Naked, Deformed, Violated Body. A Montage in the Histoire(s du cinema of Jean-Luc Godard

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Alberto Brodesco

2013-07-01

Full Text Available The article analyses Histoire(s du cinéma (1988-1998, a cinematic essay by Jean-Luc Godard, and in particular it focuses on the controversial montage in which the French director aligns extracts from a pornographic film, Tod Browning’s Freaks, and footage from the concentration camps. With this sequence Godard inquires his own theory of montage: the idea of a productive reconciliation between opposing realities. This shocking sequence (the violence of images is compared to a similar shock (the violence of asking to witness produced by a scene of the documentary Shoah by Claude Lanzmann. The trauma of Godard’s editing choice induces the viewer to examine the issues of the degradation of the indexical status of the film, the limits of representation and the ethics of the gaze.

Public Lecture | Making the most of your presentation | By Jean-Luc Doumont | 26 June

CERN Multimedia

2014-01-01

Making the most of your presentation, by Dr. Jean-Luc Doumont (Principiae).   Thursday 26 June 2014 from 14:30 to 16:30 at CERN (4-3-006 - TH Conference Room) Want to participate? Apply here. Strong presentation skills are a key to success for engineers and scientists, yet many of these do not exploit their potential to reach the audience. Systematic as they can be in their work, they go at it intuitively, with much good will but with results that could be much better. In this talk, Dr. Doumont proposes a systematic way to prepare and deliver an oral presentation: he covers structure, slides, and delivery, as well as stage fright. An engineer (Louvain) and PhD in applied physics (Stanford), Dr. Jean-Luc Doumont is acclaimed worldwide for his no-nonsense approach, his highly applicable, often life-changing recommendations on a wide range of topics, and Trees, maps, and theorems, his book about “effective communication for rational minds”. He had his first rese...

Je vous salue Marie de Jean-Luc Godard : modalités et enjeux d’un retour du religieux au cinéma “Hail Mary, full of grace”, a film by Jean-Luc Godard

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Natalie Malabre

2012-06-01

Full Text Available Est-il possible de filmer un sujet aussi sensible que celui de la virginité de Marie en dehors des références aux canons religieux ? Ce fut le défi de Jean-Luc Godard au milieu des années 1980, lorsqu’il réalisa Je vous salue Marie. Sans surprise, certains catholiques manifestèrent leur opposition. Mais d’autres essayèrent d’expliquer et de soutenir cette manière non traditionnelle d’approcher le mystère de la transcendance.Is it possible to film religious subject, a very sensitive one like the virginity of Mary, out of the references of religious stances? That was the challenge of Jean-Luc Godard in the middle of the 80’s when he promoted “Je vous salue Marie”. Without surprise, some Catholics demonstrated their opposition. But some of them tried to explain and support the untraditional way to approach the mystery of transcendence.

Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals.

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Smailhodzic, Edin; Hooijsma, Wyanda; Boonstra, Albert; Langley, David J

2016-08-26

Since the emergence of social media in 2004, a growing percentage of patients use this technology for health related reasons. To reflect on the alleged beneficial and potentially harmful effects of social media use by patients, the aim of this paper is to provide an overview of the extant literature on the effects of social media use for health related reasons on patients and their relationship with healthcare professionals. We conducted a systematic literature review on empirical research regarding the effects of social media use by patients for health related reasons. The papers we included met the following selection criteria: (1) published in a peer-reviewed journal, (2) written in English, (3) full text available to the researcher, (4) contain primary empirical data, (5) the users of social media are patients, (6) the effects of patients using social media are clearly stated, (7) satisfy established quality criteria. Initially, a total of 1,743 articles were identified from which 22 were included in the study. From these articles six categories of patients' use of social media were identified, namely: emotional, information, esteem, network support, social comparison and emotional expression. The types of use were found to lead to seven identified types of effects on patients, namely improved self-management and control, enhanced psychological well-being, and enhanced subjective well-being, diminished subjective well-being, addiction to social media, loss of privacy, and being targeted for promotion. Social media use by patients was found to affect the healthcare professional and patient relationship, by leading to more equal communication between the patient and healthcare professional, increased switching of doctors, harmonious relationships, and suboptimal interaction between the patient and healthcare professional. Our review provides insights into the emerging utilization of social media in healthcare. In particular, it identifies types of use by patients

A Poetics at the Limit of the Subject: Nancy’s Philosophy of Singular Being in Conrad’s “The Secret Sharer”

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Brenda MACHOSKY

2004-10-01

Full Text Available In concluding the Preface to La communauté désoeuvrée, Jean-Luc Nancy laments the possibility (or likelihood that as human beings we will soon be deprived of our finite existence, the experience of the finitude at the essence of our being. The myth of much contemporary discourse, the myth Nancy hopes to interrupt with “literary communism,” is the sublation or overcoming of finitude. In articulating a discourse of “singularity” Nancy disrupts the narrative flow of subjectivity. He does not pr...

Managing Ethical Difficulties in Healthcare: Communicating in Inter-professional Clinical Ethics Support Sessions.

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Grönlund, Catarina Fischer; Dahlqvist, Vera; Zingmark, Karin; Sandlund, Mikael; Söderberg, Anna

2016-12-01

Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support (CES) inspired by Habermas' theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved.

Practical virtue ethics: healthcare whistleblowing and portable digital technology.

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Bolsin, S; Faunce, T; Oakley, J

2005-10-01

Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers' agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical "coalfaces". Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety.Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development.

An exploration of partnership through interactions between young 'expert' patients with cystic fibrosis and healthcare professionals.

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MacDonald, Kath; Irvine, Lindesay; Smith, Margaret Coulter

2015-12-01

To explore how young 'expert patients' living with Cystic Fibrosis and the healthcare professionals with whom they interact perceive partnership and negotiate care. Modern healthcare policy encourages partnership, engagement and self-management of long-term conditions. This philosophy is congruent with the model adopted in the care of those with Cystic Fibrosis, where self-management, trust and mutual respect are perceived to be integral to the development of the ongoing patient/professional relationship. Self-management is associated with the term; 'expert patient'; an individual with a long-term condition whose knowledge and skills are valued and used in partnership with healthcare professionals. However, the term 'expert patient' is debated in the literature as are the motivation for its use and the assumptions implicit in the term. A qualitative exploratory design informed by Interpretivism and Symbolic Interactionism was conducted. Thirty-four consultations were observed and 23 semi-structured interviews conducted between 10 patients, 2 carers and 12 healthcare professionals. Data were analysed thematically using the five stages of 'Framework' a matrix-based qualitative data analysis approach and were subject to peer review and respondent validation. The study received full ethical approval. Three main themes emerged; experiences of partnership, attributes of the expert patient and constructions of illness. Sub-themes of the 'ceremonial order of the clinic', negotiation and trust in relationships and perceptions of the expert patient are presented. The model of consultation may be a barrier to person-centred care. Healthcare professionals show leniency in negotiations, but do not always trust patients' accounts. The term 'expert patient' is unpopular and remains contested. Gaining insight into structures and processes that enable or inhibit partnership can lead to a collaborative approach to service redesign and a revision of the consultation model. © 2015

Moral mindfulness: The ethical concerns of healthcare professionals working in a psychiatric intensive care unit.

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Salzmann-Erikson, Martin

2018-06-22

Healthcare professionals working on inpatient wards face the externalizing or challenging behaviour of the patients who are admitted. Ethical values and principles in psychiatric nursing have been reported to be important when approaching patients during the most acute phase of deterioration in their mental health. Hence, the aim of this study was to discover and describe staff members' ethical and moral concerns about their work as healthcare professionals in a psychiatric intensive care unit. The study has a qualitative descriptive design and makes use of Framework Analysis. Registered nurses and psychiatric aides in a psychiatric intensive care unit in Sweden were observed during ethical reflection meetings. Four to six staff attended the 90-min meetings. The data comprise observations from six meetings, which provided 94 pages of text. The results demonstrate that the work was described as being both motivating and exhausting. The staff faced ethical concerns in their daily work, as patients often demonstrated challenging behaviours. Three themes were identified as follows: (i) concerns about the staff impacting on patients' experience of care, (ii) concerns about establishing a safe working environment, and (iii) concerns about becoming unprofessional due to expectations and a high workload. Ethical concerns included simultaneously taking into account both the patients' dignity and safety aspects, while also being exposed to high workloads. These elements of work are theorized as influencing complex psychiatric nursing. If we are to bring these influential factors to light in the workplace, advanced nursing practice must be grounded in moral mindfulness. © 2018 Australian College of Mental Health Nurses Inc.

Quality of healthcare services and its relationship with patient safety culture and nurse-physician professional communication.

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Ghahramanian, Akram; Rezaei, Tayyebeh; Abdullahzadeh, Farahnaz; Sheikhalipour, Zahra; Dianat, Iman

2017-01-01

Background: This study investigated quality of healthcare services from patients' perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz-Iran. Data were collected using the service quality measurement scale (SERVQUAL), hospital survey on patient safety culture (HSOPSC) and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD) scores of the patients' perception on the healthcare services quality belonged to the assurance 13.92 (±3.55) and empathy 6.78 (±1.88) domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD) scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35) and "non-participative decision-making" 2.84 (±0.34) domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01) and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001) predicted the patients'perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non-punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.

Korean nurses' ethical dilemmas, professional values and professional quality of life.

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Kim, Kyunghee; Han, Yonghee; Kim, Ji-su

2015-06-01

In the changing medical environment, professional stress continuously increases as the individual's quality of life suffers. Of all the healthcare professions, nursing is especially prone to burnout, compassion fatigue and reduced compassion satisfaction, due to the tensions resulting from the physical and psychological stress of caring for extremely ill patients. This study examined the professional quality of life of clinical nurses in Korea and the relationship between their experiences in ethical dilemmas and professional values. This was a cross-sectional study of a convenience sample consisting of 488 clinical nurses. We used four questionnaires to measure the participants' demographic characteristics, experiences in ethical dilemmas, professional nursing values and professional quality of life (ProQOL assessment, Version 5). Ethical considerations: This study received approval from the Institutional Review Board of Bronco Memorial Hospital. Written informed consent was given by all participants. The nurses' professional quality of life was affected by ethical dilemmas and professional nursing values. The factors influencing compassion satisfaction were age, client domain of ethical dilemmas, social awareness, professionalism of nursing and the roles of nursing services in professional values. The factors influencing burnout were marital status (married), religion (yes), human life domain, professional work domain of ethical dilemmas, social awareness and the role of nursing services in nursing professional values. The factors influencing secondary traumatic stress were human life domain, client domain and the professional work domain of ethical dilemmas. Intervention to help nurses increase their professional quality of life will have a greater chance of success if they are based on the nurses' values and beliefs about the ethical dilemmas they face and foster the establishment of positive professional values. © The Author(s) 2014.

Homo sacer w świecie chaosu. Szkic o związkach Agambena z Nancym i Serres’em (Homo Sacer in the World of Chaos. Essay about Agamben’s Associations with Nancy and Serres

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Marcin M. Bogusławski

2010-12-01

Full Text Available This paper concerns political philosophy of Agamben, which I consider as variety of philosophy of relations.The important point of reference for Agamben are concepts of Jean-Luc Nancy and Michel Serres. According to this, as I show in my sketch, this associations are only superficial. In my opinion consequent philosophy of relations undermines main theses of Agamben’s philosophical project.

Engineering innovation in healthcare: technology, ethics and persons.

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Bowen, W Richard

2011-01-01

Engineering makes profound contributions to our health. Many of these contributions benefit whole populations, such as clean water and sewage treatment, buildings, dependable sources of energy, efficient harvesting and storage of food, and pharmaceutical manufacture. Thus, ethical assessment of these and other engineering activities has often emphasized benefits to communities. This is in contrast to medical ethics, which has tended to emphasize the individual patient affected by a doctor's actions. However technological innovation is leading to an entanglement of the activities, and hence ethical responsibilities, of healthcare professionals and engineering professionals. The article outlines three categories of innovation: assistive technologies, telehealthcare and quasi-autonomous systems. Approaches to engineering ethics are described and applied to these innovations. Such innovations raise a number of ethical opportunities and challenges, especially as the complexity of the technology increases. In particular the design and operation of the technologies require engineers to seek closer involvement with the persons benefiting from their work. Future innovation will require engineers to have a good knowledge of human biology and psychology. More particularly, healthcare engineers will need to prioritize each person's wellbeing, agency, human relationships and ecological self rather than technology, in the same way that doctors prioritize the treatment of persons rather than their diseases.

Quality of healthcare services and its relationship with patient safety culture and nurse-physician professional communication

Directory of Open Access Journals (Sweden)

Akram Ghahramanian

2017-06-01

Full Text Available Background: This study investigated quality of healthcare services from patients’ perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz–Iran. Data were collected using the service quality measurement scale (SERVQUAL, hospital survey on patient safety culture (HSOPSC and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD scores of the patients’ perception on the healthcare services quality belonged to the assurance 13.92 (±3.55 and empathy 6.78 (±1.88 domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35 and "non participative decision-making" 2.84 (±0.34 domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01 and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001 predicted the patients’perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.

Kohti elokuvallista ajattelua : virtuaalisen todellisen ontologia Gilles Deleuzen ja Jean-Luc Godardin elokuvakäsityksissä

OpenAIRE

Oravala, Juha

2008-01-01

Juha Oravala tarkastelee tutkimuksessaan yhteyttä ranskalaisen filosofin Gilles Deleuzen (1925–1995) elokuvalle ominaisten liikkeen ja ajan kategorioille rakentuvan monijakoisen todellisuuskäsityksen sekä ranskalaisen elokuvaohjaaja Jean-Luc Godardin tutkivan elokuvakäsityksen välillä.Aikaisempi elokuvateoria painotti laajalti tekijälähtöistä näkökulmaa. Sen yksi vallitseva tulkinnallinen totuus oli, että tekijä pyrkii ilmaisemaan elokuvien kautta sisäistä kokemusmaailmaansa ja sisäistä puhet...

Do we treat individuals as patients or as potential donors? A phenomenological study of healthcare professionals' experiences.

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Orøy, Aud; Strømskag, Kjell Erik; Gjengedal, Eva

2015-03-01

Organ donation and transplantation have made it possible to both save life and to improve the quality of life for a large number of patients. In the last years there has been an increasing gap between the number of patients who need organs and organs available for transplantation, and the focus worldwide has been on how to meet the organ shortage. This also rises some ethical challenges. The objective of this study was to explore healthcare professionals' experience of ethics related to care and interaction with critically ill patients with severe brain injuries and their families. A hermeneutic phenomenological approach was used to explore the participants' experiences. Methods for collecting data were a combination of participant observations and in-depth interviews. Two ICUs in a Norwegian university hospital were recruited for data collection. A total of 12 cases were observed, and 32 of the healthcare professionals involved were interviewed. The study was approved by the Regional Committee for Research Ethics. Permission to the study in the ICUs was obtained from the Chief Physician in the two ICUs respectively. The right of the participants was ensured by written, voluntary, and informed consent. From the thematic analysis, a structure of the participants' experiences emerged as a process. While the patients' condition was clarified through phases of prognostic ambiguity, gradual clarification and prognostic certainty, interaction with the families was characterized by ambiguity that involved withholding. The prognostic process had a great impact on how the healthcare professionals interacted with the family. The interaction challenged the participants' caring values in various ways and captured an important structure in their experiences of the ethical interaction with the patients' families. These challenges distinguish caring for families in donation situations from caring for relatives of critically ill patients in general. In the discussion we have

Ethical Issues of Social Media Usage in Healthcare.

