Hec Forum最新文献_第2页

Everyday Clinical Ethics: Essential Skills and Educational Case Scenarios. 日常临床伦理：基本技能和教育案例情景。

IF 1.3 4区哲学

Hec Forum Pub Date : 2024-07-09 DOI: 10.1007/s10730-024-09533-6

Elaine C Meyer, Giulia Lamiani, Melissa Uveges, Renee McLeod-Sordjan, Christine Mitchell, Robert D Truog, Jonathan M Marron, Kerri O Kennedy, Marilyn Ritholz, Stowe Locke Teti, Aimee B Milliken

{"title":"Everyday Clinical Ethics: Essential Skills and Educational Case Scenarios.","authors":"Elaine C Meyer, Giulia Lamiani, Melissa Uveges, Renee McLeod-Sordjan, Christine Mitchell, Robert D Truog, Jonathan M Marron, Kerri O Kennedy, Marilyn Ritholz, Stowe Locke Teti, Aimee B Milliken","doi":"10.1007/s10730-024-09533-6","DOIUrl":"https://doi.org/10.1007/s10730-024-09533-6","url":null,"abstract":"Bioethics conjures images of dramatic healthcare challenges, yet everyday clinical ethics issues unfold regularly. Without sufficient ethical awareness and a relevant working skillset, clinicians can feel ill-equipped to respond to the ethical dimensions of everyday care. Bioethicists were interviewed to identify the essential skills associated with everyday clinical ethics and to identify educational case scenarios to illustrate everyday clinical ethics. Individual, semi-structured interviews were conducted with a convenience sample of bioethicists. Bioethicists were asked: (1) What are the essential skills required for everyday clinical ethics? And (2) What are potential educational case scenarios to illustrate and teach everyday clinical ethics? Participant interviews were analyzed using qualitative content analysis. Twenty-five (25) bioethicists completed interviews (64% female; mean 14.76 years bioethics experience; 80% white). Five categories of general skills and three categories of ethics-specific skills essential for everyday clinical ethics were identified. General skills included: (1) Awareness of Core Values and Self-Reflective Capacity; (2) Perspective-Taking and Empathic Presence; (3) Communication and Relational Skills; (4) Cultural Humility and Respect; and (5) Organizational Understanding and Know-How. Ethics-specific skills included: (1) Ethical Awareness; (2) Ethical Knowledge and Literacy; and (3) Ethical Analysis and Interaction. Collectively, these skills comprise a Toolbox of Everyday Clinical Ethics Skills. Educational case scenarios were identified to promote everyday ethics. Bioethicists identified skills essential to everyday clinical ethics. Educational case scenarios were identified for the purpose of promoting proficiency in this domain. Future research could explore the impact of integrating educational case scenarios on clinicians' ethical competencies.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Structure of Clinical Ethical Decision-Making: A Hospital System Needs Assessment. 临床伦理决策的结构：医院系统需求评估。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-06-08 DOI: 10.1007/s10730-024-09534-5

Leana G Araujo, Martin Shaw, Edwin Hernández

{"title":"The Structure of Clinical Ethical Decision-Making: A Hospital System Needs Assessment.","authors":"Leana G Araujo, Martin Shaw, Edwin Hernández","doi":"10.1007/s10730-024-09534-5","DOIUrl":"https://doi.org/10.1007/s10730-024-09534-5","url":null,"abstract":"Bioethical dilemmas can emerge in research and clinical settings, from end-of-life decision-making to experimental therapies. The COVID-19 pandemic raised serious ethical challenges for healthcare organizations, highlighting the need to conduct needs assessments of the bioethics infrastructures of healthcare organizations. Clinical ethics committees (CECs) also create equitable policies, train staff on ethics issues, and play a consultative role in resolving the difficulty of complex individual cases. The main objective of this project was to conduct a needs assessment of the bioethics infrastructure within a comprehensive hospital system. A cross-sectional anonymous online survey, including quantitative and qualitative formatted questions. The survey was sent to five key leaders from the organization's hospitals. Survey questions focused on the composition, structure, function, and effectiveness of their facilities' bioethics infrastructure and ethics-related training and resources. Positive findings included that most facilities have active CECs with multidisciplinary membership; CECs address critical issues and encourage team members to express clinical ethics concerns. Areas of concern included uncertainty about how CECs function and the process for resolving clinical ethics dilemmas. Most reported no formal orientation process for CEC members, and many said there was no ongoing ethics education process. The authors conclude that if CECs are a critical institutional resource where the practice of medicine and mission intersect, having well-functioning ethics committees with trained and oriented members demonstrates an essential commitment to the mission. The survey revealed that more needs to be done to bolster the bioethics infrastructure of this institution.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Living Organ Donation for Transplantation in Bangladesh: Reality and Problems. 孟加拉国用于移植的活体器官捐献：现实与问题。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2022-11-10 DOI: 10.1007/s10730-022-09500-z

