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Автор: Grafiati
Опубліковано: 10 грудня 2022
Оновлено: 28 січня 2023

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Статті в журналах з теми "End of life care ethical issues"

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Walker, Robert M. "Ethical Issues in End-of-Life Care." Cancer Control 6, no. 2 (March 1999): 162–67. http://dx.doi.org/10.1177/107327489900600204.

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Greenberger, Chaya. "Enteral nutrition in end of life care." Nursing Ethics 22, no. 4 (August 4, 2014): 440–51. http://dx.doi.org/10.1177/0969733014538891.

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Анотація:
Providing versus foregoing enteral nutrition is a central issue in end-of-life care, affecting patients, families, nurses, and other health professionals. The aim of this article is to examine Jewish ethical perspectives on nourishing the dying and to analyze their implications for nursing practice, education, and research. Jewish ethics is based on religious law, called Halacha. Many Halachic scholars perceive withholding nourishment in end of life, even enterally, as hastening death. This reflects the divide they perceive between allowing a fatal disease to naturally run its course until an individual’s vitality (life force or viability) is lost versus withholding nourishment for the vitality that still remains. The latter they maintain introduces a new cause of death. Nevertheless, coercing an individual to accept enteral nourishment is generally considered undignified and counterproductive. A minority of Halachic scholars classify withholding enteral nutrition as refraining from prolonging life, permitted under certain circumstances, especially in situations where nutritional problems flow directly from a fatal pathology. In the very final stages of dying, moreover, there is a general consensus that enteral nourishment may be withheld, providing that this reflects the dying individuals’ wishes. In the event of enteral nourishment becoming a source of overwhelming discomfort, two Halachic ethical mandates would come into conflict: sustaining life by providing nourishment and alleviating suffering. As in all moral conflicts, these would have to be resolved in practice. This article presents the issue of enteral nourishment as it unfolds in Halacha in comparison to secular and other religious perspectives. It is meant to serve as a foundation for nurses to reflect on their own practice and to explore the implications for nursing practice, education, and research. In a world that remains broadly religious, it is important to sensitize health practitioners to the similarities and differences among religions and between secular and religious approaches to ethical issues.
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Childress, Sue. "Ethics at the End of Life." Home Health Care Management & Practice 20, no. 5 (December 26, 2007): 414–17. http://dx.doi.org/10.1177/1084822307311829.

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Patients, families, and health care providers all face ethical issues at the end of life. Related to increased technology, decreased resources, and immense cultural diversity, these controversies are a common concern to providers in home care. Increased knowledge and skills related to ethical discussions are crucial tools for providers in home care. Providers'abilities to facilitate these discussions with families and patients at the end of life can ease the transition from aggressive care to hospice care. This article describes basic principles of an ethical discussion and discusses the common ethical dilemmas faced at the end of life.
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Izumi, Shigeko. "Ethical practice in end-of-life care in Japan." Nursing Ethics 17, no. 4 (July 2010): 457–68. http://dx.doi.org/10.1177/0969733010364584.

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Nurses are obliged to provide quality nursing care that meets the ethical standards of their profession. However, clear descriptions of ethical practice are largely missing in the literature. Qualitative research using a phenomenological approach was conducted to explicate ethical nursing practice in Japanese end-of-life care settings and to discover how ethical practices unfold in clinical situations. Two paradigm cases and contrasting narratives of memorable end-of-life care from 32 Japanese nurses were used to reveal four levels of ethical practice: ethical, distressed, uncertain, and unethical. Having the ability to actualize, justify, and recognize what is the good and/or right differentiated between these levels of ethical practice, empirical descriptions of which are given, followed by discussion of how nurses gain the skilled knowledge necessary for ethical practice.
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Kyba, Ferne C. "Legal and ethical issues in end-of-life care." Critical Care Nursing Clinics of North America 14, no. 2 (June 2002): 141–55. http://dx.doi.org/10.1016/s0899-5885(01)00004-1.

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Thorns, Andrew. "Ethical and legal issues in end-of-life care." Clinical Medicine 10, no. 3 (June 2010): 282–85. http://dx.doi.org/10.7861/clinmedicine.10-3-282.

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Matzo, Marianne LaPorte, Deborah Witt Sherman, Paula Nelson-Marten, Anne Rhome, and Marcia Grant. "Ethical and Legal Issues in End-of-Life Care." Journal for Nurses in Staff Development (JNSD) 20, no. 2 (March 2004): 59–66. http://dx.doi.org/10.1097/00124645-200403000-00001.

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Rejnö, Åsa, and Linda Berg. "Strategies for handling ethical problems in end of life care: obstacles and possibilities." Nursing Ethics 22, no. 7 (October 6, 2014): 778–89. http://dx.doi.org/10.1177/0969733014547972.

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Background: In end of life care, ethical problems often come to the fore. Little research is performed on ways or strategies for handling those problems and even less on obstacles to and possibilities of using such strategies. A previous study illuminated stroke team members’ experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. These findings have been further explored in this study. Objective: The aim of the study was to illuminate obstacles and possibilities perceived by stroke team members in using strategies for handling ethical problems when caring for patients afflicted by sudden and unexpected death caused by stroke. Research design: A qualitative method with combined deductive and inductive content analysis was utilized. Participants and research context: Data were collected through individual interviews with 15 stroke team members working in stroke units of two associated county hospitals in western Sweden. Ethical considerations: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. Permission was also obtained from the director of each stroke unit. Findings: All the studied strategies for handling of ethical problems were found to have both obstacles and possibilities. Uncertainty is shown as a major obstacle and unanimity as a possibility in the use of the strategies. The findings also illuminate the value of the concept “the patient’s best interests” as a starting point for the carers’ ethical reasoning. Conclusion: The concept “the patient’s best interests” used as a starting point for ethical reasoning among the carers is not explicitly defined yet, which might make this value difficult to use both as a universal concept and as an argument for decisions. Carers therefore need to strengthen their argumentation and reflect on and use ethically grounded arguments and defined ethical values like dignity in their clinical work and decisions.
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Hernández-Marrero, Pablo, Emília Fradique, and Sandra Martins Pereira. "Palliative care nursing involvement in end-of-life decision-making: Qualitative secondary analysis." Nursing Ethics 26, no. 6 (May 28, 2018): 1680–95. http://dx.doi.org/10.1177/0969733018774610.

