Health Care Analysis最新文献_第3页

Sustainability as an Intrinsic Moral Concern for Solidaristic Health Care. 可持续性是团结医疗的内在道德关怀。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-12-01 Epub Date: 2023-09-04 DOI: 10.1007/s10728-023-00469-5

Marcel Verweij, Hans Ossebaard

{"title":"Sustainability as an Intrinsic Moral Concern for Solidaristic Health Care.","authors":"Marcel Verweij, Hans Ossebaard","doi":"10.1007/s10728-023-00469-5","DOIUrl":"10.1007/s10728-023-00469-5","url":null,"abstract":"Environmental pollution and greenhouse gas emissions that contribute to climate change have adverse impacts on global health. Somewhat paradoxically, health care systems that aim to prevent and cure disease are themselves major emitters and polluters. In this paper we develop a justification for the claim that solidaristic health care systems should include sustainability as one of the criteria for determining which health interventions are made available or reimbursed - and which not. There is however a complication: most adverse health effects due to climate change do occur elsewhere in the world. If solidarity would commit us to take care of everyone's health, worldwide, it might imply that solidaristic health system cannot justifiably restrict universal access to their own national populations. In response we explain health solidarity is to be considered as a moral ideal. Such an ideal does not specify what societies owe to whom, but it does have moral implications. We argue that ignoring sustainability in political decision making about what health care is to be offered, would amount to betrayal of the ideal of solidarity.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"261-271"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Ethical, Psychological and Social Un/certainties in the Face of Deemed Consent for Organ Donation in England. 在英格兰，面对器官捐献的 "视为同意"，伦理、心理和社会方面的不确定性。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI: 10.1007/s10728-024-00492-0

Laura L Machin, Elizabeth Wrench, Jessie Cooper, Heather Dixon, Mark Wilkinson

{"title":"Ethical, Psychological and Social Un/certainties in the Face of Deemed Consent for Organ Donation in England.","authors":"Laura L Machin, Elizabeth Wrench, Jessie Cooper, Heather Dixon, Mark Wilkinson","doi":"10.1007/s10728-024-00492-0","DOIUrl":"10.1007/s10728-024-00492-0","url":null,"abstract":"Deemed consent legislation for deceased organ donation was introduced in England in 2020, and is considered a vital part of the new UK NHS Blood and Transplant's 10-year strategy to increase consent for organ donation. Despite the legislation containing safeguards to protect the public, the introduction of deemed consent creates ethical, psychological and social un/certainties for healthcare professionals in their practice. In this paper, we offer insights into healthcare professionals' perspectives on deemed consent, drawn from interview data with 24 healthcare professionals in an NHS Trust in England, prior to the introduction of the legislation. Whilst participants supported deemed consent in principle, they were concerned that it would present a threat to the nature of donation as a 'gift'; the notion of informed consent (or non-consent); and the autonomy of donors, their relatives, and their own roles as health professionals, posing dilemmas for practice. We argue that healthcare professionals present themselves as guardians of potential (non)donors and thus as having ethics and integrity in their own practice. We draw conclusions around the values and principles that matter to healthcare professionals when contemplating consent in deceased donation which will be useful for organ donation committees and ethics forums.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"272-289"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

"I Do Not Believe We Should Disclose Everything to an Older Patient": Challenges and Ethical Concerns in Clinical Decision-Making in Old-Age Care in Ethiopia. "我不认为我们应该向老年患者披露一切"：埃塞俄比亚老年护理临床决策中的挑战和伦理问题。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-12-01 Epub Date: 2024-10-01 DOI: 10.1007/s10728-024-00494-y

