs of health care, universal health insurance and an evolving regulatory framework, are among the factors influencing doctor?pharmacist relations. The prescribing and dispensing of medicines must be guided by an ethical clinical governance structure encompassing health professionals, regulators, the pharmaceutical industry and consumers. There must be close monitoring of safety and effectiveness, and promotion of quality use of medicines and improved patient outcomes. Ongoing training and professional development, within and across professional boundaries, is essential to support harmonious and cost-effective interprofessional practice. The approach must be ?apothecarial? with complementary roles and responsibilities for the prescriber and dispenser within the patient?clinician therapeutic relationship, and not adversarial.
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Perelló-Campaner, Catalina, Antonio González-Trujillo, Carme Alorda-Terrassa, Maite González-Gascúe, Josep Antoni Pérez-Castelló, José Miguel Morales-Asencio i Jesús Molina-Mula. "Determinants of Communication Failure in Intubated Critically Ill Patients: A Qualitative Phenomenological Study from the Perspective of Critical Care Nurses". Healthcare 11, nr 19 (28.09.2023): 2645. http://dx.doi.org/10.3390/healthcare11192645.
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Aim: To explore what factors determine communication with awake intubated critically ill patients from the point of view of critical care nursing professionals. Background: Impaired communication frequently affects mechanically ventilated patients with artificial airways in the intensive care unit. Consequences of communication breaches comprise emotional and ethical aspects as well as clinical safety, affecting both patients and their conversation partners. Identification of determining factors in communication with awake intubated patients is needed to design effective action strategies. Design: A qualitative phenomenological approach was used. Methods: Semi-structured interviews were used as the data collection method. A total of 11 participants from three intensive care units of three Majorcan public hospitals, selected by purposive sampling, were interviewed. Findings: Three major themes regarding the communication determinants of the awake intubated critically ill patients were identified from the interviewees’ statements: factors related to the patient (physical and cognitive functionality to communicate, their relational and communicative style and their personal circumstances), to the context (family presence, ICU characteristics, workload, availability/adequacy of communication aids, features of the messages and communication situations) and, finally, those related to the professionals themselves (professional experience and person-centredness). Conclusions: The present study reveals determinants that influence communication with the awake intubated patient, as there are attitudes and professional beliefs. Relevance to clinical practice: The discovery of relations between different kinds of determinants (of patient, context or professionals) provides a multi-factor perspective on the communicative problem which should be considered in the design of new approaches to improve communicative effectiveness. This study is reported according to the COREQ checklist.
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Cybelle Enta do Prado, Luciana Damasceno Ferreira Kanunfre, Alessandra Pinto Feistler i Wellington Zaitter. "Criminal liability in dental practice". RSBO 10, nr 1 (28.03.2014): 96–101. http://dx.doi.org/10.21726/rsbo.v10i1.902.
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The technical and scientific evolution is the greatest advance in dentistry since its regulation with the law 5.081/1966;however it is worth remembering that constant modernization of treatments brings along a proportional increase on the dentist’s responsibilities with his patient. The professional should always keep in mind that along with his hand ability, innovative techniques and the best material applied there is Deontology evaluating three areas: civil, ethical-administrative and criminal. It is the dentist’s obligation to follow and respect the deontological issue in a world where lawsuits against peers have increased exponentially. Objective and Conclusion: The presented study reports the relations in the Brazilian penal code concerning to criminal responsibility of the health professionals, analyzing the dental behaviors which, once applied, configure criminal types, �ecting the agent to the prosecution and trial of criminal justice. A little known subject hardly ever discussed in dentistry.
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Facey, Marcia, Nancy Baxter, Melanie Hammond Mobilio, Elizabeth Peter, Carol-anne Moulton i Elise Paradis. "Surgical safety checklist compliance process as a moral hazard: An institutional ethnography". PLOS ONE 19, nr 2 (26.02.2024): e0298224. http://dx.doi.org/10.1371/journal.pone.0298224.