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Background: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the “Guide on the decision-making process regarding medical treatment in end-of-life situations” (hereinafter, Guide), aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses’ current end-of-life care practices. Design: Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética (Ethics Research Lab of the Institute of Bioethics) (Ref.04.2015). Ethical procedures are thoroughly described. Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients’ preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses’ involvement and practices in end-of-life decision-making.
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Karnik, Sameera, and Amar Kanekar. "Ethical Issues Surrounding End-of-Life Care: A Narrative Review." Healthcare 4, no. 2 (May 5, 2016): 24. http://dx.doi.org/10.3390/healthcare4020024.

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Більше джерел

Дисертації з теми "End of life care ethical issues"

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Masko, Meganne Kathleen. "Music therapy and spiritual care in end-of-life: ethical and training issues identified by chaplains and music therapists." Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/5021.

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The overarching purpose of this study was to explore the thoughts and attitudes of hospice chaplains and music therapists (MTs) related to the questions, "Is it appropriate for music therapists to provide spiritual care as part of the hospice team," "What kind of training and preparation do music therapists and chaplains think hospice music therapists should have before engaging in spiritual care work," and "What should the content be of spiritual care training for music therapists?" The study used a sequential exploratory qualitative/quantitative mixed methods design utilizing parallel purposive subject samples to examine the research questions. The first phase of the study included semi-structured interviews with eight music therapists and seven chaplains specializing in hospice care. These interviews were designed to collect in-depth information about the research questions. Each interview was recorded, transcribed, and analyzed using open coding within a grounded theory approach. Thematic analysis revealed the prevalence of the categories of "ethics" and "training." Participants discussed issues related to scope of practice, cultural competence, maintaining personal boundaries, educational content, and educational methods. Analysis of the data information also indicated the need to expand the research questions, which were examined with larger participant samples in the second phase of the study. Phase II of the study included the development and implementation of a survey tool to explore the results of Phase I with a larger group of participants. The following questions were used as the basis for the survey tool: 1) How appropriate do chaplains and music therapists feel it is for music therapists to provide spiritual care as part of the hospice team? 2) What is the scope of practice for music therapists with regards to providing spiritual care as part of the hospice team? 3) How important are specific aspects of cultural competence in providing ethically sound spiritual care to hospice patients? 4) How do music therapists' music selections for addressing spiritual goals reflect culturally competent practice? 5) What are the personal boundaries that should be maintained by music therapists in order to provide ethically sound spiritual care? 6) How do music therapists feel their personal spiritual beliefs influence their interactions with patients? 7) What types of previous spiritual care training do music therapists report completing? 8) What training topics do music therapists and chaplains feel music therapists should study in order to provide competent spiritual care? 9) What types of training methods do music therapists and chaplains think are most appropriate for music therapists wanting to learn more about spiritual care? 10) What, if any, differences exist between chaplains' and music therapists' responses to these research questions? A final sample of music therapists (n=48) and chaplains (n=44) completed the survey. Results indicated that the role of music therapists includes providing spiritual care as part of the hospice team. The spiritual care scope of practice for music therapists identified by survey participants included assisting with spiritual practices, experiencing God or a higher power, assisting with meditative practices, and assisting with guided imagery experiences. According to participants, music therapists should not lead religious rituals or ceremonies, nor should they conduct spiritual assessments. Music therapists felt that all aspects of cultural competence mentioned in the survey were important, especially selecting interventions that are reflective of patients' cultural and spiritual backgrounds. This was also reflected in the ways music therapists wrote about selecting music for use in addressing spiritual goals. Participants identified specific personal boundaries that should be maintained when providing spiritual care, including avoiding pushing one's personal beliefs onto a patient or family. Music therapists expressed a variety of opinions about how their personal beliefs affected their interactions with patients. These varied from "not at all" to "allows me to be open to others." Music therapists and chaplains expressed similarly varied responses to a question about the wearing of religious symbols when providing hospice services. Questions about spiritual care training methods and content revealed that music therapists were more likely to engage in on-the-job learning, or attend continuing education and conference presentations about spiritual care. Music therapists and chaplains also wrote about learning from patients, participating in group feedback sessions, and reading materials about spiritual care as ways to learn about spiritual care provision. Differences were seen between music therapists and chaplains on their understanding of the concept of "spirituality" and "spiritual care." There were also differences between the two groups on questions of the importance of knowing one's own background as a component of cultural competence, as well as the appropriateness of music therapists providing spiritual care/counseling.
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Oliveira, Mariana Leitão de. "Cessação voluntária de alimentação e de hidratação no fim de vida." Bachelor's thesis, [s.n.], 2020. http://hdl.handle.net/10284/9336.