Kirubel Manyazewal Mussie, Mirgissa Kaba, Jenny Setchell, Bernice Simone Elger

{"title":"\"I Do Not Believe We Should Disclose Everything to an Older Patient\": Challenges and Ethical Concerns in Clinical Decision-Making in Old-Age Care in Ethiopia.","authors":"Kirubel Manyazewal Mussie, Mirgissa Kaba, Jenny Setchell, Bernice Simone Elger","doi":"10.1007/s10728-024-00494-y","DOIUrl":"10.1007/s10728-024-00494-y","url":null,"abstract":"Clinical decision-making in old-age care is a complex and ethically sensitive process. Despite its importance, research addressing the challenges of clinical decision-making in old-age care within this cultural context is limited. This study aimed to explore the challenges and ethical concerns in clinical decision-making in old-age care in Ethiopia. This qualitative study employed an inductive approach with data collected via semi-structured interviews with 20 older patients and 26 health professionals recruited from healthcare facilities in Ethiopia. Data were analysed using reflexive thematic analysis. Our analysis identified three key themes. First, participants highlighted perceptions that older patients' religious beliefs interfere with the clinical decisions both older patients and health professionals make. Second, older patients often receive limited information from health professionals about their diagnosis and treatment. Third, families of older patients appear to strongly influence clinical decisions made by older patients or health professionals. This research enhances the understanding of clinical decision-making in old-age care within Ethiopia, a context where such research is scarce. As a result, this study contributes towards advancing the deliberation of ethical dilemmas that health professionals who work with older patients in Ethiopia might face. A key implication of the study is that there is a need for more ethics and cultural competence training for health professionals working with older patients in Ethiopia.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"290-311"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Recontextualization and Imagination: The Public Health Professional and the U.S. Health Care System. 重新语境化与想象力：公共卫生专业人员与美国医疗保健系统》。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-12-01 Epub Date: 2024-05-20 DOI: 10.1007/s10728-024-00482-2

William Minter

引用次数: 0

The Epistemic Policies of Anti-Ageing Medicines in the European Union. 欧盟抗衰老药物的认识论政策》。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-11-19 DOI: 10.1007/s10728-024-00497-9

Guillermo Marín Penella

{"title":"The Epistemic Policies of Anti-Ageing Medicines in the European Union.","authors":"Guillermo Marín Penella","doi":"10.1007/s10728-024-00497-9","DOIUrl":"10.1007/s10728-024-00497-9","url":null,"abstract":"Anti-ageing medicines are products intended to extend lifespan and healthspan in humans that have a good potential use in public health policies. In the European Union, their development, production and consumption are dependent on regulatory science performed by the European Medicines Agency and its associated epistemic policies. They impose, among other things, an unfavourable burden of proof, a strict standard of proof and meta-methodological constrictions related to some theoretical issues. This results in a distribution of errors that tends to reduce false positives while increasing false negatives, leading to a set of social consequences that are generally accepted when the focus is placed on conventional medicines. However, when the same epistemic policies are applied to anti-ageing medicines, the distribution of errors is imbalanced, and undesirable outcomes like research discouragement and waiting time extensions appear. Three possible strategies that policymakers could implement to unblock the situation are presented for future reflection: the consideration of ageing as a disease, the application of methodological asymmetry and the use of biomarkers during clinical research.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Perceptions and Expectations of Midwives and Women Regarding Prenatal Care within the Scope of Primary Health Care Services in Türkiye. 助产士和妇女对土耳其初级保健服务范围内产前护理的看法和期望。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-11-14 DOI: 10.1007/s10728-024-00501-2

Nazli Unlu Bidik, Zekiye Turan

{"title":"Perceptions and Expectations of Midwives and Women Regarding Prenatal Care within the Scope of Primary Health Care Services in Türkiye.","authors":"Nazli Unlu Bidik, Zekiye Turan","doi":"10.1007/s10728-024-00501-2","DOIUrl":"https://doi.org/10.1007/s10728-024-00501-2","url":null,"abstract":"One of the Sustainable Development Goals is to reduce the global maternal mortality rate. Antenatal care is a crucial component in achieving this goal. The aim of our study is to reveal the perceptions and expectations of midwives and women regarding antenatal care. In this qualitative study, Husserl's philosophy of phenomenology was adopted to emphasize the knowledge of experiences. One-to-one in-depth interviews were conducted with 31 participants - 15 midwives and 16 women - who received antenatal care in Türkiye. Each interview was recorded and transcribed verbatim. The data obtained from the research were analyzed using traditional content analysis, resulting in five main themes and ten sub-themes. The main themes were \"Lack of knowledge/awareness,\" \"Midwifery in Antenatal Care Services,\" \"Practices within the Scope of Antenatal Care,\" \"Factors Hindering Receiving Antenatal Care,\" and \"Expectations from Antenatal Care.\" The women participating in the research could not define the concept of \"Antenatal care\" and did not consider the service they received during pregnancy as antenatal care. It was determined that midwives could not provide quality antenatal care services to women for various reasons. Midwives should raise women's awareness about antenatal care, which includes examination, treatment, education, and counselling. In addition, the areas of need of primary health care services should be determined, and necessary improvements should be made.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Severity and Temporality in Healthcare Priority Setting - A Case for A Condition-specific Affectable Time-neutral Approach. 医疗保健优先级设定中的严重性和时间性--特定病症可影响时间的中性方法案例。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-10-24 DOI: 10.1007/s10728-024-00493-z