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Denecke, K; Bamidis, P; Bond, C; Gabarron, E; Househ, M; Lau, A Y S; Mayer, M A; Merolli, M; Hansen, M

2015-08-13

Social media, web and mobile technologies are increasingly used in healthcare and directly support patientcentered care. Patients benefit from disease self-management tools, contact to others, and closer monitoring. Researchers study drug efficiency, or recruit patients for clinical studies via these technologies. However, low communication barriers in socialmedia, limited privacy and security issues lead to problems from an ethical perspective. This paper summarizes the ethical issues to be considered when social media is exploited in healthcare contexts. Starting from our experiences in social-media research, we collected ethical issues for selected social-media use cases in the context of patient-centered care. Results were enriched by collecting and analyzing relevant literature and were discussed and interpreted by members of the IMIA Social Media Working Group. Most relevant issues in social-media applications are confidence and privacy that need to be carefully preserved. The patient-physician relationship can suffer from the new information gain on both sides since private information of both healthcare provider and consumer may be accessible through the Internet. Physicians need to ensure they keep the borders between private and professional intact. Beyond, preserving patient anonymity when citing Internet content is crucial for research studies. Exploiting medical social-media in healthcare applications requires a careful reflection of roles and responsibilities. Availability of data and information can be useful in many settings, but the abuse of data needs to be prevented. Preserving privacy and confidentiality of online users is a main issue, as well as providing means for patients or Internet users to express concerns on data usage.

Patient participation, a prerequisite for care: A grounded theory study of healthcare professionals' perceptions of what participation means in a paediatric care context.

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Carlsson, Ing-Marie; Nygren, Jens M; Svedberg, Petra

2018-01-01

To explore healthcare professionals' perceptions of what patient participation means in a paediatric care context . A qualitative explorative design with grounded theory. Fifteen healthcare professionals who worked in paediatric care settings were either interviewed or asked open-ended questions in a survey, during December 2015-May 2016. Grounded theory was used as a method. The study results provide a theoretical conceptualization of what patient participation meant for healthcare professionals in paediatric care and how participation was enabled. The core category "participation a prerequisite for care" emerged as the main finding explaining the concept as ethical, practical and integrated in the care givers way of working. However, the concept was implicit in the organization. Four additional categories illustrated the healthcare professionals' different strategies used to enhance patient participation; "meeting each child where the child is," "building a relationship with the child," "showing respect for each individual child" and "making the most of the moment."

Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals

OpenAIRE

Smailhodzic, Edin; Hooijsma, Wyanda; Boonstra, Albert; Langley, David J.

2016-01-01

Background Since the emergence of social media in 2004, a growing percentage of patients use this technology for health related reasons. To reflect on the alleged beneficial and potentially harmful effects of social media use by patients, the aim of this paper is to provide an overview of the extant literature on the effects of social media use for health related reasons on patients and their relationship with healthcare professionals. Methods We conducted a systematic literature review on em...

Ethical implications of digital communication for the patient-clinician relationship: analysis of interviews with clinicians and young adults with long term conditions (the LYNC study).

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Ignatowicz, Agnieszka; Slowther, Anne-Marie; Elder, Patrick; Bryce, Carol; Hamilton, Kathryn; Huxley, Caroline; Forjaz, Vera; Sturt, Jackie; Griffiths, Frances

2018-02-23

Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions. A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom (UK)-based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites (cancer, liver, renal, cystic fibrosis and mental health) were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms. Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician's duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical

Evaluation of ethical reflections in community healthcare: a mixed-methods study.

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Söderhamn, Ulrika; Kjøstvedt, Helga Tofte; Slettebø, Åshild

2015-03-01

Ethical reflections over care practices are important. In order to be able to perform such reflections, healthcare professionals must learn to think critically about their care practice. The aim of this study was to evaluate whether an introduction to and practice in ethical reflections in community healthcare have consequences for the healthcare personnel's practice. A mixed-methods design was adopted with five focus group interviews and an electronic questionnaire based on results from the interviews. A total of 29 community healthcare personnel with experience in ethical reflections participated in the interviews. The electronic questionnaire was sent via email to 2382 employees in community healthcare services in 13 municipalities in southern part of Norway. The study was guided by the intentions of the Declaration of Helsinki and ethical standard principles and approved by the Norwegian Social Science Data Services. An introduction to and practice in performing ethical reflections brought about an ethical awareness with understanding and respect for both colleagues and patients. The leader had a key role. Lack of time was a hindrance for ethical reflections. Three factors could predict meaningful ethical reflections: higher age of personnel, higher percentage of employment and longer experience with ethical reflections. According to other studies, ethical reflections may enhance moral development of colleagues and their actions as advocates for the patients. A deepened ethical awareness, professional competency and sufficient time resources will guarantee proper caregiving. A supportive environment that prioritizes participation in reflection meetings is decisive. To practice ethical reflections will provide better care for patients. A challenge for the community healthcare system is to offer adequate positions that provide the personnel an opportunity to be involved as caregivers and to participate in ethical reflections. © The Author(s) 2014.

Development of professionalism: case study of HIV/AIDS-related stigma among healthcare students

OpenAIRE

Ahmadi, Keivan

2015-01-01

A healthcare workforce that is responsive and fair in its treatment of patients is one of the central pillars of a modern health system (1). It is for this reason, among others, that healthcare workers are ethically bound to treat patients according to their need, and not according to their gender, religious beliefs, sexual orientation, skin color, or other socially (de)valued attribute. Within a modern healthcare program, there is also a focus on professional ethics and professional practice...

The discursive production of professionals about humanizing health: singularity, rights and ethics1

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Silva, Rose Mary Costa Rosa Andrade; de Oliveira, Denize Cristina; Pereira, Eliane Ramos

2015-01-01

Objective: to describe the discursive production of professionals about the humanization of health. Method: qualitative study of descriptive approach, inspired by the social representation theory, with 24 professionals in the healthcare field, working in a university hospital with the established humanization policy. The selection of participants was conducted according to criteria of adequacy and diversity for an intentional sample. Data collection was conducted by semi-structured interviews. Results: through content analysis, three categories emerged, around which the analyses were conducted: "humanizing health as an act of accepting the other as unique", "humanizing health as a matter of right" and "humanizing health as an ethical issue". The discursive production of professionals is based on a perspective which is based on the humanist prospect with socio-historical bias. Conclusion: healthcare professionals must know the National Humanization Policy in order to provide quality care, promoting the meeting, welcoming and recognition of oneself, others and their profession in the political and socio-historical scenario of their country as a citizen, not only of rights, but also of obligations. PMID:26487145

Ethical concerns and dilemmas of Finnish and Dutch health professionals.

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Hopia, Hanna; Lottes, Ilsa; Kanne, Mariël

2016-09-01

Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. To describe ethical dilemmas and concerns at work from the perspectives of Finnish and Dutch healthcare professionals studying at the master's level. Exploratory, qualitative study that used the text of student online discussions of ethical dilemmas at work as data. Participants' online discussions were analyzed using inductive content analysis. The sample consisted of 49 students at master's level enrolled in professional ethics courses at universities in Finland and the Netherlands. Permission for conducting the study was granted from both universities of applied sciences. All students provided their informed consent for the use of their assignments as research data. Participants described 51 problematic work situations. Among these, 16 were found to be ethical dilemmas, and the remaining were work issues with an ethical concern and did not meet criteria of a dilemma. The most common problems resulted from concerns about quality care, safety of healthcare professionals, patients' rights, and working with too few staff and inadequate resources. The results indicated that participants were concerned about providing quality of care and raised numerous questions about how to provide it in challenging situations. The results show that it was difficult for students to differentiate ethical dilemmas from other ethical work concerns. Online discussions among healthcare providers give them an opportunity to relate ethical principles to real ethical dilemmas and problems in their work as well as to critically analyze ethical issues. We found that discussions with descriptions of ethical dilemmas and concerns by health professionals provide important information and recommendations not only for education and practice but also for health policy. © The Author(s) 2015.

Ethical and Legal Considerations of Healthcare Informatics

Directory of Open Access Journals (Sweden)

Maria ALUAŞ

2016-12-01

Full Text Available Internet, cloud computing, social networks and mobile technology, all facilitate information transfer. Healthcare professionals, physicians and patients can use informatic devices in order to simplify their access to medical information, to streamline testing, and to understand clinical results. The use of computers and software facilitate doctor-patient interactions by optimizing communication and information flow. However, digital interfaces also increase the risks that information specialists use information without fully complying with ethical principles and laws in force. Our premise is that these information specialists should: 1 be informed of the rights, duties, and responsibilities linked to their profession and laws in force; 2 have guidelines and ethical tutoring on what they need to do in order to avoid or prevent conflict or misconduct; 3 have renewed specific training on how to interpret and translate legal frameworks into internal rules and standards of good practice. The purpose of this paper was: 1 to familiarize professionals who work in healthcare informatics with the ethical and legal issues related to their work; 2 to provide information about codes of ethics and legal regulations concerning this specific area; 3 to summarize some risks linked to wrong or inadequate use of patient information, such as medical, genetic, or personal data.

Learning professional ethics: Student experiences in a health mentor program.

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Langlois, Sylvia; Lymer, Erin

2016-01-01

The use of patient centred approaches to healthcare education is evolving, yet the effectiveness of these approaches in relation to professional ethics education is not well understood. The aim of this study was to explore the experiences and learning of health profession students engaged in an ethics module as part of a Health Mentor Program at the University of Toronto. Students were assigned to interprofessional groups representing seven professional programs and matched with a health mentor. The health mentors, individuals living with chronic health conditions, shared their experiences of the healthcare system through 90 minute semi-structured interviews with the students. Following the interviews, students completed self-reflective papers and engaged in facilitated asynchronous online discussions. Thematic analysis of reflections and discussions was used to uncover pertaining to student experiences and learning regarding professional ethics. Five major themes emerged from the data: (1) Patient autonomy and expertise in care; (2) ethical complexity and its inevitable reality in the clinical practice setting; (3) patient advocacy as an essential component of day-to-day practice; (4) qualities of remarkable clinicians that informed personal ideals for future practice; (5) patients' perspectives on clinician error and how they enabled suggestions for improving future practice. The findings of a study in one university context suggest that engagement with the health mentor narratives facilitated students' critical reflection related to their understanding of the principles of healthcare ethics.

Should professional ethics education incorporate single-professional or interprofessional learning?

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Caldicott, Catherine V; Braun, Eli A

2011-03-01

Since ethical issues in the contemporary delivery of health care involve doctors, nurses, technicians, and members of other health professions, the authors consider whether members of diverse health care occupations might benefit from studying ethics in a single classroom. While interprofessional courses may be better at teaching the ethics of the relationships between and among the various health professions, single-professional courses may be better at teaching the ethics of relationships between particular kinds of professionals and patients. An ethics instructor's professional discipline affects his/her credibility with the students, and the course readings may not always be relevant to the actual work of a given discipline. With these challenges in mind, the authors suggest that the boundaries of ethics education in the health professions be reconceived to accommodate the professional mission of a specific discipline as well as the interdependence and collaboration that marks high quality health care.

Patient data and patient rights: Swiss healthcare stakeholders' ethical awareness regarding large patient data sets - a qualitative study.

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Mouton Dorey, Corine; Baumann, Holger; Biller-Andorno, Nikola

2018-03-07

There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issues regarding patient's rights, social justice and trust in public institutions. The aim of this empirical study is to gain an in-depth understanding of the awareness of possible ethical risks and corresponding obligations among those who are involved in projects using patient data, i.e. healthcare professionals, regulators and policy makers. We used a qualitative design to examine Swiss healthcare stakeholders' experiences and perceptions of ethical challenges with regard to patient data in real-life settings where clinical registries are sponsored, created and/or used. A semi-structured interview was carried out with 22 participants (11 physicians, 7 policy-makers, 4 ethical committee members) between July 2014 and January 2015. The interviews were audio-recorded, transcribed, coded and analysed using a thematic method derived from Grounded Theory. All interviewees were concerned as a matter of priority with the needs of legal and operating norms for the collection and use of data, whereas less interest was shown in issues regarding patient agency, the need for reciprocity, and shared governance in the management and use of clinical registries' patient data. This observed asymmetry highlights a possible tension between public and research interests on the one hand, and the recognition of patients' rights and citizens' involvement on the other. The advocation of further health-related data sharing on the grounds of research and public interest, without due regard for the perspective of patients and donors, could run the risk of fostering distrust towards healthcare data collections. Ultimately, this could diminish the expected social benefits. However, rather than setting patient rights against public interest, new ethical approaches could strengthen both

Distrust and patients in intercultural healthcare: A qualitative interview study.

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Alpers, Lise-Merete

2018-05-01

The importance of trust between patients and healthcare personnel is emphasised in nurses' and physicians' ethical codes. Trust is crucial for an effective healthcare personnel-patient relationship and thus for treatment and treatment outcomes. Cultural and linguistic differences may make building a trusting and positive relationship with ethnic minority patients particularly challenging. Although there is a great deal of research on cultural competence, there is a conspicuous lack of focus on the concepts of trust and distrust concerning ethnic minority patients, particularly in relation to the concept of 'othering'. To study which factors help build trust or create distrust in encounters between healthcare professionals and hospitalised ethnic minority patients, as well as study the dynamic complexities inherent within the process of 'othering'. Qualitative design, in-depth interviews and hermeneutic analysis. Participants and research context: The interviewees were 10 immigrant patients (six women and four men - eight Asians, two Africans - ages 32-85 years) recruited from a south-eastern Norwegian hospital. Ethical considerations: Study approval was obtained from the hospital's Privacy Ombudsman for Research and the hospital's leadership. Participation was voluntary and participants signed an informed consent form. Distrust and othering may be caused by differences in belief systems, values, perceptions, expectations, and style of expression and behaviour. Othering is a reciprocal phenomenon in minority ethnic patient-healthcare personnel encounters, and it influences trust building negatively. Besides demonstrating general professional skill and competence, healthcare personnel require cultural competence to create trust.

Patient involvement in blood transfusion safety: patients' and healthcare professionals' perspective.

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Davis, R; Murphy, M F; Sud, A; Noel, S; Moss, R; Asgheddi, M; Abdur-Rahman, I; Vincent, C

2012-08-01

Blood transfusion is one of the major areas where serious clinical consequences, even death, related to patient misidentification can occur. In the UK, healthcare professional compliance with pre-transfusion checking procedures which help to prevent misidentification errors is poor. Involving patients at a number of stages in the transfusion pathway could help prevent the occurrence of these incidents. To investigate patients' willingness to be involved and healthcare professionals' willingness to support patient involvement in pre-transfusion checking behaviours. A cross-sectional design was employed assessing willingness to participate in pre-transfusion checking behaviours (patient survey) and willingness to support patient involvement (healthcare professional survey) on a scale of 1-7. One hundred and ten patients who had received a transfusion aged between 18 and 93 (60 male) and 123 healthcare professionals (doctors, nurses and midwives) involved in giving blood transfusions to patients. Mean scores for patients' willingness to participate in safety-relevant transfusion behaviours and healthcare professionals' willingness to support patient involvement ranged from 4.96-6.27 to 4.53-6.66, respectively. Both groups perceived it most acceptable for patients to help prevent errors or omissions relating to their hospital identification wristband. Neither prior experience of receiving a blood transfusion nor professional role of healthcare staff had an effect on attitudes towards patient participation. Overall, both patients and healthcare professionals view patient involvement in transfusion-related behaviours quite favourably and appear in agreement regarding the behaviours patients should adopt an active role in. Further work is needed to determine the effectiveness of this approach to improve transfusion safety. © 2012 The Authors. Transfusion Medicine © 2012 British Blood Transfusion Society.

Realistic Humanism. Luc Dardenne as a Philosopher and Filmmaker

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Walter Lesch

2016-11-01

Full Text Available Luc Dardenne is not only a successful filmmaker together with his brother Jean-Pierre. He is also a stimulating philosopher who has reflected on the influence of Emmanuel Levinas on the brothers’ cinematic work. This article shows typical constellations of film and philosophy and focuses on the special contribution of a Levinasian perspec¬tive on face-to-face encounters, violence and compassion as central topics in the films of the Dardennes. Luc Dardenne has developed his philosophical approach in his dia¬ries and in the essay The Human Affair, published in 2012. This text can be used as a key for an understanding of the film Le gamin au vélo (The Kid with a Bike, Jean-Pierre and Luc Dardenne, FR/BE/IT 2011.