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Анотація:
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Ciências da Nutrição
Objetivo: compreender o conhecimento atual e global relativamente à cessação voluntária de alimentação e nutrição no fim de vida. Metodologia: Revisão da literatura. Resultados: Da literatura consultada emergiram as seguintes temáticas: (1) Definições e terminologia; (2) Motivações; (3) Processo de morte; (4) Comparações entre o suicídio assistido, a eutanásia e a Cessação Voluntária de Alimentação e Hidratação; (5) O papel dos Cuidados Paliativos neste contexto. Conclusões: A cessação voluntária de alimentação e hidratação consiste numa ação de um doente competente, que voluntariamente decide parar de comer e beber com intenção primária de antecipar a morte, devido a uma doença crónica sem possibilidade terapêutica de cura que lhe causa sofrimento intolerável. Contudo, emergem questões éticas relacionadas com esta temática. A literatura aponta que é uma temática ainda controversa dadas as questões éticas que poderão emergir nomeadamente em termos de comparação com o suicídio assistido e a eutanásia. Contudo, por ser uma forma de antecipar a morte considerada confortável e que mantém a autonomia da pessoa doente e não envolve a intervenção dos profissionais de saúde, tem sido a opção mais tomada por doentes em fim de vida mesmo com eutanásia e /ou suicídio assistido legalmente aceites nos seus países de origem.
Aim: to understand the state of the art regarding voluntary stopping of eating and drinking in the end of life. Metodologia: Review of the literature. Resultados: The following themes emerged from the literature: (1) definitions and terminology; (2) Motivations; (3) Process of death; (4) Comparisons between assited suicide, euthanasia and voluntary stopping of eating and drinking; (5) The role of palliative care in this particular context. Conclusions: The voluntary cessation of eating and drinking consists of an action by a competent patient, who voluntarily decides to stop eating and drinking with the primary intention of anticipating death, due to a chronic disease with no therapeutic possibility of cure that causes intolerable suffering. However, the literature points out that it is still a controversial topic given the ethical issues that may arise, particularly in terms of comparison to assisted suicide and euthanasia. However, as it is a way of hastening death that is considered comfortable, that maintains the autonomy of the patient and does not involve the intervention of healthcare professionals, it has been the option most taken by end-of-life patients even when euthanasia and/ or assisted suicide is legally accepted in their countries of origin.
N/A
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Pomrenke, Stefan Hakon. "Assessment of Seminary Education on End of Life Issues." VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1523.

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Background: The US health care system faces increased costs from end of life (EOL) care. The intensive approach to EOL treatment with greater use of procedures in ICUs has led to decedent spending six times greater than that of survivors in the hospital. Experts in ICU and Palliative care fields have called for greater utilization of end of life planning and education. To date, EOL education has been dominated by the technologically driven medical field and the church has been under-utilized. The US population relies on clergy support for many mental health and EOL issues. Clergy report feeling uncomfortable in their ability to provide EOL care and desire more education. Research in clergy preparation for EOL education is relatively small and no studies in Virginia have been completed. Purpose: Document the current state of Richmond, VA, seminary education on EOL issues and document graduating seminarians' desire for more EOL education. Methods: A two-page questionnaire was approved by the VCU IRB and distributed amongst graduating seminarians at the three Richmond Theological Consortium seminaries: Union-PSCE, Baptist Theological Seminary at Richmond, and Virginia Union University Seminary. The first section of the survey evaluated education on EOL issues received while in seminary. Experience with counseling the dying and bereaved along with placement at medical institutions was also evaluated. The second section evaluated the desire for more didactic and practical education. Desire for future Continuing Education Classes was also evaluated along with demographics. SAS was utilized to create frequencies and chi square associations and odds ratios.Results: Overall, 75 surveys were returned, a 35% response rate. Eighty-six percent of respondents stated that pastoral care overall education was covered (missing = 20), while 38.3% stated that medical aspects of dying was covered (missing = 9). Fifty-seven percent had some kind of placement at a medical institution. Sixty-nine percent had experience in an EOL situation. Approximately 75% wanted more education, with practical education and pastoral care predominating. Forty-eight percent desired more theologically-focused EOL continuing education classes. Prior education in preaching sermons and pastoral care of the bereaved was associated with desire for further education in those respective topics, OR = 3.42, 95%CI 1.58, 11.05 and OR = 4.64, 95%CI 1.10, 19.50, respectively. Placement at an institution was associated with desire for more didactic (OR = 3.10, 95%CI 1.03, 9.35) and practical education (OR = 3.89, 95%CI 1.22, 12.35). Experience with counseling the bereaved was associated with a decreased likelihood of wanting more education on how to interact with medical and hospice staff. Demographics were not statistically associated with desire for more education.Conclusions: Several EOL topics do not receive full coverage, specifically self care of the pastor, teaching adults about end of life planning, the medical aspects of end of life, and mobilizing the laity for the care of the dying and bereaved. Placement at an institution or experience was absent in 30-40% of participants. The majority of participants wanted more education. Placement along with previous education was associated with desire for further education. Curriculum change to reflect these findings may benefit in increasing the overall confidence and competence of pastors, increase the ministerial goals of the church, and aid in preparing the public for the end of life, thus decreasing the burden on the health care system.
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Kuhl, David R. "Exploring spiritual and psychological issues at the end of life." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0015/NQ46369.pdf.

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Hafey, Sandra M. "Exploring end of life issues a four part workshop for adult Catholics /." Chicago, IL : Catholic Theological Union at Chicago, 2006. http://dx.doi.org/10.2986/tren.033-0847.

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Adu, Addai Emmanuel. "End-of-life care, death and funerals of the Asante: An ethical and theological vision." Thesis, Boston College, 2016. http://hdl.handle.net/2345/bc-ir:106929.

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Анотація:
Thesis advisor: Melissa M. Kelley
Thesis advisor: Lisa Sowle Cahill
Thesis (STL) — Boston College, 2016
Submitted to: Boston College. School of Theology and Ministry
Discipline: Sacred Theology
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Smith-Howell, Esther Renee. "End-of-life decision-making among African Americans with serious illness." Thesis, Indiana University - Purdue University Indianapolis, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3723381.