Lars Sandman, Niklas Juth

{"title":"Severity and Temporality in Healthcare Priority Setting - A Case for A Condition-specific Affectable Time-neutral Approach.","authors":"Lars Sandman, Niklas Juth","doi":"10.1007/s10728-024-00493-z","DOIUrl":"https://doi.org/10.1007/s10728-024-00493-z","url":null,"abstract":"Priority setting of scarce resources in healthcare is high on the agenda of most healthcare systems implying a need to develop robust foundations for making fair allocation decisions. One central factor for such decisions in needs-based systems, following both empirical studies and theoretical analyses, is severity. However, it has been noted that severity is an under-theorized concept. One such aspect is how severity should relate to temporality. There is a rich discussion on temporality and distributive justice, however, this discussion needs to be adapted to the practical and ethical requirements of healthcare priority setting principles at mid-level. In this article, we analyze how temporal aspects should be taken into account when assessing severity as a modifier for cost-effectiveness. We argue that when assessing the severity of a condition, we have reason to look at complete conditions from a time-neutral perspective, meaning that we take the full affectable stretch of the condition into account without modifying severity as patients move through the temporal stretch and without discounting the future. We do not find support for taking the 'shape' of a condition into account per se, e.g. whether the severity has a declining or inclining curve, or that severity is intermittent rather than continuous. In order to take severity seriously, we argue that we have reason to apply a quantified approach where every difference in severity should impact on priority setting. In conclusion, we find that this approach is practically useful in actual priority setting.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Exploring the Broader Benefits of Obesity Prevention Community-based Interventions From the Perspective of Multiple Stakeholders. 从多方利益相关者的角度探索肥胖预防社区干预措施的更广泛益处。

IF 1.8 3区哲学

Health Care Analysis Pub Date : 2024-10-03 DOI: 10.1007/s10728-024-00495-x

J Jacobs, M Nichols, N Ward, M Sultana, S Allender, V Brown

{"title":"Exploring the Broader Benefits of Obesity Prevention Community-based Interventions From the Perspective of Multiple Stakeholders.","authors":"J Jacobs, M Nichols, N Ward, M Sultana, S Allender, V Brown","doi":"10.1007/s10728-024-00495-x","DOIUrl":"https://doi.org/10.1007/s10728-024-00495-x","url":null,"abstract":"Community-based interventions (CBIs) show promise as effective and cost-effective obesity prevention initiatives. CBIs are typically complex interventions, including multiple settings, strategies and stakeholders. Cost-effectiveness evidence, however, generally only considers a narrow range of costs and benefits associated with anthropometric outcomes. While it is recognised that the complexity of CBIs may result in broader non-health societal and community benefits, the identification, measurement, and quantification of these outcomes is limited. This study aimed to understand the perspectives of stakeholders on the broader benefits of CBIs and their measurement, as well as perceptions of CBI cost-effectiveness. Purposive sampling was used to recruit participants from three stakeholder groups (lead researchers, funders, and community stakeholders of CBIs). Online semi-structured interviews were conducted, taking a constructivist approach. Coding, theme development and analysis were based on published guidance for thematic analysis. Twenty-six stakeholders participated in the interviews (12 lead researchers; 7 funders; 6 community stakeholders). Six key themes emerged; (1) Impacts of CBIs (health impacts and broader impacts); (2) Broader benefits were important to stakeholders; (3) Measurement of benefits are challenging; (4) CBIs were considered cost-effective; (5) Framing CBIs for community engagement (6) Making equitable impacts and sustaining changes-successes and challenges. Across all stakeholders, broader benefits, particularly the establishment of networks and partnerships within communities, were seen as important outcomes of CBIs. Participants viewed the CBI approach to obesity prevention as cost-effective, however, there were challenges in measuring, quantifying and valuing broader benefits. Development of tools to measure and quantify broader benefits would allow for more comprehensive evaluation of the cost-effectiveness of CBIs for obesity prevention.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Cooperation in Return-to-work Interventions for Common Mental Disorders: An Ideal Theory Analysis of Actors, Goals, and Ethical Obstacles 常见精神障碍重返工作岗位干预中的合作：行为者、目标和伦理障碍的理想理论分析