Social media in the healthcare context: Ethical challenges and recommendations

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Christoffel Grobler

2016-05-01

Full Text Available The popularity of social media has grown rapidly and healthcare practitioners and students commonly use sites such as Facebook. The ethical and professional implications and their benefits and hazards must be considered. Concerns include blurring of boundaries between an individual’s public and professional lives, maintaining privacy and confidentiality of patient information, damaging the public image of the profession and inter-professional relationships. The same laws that apply to conduct in the real world also apply in cyberspace. Harmful or derogatory posts may result in a defamation lawsuit. The internet may also provide opportunities for patient education through peerreviewed websites and to build professional networks. Institutions should have policies on the uses of social media. Emerging technology will continue to change the landscape of social media and social networking and the way patients and practitioners use websites will continue to evolve. Practitioners should proactively manage digital identity by reviewing publicly available material and maintaining strict privacy settings about their information.

Healthcare professionals' perspectives on environmental sustainability.

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Dunphy, Jillian L

2014-06-01

Human health is dependent upon environmental sustainability. Many have argued that environmental sustainability advocacy and environmentally responsible healthcare practice are imperative healthcare actions. What are the key obstacles to healthcare professionals supporting environmental sustainability? How may these obstacles be overcome? Data-driven thematic qualitative analysis of semi-structured interviews identified common and pertinent themes, and differences between specific healthcare disciplines. A total of 64 healthcare professionals and academics from all states and territories of Australia, and multiple healthcare disciplines were recruited. Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were de-identified to protect participant anonymity. Qualitative analysis indicated that Australian healthcare professionals often take more action in their personal than professional lives to protect the environment, particularly those with strong professional identities. The healthcare sector's focus on economic rationalism was a substantial barrier to environmentally responsible behaviour. Professionals also feared conflict and professional ostracism, and often did not feel qualified to take action. This led to healthcare professionals making inconsistent moral judgements, and feeling silenced and powerless. Constraints on non-clinical employees within and beyond the sector exacerbated these difficulties. The findings are consistent with the literature reporting that organisational constraints, and strong social identification, can inhibit actions that align with personal values. This disparity can cause moral distress and residue, leading to feelings of powerlessness, resulting in less ethical behaviour. The data highlight a disparity between personal and professional actions to address environmental sustainability. Given the constraints Australian healthcare professionals encounter, they are unlikely to

Jean Francheteau (1943-2010)

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Sclater, John; Le Pichon, Xavier

2010-12-01

Jean Francheteau, pioneering marine geologist and geophysicist, AGU Fellow, and emeritus professor at the University of Brest (Université de Bretagne Occidentale), died on 21 July in St-Renan, Brittany, France, at the age of 67 after a long illness. With his passing, the field of Earth sciences lost a major contributor to the development of a definitive theory of plate tectonics and one of the first to make visual geological observations on the deep seafloor. Such scientific accomplishments, coupled with his personal charm and the ability to collaborate with researchers from many institutions, ensured that he had a huge influence not only on the world of research but also on teaching and the application of ethics to science. Jean arrived at Scripps Institution of Oceanography in La Jolla, Calif., in 1966 after obtaining a diploma in mining engineering at the prestigious Éole Nationale Supérieure de la Métallurgie et de l'Industrie des Mines in Nancy, France. He chose Victor Vacquier as his thesis supervisor and began working in Vic's lab with John Sclater, ostensibly on heat flow measurements.

Ethics in Healthcare Practice | Adesua | Journal of the Obafemi ...

African Journals Online (AJOL)

Ethics in healthcare practice has become a growing public health concern.Ethics in any discipline are guidelines to prevent abuse or misuse of power wielded by a person or group in the practise of that profession.The code of Medical Ethics provides a suitable framework defining the doctor-patient relationship in ...

La ley del deseo como esencia ética de lo político

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Farrán, Roque

2010-06-01

Full Text Available In this article I propose to interrogate the ethical - political statute of the law in its ontological difference concerning the merely normative or countable thing.In order to do that I comment some theoretical contributions of Alain Badiou, Jacques Rancière, Jacques Lacan, Giorgio Agamben, Slavoj Zizek, Jean - Luc Nancy and Roland Barthes, that allow us to think closer than the discernible by the language. The main idea that involves the crossing of these affine references is to circumscribe the fleeting act of affirmation of the law qua difference that enables the constitution of a political subject remarking its essentially ethical dimension

En el presente artículo me propongo interrogar el estatuto ético-político de la ley en su diferencia ontológica respecto a lo meramente normativo o contable, para ello comento algunos aportes teóricos de autores como Alain Badiou, Jacques Rancière, Jacques Lacan, Giorgio Agamben, Slavoj Zizek, Jean-Luc Nancy y Roland Barthes, que nos permitirán pensar más acá de lo discernible por el lenguaje establecido. La idea principal que conlleva el cruce de estas referencias afines aunque disímiles, es la de circunscribir el acto fugaz de afirmación de la ley qua diferencia que habilita la constitución de un sujeto político, remarcando así su dimensión esencialmente ética.

Solicitude: balancing compassion and empowerment in a relational ethics of hope-an empirical-ethical study in palliative care.

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Olsman, Erik; Willems, Dick; Leget, Carlo

2016-03-01

The ethics of hope has often been understood as a conflict between duties: do not lie versus do not destroy hope. However, such a way of framing the ethics of hope may easily place healthcare professionals at the side of realism and patients at the side of (false) hope. That leaves unexamined relational dimensions of hope. The objective of this study was to describe a relational ethics of hope based on the perspectives of palliative care patients, their family members and their healthcare professionals. A qualitative longitudinal method based on narrative theories was used. Semi-structured interviews on hope were conducted with twenty-nine palliative care patients, nineteen friends or family members, and fifty-two healthcare professionals, which were recorded and transcribed. Data on hope were thematically analyzed. The researchers wrote memos and did member checking with participants. When participants spoke about hope, they referred to power and empowerment, like the powerful bonding of hope between patients and physicians. They also associated hope with the loss of hope and suffering. Several participating healthcare professionals tried to balance both sides, which involved acknowledgment of hope and suffering. Hope and power were reflected in the ethical concept of empowerment, whereas suffering and the loss of hope were reflected in the ethical concept of compassion. Empowerment and compassion can be balanced in solicitude. In conclusion, a relational ethics of hope requires solicitude, in which healthcare professionals are able to weigh empowerment and compassion within particular relationships.

Predictors of healthcare professionals' intention and behaviour to encourage physical activity in patients with cardiovascular risk factors

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Kok Gerjo

2011-04-01

implying that efforts to change and strengthen the intention-behavior relationship of healthcare professionals may have beneficial effects for cardiovascular risk patients (Trial ID: ECP-92.

Care-managers' professional choices: ethical dilemmas and conflicting expectations.

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Tønnessen, Siri; Ursin, Gøril; Brinchmann, Berit Støre

2017-09-07

Care-managers are responsible for the public administration of individual healthcare decisions and decide on the volume and content of community healthcare services given to a population. The purpose of this study was to investigate the conflicting expectations and ethical dilemmas these professionals encounter in their daily work with patients and to discuss the clinical implications of this. The study had a qualitative design. The data consisted of verbatim transcripts from 12 ethical reflection group meetings held in 2012 at a purchaser unit in a Norwegian city. The participants consist of healthcare professionals such as nurses, occupational therapists, physiotherapists and social workers. The analyses and interpretation were conducted according to a hermeneutic methodology. This study is part of a larger research project. Two main themes emerged through the analyses: 1. Professional autonomy and loyalty, and related subthemes: loyalty to whom/what, overruling of decisions, trust and obligation to report. 2. Boundaries of involvement and subthemes: private or professional, care-manager or provider and accessibility. Underlying values and a model illustrating the dimensions of professional responsibility in the care-manager role are suggested. The study implies that when allocating services, healthcare professionals need to find a balance between responsibility and accountability in their role as care-managers.

Patient experiences of partnering with healthcare professionals for hand hygiene compliance: a systematic review.

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Butenko, Samantha; Lockwood, Craig; McArthur, Alexa

2017-06-01

healthcare professionals and patients do not fully support this partnership. Synthesized finding 2: Patients have differing levels of knowledge and balance partnering in hand hygiene against possible detrimental impacts on the caring relationship provided by healthcare professionals, out of concern for their own wellbeing, health outcomes, treatment and/or recovery. The current review highlights the complexity of the patient's experience of partnering with healthcare professionals for hand hygiene compliance. The experiences reported indicated that there is a possible disparity between the healthcare facility and healthcare professionals' promotion and intention of partnering for hand hygiene compliance, and the actual patient's acceptance, participation, partnership, experience and implementation of this initiative. This disconnect between intent and action appears to be influenced by a number of factors including organizational structures as well as drivers such as cultural beliefs and behavior.

Healthcare professionals' dilemmas: judging patient's decision making competence in day-to-day care of patients suffering from Korsakoff's syndrome.

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van den Hooff, Susanne; Buijsen, Martin

2014-11-01

Patient's decision making competence (PDMC) is a widely discussed subject. Issues of competence, autonomy, well-being and protection of the patient come up every day. In this article we analyse what role PDMC plays in Dutch legislation and what dilemmas healthcare professionals may experience, notably in patients suffering from Korsakoff's syndrome. Dilemmas emerge if professionals want to meet the requirements mentioned in Dutch law and the desires of their patients. The autonomy of the patient and the healthcare professionals' duty to take care of their patient's best interests, create a tension and lead to uncomfortable situations. Healthcare professionals describe difficulty finding a balance between these issues and assessing the degree of mental competence still present. In long term care situations, quality of the relationship between healthcare professionals and their patients seems to be of much more importance in decision making on minor issues of competence than simply relying on legal or house rules. In being committed to their cases, professionals will be more sensitive to individuals habits, abilities, welfare and dignity, which will make it easier to decide on issues of competence, and to find creative solutions to their dilemmas.

Patient-Targeted Googling by New Zealand Mental Health Professionals: A New Field of Ethical Consideration in the Internet Age.

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Thabrew, Hiran; Sawyer, Adam; Eischenberg, Christiane

2018-01-29

Patient-targeted Googling (PTG) describes the searching on the Internet by healthcare professionals for information about patients with or without their knowledge. Little research has been conducted into PTG internationally. PTG can have particular ethical implications within the field of mental health. This study was undertaken to identify the extent of PTG by New Zealand mental healthcare professionals and needs for further guidance regarding this issue. All (1,850) psychiatrists, clinical psychologists, and psychotherapists working in New Zealand were electronically surveyed about their experience of PTG and knowledge about the associated practice of therapist-targeted Googling (TTG) using a questionnaire that had previously been developed with a German sample. Due to ethics and advertising restrictions, only one indirect approach was made to potential participants. Eighty-eight clinicians (5%) responded to the survey invitation. More than half (53.4%, N = 47) of respondents reportedly being engaged in PTG, but only a minority (10.3%, N = 9) had ever received any education about the subject. Reasons for undertaking PTG included facilitating the therapeutic process, information being in the public domain, and mitigating risks. Reasons against undertaking PTG included impairment of therapeutic relationship, unethical invasion of privacy, and concerns regarding the accuracy and clinical relevance of online information. Two-thirds of participants reported being the subject of TTG. New Zealand psychiatrists, clinical psychologists, and psychotherapists are engaging in PTG with limited education and professional guidance. Further discussion and research are required, and so, PTG is undertaken in a manner that is safe and useful for patients and health practitioners.

Investigation Clinical Competence and Its Relationship with Professional Ethics and Spiritual Health in Nurses

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Elahe Ramezanzade Tabriz

2017-03-01

Full Text Available Abstract Background and Objectives: Study of clinical competence in nursing helps determine the quality of health care delivered to patients. Given the priority of observance of principles over caretaking and necessity of spirituality existence at the core of health care provision, this study was conducted to investigate clinical competence and its relationship with professional ethics and spiritual health in nurses. Methods: In this cross-sectional, descriptive, and correlational study, 281 nurses were enrolled by consensus sampling. Sampling was conducted from February, 2016 till June, 2016. The data were gathered by a demographics questionnaire, a self-assessment scale of clinical competence, a nursing ethics questionnaire, and a spiritual health questionnaire, and analyzed by descriptive statistics and t-test, Pearson's correlation coefficient, ANOVA, and linear regression analysis in SPSS 21. Results: The total scores for self-assessment scale of nurses' clinical competence, professional ethics, and spiritual health were moderate. In the light of the results of Spearman's correlation coefficient, there was a significant and positive correlation between clinical competence and spiritual health. Moreover, a significant positive correlation was observed between professional ethics and spiritual health but there was no correlation between professional ethics and clinical competence. Conclusion: Managers' and personnel's Knowledge about the level of nurses clinical competence, professional ethics, and spiritual health in teaching health care centers provides valuable information to develop in-service and efficacious education programs and ultimately to improve the quality of nursing services.

A narrative review of undergraduate peer-based healthcare ethics teaching.

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Hindmarch, Thomas; Allikmets, Silvia; Knights, Felicity

2015-12-12

This study explores the literature in establishing the value of undergraduate peer-based healthcare ethics teaching as an educational methodology. A narrative review of the literature concerning peer-based ethics teaching was conducted. MEDLINE, EMBASE, CINAHL, SCOPUS databases, and the Cochrane Library, were systematically searched for studies of peer-based ethics or professionalism teaching. Selected studies related peer-based teaching to ethics education outcomes. Ten publications were identified. Selected studies were varied in their chosen intervention methodology and analysis. Collectively, the identified studies suggest peer-based ethics education is an effective and valued educational methodology in training healthcare professionals. One paper suggests peer-based ethics teaching has advantages over traditional didactic methods. Peer-based ethics teaching also receives positive feedback from student participants. However, the limited literature base demonstrates a clear need for more evaluation of this pedagogy. The current literature base suggests that undergraduate peer based healthcare ethics teaching is valuable in terms of efficacy and student satisfaction. We conclude that the medical community should invest in further study in order to capitalise upon the potential of peer-based ethics teaching in undergraduate healthcare education.

Implications of organizational ethics to healthcare.

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Ells, Carolyn; MacDonald, Chris

2002-01-01

Organizational ethics is an emerging field concerned with the study and practice of the ethical behaviour of organizations. For effective application to healthcare settings, we argue that organizational ethics requires attention to organizations' special characteristics combined with tools borrowed from the fields of business ethics and bioethics. We identify and discuss several implications of this burgeoning field to healthcare organizations, showing how organizational ethics can facilitate policy making, accountability, self-evaluation, and patient and business perspectives. In our conclusion, we suggest an action plan for healthcare organizations to help them respond appropriately to their ethical responsibilities.

Ethical leadership, professional caregivers' well-being, and patients' perceptions of quality of care in oncology.

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Gillet, Nicolas; Fouquereau, Evelyne; Coillot, Hélène; Bonnetain, Franck; Dupont, Sophie; Moret, Leïla; Anota, Amélie; Colombat, Philippe

2018-04-01

Although quality of care and caregivers' well-being are important issues in their own right, relatively few studies have examined both, especially in oncology. The present research thus investigated the relationship between job-related well-being and patients' perceptions of quality of care. More specifically, we examined the indirect effects of ethical leadership on patients' perceived quality of care through caregivers' well-being. A cross-sectional design was used. Professional caregivers (i.e., doctors, nurses, assistant nurses, and other members of the medical staff; n = 296) completed a self-report questionnaire to assess perceptions of ethical leadership and well-being, while patients (n = 333) competed a self-report questionnaire to assess their perceptions of quality of care. The study was conducted in 12 different oncology units located in France. Results revealed that ethical leadership was positively associated with professional caregivers' psychological well-being that in turn was positively associated with patients' perceptions of quality of care. Professional caregivers' well-being is a psychological mechanism through which ethical leadership relates to patients' perceptions of quality of care. Interventions to promote perceptions of ethical leadership behaviors and caregivers' mental health may thus be encouraged to ultimately enhance the quality of care in the oncology setting. Copyright © 2018 Elsevier Ltd. All rights reserved.