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African Americans’ tendency to choose life-prolonging treatments (LPT) over comfort focused care (CFC) at end-of-life is well documented but poorly understood. There is minimal knowledge about African American (AA) perceptions of decisions to continue or discontinue LPT. The purpose of this study was to examine AA family members’ perceptions of factors that influenced end-of-life care decision-making for a relative who recently died from serious illness. A conceptual framework informed by the literature and the Ottawa Decision Support Framework was developed to guide this study. A retrospective, mixed methods design combined quantitative and qualitative descriptive approaches. Forty-nine bereaved AA family members of AA decedents with serious illness who died between 2 to 6 months prior to enrollment participated in a one-time telephone interview. Outcomes examined include end-of-life treatment decision, decision regret, and decisional conflict. Quantitative data were analyzed using descriptive statistics, independent-sample t-tests, Mann-Whitney U tests, chi-square tests, Spearman and Pearson correlations, and linear and logistic regressions. Qualitative data were analyzed using content analysis and qualitative descriptive methods. Family members’ decisional conflict scores were negatively correlated with their quality of general communication (rs = -.503, p = .000) and end-of-life communication scores (rs = -.414, p = .003). There was a significant difference in decisional regret scores between family members of decedents who received CFC versus those who received LPT (p = .030). Family members’ quality of general communication (p = .030) and end-of-life communication (p = .014) were significant predictors of family members’ decisional conflict scores. Qualitative themes related to AA family members’ experiences in end-of-life decision-making included understanding (e.g., feeling prepared or unprepared for death), relationships with healthcare providers (e.g., being shown care, distrust) and the quality of communication (e.g., being informed, openness, and inadequate information). Additional qualitative themes were related to perceptions of the decision to continue LPT (e.g., a lack of understanding, believe will benefit) or discontinue LPT (e.g., patient preferences, desire to prevent suffering). In conclusion, this study generated new knowledge of the factors that influenced AA bereaved family members’ end-of-life decision-making for decedents with serious illnesses. Directions for future research were identified.

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Davatgar, Elika. "Nurses’ experiences of ethical problems in the end-of-life care of patients : A literature review." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-4786.

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Background: In the background section the following terms are described: Palliative care and holistic view, care at the end-of-life, ethical problems in the end-of-life care and ethical problem and ethical dilemma. Aim: The purpose of this literature review was to describe nurses’ experiences of ethical problems in the end-of-life care of patients. Method: A literature review was selected as a method in this study based on eightscientific articles. Articles were reviewed and analyzed critically by the author. Travelbees’ theory (1971) “human- to- human relationships” was selected as a theoretical basis. Results: The result presents six themes as follows: Decision-making, ineffective treatments and therapies, insufficient communication, the lack of cooperation, inadequate respect for patient’s autonomy and uncertainty in caring role. These themes present how nurses deal with end-of-life care and in which situations ethical problems arise. Discussions: The result was discussed in relation to Travelbees’ theory (1971) “human-to-human relationships”. Nurses’ different experiences according to their different responsibilities such as insufficient communication and cooperation, decision-making processes, uncertainty in caring role and inadequate respect for patients’ autonomy were discussed.
Bakgrund: I bakgrunden beskrivs följande termer: Palliativ vård och holistiskt synsätt, vård vid livets slutskede, etiska problem i livets slutskede och definitionerna av etiskt problem och etiskt dilemma. Syfte: Syftet med denna litteraturöversikt var att beskriva sjuksköterskors upplevelser av etiska problem i vården av patienter i livets slutskede. Metod: En litteraturöversikt valdes som metod i denna studie som bygger på åtta vetenskapliga artiklar. Artiklarna granskades och analyserades av författaren. Travelbees teori (1971) “human-to-human relationships” valdes som en teoretisk grund. Resultat: Resultatet presenterar sex teman enligt följande: Beslutsfattande, ineffektiva behandlingar och terapier, otillräcklig kommunikation, bristande samarbete, otillräcklig respekt för patientens autonomi och osäkerhet i vårdande roll. Dessa teman presenterar hur sjuksköterskor hanterar vård vid livets slutskede och i vilka situationer etiska problem uppstår. Diskussion: Resultatet diskuterades utifrånTravelbees’ theory (1971) “human- to- human relationships”. Sjuksköterskors olika erfarenheter i enlighet med deras olika ansvarsområden såsom otillräcklig kommunikation och samarbete, beslutsprocesser, osäkerheten i vårdanderoll och bristande respekt för patientens autonomi diskuterades.
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Sidler, Daniel. "Medical futility as an action guide in neonatal end-of-life decisions." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/50017.