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Background Charting is an essential component of professional nursing practice and is arguably a key element of patient safety in surgery: without proper, objective, and timely documentation, both benign and tragical errors can occur. From surgery on wrong patients to wrong limbs, to the omission of antibiotics administration, many harms can happen in the operating room. Documentation has thus served as a safeguard for patient safety, professional responsibility, and professional accountability. In this context, we were puzzled by the practices we observed with respect to charting compliance with the surgical safety checklist (SSC) during a study of surgical teams in a large, urban teaching hospital in Canada (pseudonym ‘C&C’). Methods This article leverages institutional ethnography and a subset of data from a larger study to describe and explain the social organisation of the system that monitored surgical safety compliance at C&C from the standpoint of operating room nurses. This data included fieldnotes from observations of 51 surgical cases, on-the-spot interviews with nurses, formal interviews with individuals who were involved in the design and implementation of the SSC, and open-ended questions from two rounds of survey of OR teams. Findings We found that the compliance form and not the SSC itself formed the basis for reporting. To meet hospital accuracy in charting goals and legislated compliance documentation reporting requirements nurses ‘pre-charted’ compliance with the surgical checklist. The adoption of this workaround technically violated nursing charting principles and put them in ethically untenable positions. Conclusions Documenting compliance of the SSC constituted a moral hazard, constrained nurses’ autonomy and moral agency, and obscured poor checklist adherence. The findings highlight how local and extra local texts, technologies and relations create ethical issues, raise questions about the effectiveness of resulting data for decision-making and contribute to ongoing conversations about nursing workarounds.
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Betan, Abubakar, Musiana Musiana, Sinta Wisma Sari, Efendi Efendi, Badaruddin Badaruddin, M. Khalid Fredy Saputra i Andi Arfah. "Description of JKN Patient Satisfaction with the Quality of Dental Health Services in Hospitals". International Journal of Health Sciences 1, nr 1 (30.03.2023): 26–29. http://dx.doi.org/10.59585/ijhs.v1i1.48.
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The National Health Insurance (JKN) with a pre-payment financing system, which uses a capitation system for primary health services including dental and oral health services. The implementation of JKN also requires increased access and quality of health services, both at the First Level Health Facility and Advanced Health Facilities. The implementation of JKN requires support from promotive and preventive public health efforts so that the community remains healthy and does not get sick easily, and is useful in helping to control the burden of the necessary state budget. First-level health facilities that play a role in providing promotive and preventive health services are important, one of which is the Community Health Center or Puskesmas.
The purpose of this study was to determine the description of JKN patient satisfaction with the quality of dental health services. The type of research used is a literature study with the method of collecting library data, reading and recording, and processing materials. The data used comes from textbooks, journals, scientific articles, literature reviews which contain an overview of JKN Patient Satisfaction with the Quality of Dental Health Services at the Hospital.
National Health Insurance patient satisfaction in receiving this service is divided based on 5 SERVQUAL dimensions, namely tangibility, reliability, assurance, responsiveness and four. The quality of health services is health services that can satisfy every user of health services in accordance with the average satisfaction level of the population and its implementation in accordance with professional standards and ethical codes.
Conclusion: The level of patient satisfaction with health services based on reliability (Reliability), responsiveness (Responsivines), Assurance (Assurance), direct evidence (Tangiable), human relations (Empaty) is a very satisfied category.
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Hoffman, Sharona. "Physicians and Cognitive Decline: A Challenge for State Medical Boards". Journal of Medical Regulation 108, nr 2 (1.07.2022): 19–28. http://dx.doi.org/10.30770/2572-1852-108.2.19.
