Hec Forum最新文献_第5页

Specific Trends in Pediatric Ethical Decision-Making: An 18-Year Review of Ethics Consultation Cases in a Pediatric Hospital. 儿科伦理决策的具体趋势：一家儿科医院伦理咨询案例的 18 年回顾。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-02-28 DOI: 10.1007/s10730-024-09524-7

Yaa Bosompim, Julie Aultman, John Pope

引用次数: 0

What is a High-Quality Moral Case Deliberation?-Facilitators' Perspectives in the Euro-MCD Project. 什么是高质量的道德案例审议？

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-02-05 DOI: 10.1007/s10730-023-09519-w

Lena M Jakobsen, Bert Molewijk, Janine de Snoo-Trimp, Mia Svantesson, Gøril Ursin

{"title":"What is a High-Quality Moral Case Deliberation?-Facilitators' Perspectives in the Euro-MCD Project.","authors":"Lena M Jakobsen, Bert Molewijk, Janine de Snoo-Trimp, Mia Svantesson, Gøril Ursin","doi":"10.1007/s10730-023-09519-w","DOIUrl":"https://doi.org/10.1007/s10730-023-09519-w","url":null,"abstract":"The evaluation of the European Moral Case Deliberation Outcomes project (Euro-MCD) has resulted in a revised evaluation instrument, knowledge about the content of MCD (moral case deliberation), and the perspectives of those involved. In this paper, we report on a perspective that has been overlooked, the facilitators'. We aim to describe facilitators' perceptions of high-quality moral case deliberation and their Euro-MCD sessions. The research took place in Norway, Sweden, and the Netherlands using a survey combined with interviews with 41 facilitators. Facilitators' perceived that attaining a high-quality MCD implies fostering a safe and respectful atmosphere, creating a wondering mode, being an attentive authority, developing moral reflective skills, reaching a common understanding, and ensuring organisational prerequisites for the MCD sessions. Our central conclusion is that efforts at three levels are required to attain a high-quality MCD: trained and virtuous facilitator; committed, respectful participants; and organizational space. Furthermore, managers have a responsibility to prepare MCD participants for what it means to take part in MCD.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693199","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

Can We Be Creative with Communication? Assessing Decision-Making Capacity in an Adult with Selective Mutism. 我们能创造性地进行交流吗？评估患有选择性缄默症的成年人的决策能力。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-02-05 DOI: 10.1007/s10730-024-09523-8

Nicholas R Mercado

引用次数: 0

Non-Psychiatric Treatment Refusal in Patients with Depression: How Should Surrogate Decision-Makers Represent the Patient's Authentic Wishes? 抑郁症患者拒绝非精神治疗：代理决策者应如何代表患者的真实意愿？

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-01-27 DOI: 10.1007/s10730-024-09522-9

Esther Berkowitz, Stephen Trevick

{"title":"Non-Psychiatric Treatment Refusal in Patients with Depression: How Should Surrogate Decision-Makers Represent the Patient's Authentic Wishes?","authors":"Esther Berkowitz, Stephen Trevick","doi":"10.1007/s10730-024-09522-9","DOIUrl":"https://doi.org/10.1007/s10730-024-09522-9","url":null,"abstract":"Patients with mental illness, and depression in particular, present clinicians and surrogate decision-makers with complex ethical dilemmas when they refuse life-sustaining non-psychiatric treatment. When treatment rejection is at variance with the beliefs and preferences that could be expected based on their premorbid or \"authentic\" self, their capacity to make these decisions may be called into question. If capacity cannot be demonstrated, medical decisions fall to surrogates who are usually advised to decide based on a substituted judgment standard or, when that is not possible, best interest. We propose that in cases where the patient meets the widely accepted cognitive criteria for capacity but is making decisions that appear inauthentic, the surrogate may best uphold patient autonomy by following a \"restorative representation\" model. We see restorative representation as a subset of substituted judgement in which the decision-maker retains responsibility for deciding as the patient would have, but discerns the decision their \"truest self\" would make, rather than inferring their current wishes, which are directly influenced by illness. Here we present a case in which the patient's treatment refusal and previously undiagnosed depression led to difficulty determining the patient's authentic wishes and placed a distressing burden on the surrogate decision-maker. We use this case to examine how clinicians and ethicists might better advise surrogates who find themselves making these clinically and emotionally challenging decisions.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571794","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

Organizational Ethics in Healthcare: A National Survey. 医疗保健领域的组织伦理：全国调查。

IF 1.5 4区哲学

Hec Forum Pub Date : 2024-01-17 DOI: 10.1007/s10730-023-09520-3

Kelly Turner, Tim Lahey, Becket Gremmels, Jason Lesandrini, William A Nelson

{"title":"Organizational Ethics in Healthcare: A National Survey.","authors":"Kelly Turner, Tim Lahey, Becket Gremmels, Jason Lesandrini, William A Nelson","doi":"10.1007/s10730-023-09520-3","DOIUrl":"https://doi.org/10.1007/s10730-023-09520-3","url":null,"abstract":"Organizational ethics-defined as the alignment of an institution's practices with its mission, vision, and values-is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics' professionalization: while some variability is appropriate to the field's relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477970","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

Medical-Legal Partnerships and Prevention: Caring for Unrepresented Patients Through Early Identification and Intervention. 医疗-法律合作与预防：通过早期识别和干预照顾无代表病人。