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Анотація:
Thesis (MPhil)--University of Stellenbosch, 2004.
ENGLISH ABSTRACT: This thesis discusses the value of medical futility as an action guide for neonatal endof- life decisions. The concept is contextualized within the narrative of medical progress, the uncertainty of medical prognostication and the difficulty of just resource allocation, within the unique African situation where children are worse off today than they were at the beginning of the last century. parties actively engage in an interactive deliberation for a plan of action. Both parties ought to accept moral responsibility. Such a model of deliberation has the added advantage of transcending the limitations of the participants to arrive at a higher-level solution, which is considered more than just a consensus. It has been argued that medical progress has obscured the basic need for human compassion for the dying and for their loved ones. The literature furthermore reports that the quality of end-of-life care is unsatisfactory for both patients and their families. It is within this context that the concept of medical futility is positioned as a useful action guide. As we do not have the luxury of withdrawing from the responsibility to engage in the deliberation of end-of-life decisions, such responsibility demands an increasing awareness of ethical dilemmas and a model of medical training where communication, conflict-resolution, inclusive history taking, with assessment of patient values and preferences, is focussed on. The capacity for empathetic care has to be emphasized as an integral part of such approach. Finally, in this thesis, the concept of medical futility is tested and applied to clinical case scenarios. It is argued that the traditional medical paradigm, with its justification of an 'all out war' against disease and death, in order to achieve utopia for all, is outdated. Death in the neonatal intensive care unit is increasingly attributed to end-of-life decisions. Futile treatment could be considered a waste of scarce resources, contradicting the principle of nonmaleficence and justice, particularly in an African context. The ongoing confidence in, and uncritical submission to the technological progress in medicine is understood as a defence and coping mechanism against the backdrop of the experience of life's fragility, suffering and the inevitability of death. Such uncritical acceptance of the technological imperative could lead to a harmful fallacy that cure is effected by prolonging life at all cost. What actually occurs, instead, is the prolongation of the dying process, increasing suffering for all parties involved. The historical development of the concept of medical futility is discussed, highlighting its applicability to the paradigmatic scenario of cardio-pulmonary resuscitation. Particular attention is given to ways in which the concept could endanger patient-autonomy by allowing physicians to make unilateral, paternalistic decisions. It is argued that the informative model of the patient-physician relationship, where the physician's role is to disclose information in order for the patient to indicate her preferences, ought to be replaced by a more adequate deliberative model, where both
AFRIKAANSE OPSOMMING: Hierdie tesis bespreek die waarde van mediese futiliteit as 'n maatstaf vir aksie in gevalle van neonatale 'einde-van-lewe' besluite. Die konsep word gekontekstualiseer binne die wêreldbeskouing van mediese vooruitgang, die onsekerheid van mediese prognostikering en die probleme wat geassosieer IS met regverdige hulpbrontoekenning; spesifiek binne die unieke Afrika-situasie. Dit word aangevoer dat die tradisionele mediese paradigma, met regverdiging vir voorkoming van siekte en dood ten alle koste, verouderd is. Sterftes in neonatale intensiewe sorgeenhede word toenemend toegeskryf aan 'einde-van-lewe' besluite Futiele behandeling sou dus beskou kon word as 'n vermorsing van skaars hulpbronne, wat teenstrydig sou wees met die beginsels nie-skadelikheid ('nonmaleficence') en regverdigheid. Die volgehoue vertroue in en onkritiese aanvaarding van aansprake op tegnologiese vooruitgang lil geneeskunde, kan beskou word as verdediging- en hanteringsmeganisme in die belewenis van lewenskwesbaarheid, lyding en die onafwendbaarheid van die dood. Sodanige onkritiese aanvaarding van die tegnologiese imperatief kan tot 'n onverantwoordbare denkfout, naamlik dat genesing plaasvind deur verlenging van lewe ten alle koste, lei. Wat hierteenoor eerder mag plaasvind, is 'n verlenging die sterwensproses en, gepaard daarmee, toenemende lyding van all betrokke partye. Die historiese ontwikkeling van die konsep van mediese futiliteit word bespreek met klem op die toepaslikheid daarvan op die paradigmatiese situasie van kardiopulmonêre resussitasie. Spesifieke aandag word gegee aan maniere waarop die konsep pasiënte se outonomie in gevaar stel, deur die betrokke medici die reg te gee tot eensydige, paternalistiese besluitneming. Die argument is dan dat die informatiewe model, waar die verhouding tussen die dokter en pasiënt gebasseer is op die beginsel dat die dokter inligting moet verskaf aan die pasiënt sodat die pasiënt 'n ingeligte besluit kan neem, vervang moet word met 'n meer toepaslike beraadslagende model, waar sowel die dokter as die pasiënt aktief deelneem aan interaktiewe beraadslaging oor 'n aksieplan. Albei partye word dan moreel verantwoordbaar. So 'n model van beraadslaging het die bykomende voordeel dat dit die beperkings van die deelnemers kan transendeer. Sodoende word 'n hoër-vlak oplossing - iets meer as 'n blote consensus - te weeg gebring. Die argument word ontwikkel dat mediese vooruitgang meelewing met die sterwendes en hul geliefdes mag verberg. Verder dui die literatuur daarop dat die kwaliteit van einde-van-lewe-sorg vir sowel die pasiënte as hul familie onaanvaarbaar is. Dit is binne hierdie konteks dat die konsep van mediese futiliteit kan dien as 'n maatstaf vir aksie. Medici kan nie verantwoordelikheid vir deelname aan beraadslaging rondom eindevan- lewe beluitneming vermy nie, en as sodanig vereis die situasie toenemende bewustheid van sowel die etiese dilemmas as 'n mediese opleidingsmodel waann kommunikasie, konflikhantering, omvattende geskiedenis-neming, met insluiting van die pasient se waardes en voorkeure, beklemtoon word. Die kapasiteit vir empatiese sorg moet weer eens beklemtoon word as 'n integrale deel van hierdie benadering. Ten slotte, hierdie tesis poog om die konsep van mediese futiliteit te toets en toe te pas op kliniese situasies.
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Johns, Amanda E. "Ethical Decision Making of Counseling Mental Health Practitioners Working With Clients Right-To-Die Issues." ScholarWorks@UNO, 2015. http://scholarworks.uno.edu/td/2028.