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ABSTRACT Older physicians benefit from their many years of experience and the skills they have developed over decades of practice. At the same time, they may be at risk of cognitive decline, which raises concerns about job performance deficits. The question that this article addresses is whether state medical boards have a role to play in identifying clinicians with cognitive decline. It discusses what state medical boards currently do in this regard and analyzes whether they should do more. It also discusses relevant legal constraints and ethical obligations. The article ultimately concludes that state medical boards would be wise to adopt late career screening programs that are carefully designed to balance the interest of clinicians and patient safety. Such programs could be implemented only after experts determine which preliminary tests and more comprehensive follow-up tests can best identify job-related cognitive impairment and at what age the testing program should commence. Any testing program would have to include due process protections, efforts to provide reasonable accommodations to facilitate job performance, and a public relations campaign to build support among clinicians and professional organizations. Although the article focuses on state medical boards, its analysis and recommendation are relevant to all state licensing boards that oversee health care providers.
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Gray, Ben, Jo Hilder i Maria Stubbe. "How to use interpreters in general practice: the development of a New Zealand toolkit". Journal of Primary Health Care 4, nr 1 (2012): 52. http://dx.doi.org/10.1071/hc12052.
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BACKGROUND AND CONTEXT: New Zealand is becoming more ethnically diverse, with more limited English proficiency (LEP) people. Consequently there are more primary care consultations where patients have insufficient English to communicate adequately. Because effective communication is essential for good care, interpreters are needed in such cases. ASSESSMENT OF PROBLEM: The literature on the use of interpreters in health care includes the benefits of using both trained interpreters (accuracy, confidentiality, ethical behaviour) and untrained interpreters (continuity, trust, patient resistance to interpreter). There is little research on the actual pattern of use of interpreters. RESULTS: Our research documented a low use of trained interpreters, despite knowledge of the risks of untrained interpreters and a significant use of untrained interpreters where clinicians felt that the communication was acceptable. A review of currently available guidelines and toolkits showed that most insist on always using a trained interpreter, without addressing the cost or availability. None were suitable for direct use in New Zealand general practice. STRATEGIES FOR IMPROVEMENT: We produced a toolkit consisting of flowcharts, scenarios and information boxes to guide New Zealand practices through the structure, processes and outcomes of their practice to improve communication with LEP patients. This paper describes this toolkit and the links to the evidence, and argues that every consultation with LEP patients requires clinical judgement as to the type of interpreting needed. LESSONS: Primary care practitioners need understanding about when trained interpreters are required. KEYWORDS: Communication barriers; primary health care; New Zealand; quality of health care; professionalpatient relations; cultural competency
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Kaur, Amanpreet, Mahendra P. Sharma i Santosh K. Chaturvedi. "Psychological Well-Being amongst Cancer Palliative Care Professionals working in Bengaluru, India". Indian Journal of Palliative Care 28 (20.01.2022): 37–42. http://dx.doi.org/10.25259/ijpc_115_21.
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Objectives: Increased levels of psychological distress and burnout in cancer palliative care professionals have implications on their psychological well-being, quality of patient care they provide and for their employing organisations. There is a dearth of studies on psychological well-being with no published study available on psychological well-being amongst cancer palliative care professionals in India. The aim of the present study was to assess psychological well-being amongst cancer palliative care professionals. Materials and Methods: The study was cross-sectional and quantitative which was carried out at four cancer palliative care centers (one hospice and three hospitals) in Bengaluru city of India. The tools sociodemographic and professional datasheet and psychological well-being (PWB-20) scale were administered with 65 participants (Mean Age = 32.5, SD = 11.78). Purposive sampling method was used to recruit the participants working full-time at respective centers after obtaining permissions and ethical approvals. Descriptive, correlational, and inferential analysis of the quantitative data was carried out based on normality of the distribution. Results: The results revealed above average levels of self-acceptance and engagement and growth, below average levels of mastery and competence, while average levels of positive relations and PWB (total score). Significant differences in PWB domains based on age (P < 0.05) and self-care practices (P < 0.05) were seen. Sense of engagement and growth was found to be positively correlated with age and income earned per month (P = 0.01). Conclusion: Findings from the present study suggest that cancer palliative care professionals had moderate levels of PWB with implications in training and future research.