How to succeed with ethics reflection groups in community healthcare? Professionals' perceptions.

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Karlsen, Heidi; Lillemoen, Lillian; Magelssen, Morten; Førde, Reidun; Pedersen, Reidar; Gjerberg, Elisabeth

2018-01-01

Healthcare personnel in the municipal healthcare systems experience many ethical challenges in their everyday work. In Norway, 243 municipalities participated in a national ethics project, aimed to increase ethical competence in municipal healthcare services. In this study, we wanted to map out what participants in ethics reflection groups experienced as promoters or as barriers to successful reflection. To examine what the staff experience as promoters or as barriers to successful ethics reflection. The study has a qualitative design, where 56 participants in municipal healthcare participated in 10 different focus-group interviews. Ethical considerations: The data collection was based on the participants' informed consent and approved by the Data Protection Official of the Norwegian Centre for Research Data. The informants had different experiences from ethics reflection group. Nevertheless, we found that there were several factors that were consistently mentioned: competence, facilitator's role, ethics reflection groups organizing, and organizational support were all experienced as promoters and as a significant effect on ethics reflection groups. The absence of such factors would constitute important barriers to successful ethics reflection. The results are coincident with other studies, and indicate some conditions that may increase the possibility to succeed with ethics reflection groups. A systematic approach seems to be important, the systematics of the actual reflections, but also in the organization of ethics reflection group at the workplace. Community healthcare is characterized by organizational instabilities as many vacancies, high workloads, and lack of predictability. This can be a hinder for ethics reflection group. Both internal and external factors seem to influence the organization of ethics reflection group. The municipalities' instabilities challenging this work, and perceived as a clear inhibitor for the development. The participants

Ethical concerns and dilemmas of Finnish and Dutch health professionals

NARCIS (Netherlands)

Ilsa Lottes; Hanna Hopia; Mariël Kanne

2016-01-01

Abstract Background: Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. Research objective: To describe ethical dilemmas and concerns at work

Health-care professionals' knowledge, attitudes and behaviours relating to patient capacity to consent to treatment: an integrative review.

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Lamont, Scott; Jeon, Yun-Hee; Chiarella, Mary

2013-09-01

This integrative review aims to provide a synthesis of research findings of health-care professionals' knowledge, attitudes and behaviours relating to patient capacity to consent to or refuse treatment within the general hospital setting. Search strategies included relevant health databases, hand searching of key journals, 'snowballing' and expert recommendations. The review identified various knowledge gaps and attitudinal dispositions of health-care professionals, which influence their behaviours and decision-making in relation to capacity to consent processes. The findings suggest that there is tension between legal, ethical and professional standards relating to the assessment of capacity and consent within health care. Legislation and policy guidance concerning capacity assessment processes are lacking, and this may contribute to inconsistencies in practice.

Ethical challenges within Veterans Administration healthcare facilities: perspectives of managers, clinicians, patients, and ethics committee chairpersons.

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Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa; Altemose, Jane K; Fox, Ellen

2009-04-01

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions.

A Study of the Relationship Between Nurses’ Professional Self-Concept and Professional Ethics in Hospitals Affiliated to Jahrom University of Medical Sciences, Iran

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Parandavar, Nehleh; Rahmanian, Afifeh; Jahromi, Zohreh Badiyepeymaie

2016-01-01

Background: Commitment to ethics usually results in nurses’ better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses’ professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences. Methods: This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses’ self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics. Results: The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16). Conclusion: In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses’ self-concept, which can boost their commitment to ethics, be given more consideration. PMID:26573035

A Study of the Relationship Between Nurses' Professional Self-Concept and Professional Ethics in Hospitals Affiliated to Jahrom University of Medical Sciences, Iran.

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Parandavar, Nehleh; Rahmanian, Afifeh; Badiyepeymaie Jahromi, Zohreh

2015-07-31

Commitment to ethics usually results in nurses' better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses' professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences. This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses' self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics. The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16). In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses' self-concept, which can boost their commitment to ethics, be given more consideration.

[Interprofessional ethical shared values for an integral healthcare].

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Galán González-Serna, José María

2013-01-01

Healthcare today requires the rapport of diverse professionals to give a comprehensive response to the needs and requirements of the population's health. Codes of ethics are the normative expression of secular reflection on the ethical values of the professions. In this study we aim to identify ethical values shared by various professionals codes of conduct and propose a method for evaluating the ethical estimate. For this reason, we have reviewed codes of ethics of the medical, nursing, physiotherapy, podiatry and psychology professions, identifying 30 values. These values were classified into two groups, depending on if these are shared by the 5 professionals codes or not (VIP vs VP). In order to provide a method for estimating common values it has been designed a survey likert type. Is possible to conclude there are ethical formally shared values identifiable in professional codes of conduct and it is possible to measure the estimate of ethical values accepted by health professionals. This measurement can be an effective aid to apply management methods of human resources that make it possible to achieve the comprehensive assistance based on inter-professional teams.

Evaluating clinical ethics support in mental healthcare: a systematic literature review.

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Hem, Marit Helene; Pedersen, Reidar; Norvoll, Reidun; Molewijk, Bert

2015-06-01

A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded 'grey zone articles', in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients' and caregivers' views on ethical challenges, is presented. © The Author(s) 2014.

The Phenomenological Challenge of Jean-Luc Marion’s Gift Theology

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Alex Y. Tiempo

2016-05-01

Full Text Available The tendency in most prayers is to preempt an answer coming from God. Yet such predetermination often results to a short-sighted vision of God’s action. The mysterious dimension in this case is subsumed by man’s finite gaze of the divine. Man often “thinks” that what he asks for in prayer elicits an answer from God, in which case the latter has a “duty” to respond to the former. Thus, if man’s wish is not granted, he tends to doubt the existence of the divine. To counteract such tendency, this paper presents phenomenology as a possible explanation. First, it will analyze the problem through the Husserlian method of bracketing one’s biases or preconceived notions of God. The notion of intentionality is given as a probable cause of the usual tendency in prayers where man often “intends” according to how he perceives the divine. Next, it will apply Jean-Luc Marion’s reverse intentionality which considers that God initiates the dialog. Man’s role is simply to respond to such a call. This paper concludes that prayer or any acts attributed to God should be interpreted within the context of Marion’s reverse intentionality. The one thing that man needs to avoid is the tendency toward predetermination – that is, toward the thinking that man predetermines God’s answer. Intentionality could be a helpful guide in the phenomenological interpretation, but it is limited only to the act of bracketing previously held notions of God. It is precisely the difficulty in seeing the invisible that one needs, at most, a possible phenomenon that allows for the divine to reveal as a gift.

Same Principles, Different Worlds: A Critical Discourse Analysis of Medical Ethics and Nursing Ethics in Finnish Professional Texts.

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Saxén, Salla

2018-03-01

This qualitative social scientific study explores professional texts of healthcare ethics to understand the ways in which ethical professionalism in medicine and nursing are culturally constructed in Finland. Two books in ethics, published by Finnish national professional organizations-one for nurses and one for physicians-were analyzed with the method of critical discourse analysis. Codes of ethics for each profession were also scrutinized. Analysis of the texts sought to reveal what is taken for granted in the texts as well as to speculate what appeared to be relegated to the margins of the texts or left entirely invisible. Physicians' ethics was discovered to emphasize objectivity and strong group membership as a basis for ethical professionalism. The discourses identified in the physicians' ethics guidebook were universal ethics, reductionism, non-subjectivity, and threat. Nursing ethics was discovered to highlight reflectivity as its central focus. This idea of reflectivity was echoed in the identified discourses: local ethics, enlightenment, and moral agency. The analysis exposes a cultural gap between the ethics discourses of medicine and nursing. More work is needed to bridge ethics discourses in Finland in a way that can support healthcare professionals to find common ground and to foster inclusivity in ethical dialogue. Further development of bioethical practices is suggested as a potential way forward.

[Patient safety in education and training of healthcare professionals in Germany].

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Hoffmann, Barbara; Siebert, H; Euteneier, A

2015-01-01

In order to improve patient safety, healthcare professionals who care for patients directly or indirectly are required to possess specific knowledge and skills. Patient safety education is not or only poorly represented in education and examination regulations of healthcare professionals in Germany; therefore, it is only practiced rarely and on a voluntary basis. Meanwhile, several training curricula and concepts have been developed in the past 10 years internationally and recently in Germany, too. Based on these concepts the German Coalition for Patient Safety developed a catalogue of core competencies required for safety in patient care. This catalogue will serve as an important orientation when patient safety is to be implemented as a subject of professional education in Germany in the future. Moreover, teaching staff has to be trained and educational and training activities have to be evaluated. Patient safety education and training for (undergraduate) healthcare professional will require capital investment.

The Just War Tradition: A Model for Healthcare Ethics.

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Connolly, Chaplain John D

2018-06-01

Healthcare ethics committees, physicians, surgeons, nurses, families, and patients themselves are constantly under pressure to make appropriate medically ethical decisions concerning patient care. Various models for healthcare ethics decisions have been proposed throughout the years, but by and large they are focused on making the initial ethical decision. What follows is a proposed model for healthcare ethics that considers the most appropriate decisions before, during, and after any intervention. The Just War Tradition is a model that is thorough in its exploration of the ethics guiding a nation to either engage in or refuse to engage in combatant actions. In recent years, the Just War Tradition has expanded beyond the simple consideration of going to war or not to include how the war is conducted and what the post-war phase would look like ethically. This paper is an exploration of a healthcare ethics decision making model using the tenets of the Just War Tradition as a framework. It discusses the initial consult level of decision making prior to any medical intervention, then goes further in considering the ongoing ethical paradigm during medical intervention and post intervention. Thus, this proposal is a more holistic approach to healthcare ethics decision making that encourages healthcare ethics committees to consider alternate models and ways of processing so that ultimately what is best for patient, family, staff, and the environment is all taken into consideration.

How Healthcare Professionals "Make Sense" of an Electronic Patient Record Adoption

DEFF Research Database (Denmark)

Jensen, Tina Blegind; Aanestad, Margunn

2007-01-01

This article examines how healthcare professionals experience an Electronic Patient Record (EPR) adoption process. Based on a case study from two surgical wards in Danish hospitals, we analyze the healthcare professionals' conceptions of the technology, how it relates to their professional roles...

La comunidad en obra. Jean-Luc Nancy en diálogo con Maurice Blanchot: Un desacuerdo tácito

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van Rooden, A.

2011-01-01

From the nancyan notion of community as being-in-common, whose formation can not be determinate or realized neither from an essence nor as an origin, destiny or project, but as the simple being together of singularities, beyond their foundation, legitimation or desire of system, the text approaches

Revolution without Guarantees: Community and Subjectivity in Nancy, Lingis, Sartre and Levinas

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Andrew Ryder

2012-05-01

Full Text Available Jean-Luc Nancy’s The Inoperative Community, a collection of writings first published in 1985 and 1986, suggests an understanding of community as irreducibly linked to finitude. Alongside this, he advocates a redefinition of the project of revolutionary communism. This endeavor draws equally on the writings on communication of Georges Bataille and the insistence on finitude found in Martin Heidegger. First, we should recapitulate Nancy’s argument in order to determine his presentation of a novel politics as well as the links and disjunctions of his predecessors. More than this, I would like to suggest that a reading of Alphonso Lingis’s The Community of Those Who Have Nothing in Common, published almost a decade later, suggests an intriguing and promising extension or modification of Nancy’s argument. In particular, Lingis suggests an understanding of revolution that appears somewhat closer to the Marxist tradition. I argue that this is partly a result of an inheritance from Emmanuel Levinas, and in particular his account of ethical subjectivity, which, surprisingly, can be productively allied with the political thought of Jean-Paul Sartre. This friendship between the ethics of Levinas and the politics of Sartre suggests the best groundwork for Lingis’s development of Nancy’s insights.

L’histoire au théâtre ou l’onde sphérique divergente dans l’œuvre de Jean-Luc Lagarce

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Cristina Vinuesa Muñoz

2012-01-01

Full Text Available The aim is to propose a parallel between a geometric figure and the dramatic work of Jean-Luc Lagarce to elucidate the essence of his writing technique and understanding the proposed dramaturgical challenge. If the comparison between the divergent spherical wave and the author’s playwriting is compelling, it may perhaps serve as a method of textual analysis with yet a method with yet unknown playwrights and see if the circularity can be seen as a contemporary trend. We will observe how a central dramatic event will cause a series of growing dramatic earthquakes interrelated by a complex language and an inter-character specific space.

Transformative leadership: an ethical stewardship model for healthcare.

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Caldwell, Cam; Voelker, Carolyn; Dixon, Rolf D; LeJeune, Adena

2008-01-01

The need for effective leadership is a compelling priority for those who would choose to govern in public, private, and nonprofit organizations, and applies as much to the healthcare profession as it does to other sectors of the economy (Moody, Horton-Deutsch, & Pesut, 2007). Transformative Leadership, an approach to leadership and governance that incorporates the best characteristics of six other highly respected leadership models, is an integrative theory of ethical stewardship that can help healthcare professionals to more effectively achieve organizational efficiencies, build stakeholder commitment and trust, and create valuable synergies to transform and enrich today's healthcare systems (cf. Caldwell, LeJeune, & Dixon, 2007). The purpose of this article is to introduce the concept of Transformative Leadership and to explain how this model applies within a healthcare context. We define Transformative Leadership and identify its relationship to Transformational, Charismatic, Level 5, Principle-Centered, Servant, and Covenantal Leadership--providing examples of each of these elements of Transformative Leadership within a healthcare leadership context. We conclude by identifying contributions of this article to the healthcare leadership literature.

Ethical Dilemmas as Perceived by Healthcare Students with Teaching Implications

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Buelow, Janet R.; Mahan, Pamela L.; Garrity, April W.

2010-01-01

Ethical dilemmas are experienced by all individuals, but are especially prevalent among healthcare professionals. Universities and colleges preparing students to work and provide care in this arena are currently addressing this challenge through traditional ethics courses and lectures. However, student perspectives of the major ethical dilemmas in…

Pod znakiem serca. „Ja” czujące późnej nowoczesności (Leśmian, Joyce, Derrida, Nancy

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Aldona Kopkiewicz

2016-06-01

Full Text Available In this article I try to show the changing paradigm of romantic expressionism in late modernity. I concentrate on the category of text, which I describe using literature: Bolesław Leśmian’s tale The Adventures of Sindbad the Sailor and a fragment of James Joyce’s Ulysses, as well as theoretical discourses by Jacques Derrida and Jean-Luc Nancy. I am interested first and foremost in the problem of the arbitrary nature of the bond between heart and word, affect and language. I find this problem to be the core of the possibility of thinking about literary creativity, especially its inventive, poetical potention. I try to explain how affect and language meet in the category of textuality and how modern subjectivity can cope with its basic conflict, which lies in the demand of opening and closing itself to the affective experience of otherness.

The influence of teams, supervisors and organizations on healthcare practitioners' abilities to practise ethically.

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Wall, Sarah; Austin, Wendy

2008-01-01

Healthcare practitioners make many important ethical decisions in their day-to-day practices. Questions arising in daily practice require practitioners to make prudent, balanced and good decisions, which are most effectively made interpersonally and reflectively. It is commonly assumed that the team-based structure of healthcare delivery can provide practitioners with the support needed to address ethical questions in their practice, especially if the team involves multidisciplinary collaboration. A phenomenological study was conducted in which the impact of the team and the larger organization on practitioners' experiences of dealing with moral challenges was uncovered. Various mental healthcare professionals shared their experiences of ethically challenging situations in their practices and described the ways in which their teammates and supervisors affected how they faced these troubling situations. These findings allow us to see that there is considerable room for healthcare managers, many of whom are nurses, to facilitate supportive, ethical environments for healthcare professionals. An understanding of the essential experience of practising ethically allows for an appreciation of the significance of the team's role in supporting it and enables healthcare managers to target support for ethical healthcare work.

Professional competence and palliative care: an ethical perspective.