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The purpose this study was to explore the relationship between counseling mental health practitioners’ attitudes toward euthanasia and their ethical decision making levels when confronted with clients facing end-of-life concerns. A review of literature indicated a series of complex ethical, moral, and societal issues surrounding clients’ right-to-die issues. Because of the lack of research in the counseling field and the growing prevalence of right-to-die issues with clients who have a diagnosis of a terminal illness, more research in the counseling field is needed (Hadjistavropoulos, 1996; Winograd, 2012). Participants for the present study were recruited from six state divisions of the American Counseling Association; Alabama, Louisiana, North Dakota, Maryland, Vermont, and Utah. Two multiple regressions were conducted in addition to one correlation and one MANOVA. One multiple regression was conducted using EDMS-R ans the dependent variable and one multiple regression was conducted using ATE overall score as the dependent variable. The Independent variables used were years in practice, gender, state, and religion. The dependent variables used were participant EDMS-R score and participant ATE score. Variables were chosen to examine variability accounted for in ATE and EDMS-R participant scores. Findings from this small study indicated that counselors’ years in practice, gender, state, and religion accounted for more of the variability in their beliefs about euthanasia (13.5) than their ethical decision making levels (2.7). Also, counselors’ religion had the greatest effect on participants’ ATE overall scores and on their EDMS-R P index scores. Counselors’ ATE overall scores as well as their both active and passive scores were all shown to be correlated to their P index scores with their ATE active scores exhibiting the strongest correlation and their ATE passive score exhibiting the weakest correlation. Future research suggestions include assessing counselors’ religion in more depth, and focusing on the other demographic variables in the study, as well as conducting an initial qualitative study to provide insight from individual participants as opposed to assessing a large group of participants.
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Книги з теми "End of life care ethical issues"

1

End-of-life care and pragmatic decision making: A bioethical perspective. Cambridge: Cambridge University Press, 2010.

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Hester, D. Micah. End-of-life care and pragmatic decision making: A bioethical perspective. Cambridge: Cambridge University Press, 2010.

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3

Kathryn, Braun, Pietsch James H, and Blanchette Patricia L, eds. Cultural issues in end-of-life decision making. Thousand Oaks, Calif: Sage Publications, 2000.

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Elizabeth, Chaitin, ed. Ethics and end-of-life decisions in social work practice. Chicago, Ill: Lyceum Books, 2005.

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5

Csikai, Ellen L. Ethics in end-of-life decisions in social work practice. Chicago, Ill: Lyceum Books, 2006.

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6

1938-, Hardy Mark A., ed. Psychosocial aspects of end-stage renal disease: Issues of our times. New York: Haworth Press, 1991.

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7

Caroline, Young. End of life care issues guidebook. Los Angeles, CA: UniversityofHealthCare, 2005.

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8

Florida. Agency for Health Care Administration. End of life issues: A practical planning guide. Tallahassee, FL: Florida Agency for Health Care Administration, 2002.

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9

McCarthy, Joan. End-of-life care: Ethics and law. Cork, Ireland: Cork University Press, 2011.

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End-of-life care: Ethics and law. Cork, Ireland: Cork University Press, 2011.

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Частини книг з теми "End of life care ethical issues"

1

Magidson, Phillip D., and Jon Mark Hirshon. "Ethical issues and end-of-life care." In Geriatric Emergencies, 386–93. Chichester, UK: John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781118753262.ch25.

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Ratre, Brajesh Kumar, and Sushma Bhatnagar. "Ethical Issues at End of Life Care in the ICU." In Onco-critical Care, 525–31. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-16-9929-0_42.

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Halli-Tierney, Anne, Amy Albright, Deanna Dragan, Megan Lippe, and Rebecca S. Allen. "Ethical issues in palliative and end-of-life care." In Perspectives on Palliative and End-of-Life Care, 91–118. Milton Park, Abingdon, Oxon ; New York, NY : Routledge, 2018. | Series: Aging and mental health research: Routledge, 2018. http://dx.doi.org/10.4324/9780429489259-5.

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Gallagher, Colleen M., Jessica A. Moore, and Allen H. Roberts. "Ethical Issues at the End-of-Life in the Cancer Patient." In Oncologic Critical Care, 1–26. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74698-2_137-1.

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Gallagher, Colleen M., Jessica A. Moore, and Allen H. Roberts. "Ethical Issues at the End-of-Life in the Cancer Patient." In Oncologic Critical Care, 1937–62. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74588-6_137.

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Holt, Janet. "Withdrawing Treatment: Ethical Issues at the End of Life." In Advancing Nursing Practice in Cancer and Palliative Care, 175–86. London: Macmillan Education UK, 2002. http://dx.doi.org/10.1007/978-1-349-88882-5_9.

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Eleuteri, Stefano, Arianna Caruso, and Ranjeev C. Pulle. "End of Life, Food, and Water: Ethical Standards of Care." In Perspectives in Nursing Management and Care for Older Adults, 261–71. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63892-4_21.

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AbstractEnd-of-life care constitutes an important situation of extreme nutritional vulnerability for older adults. Feeding decisions in late-stage dementia often provoke moral and ethical questions for family members regarding whether or not to continue hand-feeding or opt for tube-feeding placement. Despite the knowledge that starvation and dehydration do not contribute to patient suffering at the end of life and in fact may contribute to a comfortable passage from life, the ethics of not providing artificial nutrition and hydration (ANH) continue to be hotly debated. However, in the past two decades, voluntary stopping of eating and drinking (VSED) has moved from a palliative option of last resort to being increasingly recognized as a valid means to intentionally hasten death for cognitively intact persons dealing with a serious illness. Across many settings globally, when oral intake is deemed unsafe, decisions to withhold oral feeding and to forgo artificial means of providing nutrition are deemed to be ethically and legally sanctioned when the decision is made by a capable patient or their legally recognized substitute decision-maker. Decision-making at the end of life involves knowledge of and consideration of the legal, ethical, cultural, religious, and personal values involved in the issue at hand. This chapter attempted to illustrate the unique complexities when considering nutrition therapy (by oral and artificial means) at the end of life.
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Ahmad, Ayesha. "Ethics and Intercultural Issues in End of Life Care." In Philosophy and Medicine, 367–79. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-40033-0_24.