Md Sanwar Siraj

{"title":"Living Organ Donation for Transplantation in Bangladesh: Reality and Problems.","authors":"Md Sanwar Siraj","doi":"10.1007/s10730-022-09500-z","DOIUrl":"10.1007/s10730-022-09500-z","url":null,"abstract":"The stipulation of living organ transplantation policy and practice in Bangladesh is family-oriented, with relatives being the only people legally eligible to donate organs. There have been very few transplantations of bone marrows, liver lobes, and kidneys from related-living donors in Bangladesh. The major question addressed in this study is why Bangladesh is not getting adequate organs for transplantation. In this study, I examin the stipulations of the policy and practice of living organ donation through the lens of 32 key stakeholders including physicians and nurses, a health administrator, organ donors and recipients, and their family members, as they can shed light on the realities and problems of organ donation for transplantation in Bangladesh. My ethnography reveals that the family members are always encouraged to donate organs for transplantation, and saving the lives of relatives through organ donation is seen as a moral obligation. Many view saving the life of a relative by donating one's organs as equivalent to saving one's own life. An assessment of the dynamics of biomedicine, religion, and culture leads to the conclusion that the family-oriented organ donation policy and practice have been widely endorsed and accepted in Bangladesh, and Islamic ethical principles and collective family ethos undergird that policy and practice. However, the unavailability of medical resources, lack of post-operative coverage for organ donors, religious misconceptions and unawareness of the general public, and the absence of posthumously donated vital organs for transplantation are perceived to be the most common barriers to a successful living donor-recipient pair organ transplantation. By overcoming these obstacles, Bangladesh can develop a successful living donor-recipient pair organ transplantation program that will ensure improved healthcare outcomes, promote altruism and solidarity among Bangladeshi families, and protect the poor from having their organs sold to wealthy patients.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40464335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Aging, Equality and the Human Healthspan. 老龄化、平等与人类健康寿命。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2022-11-08 DOI: 10.1007/s10730-022-09499-3

Colin Farrelly

{"title":"Aging, Equality and the Human Healthspan.","authors":"Colin Farrelly","doi":"10.1007/s10730-022-09499-3","DOIUrl":"10.1007/s10730-022-09499-3","url":null,"abstract":"John Davis (New Methuselahs: The Ethics of Life Extension, The MIT Press, Cambridge, 2018) advances a novel ethical analysis of longevity science that employs a three-fold methodology of examining the impact of life extension technologies on three distinct groups: the \"Haves\", the \"Have-nots\" and the \"Will-nots\". In this essay, I critically examine the egalitarian analysis Davis deploys with respect to its ability to help us theorize about the moral significance of an applied gerontological intervention. Rather than focusing on futuristic scenarios of radical life extension, I offer a rival egalitarian analysis that takes seriously (1) the health vulnerabilities of today's aging populations, (2) the health inequalities of the \"aging status quo\" and, (3) the prospects for the fair diffusion of an aging intervention over the not-so-distant future. Despite my reservations about Davis's focus on \"life-extension\" vs. increasing the human \"healthspan\", I agree with his central conclusion that an aging intervention would be, on balance, a good thing and that we should fund such research aggressively. But, I make an even stronger case and conjecture that an intervention that slows down the rate of molecular and cellular decline from the inborn aging process will likely be one of the most important public health advancements of the twenty-first century. This is so because aging is the most prevalent risk factor for chronic disease, frailty and disability, and it is estimated that there will be over 2 billion persons age > 60 by the year 2050.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9644010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40461604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Ethics Consultation in Chronic Illness: Challenging Epistemic Injustice Through Epistemic Modesty. 慢性病的临床伦理咨询：通过认识论上的谦虚挑战认识论上的不公正。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2022-09-07 DOI: 10.1007/s10730-022-09494-8

Tatjana Weidmann-Hügle, Settimio Monteverde

{"title":"Clinical Ethics Consultation in Chronic Illness: Challenging Epistemic Injustice Through Epistemic Modesty.","authors":"Tatjana Weidmann-Hügle, Settimio Monteverde","doi":"10.1007/s10730-022-09494-8","DOIUrl":"10.1007/s10730-022-09494-8","url":null,"abstract":"Leading paradigms of clinical ethics consultation closely follow a biomedical model of care. In this paper, we present a theoretical reflection on the underlying biomedical model of disease, how it shaped clinical practices and patterns of ethical deliberation within these practices, and the repercussions it has on clinical ethics consultations for patients with chronic illness. We contend that this model, despite its important contribution to capturing the ethical issues of day-to-day clinical ethics deliberation, might not be sufficient for patients presenting with chronic illnesses and navigating as \"lay experts\" of their medical condition(s) through the health care system. Not fully considering the sources of personal knowledge and expertise may lead to epistemic injustice within an ethical deliberation logic narrowly relying on a biomedical model of disease. In caring \"for\" and collaboratively \"with\" this patient population, we answer the threat of epistemic injustice with epistemic modesty and humility. We will propose ideas about how clinical ethics could contribute to an expansion of the biomedical model of care, so that important aspects of chronic illness experience would flow into clinical-ethical decision-making.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40354776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Democratizing Conscientious Refusal in Healthcare. 医疗保健领域良心拒绝的民主化。