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Olthuis, Gert; Dekkers, Wim

2003-01-01

The aim of this article is to explore an ethical view of professional competence by examining the professional competence of physicians in the context of palliative care. A discussion of the four dimensions of professional competence--knowledge, technical skills, relationships, and affective and moral attitude--leads us to the conclusion that "habits of mind" are important in every aspect of professional competence. This observation is then considered in the context of virtue ethics and ethics of care. Virtue ethics focuses on personal qualities and moral attitudes, while the ethics of care concentrates on the way these qualities are lived out in specific care relationships. Our conclusion points up the importance of education in ethics in the development of professional competence, and argues that because palliative care involves intense human interactions, integrating palliative care into the medical curriculum may improve the ethical culture of health care as a whole.

Are healthcare professionals working in Australia's immigration detention centres condoning torture?

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Isaacs, David

2016-07-01

Australian immigration detention centres are in secluded locations, some on offshore islands, and are subject to extreme secrecy, comparable with 'black sites' elsewhere. There are parallels between healthcare professionals working in immigration detention centres and healthcare professionals involved with or complicit in torture. In both cases, healthcare professionals are conflicted between a duty of care to improve the health of patients and the interests of the government. While this duality of interests has been recognised previously, the full implications for healthcare professionals working in immigration detention have not been addressed. The Australian Government maintains that immigration detention is needed for security checks, but the average duration of immigration detention has increased from 10 weeks to 14 months, and detainees are not informed of the progress of their application for refugee status. Long-term immigration detention causes major mental health problems, is illegal in international law and arguably fulfils the recognised definition of torture. It is generally accepted that healthcare professionals should not participate in or condone torture. Australian healthcare professionals thus face a major ethical dilemma: patients in immigration detention have pressing mental and physical health needs, but providing healthcare might support or represent complicity in a practice that is unethical. Individual healthcare professionals need to decide whether or not to work in immigration detention centres. If they do so, they need to decide for how long and to what extent restrictive contracts and gagging laws will constrain them from advocating for closing detention centres. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Perception of ethical misconduct by neuropsychology professionals in Spain.

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Olabarrieta-Landa, Laiene; Romero, Alfonso Caracuel; Panyavin, Ivan; Arango-Lasprilla, Juan Carlos

2017-01-01

To examine the prevalence of perceived ethical misconduct in clinical practice, teaching, and research in the field of neuropsychology in Spain. Two hundred and fifteen self-identified mental health professionals who engage in neuropsychology practice in Spain completed an online survey from July to December of 2013. In the ethics section of the survey, participants were asked to identify if neuropsychologists they know who work in their country engaged in specific kinds of ethical misconduct. 41% reported receiving formal training in professional ethics. The clinical findings are as follows. The highest rate of perceived misconduct was found in the area of professional training and expertise, with an average of 40.7%, followed by research/publications (25.6%), clinical care (23.9%), and professional relationships (8.8%). Specifically, regarding training, over half of respondents (56.7%) know professionals who claim themselves to be neuropsychologists, even though they lack proper training or expertise and 46.0% know professionals in the field who do not have adequate training for experience to be working in the field. Regarding research/publications, 41.9% of respondents know professionals who appear as authors on publications where they have not made a significant contribution. Regarding clinical care, over one third of respondents endorse knowing professionals who (1) provide results of neuropsychological evaluations in such a way that patients or other professionals are not likely to understand (37.2%) and (2) do not have the skills or training to work with patients who are culturally different from them (34.9%). Less than half of survey respondents reported receiving ethics training. It is possible that introducing more or improved ethics courses into pre-graduate and/or graduate school curriculums, and/or requiring continuing ethics education certification may reduce perceived ethical misconduct among neuropsychological professionals in Spain.

Factors affecting professional ethics in nursing practice in Iran: a qualitative study.

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Dehghani, Ali; Mosalanejad, Leili; Dehghan-Nayeri, Nahid

2015-09-09

Professional ethics refers to the use of logical and consistent communication, knowledge, clinical skills, emotions and values in nursing practice. This study aimed to explore and describe factors that affect professional ethics in nursing practice in Iran. This qualitative study was conducted using conventional content analysis approach. Thirty nurses with at least 5 years of experience participated in the study; they were selected using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. After encoding and classifying the data, five major categories were identified: individual character and responsibility, communication challenges, organizational preconditions, support systems, educational and cultural development. Awareness of professional ethics and its contributing factors could help nurses and healthcare professionals provide better services for patients. At the same time, such understanding would be valuable for educational administrators for effective planning and management.

Realizing good care within a context of cross-cultural diversity: an ethical guideline for healthcare organizations in Flanders, Belgium.

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Denier, Yvonne; Gastmans, Chris

2013-09-01

In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks. Copyright © 2013. Published by Elsevier Ltd.

Quality dementia care: Prerequisites and relational ethics among multicultural healthcare providers.

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Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Jakobsen, Rita; Sørlie, Venke

2017-01-01

Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia. The study is part of a greater participatory action research project: 'Hospice values in the care for persons with dementia'. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation. Participants and research context: Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins. Ethical considerations: The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services. The results show that good working relationships, characterized by understanding each other's vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings. The results are discussed in the light of Lögstrup's relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech. The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance.

How motivated are patients with type 2 diabetes to change their lifestyle? A survey among patients and healthcare professionals.

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Linmans, Joris J; Knottnerus, J André; Spigt, Mark

2015-12-01

It is unknown to what extend patients with type 2 diabetes mellitus (T2DM) in primary care are motivated to change their lifestyle. We assessed the level of motivation to change lifestyle and the agreement for that level between patients and healthcare professionals. Patients with T2DM (150) filled in a questionnaire to assess the level of motivation to change their lifestyle, using a single question with three answer options. We investigated the agreement for this level between these patients and their healthcare professionals (12 professionals). In addition, we investigated and compared the level of physical activity as indicated by the patients and the healthcare professionals. A large part of the patients reported to have a deficient physical activity level (35% according to patients, 47% according to healthcare professionals, kappa 0.32) and were not motivated to change their lifestyle level (29% according to patients, 43% according to healthcare professionals, kappa 0.13). Patients tended to overestimate their physical activity and their motivation to change in comparison with their healthcare professionals. Patients with T2DM in primary care should increase their physical activity level. Healthcare professionals often do not know whether patients are motivated to change their lifestyle, and should therefore assess motivation regularly to optimize lifestyle management. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Assessing the impact of DRGs on patient care and professional practice in Switzerland (IDoC) - a potential model for monitoring and evaluating healthcare reform.

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Wild, Verina; Carina, Fourie; Frouzakis, Regula; Clarinval, Caroline; Fässler, Margrit; Elger, Bernice; Gächter, Thomas; Leu, Agnes; Spirig, Rebecca; Kleinknecht, Michael; Radovanovic, Dragana; Mouton Dorey, Corine; Burnand, Bernard; Vader, John-Paul; Januel, Jean-Marie; Biller-Andorno, Nikola; The IDoC Group

2015-01-01

The starting point of the interdisciplinary project "Assessing the impact of diagnosis related groups (DRGs) on patient care and professional practice" (IDoC) was the lack of a systematic ethical assessment for the introduction of cost containment measures in healthcare. Our aim was to contribute to the methodological and empirical basis of such an assessment. Five sub-groups conducted separate but related research within the fields of biomedical ethics, law, nursing sciences and health services, applying a number of complementary methodological approaches. The individual research projects were framed within an overall ethical matrix. Workshops and bilateral meetings were held to identify and elaborate joint research themes. Four common, ethically relevant themes emerged in the results of the studies across sub-groups: (1.) the quality and safety of patient care, (2.) the state of professional practice of physicians and nurses, (3.) changes in incentives structure, (4.) vulnerable groups and access to healthcare services. Furthermore, much-needed data for future comparative research has been collected and some early insights into the potential impact of DRGs are outlined. Based on the joint results we developed preliminary recommendations related to conceptual analysis, methodological refinement, monitoring and implementation.

French healthcare professionals' perceived barriers to and motivation for therapeutic patient education: A qualitative study.

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Lelorain, Sophie; Bachelet, Adeline; Bertin, Nicole; Bourgoin, Maryline

2017-09-01

Therapeutic patient education is effective for various patient outcomes; however, healthcare professionals sometimes lack the motivation to carry out patient education. Surprisingly, this issue has rarely been addressed in research. Therefore, this study explores healthcare professionals' perceived barriers to and motivation for therapeutic patient education. Healthcare professionals, mainly nurses, working in different French hospitals were interviewed. Thematic content analysis was performed. Findings included a lack of skills, knowledge, and disillusionment of the effectiveness of therapeutic patient education were features of a demotivated attitude. In contrast, a positive attitude was observed when therapeutic patient education met a need to work differently and more effectively. A key factor motivating professionals was the integration of therapeutic patient education in routine care within a multidisciplinary team. To keep healthcare professionals motivated, managers should ensure that therapeutic patient education is implemented in accordance with its core principles: a patient-centered approach within a trained multidisciplinary team. In the latter case, therapeutic patient education is viewed as an efficient and rewarding way to work with patients, which significantly motivates healthcare professionals. © 2017 John Wiley & Sons Australia, Ltd.

The Quality of Clinical Information in Adverse Drug Reaction Reports by Patients and Healthcare Professionals: A Retrospective Comparative Analysis.

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Rolfes, Leàn; van Hunsel, Florence; van der Linden, Laura; Taxis, Katja; van Puijenbroek, Eugène

2017-07-01

Clinical information is needed to assess the causal relationship between a drug and an adverse drug reaction (ADR) in a reliable way. Little is known about the level of relevant clinical information about the ADRs reported by patients. The aim was to determine to what extent patients report relevant clinical information about an ADR compared with their healthcare professional. A retrospective analysis of all ADR reports on the same case, i.e., cases with a report from both the patient and the patient's healthcare professional, selected from the database of the Dutch Pharmacovigilance Center Lareb, was conducted. The extent to which relevant clinical information was reported was assessed by trained pharmacovigilance assessors, using a structured tool. The following four domains were assessed: ADR, chronology, suspected drug, and patient characteristics. For each domain, the proportion of reported information in relation to information deemed relevant was calculated. An average score of all relevant domains was determined and categorized as poorly (≤45%), moderately (from 46 to 74%) or well (≥75%) reported. Data were analyzed using a paired sample t test and Wilcoxon signed rank test. A total of 197 cases were included. In 107 cases (54.3%), patients and healthcare professionals reported a similar level of clinical information. Statistical analysis demonstrated no overall differences between the groups (p = 0.126). In a unique study of cases of ADRs reported by patients and healthcare professionals, we found that patients report clinical information at a similar level as their healthcare professional. For an optimal pharmacovigilance, both healthcare professionals and patient should be encouraged to report.

Impossible Practice and Theories of the Impossible: A Response to Helene Illeris's "Potentials of Togetherness"

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Kallio-Tavin, Mira

2014-01-01

In a recent commentary in "Studies in Art Education," Helene Illeris (2013) discussed the idea of "performative experimental communities" via a critique of visual culture pedagogy and the romanticism of community-oriented art education in Nordic countries. Illeris underpinned her arguments with Jean-Luc Nancy's (1997)…

Patients' and professionals' experiences and perspectives of obesity in health-care settings: a synthesis of current research.

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Mold, Freda; Forbes, Angus

2013-06-01

Obesity-related stigma likely influences how obese people interact with health-care professionals and access health care. To undertake a synthesis of studies examining the views and experiences of both obese people in relation to their health-care provision and health-care professionals in providing care to obese patients. A systematic search of key electronic databases relating to professional or patient experiences of, or perspectives on, obesity was performed in 2008 and updated in 2010. Reference lists of article bibliographies were searched, along with hand searches of relevant journals.   Studies were screened against explicit inclusion criteria and published between 1990 and 2010. Findings were examined and organized thematically.   Data were extracted focusing on obesity, stigma and access to health-care services. All included studies were subject to critical appraisal to assess the quality of the research. Thirty studies were identified. All the studies reported obesity impacting on health-care interactions. Key themes identified were experiences of stigma and feelings of powerlessness, treatment avoidance, psycho-emotional functioning, professional attitudes, confidence and training, variations in health contact time and finally, differences in treatment options and preventative measures. Obesity is a stigmatized condition that impacts negatively on the relationship between patients and health-care providers. Given the increasing prevalence of obesity and the range of therapeutic options available, further work is necessary to understand how the presence of obesity affects health-care interactions and decision making. © 2011 John Wiley & Sons Ltd.

A case study exploring the ethical and policy dimensions of allocating acute care resources to a dying patient.

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Cooke, Mary; Hurley, Ciarán

2008-05-01

We aimed to identify policy, process and ethical issues related to allocation of National Health Service resources when patients with end-of-life illness are referred to acute care services. Sharing healthcare decisions denotes a different partnership between professionals and patients when patients are empowered to define their needs. Implementation of a transition from professional to patient decision-making appears to be dependent upon its interpretation by personnel delivering care using the local trust policy. The outcome of this is a reformation of responsibility for budget allocation, choice of acute care provider and selecting services, currently in the realm of primary care; be it the general practitioner, community practitioners, or the patient. We used a 'lens' approach to case study analysis in which the lens is constructed of a model of policy analysis and four principles of biomedical ethics. A patient's decision to decline care proposed by an Accident and Emergency department nurse and the nurse's response to that decision expose a policy that restricts the use of ambulance transport and with that, flexibility in responses to patients' decisions. End-of-life care partnership decisions require sensitivity and flexibility from all healthcare practitioners. We found that policy-based systems currently used to deliver care across the primary care - hospital care border are far from seamless and can lead to foreseeable problems. Health professionals responsible for the care of a patient at the end of life should consider the holistic outcomes of resource allocation decisions for patients. Government and health professional agenda suggest that patients should be given a greater element of control over their healthcare than has historically been the case. When patients take responsibility for their decisions, healthcare personnel should recognize that this signals a shift in the nature of the professional-patient relationship to one of partnership.

Behavior of personality type toward stress and job performance: a study of healthcare professionals.

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Janjhua, Yasmin; Chandrakanta

2012-07-01

The present paper has examined the sources of stress among the healthcare professionals and the difference between responses of personality type A and type B healthcare professionals toward stressful situations. Further, the difference in the performance of both the personality types has been studied. The relationship between stress and performance among the healthcare professionals in general and with respect to personality type A and type B healthcare professionals in particular has also been investigated. A total of 160 healthcare professionals of Post Graduate Institute (PGI), Chandigarh, were subjects of this study. Identification with patients, deterioration and complication in the patient condition, and job criticism emerged to be the sources of stress. Significant difference between personality type A and personality type B professionals' response pertaining to identification with the patients only has been reported. However, type A individuals showed slightly higher inclination as compared to type B individuals on majority of stressful situations. It was further noted that type A individuals had scored higher on almost all the performance indicators as compared to personality type B individuals. The mean difference between the personality types was found to be significant for two performance dimensions, i.e., relationship with colleagues, and teaching and training. The stressful situation relationship with patients was found to have significantly negative impact on the performance factors such as good clinical care and rapport with patients. Daily work was also found to be negatively related to good medical practice.

Laws of Contamination and Blend. Don DeLillo and Jean-luc Godard: an Illuminating Challenge

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Mariangela Bio

2012-07-01

Full Text Available Aim The present paper aims at highlithing the new dynamics of comparison and exchange between literature and arts. It assumes the idea of a literature centred on the relations between text and context, bent on exhalting its "social" disposition. Then it deals with the subject of the work's originality in terms of identitary pact constantly renegotiated with works belonging to other semiologic themes. In this perspective, this article briefly investigates the complex relation between Don De Lillo's and Jean-Luc Godard's works. Methodology The analytic approach moves between comparative literature and cultural criticism, in a very well-known field in the area of traditional literary studies and a very important sector in the structuration of contemporary imaginary: the relation between literature and cinema. The methodology adopted employs the comparative dynamics typical of text semiotcs, to underline exchange categories, among different languages and codes, which prove to be flowing, open and constantly changing. Results The article highlights and explores new possibilities in the relation between cinema and literature, investigating them on the basis of the present observations on the notion of text; it also explains the urgency of a semantic reassessment of the concept of "work's originality" in the contemporary semiosphere.

