Cambridge Quarterly of Healthcare Ethics最新文献

The Roles of Understanding and Belief in Prognostic Awareness. 理解和信念在预后意识中的作用。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-22 DOI: 10.1017/S0963180124000628

Alexander T Yahanda, Bryan A Sisk

{"title":"The Roles of Understanding and Belief in Prognostic Awareness.","authors":"Alexander T Yahanda, Bryan A Sisk","doi":"10.1017/S0963180124000628","DOIUrl":"https://doi.org/10.1017/S0963180124000628","url":null,"abstract":"Conventional understanding and research regarding prognostic understanding too often focuses on transmission of information. However, merely overcoming barriers to patient understanding may not be sufficient. In this article the authors provide a more nuanced understanding of prognostic awareness, using oncological care as an overarching example, and discuss factors that may lead to prognostic discordance between physicians and patients. We summarize the current literature and research and present a model developed by the authors to characterize barriers to prognostic awareness. Ultimately, multiple influences on prognostic understanding may impede acceptance by patients even when adequate transfer of information takes place. Physicians should improve how they transmit prognostic information, as this information may be processed in different ways. A model of misunderstandings in awareness, ranging from patient understanding to patient belief, may be useful to guide future discussions. Future decision-making studies should consider these many variables so that interventions may be created to address all aspects of the prognostic disclosure process.","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","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 and the Observant Jewish and Muslim Patient: Shared Theocentric Perspectives in Practice. 临床伦理与笃信犹太教和穆斯林的病人：在实践中共享以神论为中心的观点。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-22 DOI: 10.1017/S0963180124000379

Fahmida Hossain, Ezra Gabbay, Joseph J Fins

引用次数: 0

Decreasing Perceived Moral Distress in Pediatrics Residents: A Pilot Study. 降低儿科住院医师的道德压力感：试点研究。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-20 DOI: 10.1017/S0963180124000355

Allison N J Lyle, Angela Quain, Sara Ali, Zeynep N Inanc Salih

{"title":"Decreasing Perceived Moral Distress in Pediatrics Residents: A Pilot Study.","authors":"Allison N J Lyle, Angela Quain, Sara Ali, Zeynep N Inanc Salih","doi":"10.1017/S0963180124000355","DOIUrl":"https://doi.org/10.1017/S0963180124000355","url":null,"abstract":"Pediatric residents experience ethical dilemmas and moral distress during training. Few studies have identified meaningful methods in reducing moral distress in pediatric trainees. The authors aimed to determine how residents perceive ethics case discussions, whether such a program affects trainee ethics knowledge and perceived moral distress, and if residents' perceived moral distress changes before, during, and after a discussion series. Participants included pediatric residents in a single residency program. Five separate 1-hour sessions were presented over a 5-month period. Each session consisted of a case presentation by a resident developed under the guidance of an ethicist. Multidisciplinary services and content experts were present during sessions. Baseline, postsession, and final surveys were distributed to resident attendees. Open-ended responses were recorded. When comparing baseline and final responses, the only significance was increased preparedness to navigate ethical decisions (p = 0.004). A 10.2% decline was observed in perceived moral distress. An increase in ethics knowledge was observed. Residents favored case-based, multidisciplinary discussions. Residents desire more sessions, time for small-group discussions, and legal insight. Satisfaction was high with 90.7% of respondents feeling better prepared to address ethical concerns. Pediatric trainees desire case-based ethics training that incorporates small-group discussions and insight from multidisciplinary topic experts.","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"Intellectual Lightening": A Tribute to John Harris through a Collection of Memories, Imaginary Books, Fictional Reviews, and an Interview. "智慧之光"：通过回忆、想象书籍、小说评论和访谈集向约翰-哈里斯致敬。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-20 DOI: 10.1017/S0963180124000574

Inez de Beaufort

引用次数: 0

An Educational Framework for Healthcare Ethics Consultation to Approach Structural Stigma in Mental Health and Substance Use Health. 医疗保健伦理咨询的教育框架，以解决心理健康和药物使用健康中的结构性污名问题。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-19 DOI: 10.1017/S0963180124000410

Zahra S Hasan, Daniel Z Buchman

{"title":"An Educational Framework for Healthcare Ethics Consultation to Approach Structural Stigma in Mental Health and Substance Use Health.","authors":"Zahra S Hasan, Daniel Z Buchman","doi":"10.1017/S0963180124000410","DOIUrl":"10.1017/S0963180124000410","url":null,"abstract":"This paper addresses the need for, and ultimately proposes, an educational framework to develop competencies in attending to ethical issues in mental health and substance use health (MHSUH) in healthcare ethics consultation (HCEC). Given the prevalence and stigma associated with MHSUH, it is crucial for healthcare ethicists to approach such matters skillfully. A literature review was conducted in the areas of bioethics, health professions education, and stigma studies, followed by quality improvement interviews with content experts to gather feedback on the framework's strengths, limitations, and anticipated utility. The proposed framework describes three key concepts: first, integrating self-reflexive practices into formal, informal, and hidden curricula; second, embedding structural humility into teaching methods and contexts of learning; and third, striking a balance between critical consciousness and compassion in dialogue. The proposed educational framework has the potential to help HCEC learners enhance their understanding and awareness of ethical issues related to structural stigma and MHSUH. Moreover, context-specific learning, particularly in MHSUH, can play a significant role in promoting competency-building among healthcare ethicists, allowing them to address issues of social justice effectively in their practice. Further dialogue is encouraged within the healthcare ethics community to further develop the concepts described in this framework.","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Teaching Ethics Consultation Using a Tabletop Exercise. 利用桌面练习教授伦理咨询。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-19 DOI: 10.1017/S0963180124000409