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Popova, Olga. "Medical-genetic counseling within the system of social factors: problems and search for solutions". Политика и Общество, nr 2 (luty 2021): 29–39. http://dx.doi.org/10.7256/2454-0684.2021.2.36738.
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The subject of this research is ethical, socio-psychological, and legal problems arising in the process of medical-genetic counseling. It is demonstrated that medical-genetic counseling forms in the context of intertwinement of different social factors, and is a complex communicative process that involves scientists, medical doctors, patients, and their relatives in various forms of relationships. It is associated with myths and biases, as well as personal attitudes that distort the information about the diagnosis. It also transforms in the course of technological development. Description is given to the difficulties faced by the geneticist that affect the counseling process. The article demonstrates the peculiarities of family psychodynamics that determine the way of perception of genetic information. It is also indicated that genetic testing is aimed not only at personality of the patient, but may touch upon a wide range of relations: with relatives and friends, employers, and other interested parties. At the same time, the distribution of information on the risks of the disease may instigate discrimination against a person, stigmatization and elimination of a number of social opportunities, namely related to their professional activity. Genetic information pertains not only to physicality of an individual, but also to social body; affect the interests of the family and people living in a certain territory; bearers of common genetic information; as well as employers, insurers, etc. The conclusion is made that the process of genetic counseling based on the basic bioethical principles of autonomy, benevolence, justice, and informed consent requires additional interpretation. Based on consideration of incident A. Jolie and ethical analysis of the possibility of polygenic embryonic screening, the author reveals the peculiarities of perception of genetic information and its personal interpretation, which cause realization of the new types of responsibility in the process of genetic counseling, where the geneticist deals not with the establishment of diagnosis (fact), but with the likelihood of development of a particular pathology (prognosis).
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Booth, Andrew. "Nursing Professionals Use and Value Information but Favour Work-based Sources and Colleagues in Preference to Libraries". Evidence Based Library and Information Practice 2, nr 4 (7.12.2007): 92. http://dx.doi.org/10.18438/b8p01b.
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A review of:
Urquhart, C., and R. Davies. ”EVINCE: The Value of Information in Developing Nursing Knowledge and Competence.” Health Libraries Review 14.2 (1997): 61-72.
Objective – To examine the impact of information on the clinical knowledge and practice of nurses, midwives and health visitors.
Design – Two surveys: a one-page critical incident questionnaire survey sent weekly over four weeks, and a questionnaire attached to information requests and searches, followed up by interviews.
Setting – UK health information providers serving nurses (national information providers, National Health Service trust libraries, higher education funded library and information services, and a health promotion library).
Subjects – A random sample of 210 nurses, midwives and health visitors were targeted in the critical incident survey, and 776 of those requesting information or searches at participating library and information centres received questionnaires for the second survey.
Methods – Opinion leaders were consulted to inform a pilot study. A critical incident type questionnaire survey was then administered to a random sample of 210 nurses, midwives and health visitors. The same one-page questionnaire was sent weekly (for four weeks) to 10% of a randomly selected sample of staff at each site. Staff were asked to identify one occasion during that week when they needed information, the purpose of the information needed, the sources chosen to answer the query and how successful the quest was. The impact of the information provided by the library and information services on present and future professional practice was examined through a complementary survey. Responses were coded using three categories of competence: assessment, monitoring of care and evaluation of care. Follow-up interviews then explored the nature of the incident described or the quality of information provided.
Main results – The response rate for the critical incident survey was 52% (434 out of 840 completed questionnaires returned) with 78% (163/210) of participants replying at least once. The total response rate for the second survey was 40% (311/776). Ninety percent of respondents stated that the information they obtained from the library or information service added to their knowledge, and 86% had been able to use some information immediately. Sixty-one percent reported that information had refreshed their memory, and 75% agreed that information substantiated what they had known or suspected. Seventy-six percent of respondents agreed that they needed to obtain more information on the topic, while 23% had expected to find something else. Eighty-eight percent of respondents indicated that they would share the information with colleagues. Ninety-six percent of respondents agreed that the information obtained would contribute to future practice. Seventy percent felt that the information would or did help in evaluation of practice outcomes, 68% for improved quality of life for patient and/or family and 61% in interpersonal relations with clients/patients. Other majority responses were for Audit or standards of care (57%), Monitoring of care (56%) and Legal or ethical issues (51%). Base or ward sources were used in 72% of patient care related incidents and colleagues in 56% of these incidents. Of 148 incidents involving use of a library, the primary purposes were personal updating (62%), coursework (54%), patient care – specific drug or therapy (44%), and teaching staff, students or colleagues (39%).