Le contrôle de l'Univers: la dialettica del potere nelle Histoire(s du cinéma di Jean-Luc Godard

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Michele Guerra

2010-01-01

Full Text Available In Histoire(s du cinéma, Jean-Luc Godard finally connects his human being’s existence with history of cinema as uncontrollable stream of images, as a system of screens and mirrors that our experience produces and from which it is produced. The image is the nothing’s negation – Godard says – but also the nothing’s gaze on us. Through an omnivorous cinematographic writing, through the exploitation of quotation’s potentiality of movies – made possible only for a director –, Godard prepares a dialectic mechanism of visual power that points out the individual’s endurance versus images and images’endurance versus the individual. Between film-archive and film-museum, Godard manipulates images until to reveal us their secret power structure.

The Denaturation of Environmental Education: Exploring the Role of Ecotechnologies

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Gough, Annette; Gough, Noel

2016-01-01

This article explores the changing ways "environment" has been represented in the discourses of environmental education and education for sustainable development (ESD) in United Nations (and related) publications since the 1970s. It draws on the writings of Jean-Luc Nancy and discusses the increasingly dominant view of the environment as…

Affective telepathy, or the intuition of the heart: 'Persona' with 'Mulholland Drive'

NARCIS (Netherlands)

Laine, T.

2009-01-01

This paper investigates the affective dynamism of the cinematic experience in terms of the so-called intuition of the heart. Inspired by the writings of Jean-Luc Nancy, it shows how the affective circulation between the film and the spectator can be a matter of sharing rather than a consequence of

Intimate Distance: Rethinking the Unthought God in Christianity

NARCIS (Netherlands)

Kate, L. ten

2008-01-01

The work of the French philosopher Jean-Luc Nancy shares with the thinkers of the ‘theological turn in phenomenology’ the programmatic desire to place the ‘theological’, in the broad sense of rethinking the religious traditions in our secular time, back on the agenda of critical thought. Like those

Engaging with Families Is a Challenge: Beliefs among Healthcare Professionals in Forensic Psychiatric Care

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Hörberg, Ulrica; Erlingsson, Christen; Syrén, Susanne

2015-01-01

Being healthcare professionals in the complex field of forensic psychiatry care (FPC) seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer's philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient's care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one's own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family's resources. PMID:26448874

Behavior of Personality Type Toward Stress and Job Performance: A Study of Healthcare Professionals

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Yasmin Janjhua

2012-01-01

Full Text Available Background: The present paper has examined the sources of stress among the healthcare professionals and the difference between responses of personality type A and type B healthcare professionals toward stressful situations. Further, the difference in the performance of both the personality types has been studied. The relationship between stress and performance among the healthcare professionals in general and with respect to personality type A and type B healthcare professionals in particular has also been investigated. Methods: A total of 160 healthcare professionals of Post Graduate Institute (PGI, Chandigarh, were subjects of this study. Results: Identification with patients, deterioration and complication in the patient condition, and job criticism emerged to be the sources of stress. Significant difference between personality type A and personality type B professionals′ response pertaining to identification with the patients only has been reported. However, type A individuals showed slightly higher inclination as compared to type B individuals on majority of stressful situations. It was further noted that type A individuals had scored higher on almost all the performance indicators as compared to personality type B individuals. The mean difference between the personality types was found to be significant for two performance dimensions, i.e., relationship with colleagues, and teaching and training. Conclusions: The stressful situation relationship with patients was found to have significantly negative impact on the performance factors such as good clinical care and rapport with patients. Daily work was also found to be negatively related to good medical practice.

Ethical competence: A concept analysis.

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Kulju, Kati; Stolt, Minna; Suhonen, Riitta; Leino-Kilpi, Helena

2016-06-01

Exploring the concept of ethical competence in the context of healthcare is essential as it pertains to better quality of care. The concept still lacks a comprehensive definition covering the aspects of ethical expertise, ethical knowledge and action of a health professional. This article aims to report an analysis of the concept of ethical competence. A modified strategy suggested by Walker and Avant was used to analyse the concept. As a result, the concept of ethical competence can be defined in terms of character strength, ethical awareness, moral judgement skills and willingness to do good. Virtuous professional, experience of a professional, human communication, ethical knowledge and supporting surroundings in the organisation can be seen as prerequisites for ethical competence. Ethical competence results in the best possible solutions for the patient, reduced moral distress at work and development and democratisation of society. The results of the analysis establish a basis for an instrument to evaluate health professionals' ethical competence. It will guide educators, as well as managers in healthcare, to support the development of ethical conduct in healthcare. © The Author(s) 2015.

Factors affecting patients' knowledge about dispensed medicines: A Qualitative study of healthcare professionals and patients in Pakistan.

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Saqib, Anum; Atif, Muhammad; Ikram, Raazeyah; Riaz, Fatima; Abubakar, Muhammad; Scahill, Shane

2018-01-01

Patients' knowledge about their prescribed medicines is one of the most important antecedents of successful therapy. Poor knowledge about medicines can lead to serious consequences such as non-adherence and misunderstanding of the significance of adverse events. The objective of this study is to understand the factors that are responsible for a patients' lack of knowledge regarding their medicines, by taking the perspective of the patient as well as that of healthcare professionals. Much of the work in this area has been undertaken in the setting of developed or semi-developed countries, and there is a scarcity of information from developing nations such as Pakistan. This was a large qualitative study set in the hospital outpatient environment in a teaching hospital in the Punjab province of Pakistan. Data were collected from dialogue with patients (n = 19) and healthcare providers (n = 16) i.e., doctors and dispensers (where a dispenser is a person who merely dispenses medicines; i.e. is not a pharmacist) through in-depth semi-structured interviews. Patients having limited knowledge about their dispensed medicines were assessed using a checklist. The healthcare providers were recruited through a convenience sampling strategy, based on their availability and willingness to participate in the study. Based on the objectives of the study, a pilot tested interview protocol was developed, and used to conduct the interviews. The sample size was controlled by using saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using inductive thematic content analysis. The analysis of data yielded 31 categories (patients = 19, healthcare professionals = 12), 10 subthemes and three themes. The major themes were healthcare professional-related factors, patient-related factors and system-related factors. The health professional related subthemes included: behaviour and attitude and professional liabilities

A Rasch analysis of patients' opinions of primary health care professionals' ethical behaviour with respect to communication issues.

Science.gov (United States)

González-de Paz, Luis; Kostov, Belchin; López-Pina, Jose A; Solans-Julián, Pilar; Navarro-Rubio, M Dolors; Sisó-Almirall, Antoni

2015-04-01

Patients' opinions are crucial in assessing the effectiveness of the ethical theories which underlie the care relationship between patients and primary health care professionals. To study the ethical behaviour of primary health care professionals with respect to communication issues according to patients' opinions. Cross-sectional study using a self-administered questionnaire in patients from a network of 15 urban primary health centres. Participants were patients attended at the centres when the study was conducted. We used a Rasch analysis to verify the structure of the 17 questionnaire items, and to calculate interval level measures for patients and items. We analysed differences according to patient subgroups using analysis of variance tests and differences between the endorsement of each item. We analysed 1013 (70.34%) of questionnaires. Data fit to the Rasch model was achieved after collapsing two categories and eliminating five items. Items with the lowest degree of endorsement were related to the management of differences in conflictive situations between patients and health care professionals. We found significant differences (P communication skills were respected by family physicians and nurses. However, opinions on endorsement were lower when patients disagreed with health care professionals. The differences found between patient subgroups demonstrated the importance of trust and confidence between patients and professionals. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Email for clinical communication between patients/caregivers and healthcare professionals.

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Atherton, Helen; Sawmynaden, Prescilla; Sheikh, Aziz; Majeed, Azeem; Car, Josip

2012-11-14

Email is a popular and commonly-used method of communication, but its use in health care is not routine. Where email communication has been demonstrated in health care this has included its use for communication between patients/caregivers and healthcare professionals for clinical purposes, but the effects of using email in this way is not known.This review addresses the use of email for two-way clinical communication between patients/caregivers and healthcare professionals. To assess the effects of healthcare professionals and patients using email to communicate with each other, on patient outcomes, health service performance, service efficiency and acceptability. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010) and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists, contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies examining interventions using email to allow patients to communicate clinical concerns to a healthcare professional and receive a reply, and taking the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two authors independently assessed the risk of bias of included studies and extracted data. We contacted study authors for additional information. We assessed risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. For continuous measures, we report effect sizes as mean

Analysis of the ethical aspects of professional confidentiality in dental practice

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Cléa Adas Saliba Garbin

2008-02-01

Full Text Available From the point of view of deontological ethics, privacy is a moral right that patients are entitled to and it is bound to professional confidentiality. Otherwise, the information given by patients to health professionals would not be reliable and a trustable relationship could not be established. The aim of the present study was to assess, by means of questionnaires with open and closed questions, the awareness and attitudes of 100 dentists working in the city of Andradina, São Paulo State, Brazil, with respect to professional confidentiality in dental practice. Most dentists (91.43% reported to have instructed their assistants on professional confidentiality. However, 44.29% of the interviewees showed to act contradictorily as reported talking about the clinical cases of their patients to their friends or spouses. The great majority of professionals (98.57% believed that it is important to have classes on Ethics and Bioethics during graduation and, when asked about their knowledge of the penalties imposed for breach of professional confidentiality, only 48.57% of them declared to be aware of it. Only 28.57% of the interviewees affirmed to have exclusive access to the files; 67.14% reported that that files were also accessed by their secretary; 1.43% answered that their spouses also had access, and 2.86% did not answer. From the results of the present survey, it could be observed that, although dentists affirmed to be aware of professional confidentiality, their attitudes did not adhere to ethical and legal requirements. This stand of health professionals has contributed to violate professional ethics and the law itself, bringing problems both to the professional and to the patient.

Analysis of the ethical aspects of professional confidentiality in dental practice.

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Garbin, Cléa Adas Saliba; Garbin, Artênio José Isper; Saliba, Nemre Adas; de Lima, Daniela Coelho; de Macedo, Ana Paula Ayala

2008-01-01

From the point of view of deontological ethics, privacy is a moral right that patients are entitled to and it is bound to professional confidentiality. Otherwise, the information given by patients to health professionals would not be reliable and a trustable relationship could not be established. The aim of the present study was to assess, by means of questionnaires with open and closed questions, the awareness and attitudes of 100 dentists working in the city of Andradina, São Paulo State, Brazil, with respect to professional confidentiality in dental practice. Most dentists (91.43%) reported to have instructed their assistants on professional confidentiality. However, 44.29% of the interviewees showed to act contradictorily as reported talking about the clinical cases of their patients to their friends or spouses. The great majority of professionals (98.57%) believed that it is important to have classes on Ethics and Bioethics during graduation and, when asked about their knowledge of the penalties imposed for breach of professional confidentiality, only 48.57% of them declared to be aware of it. Only 28.57% of the interviewees affirmed to have exclusive access to the files; 67.14% reported that that files were also accessed by their secretary; 1.43% answered that their spouses also had access, and 2.86% did not answer. From the results of the present survey, it could be observed that, although dentists affirmed to be aware of professional confidentiality, their attitudes did not adhere to ethical and legal requirements. This stand of health professionals has contributed to violate professional ethics and the law itself, bringing problems both to the professional and to the patient.

Healthcare professionals' perceptions of the value and impact of the arts in healthcare settings: A critical review of the literature.

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Wilson, Ceri; Bungay, Hilary; Munn-Giddings, Carol; Boyce, Melanie

2016-04-01

Internationally there is growing interest in the use of the arts in the healthcare context evidenced by the number of research studies reported in the nursing and medical literature. Establishing successful projects in healthcare environments will to some extent be reliant on the cooperation of staff working in these settings: healthcare professionals and their cultural values will be the lynchpin in the relationship between the artists organising the activities and the patients. This review appraises healthcare professionals' perceptions of the value of the arts in healthcare settings, and the impact of the arts on healthcare professionals. A critical review of the literature between 2004 and 2014 was undertaken. The following databases were searched: MedLine, CINAHL, AMED, Web of Science and ASSIA. Searches included words from three categories: arts activities; healthcare settings, and healthcare providers. Studies were included if they were written in English, explored the attitudes of healthcare professionals on the use of the arts in healthcare settings or the impact of arts activities on healthcare staff. Studies conducted in community venues and/or reporting on arts therapies (art, drama or music) were excluded. An initial 52 studies were identified and following screening for relevance and quality 27 articles were reviewed. Arts interventions were diverse and included music listening, visual arts, reading and creative writing, and dance. Despite some methodological limitations of the reviewed studies it was found that the majority of staff believed that engaging in arts interventions has a positive impact on patients' health and well-being. The findings suggest that arts interventions are perceived to have an impact on patients' stress, mood, pain levels, and sleep. Furthermore, staff believed that the arts can enhance communication between staff and patients, helping to build rapport and strengthen interactions. The majority of reported staff outcomes were

The Motivating Function of Healthcare Professional in eHealth and mHealth Interventions for Type 2 Diabetes Patients and the Mediating Role of Patient Engagement.

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Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea; Menichetti, Julia

2016-01-01

eHealth and mHealth interventions for type 2 diabetes are emerging as useful strategies to accomplish the goal of a high functioning integrated care system. However, mHealth and eHealth interventions in order to be successful need the clear endorsement from the healthcare professionals. This cross-sectional study included a sample of 93 Italian-speaking type 2 diabetes patients and demonstrated the role of the perceived ability of healthcare professionals to motivate patients' initiative in improving the level of their engagement and activation in type 2 diabetes self-management. The level of type 2 diabetes patients' activation resulted also in being a direct precursor of their attitude to the use of mHealth and eHealth. Furthermore, patient engagement has been demonstrated to be a mediator of the relationship between the perceived ability of healthcare professionals in motivating type 2 diabetes patients and patients' activation. Finally, type 2 diabetes patients adherence did not result in being a direct consequence of the frequency of mHealth and eHealth use. Patient adherence appeared to be directly influenced by the level of perceived healthcare professionals ability of motivating patients' autonomy. These results offer important insights into the psychosocial and organizational elements that impact on type 2 diabetes patients' activation in self-management and on their willingness to use mHealth and eHealth devices.

Infusing an Inter-Professional and Inter-University Perspective into Healthcare Education

Science.gov (United States)

Goldberg, Lynette R.; Koontz, Jennifer Scott; Downs, David; Uhlig, Paul; Kumar, Neil G.; Shah, Sapna; Clark, Paige E.; Coiner, Christina; Crumrine, Daiquirie

2010-01-01

A national (USA) student-led, case-based CLinician/Administrator Relationship Improvement OrganizatioN (CLARION) competition focuses students in medical and related healthcare programs on the provision of healthcare that is safe, timely, equitable, patient-centred, effective and efficient. Students work in four-person, inter-professional teams to…

Physical therapists' perception of workplace ethics in an evolving health-care delivery environment: a cross-sectional survey.

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Cantu, Roberto

2018-03-30

Physical therapists are trained and obligated to deliver optimal health care and put patients first above all else. In the changing health-care environment, health-care organizations are grappling with controlling cost and increasing revenues. Moral distress may be created when physical therapists' desire to provide optimal care conflicts with their organization's goals to remain financially viable or profitable. Moral distress has been associated with low perception of ethical environment, professional burnout, and high turnover in organizations. This study identified groups who may be vulnerable to low perception of organizational ethical environment and identified self-reported strategies to remedy these perceptions. An ethics environment questionnaire was mailed to a random sample of 1200 physical therapists in Georgia. Respondents (n = 340) were analyzed by age, workplace setting, and position in organization. Therapists working in skilled nursing/assisted living environments scored the lowest on the questionnaire and voiced concerns regarding their ethical work environments. Owners and executives perceived their organizations to be more ethical than front-line clinicians. Respondent concerns included high productivity standards, aggressive coding/billing policies, decreased reimbursement, and increased insurance regulation. Possible solutions included more frequent communication between management and clinicians about ethics, greater professional autonomy, and increased training in business ethics and finance.