Hilary Mabel, Susan McCammon, Margot M Eves

引用次数: 0

The Contested Value of Life. 有争议的生命价值

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-15 DOI: 10.1017/S0963180124000598

Søren Holm

{"title":"The Contested Value of Life.","authors":"Søren Holm","doi":"10.1017/S0963180124000598","DOIUrl":"https://doi.org/10.1017/S0963180124000598","url":null,"abstract":"Putting a specific value on human life is important in many contexts and forms part of the basis for many political, administrative, commercial, and personal decisions. Sometimes, the value is set explicitly, sometimes even in monetary terms, but much more often, it is set implicitly through a decision that allows us to calculate the valuation of a life implicit in a certain rule or a certain resource allocation. We also value lives in what looks like a completely different way when we evaluate whether a particular life is being or has been lived well. Both of these ways of valuing are done from an outside or third-person perspective, but there is also a third way of valuing a life which is from the first-person perspective, and which essentially asks how much my life is worth to me. Is there any connection between these different ways of valuing life, and if so what is the connection between them? This paper provides an account of John Harris' analysis of the value of life and discusses whether it can bridge the gap between first-person and third-person evaluations of the value of life, and whether it can do so in a way that still allows for resource allocation decisions to be made in health care and other sectors.","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing a Postpandemic Model for Hybrid Clinical Ethics Rotations in Postgraduate Medical Education. 为医学研究生教育中的混合临床伦理轮训开发一种后流行模式。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-13 DOI: 10.1017/S0963180124000458

Sara Kolmes, Kevin M Dirksen

{"title":"Developing a Postpandemic Model for Hybrid Clinical Ethics Rotations in Postgraduate Medical Education.","authors":"Sara Kolmes, Kevin M Dirksen","doi":"10.1017/S0963180124000458","DOIUrl":"https://doi.org/10.1017/S0963180124000458","url":null,"abstract":"Bioethics education in residency helps trainees achieve many of the Accreditation Council for Graduate Medical Education milestones and gives them resources to respond to bioethical dilemmas. For this purpose, The Providence Center for Health Care Ethics has offered a robust clinical ethics rotation since 2000. The importance of bioethics for residents was highlighted as the COVID-19 pandemic raised significant bioethical concerns and moral distress for residents. This, combined with significant COVID-19-related practical stressors on residents led us to develop a virtual ethics rotation. A virtual rotation allowed residents flexibility as they were called to help respond to the unprecedented demands of a pandemic without compromising high quality education. This virtual rotation prioritized flexibility to support resident wellbeing and ethical analysis of resident experiences. This article describes how this rotation was able to serve residents without overstraining limited bandwidth, and address the loci of resident pandemic distress. As pandemic pressures lessened, The Providence Center for Health Care Ethics transitioned to a hybrid rotation which continues to prioritize resident wellbeing and analysis of ongoing stressors while incorporating in-person elements where they can improve learning. This article provides a description of the rotation in its final form and resident feedback on its effectiveness.","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What It Means to Be Human: A Response to Harzheim. 做人意味着什么？对哈茨海姆的回应

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-12 DOI: 10.1017/S0963180124000525

Ezra N S Lockhart

{"title":"What It Means to Be Human: A Response to Harzheim.","authors":"Ezra N S Lockhart","doi":"10.1017/S0963180124000525","DOIUrl":"https://doi.org/10.1017/S0963180124000525","url":null,"abstract":"This response engages critically with Harzheim's review of Thomas Fuchs' In Defense of the Human Being: Foundational Questions of an Embodied Anthropology. Fuchs' work offers a profound exploration of embodied cognition, arguing that human cognition and existence are deeply shaped by our physical interactions. Harzheim's critique highlights significant aspects of Fuchs' framework, including his critique of functionalist models, the impact of transhumanist technologies, and ethical concerns in healthcare technology. This paper extends Harzheim's review by proposing an integration of functionalist and embodied cognitive models, emphasizing the need for a comprehensive evaluation of technological impacts, and advocating for a more robust ethical framework that considers social equity. Additionally, it addresses the is-ought distinction and explores the implications of technological advancements on human identity and mental health. Doede's critique is also discussed, underscoring the importance of integrating diverse cognitive models and addressing technological determinism. Overall, this response calls for a more nuanced and inclusive approach to the discourse on embodied cognition, aiming to enrich the scholarly conversation and address the complexities and implications of Fuchs' analysis.","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-3"},"PeriodicalIF":1.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Value of Life and Reproductive and Professional Autonomy. 生命价值与生殖和职业自主权。

IF 1.5 4区医学

Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-11-11 DOI: 10.1017/S0963180124000537

Lucy Frith

引用次数: 0