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Hellmann, Jonathan. "End-of-Life Decision-Making in the Neonatal Intensive Care Unit: Serving the Best Interests of the Newborn within a Family-Centred Care Framework." In Paediatric Patient and Family-Centred Care: Ethical and Legal Issues, 221–44. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4939-0323-8_14.

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Marik, Paul Ellis. "End-of-Life Issues." In Evidence-Based Critical Care, 805–10. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-11020-2_51.

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Тези доповідей конференцій з теми "End of life care ethical issues"

1

Tuta, Liliana. "END-OF-LIFE CARE IN ELDERLY PATIENTS WITH END-STAGE RENAL DISEASE - ETHICAL AND CLINICAL ISSUES." In 2nd International Multidisciplinary Scientific Conference on Social Sciences and Arts SGEM2015. Stef92 Technology, 2015. http://dx.doi.org/10.5593/sgemsocial2015/b11/s2.062.

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Vava (Laknori), Odeta. "Attitudes of Biology Students Toward Ethical Issues Concerning the Beginning and The End of Human Life in Albania." In 3rd International Conference on New Approaches in Education. GLOBALKS, 2021. http://dx.doi.org/10.33422/3rd.icnaeducation.2021.07.30.

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Janković, Sunčana, Marko Ćurković, Dina Vrkić, Ana Jozepović, Bojana Nevajdić, Milivoj Novak, Štefan Grosek, and Ana Borovečki. "328 A review of expert recommendations on end-of-life issues in pediatric intensive care setting." In 10th Europaediatrics Congress, Zagreb, Croatia, 7–9 October 2021. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2021. http://dx.doi.org/10.1136/archdischild-2021-europaediatrics.328.

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Turner, Rebecca. "P-9 Challenging conversations: training volunteers to support the elderly around end of life issues." In Dying for change: evolution and revolution in palliative care, Hospice UK 2019 National Conference, 20–22 November 2019, Liverpool. British Medical Journal Publishing Group, 2019. http://dx.doi.org/10.1136/bmjspcare-2019-huknc.33.

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Janković, Sunčana, Dina Vrkić, Marko Ćurković, Bojana Nevajdić, Milivoj Novak, Štefan Grosek, Chris Gastmans, Bert Gordijn, Branka Polić, and Ana Borovečki. "340 Ethical Content of Guidelines for End-of-Life Decision-Making in Pediatric and Neonatal Intensive Care Units: a systematic review." In 10th Europaediatrics Congress, Zagreb, Croatia, 7–9 October 2021. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2021. http://dx.doi.org/10.1136/archdischild-2021-europaediatrics.340.

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Waterfield, Kerry, and Dawn Orr. "10 Engaging young people in key issues surrounding end of life care through the development of curriculum resources for secondary schools." In Accepted Oral and Poster Abstract Submissions, The Palliative Care Congress 1 Specialty: 3 Settings – home, hospice, hospital 25 – 26 March 2021 | A virtual event, hosted by Make it Edinburgh Live, the Edinburgh International Conference Centre’s hybrid event platform. British Medical Journal Publishing Group, 2021. http://dx.doi.org/10.1136/spcare-2021-pcc.10.

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Cordero-Díaz, MA, and MP González-Amarante. "HUMANISM IN TIMES OF PANDEMIC: ONLINE CLINICAL SIMULATION FOR THE DEVELOPMENT OF ETHICAL COMPETENCIES." In The 7th International Conference on Education 2021. The International Institute of Knowledge Management, 2021. http://dx.doi.org/10.17501/24246700.2021.7113.

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The SARS-COV2 health contingency and the cessation of face-to-face activities has motivated multiple educational innovations for distance teaching. Medical schools are particularly defied because of the need for clinical training, however simulation offers opportunities to achieve continuity. A clinical simulation exercise was redesigned and transformed to an online synchronic simulation via Zoom. The participating groups of medical students (n=53) were in the Bioethics and Clinical Bioethics courses, adjunct to their Pediatrics and Obstetrics and Gynecology (ObGyn) clerkships in June 2020. Two simulated clinical cases were performed via Zoom, followed by a debriefing session. Later, an online survey was applied to the participants to know their perception and experience with this new version, considering they had experienced the original face-toface simulation on the alternate clerkship the prior trimester. A mixed method approach was used to analyze the responses. The results showed that the virtual format was very effective, 72% considered it very similar to the original version. The exercise revealed high emotional commitment, allowing students to develop their socio-emotional skills. Student reactions were categorized and coded as emotions triggered by a) their performance as professionals, b) those related directly to the patient’s emotions and situation, which showed significant gender differences, and c) students' anxiety related to the academic exercise itself, the least found. The fact that the clinical component was restructured due to the remote format may have helped in focusing on the preponderance of emotional, communication and relational aspects of the patient-doctor relationship. Also, most students identified the exercise was meaningful in approaching bioethics contents, including end-of-life decisions in patient care, and informed consent. In conclusion, the online clinical simulation activity proved effective in integrating professionalism outcomes that encompass ethical knowledge, skills and attitudes that prepare medical students for their professional role, along with the debriefing reinforcing insightful learning integration. Keywords: educational innovation, higher education, clinical simulation, humanism, ethics
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Tallon, Rachel, and Joey Domdom. "Navigating Tensions in the Secular Workplace by Christians in the Social Services: Findings from an Aotearoa New Zealand Study." In 2021 ITP Research Symposium. Unitec ePress, 2022. http://dx.doi.org/10.34074/proc.2205015.