Ethics in health care: healthcare fraud

African Journals Online (AJOL)

Ethics CPD Supplement: Ethics in health care: Healthcare Fraud. S10. Vol 56 No 1 Supplement 1. S Afr Fam Pract 2014. Introduction. Vintage images are easily found depicting a virtuous doctor with a look of honesty and compassion on his or her face bending over a patient, stethoscope in hand, ready to perform a clinical ...

Ethical sensitivity in professional practice: concept analysis.

Science.gov (United States)

Weaver, Kathryn; Morse, Janice; Mitcham, Carl

2008-06-01

This paper is a report of a concept analysis of ethical sensitivity. Ethical sensitivity enables nurses and other professionals to respond morally to the suffering and vulnerability of those receiving professional care and services. Because of its significance to nursing and other professional practices, ethical sensitivity deserves more focused analysis. A criteria-based method oriented toward pragmatic utility guided the analysis of 200 papers and books from the fields of nursing, medicine, psychology, dentistry, clinical ethics, theology, education, law, accounting or business, journalism, philosophy, political and social sciences and women's studies. This literature spanned 1970 to 2006 and was sorted by discipline and concept dimensions and examined for concept structure and use across various contexts. The analysis was completed in September 2007. Ethical sensitivity in professional practice develops in contexts of uncertainty, client suffering and vulnerability, and through relationships characterized by receptivity, responsiveness and courage on the part of professionals. Essential attributes of ethical sensitivity are identified as moral perception, affectivity and dividing loyalties. Outcomes include integrity preserving decision-making, comfort and well-being, learning and professional transcendence. Our findings promote ethical sensitivity as a type of practical wisdom that pursues client comfort and professional satisfaction with care delivery. The analysis and resulting model offers an inclusive view of ethical sensitivity that addresses some of the limitations with prior conceptualizations.

Healthcare professionals? views on feedback of a patient safety culture assessment

OpenAIRE

Zwijnenberg, Nicolien C.; Hendriks, Michelle; Hoogervorst-Schilp, Janneke; Wagner, Cordula

2016-01-01

Background By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals? views on the feedback of a patient safety culture assessment. Methods Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a websi...

[Digital health as a motor for change towards new healthcare models and the relationship between patients and healthcare professionals. Disruption of healthcare processes].

Science.gov (United States)

Garcia-Cuyàs, Francesc; de San Pedro, Marc; Martínez Roldan, Jordi

2015-11-01

We find ourselves at the end of an era of asymmetry in the domain of health information where the majority of this data is in the hands of the healthcare system. Increasingly, the public are calling for a more central role in the new paradigm that enables them to duly exercise their right of access to their health data while availing of more reliable and safer technologies which contribute to the management of their condition and promote healthy lifestyles. So far, the TIC Salud strategic plan has been developed independently from the Generalitat de Catalunya Health Department's Healthcare Plan, which sets out health policy strategy in Catalonia. However, from its initial design stage the new Healthcare Plan (2016- 2020) envisages incorporating a new strategic Information and communications technology (ICT) line called "Digital Health". Incorporating ICT into the Health Plan will allow these technologies to become integral part of all strategic healthcare processes, acting as a driving force for a shift towards a new healthcare models and an innovative relationship between the public and healthcare professionals. The Digital Health implies a disruption in itself, by way of the convergence of several technologies and their positive impact on health and healthcare procedures, by way of the public's access to information concerning their health, and by creating new opportunities for promoting health and the salutogenic paradigm which empowers people to develop their health, welfare and quality of life. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Factors affecting patients' knowledge about dispensed medicines: A Qualitative study of healthcare professionals and patients in Pakistan.

Directory of Open Access Journals (Sweden)

Anum Saqib

Full Text Available Patients' knowledge about their prescribed medicines is one of the most important antecedents of successful therapy. Poor knowledge about medicines can lead to serious consequences such as non-adherence and misunderstanding of the significance of adverse events. The objective of this study is to understand the factors that are responsible for a patients' lack of knowledge regarding their medicines, by taking the perspective of the patient as well as that of healthcare professionals. Much of the work in this area has been undertaken in the setting of developed or semi-developed countries, and there is a scarcity of information from developing nations such as Pakistan.This was a large qualitative study set in the hospital outpatient environment in a teaching hospital in the Punjab province of Pakistan. Data were collected from dialogue with patients (n = 19 and healthcare providers (n = 16 i.e., doctors and dispensers (where a dispenser is a person who merely dispenses medicines; i.e. is not a pharmacist through in-depth semi-structured interviews. Patients having limited knowledge about their dispensed medicines were assessed using a checklist. The healthcare providers were recruited through a convenience sampling strategy, based on their availability and willingness to participate in the study. Based on the objectives of the study, a pilot tested interview protocol was developed, and used to conduct the interviews. The sample size was controlled by using saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using inductive thematic content analysis.The analysis of data yielded 31 categories (patients = 19, healthcare professionals = 12, 10 subthemes and three themes. The major themes were healthcare professional-related factors, patient-related factors and system-related factors. The health professional related subthemes included: behaviour and attitude and professional

AWARENESS OF MEDICAL SPECIALISTS AND PATIENTS IN BULGARIA OF ETHICS COMMITTEES AND THE BENEFITS OF THEIR WORK

Directory of Open Access Journals (Sweden)

Neli Gradinarova

2018-02-01

Full Text Available In today’s healthcare, the role of morality emerges to the forefront as a result of the high degree of uncertainty in our modern environment. Ethically responsible behaviour is therefore perceived as a prerequisite for preventing and counteracting a number of moral risks in society. With regard to moral hazard and responsibility, ethical codes represent a rational control mechanism, lowering the extent of the probability of moral peril. Ethics committees are also founded based on such ethical codes, the purpose of such committees being the proclamation and observation of the principles and norms set forth. At the healthcare institutions of the Republic of Bulgaria, ethics committees are established that are based on the principles of medical ethics and medical law. The significance with which ethics committees are charged regarding the sustainable development of the healthcare system consists of protecting the patients, the medical professionals and the institution itself. Awareness of the significance, functions and benefits of ethics committees and their impact on the medical practice and patients in Bulgaria is, however, insufficiently low. In a questionnaire survey conducted among 149 medical specialists employed at three medical establishments for hospital care in the country, and 269 patients under treatment at them, at being asked “Do you think that ethics committees contribute to protecting and respecting patients’ rights?”, 26.2% of the respondents among the medical professionals replied that they are not sure, while 25.7% of did not provide an answer to the question thus asked due to being unfamiliar with ethics committees as an institutionalized body and their functions. The analysis of the results of the abovementioned survey among medical professionals and patients evidences a low level of awareness of the ethics committees and their work on the territory of the Republic of Bulgaria. It is essential for healthcare

Structural validity and reliability of the healthcare professionals' economic reasoning questionnaire

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Vuković Mira H.

2015-01-01

Full Text Available Introduction: The structure of healthcare professionals' economic reasoning (HPER is still unknown. The aim: The structural validity and the reliability of the HPER questionnaire were evaluated. Methods: The psychometric study about evaluation of the HPER factors was conducted. The healthcare professionals (physicians, dentists, pharmacists that are employed in healthcare state sector of Republic of Serbia were interviewed. The HPER Questionnaire contained 29 preliminary items. Its structure was evaluated by Principal Component Analysis for categorial and ordinal data. Results: The 9 items that defined seven HPER factors were extracted: (1 the negligence of the cost of quality by the administration and financier; (2 the consideration of the market price and healthcare benefit; (3 market orientation considering patient's requests; (4 the recognition of inadequate resource alocations by non-medical administrative authority; (5 the attitude about redirecting the profit from state to private healthcare sector; (6 the recognition of the unjustified spending by the healthcare professionals and (7 the relationship physician/patient. Conclusion: The HPER-9 Questionnaire has high structural validity and reliability in the HPER measurement.

La comunidad del naciente : por una biopolítica afirmativa del exceso

OpenAIRE

Gómez Montañez, César Mario

2010-01-01

Quisiéramos, en respuesta a Jean-Luc Nancy, arriesgar un desarrollo de la cuestión de la comunidad que, a su vez, nos permita resignificar la individualidad y la inmanencia. En otras palabras, se trata de rearticular individuo y comunidad desde nuevos supuestos. La cuestión es retomar el tono extático que demanda Nancy, esa figura del exceso propuesta por Bataille, y evidenciarlo en el modelo que propone Gilbert Simondon para la individuación, y Roberto Esposito para la communitas. El trabajo...

Professional values, self-esteem, and ethical confidence of baccalaureate nursing students.

Science.gov (United States)

Iacobucci, Trisha A; Daly, Barbara J; Lindell, Debbie; Griffin, Mary Quinn

2013-06-01

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg's Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses.

Nancy Huston, Self-Translation and a Transnational Poetics

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Giorgia Falceri

2014-10-01

Full Text Available Nancy Huston (Calgary, 1953 is one of the francophone authors who contributed – with an essay entitled Traduttore non è traditore – to the theo- retical volume Pour une littérature-monde (Michel Le Bris and Jean Rouaud, 2007, which inscribes as an important step in the ongoing theoretical definition of world literature. With reference to a selection of Huston’s non-fiction publications, I am going to outline her poetics of self-translation and how the latter intimately relates to what she regards as the very task of Literature. Finally, I am going to briefly sketch the content of three of her novels: L’empreinte de l’ange/The Mark of the Angel (1998- 9, Lignes de faille/Fault Lines (2006-7 and Danse Noire/Black Dance (2013-14, which epitomize Huston’s transnational/translational poetics. The peculiar nature of the experience as a bilingual writer and self-translator opens to new possible prospects on the theorization of world literature, by question- ing the boundaries of linguistic and cultural identity and by defining an ethical aspiration for both literature and translation. Nancy Huston (Calgary, 1953 ha contribuito con il saggio Traduttore non è traditore alla raccolta Pour une littérature-monde (Michel Le Bris e Jean Rouaud, 2007, volume che costituisce una tappa significativa nella teorizzazione contemporanea sulla letteratura-mondo. Attraverso l’analisi di questa e di altre pubblicazioni, il presente articolo si propone di indagare la poetica di auto-traduzione della Huston, per mostrare come essa sia intimamente connessa a quella che l’autrice ritiene essere la funzione fonda- mentale della Letteratura. Vengono inoltre presi in considerazione tre dei suoi romanzi – L’empreinte de l’ange/The Mark of the Angel (1998-9, Lignes de faille/Fault Lines (2006-7 e Danse Noire/Black Dance (2013-14 – che incarnano, a livello di conte- nuti, tale poetica traduttiva e transnazionale. Riflettendo sulla particolarit

Imagens da violência e violência das imagens: considerações em torno do documentário Jardim Ângela

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Cristiane da Silveira Lima

2007-10-01

Full Text Available Este trabalho discute a relação entre imagens e violência, nãoapenas a partir do seu conteúdo, mas sobretudo a partir domodo pelo qual elas solicitam um engajamento do olhar.Para tanto, comparamos algumas idéias de Marie-JoséMondzain, Jean-Luc Nancy e Jean-Louis Comolli. Emseguida, discorremos brevemente sobre o filme  JardimÂngela, de Evaldo Mocarzel. Por fim, nos interrogamossobre o tipo de experiência da violência que o filmeproporciona ao espectador.

Engaging with Families Is a Challenge: Beliefs among Healthcare Professionals in Forensic Psychiatric Care

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Ulrica Hörberg

2015-01-01

Full Text Available Being healthcare professionals in the complex field of forensic psychiatry care (FPC seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer’s philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient’s care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one’s own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family’s resources.

Serial murder by healthcare professionals.

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Yorker, Beatrice Crofts; Kizer, Kenneth W; Lampe, Paula; Forrest, A R W; Lannan, Jacquetta M; Russell, Donna A

2008-01-01

The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

Visionary Critique. Gender, Self and Relationship in Rosetta and Two Days, One Night

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Stephanie Knauss

2016-11-01

Full Text Available The films of Jean-Pierre and Luc Dardenne stand out for their complex, multi-dimen¬sional female and male characters whose representation disrupts gender stereotypes in numerous ways, both in how the characters themselves are depicted and in how they are shown to relate to other individuals and their social context. In this contri¬bution, I explore the themes of self, relationship, solidarity, family and work – all of them recurring issues in the films by the Dardennes – using gender as my primary category of analysis, and focusing in particular on the treatment of these themes in Rosetta (Jean-Pierre and Luc Dardenne, FR/BE 1999 and Deux jours, une nuit (Two Days, One Night, Jean-Pierre and Luc Dardenne, BE/FR/IT 2014. I argue that whereas Rosetta (1999 offers a critique of the damaging effects of the masculinized capital¬ist system on individuals and their relationships, Two Days, One Night (2014 can be understood as a vision of alternative possibilities of solidarity and women’s empower¬ment and agency even within the persistent context of masculinized capitalism.

Code of ethics for the national pharmaceutical system: Codifying and compilation.

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Salari, Pooneh; Namazi, Hamidreza; Abdollahi, Mohammad; Khansari, Fatemeh; Nikfar, Shekoufeh; Larijani, Bagher; Araminia, Behin

2013-05-01

Pharmacists as one of health-care providers face ethical issues in terms of pharmaceutical care, relationship with patients and cooperation with the health-care team. Other than pharmacy, there are pharmaceutical companies in various fields of manufacturing, importing or distributing that have their own ethical issues. Therefore, pharmacy practice is vulnerable to ethical challenges and needs special code of conducts. On feeling the need, based on a shared project between experts of the ethics from relevant research centers, all the needs were fully recognized and then specified code of conduct for each was written. The code of conduct was subject to comments of all experts involved in the pharmaceutical sector and thus criticized in several meetings. The prepared code of conduct is comprised of professional code of ethics for pharmacists, ethics guideline for pharmaceutical manufacturers, ethics guideline for pharmaceutical importers, ethics guideline for pharmaceutical distributors, and ethics guideline for policy makers. The document was compiled based on the principles of bioethics and professionalism. The compiling the code of ethics for the national pharmaceutical system is the first step in implementing ethics in pharmacy practice and further attempts into teaching the professionalism and the ethical code as the necessary and complementary effort are highly recommended.

The Motivating Function of Healthcare Professional in eHealth and mHealth Interventions for Type 2 Diabetes Patients and the Mediating Role of Patient Engagement

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Guendalina Graffigna

2016-01-01

Full Text Available eHealth and mHealth interventions for type 2 diabetes are emerging as useful strategies to accomplish the goal of a high functioning integrated care system. However, mHealth and eHealth interventions in order to be successful need the clear endorsement from the healthcare professionals. This cross-sectional study included a sample of 93 Italian-speaking type 2 diabetes patients and demonstrated the role of the perceived ability of healthcare professionals to motivate patients’ initiative in improving the level of their engagement and activation in type 2 diabetes self-management. The level of type 2 diabetes patients’ activation resulted also in being a direct precursor of their attitude to the use of mHealth and eHealth. Furthermore, patient engagement has been demonstrated to be a mediator of the relationship between the perceived ability of healthcare professionals in motivating type 2 diabetes patients and patients’ activation. Finally, type 2 diabetes patients adherence did not result in being a direct consequence of the frequency of mHealth and eHealth use. Patient adherence appeared to be directly influenced by the level of perceived healthcare professionals ability of motivating patients’ autonomy. These results offer important insights into the psychosocial and organizational elements that impact on type 2 diabetes patients’ activation in self-management and on their willingness to use mHealth and eHealth devices.

Goals of clinical ethics support: perceptions of Dutch healthcare institutions.