Conclusion – The findings demonstrate the value of information to nursing professionals while acknowledging that the library is not necessarily a principal source of such information. Ward-based resources and information from colleagues continue to play a dominant part in information use. Rather than reducing uncertainty, the value of information may lie in encouraging uncertainty and reflective practice. Information professionals must seek a greater understanding of situations and methods of presentation by which they might encourage reflective practice.
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Dvornikov, AS, OV Minkina, EG Grebenshchikova, EV Vvedenskaya i IS Mylnikova. "Physician-patient relationship in dermatology: specificity of ethical issues". Медицинская этика, nr 2022(1) (maj 2022). http://dx.doi.org/10.24075/medet.2022.037.
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The article deals with ethical aspects of physician-patient relationship in dermatology, and demonstrates their influence on success of diagnostic and treatment activities and level of satisfaction with quality of medical services. Special attention is paid to the specific nature of bioethical issues in dermatology, associated with visuality and peculiarities of the course of disease, emotional and physiological background and coexisting disorders. Special priority is given to effective strategies of physician-patient communication, respect for patient autonomy and protection of confidentiality both in clinical practice, and on the Internet. It is shown that linking personal and strategic social media accounts raises a number of ethical and legal issues, associated with obtaining voluntary informed consent, compliance with standards of corporate ethics, and perception of medical information by non-professional audience. In conclusion, compliance with principles and rules of biomedical ethics is important to set constructive relations in clinical dermatological practice, ensure social trust in medicine and prepare future specialists. It is also important to discuss ethical issues in a professional community, slowly forming an interdisciplinary space of communication between physicians, health officials, specialists in bioethics, medical law, psychology and sociology of medicine.
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Pedro, Eva Neri Rubim, Fernanda Beheregaray Cabral, Juliana Silveira Colomé, Marta Cocco, Rafael Marcelo Soder i Maria da Graça Oliveira Crossetti. "Ethics of care in public health educative actions - a literature review". Online Brazilian Journal of Nursing 5, nr 1 (22.04.2006). http://dx.doi.org/10.17665/1676-4285.2006112.
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This paper analyses ethical aspects of care within the context of public health educative actions by highlighting the practice of nursing professionals from reflections and inquiries regarding the ethical dimension of care. The ethical relations of care imply human relationships and, consequently, complex relations. Therefore, it is necessary that each subject be respected and welcome according to his/her needs what requires the construction of ties, between the professional and the patient, regulated by ethics and respect. Finally, it is pointed out that ethics in nursing pervades a holistic view of the human being what allows the nurse to recognize his/her competences and responsibilities with the patients. It is up to these professionals to take over their commitment as health educators within this process of social reconstruction by struggling for the fulfillment of public health policies and by overcoming the assistance practice and by rescuing the quality in the attendance of the population by means of competent, responsible and humanized nursing care.
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Andrade, Guilherme de Souza Almeida, Gustavo Pires Alves, Tauá Alves Melo, Vitória Amaro dos Santos i Adailson Henrique Miranda de Oliveira. "Ethical reasoning in medical decisions: the physician-patient dilemma". Revista Bioética 32 (2024). http://dx.doi.org/10.1590/1983-803420243658en.