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The social services are a value-laden field of employment as work involves frequent ethical decision-making around issues that relate to values, such as end of life, sexuality and so forth. Tensions can exist between individual practitioners, their employment agency and society, concerning ethics and values. This paper presents partial findings from a qualitative study that explored the tensions or issues faced by 16 Christian social-service practitioners working in non-faith-based settings by asking the question, “What tensions do Christian practitioners face in secular organisations?” In particular, we present themes from the findings that show utilisation of Indigenous cultural and/or spiritual practices to strengthen faith and work. The context is Aotearoa New Zealand, where there are unique relationships between religions (both from colonial settlers and Indigenous people), spirituality, secularism and the provision of social services. How these various aspects intersect and affect the Christian practitioner was of interest to this study. This paper may contribute to further research concerning the use of Indigenous practices in modern social services and healthcare.
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"CHANGES IN HEMODYNAMIC STATUS, SLEEP PATTERN, MENTAL HEALTH , AND SOCIAL LIFE AMONG NIGHT SHIFT MEDICAL WORKER IN JORDANIAN HOSPITALS." In International Conference on Public Health and Humanitarian Action. International Federation of Medical Students' Associations - Jordan, 2022. http://dx.doi.org/10.56950/bgcw7569.

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Background: Shift work is essential for many occupations like in the Emergency Medical Service that provides critical services that must be available all hours as a result of the irregularly day and night nature work (e.g., 9 p.m to 7:30 am ) with long-duration shifts (e.g., 24h and 48h) they could end up with a higher risk of disturbances in hemodynamic status which is contributed to (shock, heart failure, pressure changes, Sleep deficiency) along with mental health issue Objective: we aim to compare the blood pressure, heart rate, and O2 saturation and investigate the effect of demographic that includes (BMI, age, sex, educational level, mental status, memory, and decision-making ability. ) symptoms, and substance consumption (including caffeine, tea, energy drink, alcohol, smoking, multi-vitamin ..etc) between two group night shift and day shift Method: this study will be conducted in private hospitals and public hospitals in Jordan (Amman and Irbid ) and its design is a cross-sectional observational where adult health care providers will be invited to participate in completing an interviewer administration questionnaire Results: the high percentage of night medical workers faced a problem in many aspects including sleep disturbances, higher pressure, high caffeine intake, low focus, and decision-making ability along with social and family issues and mental health disturbances Conclusion: so we could conclude that medical night Shift work is associated with impaired alertness and low efficacy due to sleep loss and circadian disturbances so the performance remains mainly impaired during night shifts and the ability to focus and solve the problem and memorize information become lower with time In the end, we hope that medical institutions and hospitals would care more about the working environment not only the physical side but also mental health which should be put under the consideration Keywords: hemodynamic status, night shift, mental health, cardiovascular disease, social life
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Tamer, Gülay. "Aeshetic Medicine Center: Strategic Objectives of Management in Health Institutions." In International Conference on Eurasian Economies. Eurasian Economists Association, 2016. http://dx.doi.org/10.36880/c07.01477.

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Healthcare is the world’s largest industries today. Incorrect decisions which have been taken in any industrial enterprise would impact year-end balance sheet or in worst case scenario, temporary economic downturns. However, mistakes which are made in the management of health industries would end up lowering quality of human life which could give rise to deterioration of the welfare society. Management philosophy of the health care institutions has a direct impact to solution of health issues. Therefore, their approach of management play an important role in the development of quality of life. Knowledge and individual skills of those involved in the management of health managers at different levels of organization is crucial for the future of the company and consequentially for welfare of nation. In this study; Aesthetic Medicine which is one of the most exclusive and ever-developing areas of health institutions has been analyzed. These institutions aim to enhance their social perception by improving their appearance with noninvasive aesthetic treatments and by providing preventive treatments to maintain their youthful appearance. The frequency of the applied treatments in aesthetic medical institutions varies according to their clients' economic welfare, socio-cultural evolution of their society, sex, age range and many other sociological parameters. In order to meet the expectations in health institutions, it is crucial to determine the correct customer profile by utilizing present opportunities of the sector. This study is prepared to present an approach to create sectoral innovation by drawing attention to self-renewing business growth methods for aesthetic medicine management.
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Звіти організацій з теми "End of life care ethical issues"

1

Basu, Sayani. Organ Transplantation: A New Lease of Life. Science Repository, February 2021. http://dx.doi.org/10.31487/sr.blog.24.

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There is a growing debate over organ transplantation which is a successive therapeutic option for the treatment of end-stage organ diseases but the ethical issues associated with the shortage of transplantable organs must also be taken into account.
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Rast, Jessica E., Anne M. Roux, Kristy A. Anderson, Lisa A. Croen, Alice A. Kuo, Lindsay L. Shea, and Paul T. Shattuck. National Autism Indicators Report: Health and Health Care. A.J. Drexel Autism Institute, December 2020. http://dx.doi.org/10.17918/healthandhealthcare2020.

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Health and health care are critical issues for many children and adults on the autism spectrum. They may experience more frequent use of services and medications. They may need more types of routine and specialty healthcare. And their overall health and mental health care tends to be more complex than people with other types of disabilities and special health care needs. This report provides indicators of health and health care for autistic persons across the lifespan. Topics covered include overall health, health services, medication, insurance, and accessing services. We need to understand health and healthcare needs across the life course to support recommendations on how to improve health and health care at critical points across a person's life. The purpose of this report is to catalogue indicators to aid in decision making to this end.
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