IF 1.5 4区哲学

Hec Forum Pub Date : 2023-12-23 DOI: 10.1007/s10730-023-09518-x

Cathy L Purvis Lively

引用次数: 0

Clinical Ethics and Professional Integrity: A Comment on the ASBH Code 临床伦理与职业诚信：对《ASBH 守则》的评论

IF 1.5 4区哲学

Hec Forum Pub Date : 2023-12-21 DOI: 10.1007/s10730-023-09516-z

引用次数: 0

What Is It That You Want Me To Do? Guidance for Ethics Consultants in Complex Discharge Cases 您想要我做什么？复杂解雇案例中的道德顾问指南

IF 1.5 4区哲学

Hec Forum Pub Date : 2023-12-21 DOI: 10.1007/s10730-023-09517-y

Adam Omelianchuk, Aziz A. Ansari, Kayhan Parsi

{"title":"What Is It That You Want Me To Do? Guidance for Ethics Consultants in Complex Discharge Cases","authors":"Adam Omelianchuk, Aziz A. Ansari, Kayhan Parsi","doi":"10.1007/s10730-023-09517-y","DOIUrl":"https://doi.org/10.1007/s10730-023-09517-y","url":null,"abstract":"Some of the most difficult consultations for an ethics consultant to resolve are those in which the patient is ready to leave the acute-care setting, but the patient or family refuses the plan, or the plan is impeded by deficiencies in the healthcare system. Either way, the patient is “stuck” in the hospital and the ethics consultant is called to help get the patient “unstuck.” These encounters, which we call “complex discharges,” are beset with tensions between the interests of the institution and the interests of the patient as well as tensions within the ethics consultant whose commitments are shaped both by the values of the organization and the values of their own profession. The clinical ethics literature on this topic is limited and provides little guidance. What is needed is guidance for consultants operating at the bedside and for those participating at a higher organizational level. To fill this gap, we offer guidance for facilitating a fair process designed to resolve the conflict without resorting to coercive legal measures. We reflect on three cases to argue that the approach of the consultant is generally one of mediation in these types of disputes. For patients who lack decision making capacity and lack a surrogate decision maker, we recommend the creation of a complex discharge committee within the organization so that ethics consultants can properly discharge their duties to assist patients who are unable to advocate for themselves through a fair and transparent process.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138825392","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

Who Should Be Legitimate Living Donors? The Case of Bangladesh 谁应该是合法的活体捐赠者？孟加拉国的案例

IF 1.5 4区哲学

Hec Forum Pub Date : 2023-12-08 DOI: 10.1007/s10730-023-09515-0

Md. Sanwar Siraj

{"title":"Who Should Be Legitimate Living Donors? The Case of Bangladesh","authors":"Md. Sanwar Siraj","doi":"10.1007/s10730-023-09515-0","DOIUrl":"https://doi.org/10.1007/s10730-023-09515-0","url":null,"abstract":"In 1999, the Bangladesh government introduced the Human Organ Transplantation Act allowing organ transplants from both brain-dead and living-related donors. This Act approved organ donation within family networks, which included immediate family members such as parents, adult children, siblings, uncles, aunts, and spouses. Subsequently, in January 2018, the government amended the 1999 Act to include certain distant relatives, such as grandparents, grandchildren, and first cousins, in the donor lists, addressing the scarcity of donors. Nobody, without these relatives, is legally permitted to donate organs for transplantation in Bangladesh. The focus of this study was to investigate who should donate organs for transplantation in Bangladesh. The ethnographic fieldwork revealed that potential donors are not always available to immediate family members, and even when they are, they might be medically unsuitable for transplants. These considerations influenced the government in the revision of the Act. Secondly, the findings of the study suggest maintaining the current family-based regulations for living organ donation in Bangladesh. Furthermore, the study highlighted a potential consequence: amending the regulation to permit donations to unrelated recipients could significantly amplify the issue of organ selling and buying. While Islam advises Muslims to be compassionate towards all humankind, it also encourages Muslims to prioritize saving the lives of family members. This religious belief limits Muslims from donating organs to family members.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138560322","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

Responding Well to Spiritual Worldviews: A Taxonomy for Clinical Ethicists. 对精神世界观的良好回应:临床伦理学家的分类。

IF 1.5 4区哲学

Hec Forum Pub Date : 2023-12-01 Epub Date: 2022-01-07 DOI: 10.1007/s10730-021-09468-2

Trevor M Bibler

{"title":"Responding Well to Spiritual Worldviews: A Taxonomy for Clinical Ethicists.","authors":"Trevor M Bibler","doi":"10.1007/s10730-021-09468-2","DOIUrl":"10.1007/s10730-021-09468-2","url":null,"abstract":"Every clinical ethics consultant, no matter their own spirituality, will meet patients, families, and healthcare professionals whose spiritualities anchor their moral worldviews. How might ethicists respond to those who rely on spirituality when making medical decisions? And further, should ethicists incorporate their own spiritual commitments into their clinical analyses and recommendations? These questions prompt reflection on foundational issues in the philosophy of medicine, political and moral theory, and methods of proper clinical ethics consultation. Rather than attempting to offer definitive answers to these questions, this essay prompts readers to consider their own answers to these questions. Specifically, it offers a taxonomic analysis of six (6) distinct responses: assessment, delegation, examination, translation, incorporation, and assertion. Furthermore, this essay describes the role of the ethicist's own spiritual commitments during the responses. Each section also names several strengths and weaknesses that ethicists ought to consider when evaluating the purpose and scope of each response. This paper prompts readers to consider circumstances under which they might promote, critique, or incorporate spiritual worldviews-their own and those of their patients-when offering clinical analyses and recommendations.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39906764","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