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Abstract Ethics is essential to ensure responsible medical practice, committed to the well-being of patients and society. Hence, understanding patient autonomy and their active participation in decisions about treatments and medical procedures is paramount. A systematic literature review was conducted on articles published between December 2008 and May 2023 to assist in the ethical debate and professional conduct about what should be considered in a conflict between the medical decision and the patient’s wishes, and thus provide perspectives on how to manage this issue. The 18 articles selected address ethical issues related to physician-patient relations, highlighting the importance of advance directives, honest communication and respect for patient autonomy. We aim to provide perspectives and guidelines for managing ethical conflicts in medical practice.
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Baptista, Marina Kelly Santos, Regina Maria dos Santos, Sebastião Junior Henrique Duarte, Isabel Comassetto i Maria Cristina Soares Figueiredo Trezza. "The patient and the relation between power-knowledge and care by nursing professionals". Escola Anna Nery 21, nr 4 (7.08.2017). http://dx.doi.org/10.1590/2177-9465-ean-2017-0064.
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Abstract This is a study whose objective was to analyze, in the discourse of hospitalized patients, how the power of knowledge is revealed in Nursing care relations. It was developed in the qualitative perspective, having as theoretical reference the concept of power issued by Michel Foucault. The data were collected between August and December 2015 and the participants were 16 patients hospitalized in the medical and surgical clinics of a university hospital, who had the speech recorded through a semi-structured interview, after approval of the ethics committee under Opinion No. 1189934. In order to analyze the data we used the system of differentiations developed by Foucault. The results showed that the professionals exert power by the highly specialized professional knowledge and that they know what they do, so they send and control the accomplishment of the care, leading the patient to submission. It concludes that the exercise of the power to care must be based on the observance of ethical and bioethical principles.
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Barbosa, Maria Helena, Daniela Rosa Floriano, Karoline Faria de Oliveira, Kleiton Gonçalves do Nascimento i Lúcia Aparecida Ferreira. "PATIENT SAFETY CLIMATE AT A PRIVATE HOSPITAL". Texto & Contexto - Enfermagem 25, nr 3 (2016). http://dx.doi.org/10.1590/0104-07072016001460015.
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ABSTRACT Evaluate the patient safety climate from the perspective of the health team members at a medium-sized private hospital in a city in the state of Minas Gerais, Brazil and check for relations between the sociodemographic variables and the safety climate scores. This is a descriptive, exploratory and correlational study, conducted with 123 health professionals, with approval from the Research Ethics Committee. Data were collected using the Safety Attitudes Questionnaire. For analysis, we used Student's t-test, analysis of variance and Spearman's correlation (α = 0.05). The general score on the instrument was 67.50. The best domain score was found for job satisfaction (82.79) and the lowest for perceived management (58.90) and working conditions (59.58). No differences were found between the sexes, education level, presence of other employment or professional activities. The safety climate scores observed were lower than the scores recommended in the literature.
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Unger, Jean-Pierre, Ingrid Morales, Pierre De Paepe i Michel Roland. "Integrating clinical and public health knowledge in support of joint medical practice". BMC Health Services Research 20, S2 (grudzień 2020). http://dx.doi.org/10.1186/s12913-020-05886-z.