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2024-09-17 DOI: 10.1007/s10728-024-00491-1

Thomas Hartvigsson, Lars Sandman, Gunnar Bergström, Elisabeth Björk Brämberg

{"title":"Cooperation in Return-to-work Interventions for Common Mental Disorders: An Ideal Theory Analysis of Actors, Goals, and Ethical Obstacles","authors":"Thomas Hartvigsson, Lars Sandman, Gunnar Bergström, Elisabeth Björk Brämberg","doi":"10.1007/s10728-024-00491-1","DOIUrl":"https://doi.org/10.1007/s10728-024-00491-1","url":null,"abstract":"The rise in the number of people on sick leave for common mental disorders is a growing concern, both from a societal and individual perspective. One common suggestion to improve the return-to-work process is increased cooperation between the relevant parties, including at least the employer, the social insurance agency and health care. This suggestion is often made on the presumption that all parties share the common goal of reintegrating the patient-employee back into the workplace. In this paper we investigate this presumption by mapping out the ethical frameworks of these three key actors in any return-to-work process. We show that although the goals of these actors often, and to a large extent, overlap there are potential differences and tensions between their respective goals. Further, we emphasise that there may be other limitations to an actor’s participation in the process. In particular the health care system is required to respect patient autonomy and confidentiality. There is also an inherent tension in the dual roles of health care professionals as therapists and expert witnesses in work ability assessment. In conclusion, there are potential tensions between the key actors in the return-to-work process. These tensions need to be addressed in order to enable an increased cooperation between actors and to facilitate the development of a feasible plan of action for all parties, including the employee.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"202 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Legal Regulation, Financial Incentives and Professional Autonomy in the Prioritisation of Norwegian Specialist Health Services 挪威专科医疗服务优先次序中的法律规定、经济激励和专业自主权

IF 1.9 3区哲学

Health Care Analysis Pub Date : 2024-09-17 DOI: 10.1007/s10728-024-00489-9

Afsaneh Bjorvatn, Even Nilssen

{"title":"Legal Regulation, Financial Incentives and Professional Autonomy in the Prioritisation of Norwegian Specialist Health Services","authors":"Afsaneh Bjorvatn, Even Nilssen","doi":"10.1007/s10728-024-00489-9","DOIUrl":"https://doi.org/10.1007/s10728-024-00489-9","url":null,"abstract":"To study hospital physicians’ awareness and perceptions of the legal and financial regulations, and their impact on professional discretion regarding equity in access to treatment and quality of care. A sample of 637 physicians in the Norwegian specialist healthcare services selected from a survey conducted by the Institute for Studies of the Medical Profession. The paper investigates how legal and financial policy instruments affect the application of professional discretion regarding the prioritisation of specialist health services. Descriptive statistics and regressions were conducted for the analyses. Compared with financial incentives, legal regulations (laws, priority rules and guidelines) were assessed to be less negative external interventions in the exercise of medical and professional judgement. The empirical analyses revealed a positive tendency in physicians’ assessments of the impact of legal regulations on treatment equity and healthcare quality, but negative attitudes towards financial instruments. The variations revealed are attributable to various structural and epistemic features of the legal–bureaucratic and economic models of administration in this area of the welfare state. Legal and financial regulations are imposed to achieve certain social goals and values. The findings of this study can provide further insight for the health authorities in other countries concerning implementation of such regulations in the specialist healthcare services.","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":"8 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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