IF 1.3 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2022-12-15 DOI: 10.1007/s10730-022-09502-x

David C Scott

{"title":"Democratizing Conscientious Refusal in Healthcare.","authors":"David C Scott","doi":"10.1007/s10730-022-09502-x","DOIUrl":"10.1007/s10730-022-09502-x","url":null,"abstract":"Settling the debate over conscientious refusal (CR) in liberal democracies requires us to develop a conception of the healthcare provider's moral role. Because CR claims and resulting policy changes take place in specific sociopolitical contexts with unique histories and diverse polities, the method we use for deriving the healthcare norms should itself be a democratic, context-dependent inquiry. To this end, I begin by describing some prerequisites-which I call publicity conditions-for any democratic account of healthcare norms that conflict or jibe with CR. Next, drawing on Ronald Dworkin's jurisprudence and Tom Beauchamp & James Childress's approach to bioethical reasoning, I briefly introduce one method for generating healthcare norms that is faithful to the publicity conditions and has potential to constructively, and democratically, derive important boundaries for CR. Finally, I argue that many critics of CR fail to similarly ground their accounts of healthcare norms in healthcare professionals' sociopolitical contexts, often relying instead on their own interpretation of a generally stateable healthcare norm. This leads to their misconstruing both the value judgments on which their own approaches rest and the public, political values that are often invoked in favor of CR.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10356500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Islamic Jurisprudence on Harm Versus Harm Scenarios in Medical Confidentiality. 关于医疗保密中伤害与伤害情景的伊斯兰法理学。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2023-01-07 DOI: 10.1007/s10730-022-09503-w

Sayyed Mohamed Muhsin

引用次数: 0

Civility in Health Care: A Moral Imperative. 医疗保健中的文明礼貌：道德责任。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2022-12-22 DOI: 10.1007/s10730-022-09501-y

Joel M Geiderman, John C Moskop, Catherine A Marco, Raquel M Schears, Arthur R Derse

引用次数: 0

Ethical Issues in Sperm, Egg and Embryo Donation: Islamic Shia Perspectives. 精子、卵子和胚胎捐赠中的伦理问题：伊斯兰什叶派的观点。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2022-11-12 DOI: 10.1007/s10730-022-09498-4

Md Shaikh Farid

{"title":"Ethical Issues in Sperm, Egg and Embryo Donation: Islamic Shia Perspectives.","authors":"Md Shaikh Farid","doi":"10.1007/s10730-022-09498-4","DOIUrl":"10.1007/s10730-022-09498-4","url":null,"abstract":"Assisted Reproductive Technologies (ARTs) have been practiced in Islamic societies within married couples since their introduction. However, there are divergent views over the issue of third-party donation among Sunni and Shia scholars. This paper illustrates the different perspectives of Shia Muslims surrounding, sperm, egg, and embryo donation and ethical aspects thereof. The study reveals that there are different views regarding sperm, egg, and embryo donation among the Shia religious leaders around the world. Many Shia religious scholars, including the Iranian supreme religious leader Ali Hussein Khamenei allow sperm, egg, and embryo donation with certain conditions. However, the conditions stipulated by Shia religious scholars contradict the ethical and legal practices of sperm, egg, and embryo donation. Regarding sperm and egg donation, they declared that the donor child would inherit from a third-party donor and the commissioning parents would be adoptive parents. Thus, according to them, donor anonymity is impossible. Moreover, the Iranian act on embryo donation did not stipulate the right and responsibilities of the donor child and recipient couples and did not clarify the nature and number of embryos that can be donated and implanted. The paper argues that the lack of laws and guidelines on sperm, egg, and embryo donation raises many ethical problems. Based only on religious rulings, third-party donation has been practiced without foreseeing the well-being and safety of donor children, donors, and recipient couples.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40473792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Ethics Consultations and the Necessity of NOT Meeting Expectations: I Never Promised You a Rose Garden. 临床伦理咨询与不达预期的必要性：我从未向你承诺过玫瑰园。

IF 1.3 4区哲学

Hec Forum Pub Date : 2024-06-01 Epub Date: 2022-09-20 DOI: 10.1007/s10730-022-09496-6

Stuart G Finder, Virginia L Bartlett

引用次数: 0