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Abstract Background Strong relations between medicine and public health have long been advocated. Today, professional medical practice assumes joint clinical/public health objectives: GPs are expected to practice community medicine; Hospital specialists can be involved in disease control and health service organisation; Doctors can teach, coach, evaluate, and coordinate care; Clinicians should interpret protocols with reference to clinical epidemiology. Public health physicians should tailor preventive medicine to individual health risks. This paper is targeted at those practitioners and academics responsible for their teams’ professionalism and the accessibility of care, where the authors argue in favour of the epistemological integration of clinical medicine and public health. Main text Based on empirical evidence the authors revisit the epistemological border of clinical and public health knowledge to support joint practice. From action-research and cognitive psychology, we derive clinical/public health knowledge categories that require different transmission and discovery techniques. The knowledge needed to support the universal human right to access professional care bridges both clinical and public health concepts, and summons professional ethics to validate medical decisions. To provide a rational framework for teaching and research, we propose the following categories: ‘Know-how/practice techniques’, corresponding a.o. to behavioural, communication, and manual skills; ‘Procedural knowledge’ to choose and apply procedures that meet explicit quality criteria; ‘Practical knowledge’ to design new procedures and inform the design of established procedures in new contexts; and Theoretical knowledge teaches the reasoning and theory of knowledge and the laws of existence and functioning of reality to validate clinical and public health procedures. Even though medical interventions benefit from science, they are, in essence, professional: science cannot standardise eco-biopsychosocial decisions; doctor-patient negotiations; emotional intelligence; manual and behavioural skills; and resolution of ethical conflicts. Conclusion Because the quality of care utilises the professionals’ skill-base but is also affected by their intangible motivations, health systems should individually tailor continuing medical education and treat collective knowledge management as a priority. Teamwork and coaching by those with more experience provide such opportunities. In the future, physicians and health professionals could jointly develop clinical/public health integrated knowledge. To this end, governments should make provision to finance non-clinical activities.
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Serrano-Zamago, Ana-Beatriz, i Myriam M. Altamirano-Bustamante. "Appealing to Tacit Knowledge and Axiology to Enhance Medical Practice in the COVID-19 Pandemic: A Systematic Review and Hermeneutic Bioethical Analysis". Frontiers in Public Health 9 (8.12.2021). http://dx.doi.org/10.3389/fpubh.2021.686773.
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Background: The pressure of coronavirus disease 2019 (COVID-19) pandemic, epidemiological and demographic changes, personnel-patient relationship in healthcare, and the development of biotechnologies do not go unnoticed by the healthcare professional. Changes are so wide and at a high rate that guidelines and mere scientific knowledge, which are represented by evidence-based medicine, are not sufficient to lead actions, thus the experiential aspects in the configuration of an ethos present as a fundamental part of the resources to deal with critical scenarios, such as a pandemic. In this regard, the recognition of tacit knowledge as a way of teaching and learning skills related to ethical aspects such as principles, virtues, and values, revealed as a fundamental part of the clinical field. The challenge is to strengthen binomial evidence-based medicine and values-based in order to achieve excellence in the health care of the patients and the well-being of the clinical personnel.Method: A 2-fold analysis was conducted taking pediatric endocrinology as an example. First, a systematic review was carried out in electronic databases BIREME, PubMed, and PhilPapers following PEO and PRISMA approaches. A total of 132 articles were garnered. After reading their title and abstract, 30 articles were obtained. Quantitative information was arranged in an Excel database according to three themes: ethics, axiology, and tacit knowledge. A quality criterion that meets our research question was assigned to each article and those which had a quality criterion of 3 (9) were taken to carry out the hermeneutic bioethical analysis, which consisted of three stages, namely naïve reading, codification, and interpretation. The results were analyzed in Atlas.ti. to elucidate the relations between the three main themes in accordance with the objective.Results: Although there was no difference in the frequency of tacit knowledge skills, including cognitive, social, and technical, for medical practice, there is an intrinsic relationship between epistemic and ethical values with cognitive skills, this means that professionals who practice honesty, authenticity and self-control are capable of seeing patients as persons and thus respect their dignity. This suggested that there is a strong partnership between evidence-based medicine and value-based medicine, which reinforced this binomial as the two feet on which medical practice decisions rested. With regard to tacit knowledge in terms of the context of the COVID-19 pandemic, the challenges refer to (1) adapting and learning a new way of establishing trust with the patient and (2) how to capitalize on the new knowledge that new experiences have posed.Discussion: The analysis of ethical-tacit knowledge in medicine is a recent phenomenon and is in full development. Although no references were found that dealt with any of the main topics in pediatric endocrinology, there is an interest in pediatrics to explore and discuss educational strategies in ethics related to its tacit dimension as a vector of enhancement in the clinical practice. Educational strategies ought to take into consideration the development of skills that promote reflection and discussion of experiences, even more vigorously in the context of the COVID-19 pandemic.