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Dauwerse, L; Abma, T A; Molewijk, B; Widdershoven, G

2013-12-01

In previous literature, ethicists mention several goals of Clinical Ethics Support (CES). It is unknown what key persons in healthcare institutions see as main--and sub-goals of CES. This article presents the goals of CES as perceived by board members and members of ethics support staff. This is part of a Dutch national research using a mixed methods design with questionnaires, focus groups and interviews. Quantitative and qualitative data were analyzed and combined in an iterative process. Four main clusters of goals were found: 1) encouraging an ethical climate, 2) fostering an accountable and transparent organization, 3) developing professionalism and a final goal, overarching the previous three, 4) good care. Most important sub-goals of CES were: attention for ethical issues, raising awareness of ethical issues, fostering ethical reflection and supporting employees. The article ends with a discussion on the desirability to further operationalize the general goal of good care, the context-boundedness of our findings and the need to relate goals of CES to the features of organizational cultures to further improve the integration of CES in healthcare institutions.

The Relationship between Managerial Ethics Perception and Professional Burnout Levels of Employee: A Comparative Study of Five-Star Hotels’ Employees between Turkey and Italy

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Gonca Kılıç

2011-03-01

Full Text Available The purpose of this study is to determine the perceptions of the employees in five-star hotels their regarding managerial ethics and professional burnout levels and also to present the relationship between managerial ethics and professional burnout level. Survey method was used as data collection instrument. A total of 385 questionnaires were implemented on employees working in five-star hotels operating in Istanbul, Turkey and Palermo, Italy. Independent Samples t Test was used for the comparison of data obtained from each country. Furthermore, the relationship between managerial ethics and professional burnout was described through correlation and regression analyses, as a result meaningful correlations between the variables (managerial ethics and professional burnout are found.

Reflection-Based Learning for Professional Ethical Formation.

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Branch, William T; George, Maura

2017-04-01

One way practitioners learn ethics is by reflecting on experience. They may reflect in the moment (reflection-in-action) or afterwards (reflection-on-action). We illustrate how a teaching clinician may transform relationships with patients and teach person-centered care through reflective learning. We discuss reflective learning pedagogies and present two case examples of our preferred method, guided group reflection using narratives. This method fosters moral development alongside professional identity formation in students and advanced learners. Our method for reflective learning addresses and enables processing of the most pressing ethical issues that learners encounter in practice. © 2017 American Medical Association. All Rights Reserved.

EFL Teachers' Commitment to Professional Ethics and Their Emotional Intelligence: A Relationship Study

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Ashraf, Hamid; Hosseinnia, Mansooreh; Domsky, Javad GH.

2017-01-01

Emotional intelligence is the capability to realize, to create, to comprehend emotions and sentimental knowledge, and to reflectively control emotions and to improve emotional and mental growth. The purpose of this study is to examine the relationship between EFL teachers' commitment to professional ethics and their emotional intelligence. To…

An introduction to ethical theory for healthcare assistants

OpenAIRE

Rodger, Daniel; Blackshaw, B

2017-01-01

This article will explore and summarise the four main ethical theories that have relevance for healthcare assistants. These are: utilitarianism, deontology, virtue ethics and principlism. Understanding different ethical theories can have a number of significant benefits, which have the potential to shape and inform the care of patients, challenge bad practice and lead staff to become better informed about areas of moral disagreement.

Business ethics and health care: the re-emerging institution-patient relationship.

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Peppin, J F

1999-10-01

Managed care poses a challenge to the traditional conceptualization of medicine and of the physician-patient relationship. People have evaluated the merits of managed care by focusing upon the way its incentives alter the relationship between physician and patient. However, this misses the key to rightly evaluating MCOs. To address the ethics of MCOs one should focus on the institution-patient relationship, and this has not been sufficiently addressed in the literature. I will address this relationship here and show how the institution-patient relationship has evolved, why it has become increasingly prominent, and why we must move beyond business ethics for rightly understanding it.

The ethics of complex relationships in primary care behavioral health.

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Reiter, Jeff; Runyan, Christine

2013-03-01

Primary care settings are particularly prone to complex relationships that can be ethically challenging. This is due in part to three of the distinctive attributes of primary care: a whole family orientation; team-based care; and a longitudinal care delivery model. In addition, the high patient volume of primary care means that the likelihood of encountering ethically challenging relationships is probably greater than in a specialty setting. This article argues that one ethical standard of the American Psychological Association (APA, 2010, Ethical principles of psychologists and code of conduct, www.apa.org/ethics/code) (10.02, Therapy Involving Couples or Families) should be revised to better accommodate the work of psychologists in primary care. The corresponding Principles of Medical Ethics from the American Medical Association (AMA, 2012, Code of medical ethics: Current opinions with annotations, 2012-2013, Washington, DC: Author), most notably the principle regarding a physician's duty to "respect the rights of patients, colleagues, and other health professionals as well as safeguard privacy" are also noted. In addition, the article details how the three attributes of primary care often result in complex relationships, and provides suggestions for handling such relationships ethically. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Perception of Ethical Misconduct by Neuropsychology Professionals in Latin America.

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Panyavin, Ivan S; Goldberg-Looney, Lisa D; Rivera, Diego; Perrin, Paul B; Arango-Lasprilla, Juan Carlos

2015-08-01

To date, extremely limited research has focused on the ethical aspects of clinical neuropsychology practice in Latin America. The current study aimed to identify the frequency of perceived ethical misconduct in a sample of 465 self-identified neuropsychology professionals from Latin America in order to better guide policies for training and begin to establish standards for practitioners in the region. Frequencies of neuropsychologists who knew another professional engaging in ethical misconduct ranged from 1.1% to 60.4% in the areas of research, clinical care, training, and professional relationships. The most frequently reported perceived misconduct was in the domain of professional training and expertise, with nearly two thirds of participants knowing other professionals who do not possess adequate training to be working as neuropsychologists. The least frequently reported perceived misconduct was in the domain of professional relationships. Nearly one third of participants indicated that they had never received formal training in professional ethics. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ethics, Law and Professional Issues Gallagher Ann and Hodge Sue Ethics, Law and Professional Issues 192pp £20.99 Palgrave Macmillan 9780230279940 0230279945 [Formula: see text].

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2014-10-01

THE EDITORS provide a sound introduction to ethics, law and professional issues in health care. Scenarios before each chapter help the reader to digest and comprehend the information. My only criticism is that it is not directly relevant to nursing alone. Although there is some benefit in being aware of how other practitioners may be affected by these issues, another book aimed at nurses would be more appropriate. Later chapters about responding to unprofessional practice and promoting professional healthcare practice may be of more interest to nursing students and recently qualified healthcare professionals.

A social-ecological framework: A model for addressing ethical practice in nursing.

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Davidson, Patricia; Rushton, Cynda Hylton; Kurtz, Melissa; Wise, Brian; Jackson, Debra; Beaman, Adam; Broome, Marion

2018-03-01

To develop a framework to enable discussion, debate and the formulation of interventions to address ethical issues in nursing practice. Social, cultural, political and economic drivers are rapidly changing the landscape of health care in our local environments but also in a global context. Increasingly, nurses are faced with a range of ethical dilemmas in their work. This requires investigation into the culture of healthcare systems and organisations to identify the root causes and address the barriers and enablers of ethical practice. The increased medicalisation of health care; pressures for systemisation; efficiency and cost reduction; and an ageing population contribute to this complexity. Often, ethical issues in nursing are considered within the abstract and philosophical realm until a dilemma is encountered. Such an approach limits the capacity to tangibly embrace ethical values and frameworks as pathways to equitable, accessible, safe and quality health care and as a foundation for strengthening a supportive and enabling workplace for nurses and other healthcare workers. Conceptual framework development. A comprehensive literature review was undertaken using the social-ecological framework as an organising construct. This framework views ethical practice as the outcome of interaction among a range of factors at eight levels: individual factors (patients and families); individual factors (nurses); relationships between healthcare professionals; relationships between patients and nurses; organisational healthcare context; professional and education regulation and standards; community; and social, political and economic. Considering these elements as discrete, yet interactive and intertwined forces can be useful in developing interventions to promote ethical practice. We consider this framework to have utility in policy, practice, education and research. Nurses face ethical challenges on a daily basis, considering these within a social-ecological framework can

Professional Ethics of Software Engineers: An Ethical Framework.

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Lurie, Yotam; Mark, Shlomo

2016-04-01

The purpose of this article is to propose an ethical framework for software engineers that connects software developers' ethical responsibilities directly to their professional standards. The implementation of such an ethical framework can overcome the traditional dichotomy between professional skills and ethical skills, which plagues the engineering professions, by proposing an approach to the fundamental tasks of the practitioner, i.e., software development, in which the professional standards are intrinsically connected to the ethical responsibilities. In so doing, the ethical framework improves the practitioner's professionalism and ethics. We call this approach Ethical-Driven Software Development (EDSD), as an approach to software development. EDSD manifests the advantages of an ethical framework as an alternative to the all too familiar approach in professional ethics that advocates "stand-alone codes of ethics". We believe that one outcome of this synergy between professional and ethical skills is simply better engineers. Moreover, since there are often different software solutions, which the engineer can provide to an issue at stake, the ethical framework provides a guiding principle, within the process of software development, that helps the engineer evaluate the advantages and disadvantages of different software solutions. It does not and cannot affect the end-product in and of-itself. However, it can and should, make the software engineer more conscious and aware of the ethical ramifications of certain engineering decisions within the process.

Seven year overview (2007—2013 of ethical transgressions by registered healthcare professionals in South Africa

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Nico Nortje

2016-10-01

Full Text Available A move has taken place internationally in the delivery and “consumption” of health care where if clients and patients (health care consumers hold the opinion that the health care professionals/providers' behaviour has had a negative effect, impact or outcome on them, they may lodge a complaint with the relevant health professional regulatory body. Ethical transgressions of health care providers can generally be clustered into the following three categories: a Competence and conduct with clients (e.g. abandonment, sexual intimacies, dishonesty, disclosure of information; b Business practices (e.g. billing, reports, documentation; and c Professional practice (e.g. referral upon termination, obtaining appropriate potential employment opportunities, nonprofessional relationships.The primary objective of this study was to analyse the ethical transgressions of registered members of the twelve professional boards in the Health Professions Council of South Africa (HPCSA in the period 2007 to 2013. A mixed methods approach was followed in this study which specifically focused on a historical research approach. The results indicate that the boards with the highest number of transgressions per the registered practitioners were firstly the Medical and Dental practitioners, closely followed by the Optometry and Dispensing Opticians Board. The predominantly complaint made against members of both these boards was for fraudulent conduct (collectively totalling to 85% of all fraudulent cases during the period and included actions such as charging for non-rendered services, issuing false statements and submitting fraudulent medical aid claims. Cognisance needs to be taken that the South African public will increasingly demand better services and that since they are being better informed via the media of their rights and have access to a broader database of knowledge (rightly or wrongly so the internet practitioners' opinions will not necessarily be accepted

The NHS and market forces in healthcare: the need for organisational ethics.

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Frith, Lucy

2013-01-01

The NHS in England is an organisation undergoing substantial change. The passage of the Health and Social Care Act 2012, consolidates and builds on previous health policies and introduces further 'market-style' reforms of the NHS. One of the main aspects of these reforms is to encourage private and third sector providers to deliver NHS services. The rationale for this is to foster a more competitive market in healthcare to encourage greater efficiency and innovation. This changing healthcare environment in the English NHS sharpens the need for attention to be paid to the ethical operation of healthcare organisations. All healthcare organisations need to consider the ethical aspects of their operation, whether state or privately run. However, the changes in the type of organisations used to provide healthcare (such as commercial companies) can create new relationships and ethical tensions. This paper will chart the development of organisational ethics as a concern in applied ethics and how it arose in the USA largely owing to changes in the organisation of healthcare financing and provision. It will be argued that an analogous transition is happening in the NHS in England. The paper will conclude with suggestions for the development of organisational ethics programmes to address some of the possible ethical issues raised by this new healthcare environment that incorporates both private and public sector providers.

Clarifying perspectives: Ethics case reflection sessions in childhood cancer care.

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Bartholdson, Cecilia; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2016-06-01

Childhood cancer care involves many ethical concerns. Deciding on treatment levels and providing care that infringes on the child's growing autonomy are known ethical concerns that involve the whole professional team around the child's care. The purpose of this study was to explore healthcare professionals' experiences of participating in ethics case reflection sessions in childhood cancer care. Data collection by observations, individual interviews, and individual encounters. Data analysis were conducted following grounded theory methodology. Healthcare professionals working at a publicly funded children's hospital in Sweden participated in ethics case reflection sessions in which ethical issues concerning clinical cases were reflected on. The children's and their parents' integrity was preserved through measures taken to protect patient identity during ethics case reflection sessions. The study was approved by a regional ethical review board. Consolidating care by clarifying perspectives emerged. Consolidating care entails striving for common care goals and creating a shared view of care and the ethical concern in the specific case. The inter-professional perspectives on the ethical aspects of care are clarified by the participants' articulated views on the case. Different approaches for deliberating ethics are used during the sessions including raising values and making sense, leading to unifying interactions. The findings indicate that ethical concerns could be eased by implementing ethics case reflection sessions. Conflicting perspectives can be turned into unifying interactions in the healthcare professional team with the common aim to achieve good pediatric care. Ethics case reflection sessions is valuable as it permits the discussion of values in healthcare-related issues in childhood cancer care. Clarifying perspectives, on the ethical concerns, enables healthcare professionals to reflect on the most reasonable and ethically defensible care for the child

Improvement of decision-making criteria for the care of elderly cancer patients by general practitioners (Lorraine, France

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Niemier JY

2018-05-01

Full Text Available Jean-Yves Niemier,1,2 Frédérique Claudot,3,4 Phi Linh Nguyen-Thi,4 Jean-Marie Hubert,5 Hubert Rousselot,2,6 Athanase Benetos,1 Christine Perret-Guillaume1,3 1Department of Geriatric Medicine, CHRU de Nancy, Nancy, France; 2UCOG Lorraine, Nancy, France; 3EA 4360 APEMAC, Faculté de Médecine, Université de Lorraine, Nancy, France; 4PARC, CHRU de Nancy, Nancy, France; 5Spincourt Multidisciplinary MSP, Spincourt, France; 6SISSPO Department, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France Objective: The objective of this study was to identify changes in the decision-making criteria of general practitioners (GPs concerning the care of elderly cancer patients after 1 year of corrective measures for care practices in the Lorraine region, France. Materials and methods: In 2014, a postal mail questionnaire was sent to all GPs in the Lorraine region. This questionnaire was designed to identify GPs’ decision-making criteria. It was based on the results of a literature review and on existing guidelines. During 1 year, corrective measures were implemented to improve practices, especially training sessions for physicians and production of specific tools, including a guide to the accepted ideas in geriatric oncology. In 2015, the same questionnaire was resent to all GPs to compare the answers. Results: In 2014, 430 questionnaires were returned out of 2,048 sent, and in 2015, 378 questionnaires were returned out of 2,066 sent. Our results show for the first time that there exists a significant difference in the overall decision criteria between the two survey periods. This difference mainly concerns criteria related to the cancerous diseases. Physicians tend to consider the principal decision criteria to be less important after the training period. GPs express the importance of accessibility to specialists for additional advice in both 2014 and 2015; the distance between the patient’s home and an adapted care facility and the

Percived ethical misconduct: a survey of Neuropsychology professionals in Mexico

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Paola Fonseca

2016-01-01

Full Text Available Objective: To evaluate the frequency of perceived ethical misconduct in the practice of neuropsychology in Mexico. Method: One hundred fourteen psychologists answered a survey which assessed perceptions of ethical misconduct in four areas of professional practice in the field of neuropsychology. Results: The area of professional training contained the highest percentage of perception of ethical misconduct, followed by research and publications, clinical care, and professional relationships. Conclusion: The high frequency of ethical misconduct perceived by neuropsychology professionals in Mexico is a cause for concern. The results suggest the need to create and implement a system to make sure that professionals follow the ethics standards required by the profession, and to provide consequences for those who fail to do so. The profession of neuropsychology and training of professionals in the field must be regularized in the country, to reduce the frequency of future ethical misconducts.

A software platform to analyse the ethical issues of electronic patient privacy policy: the S3P example.

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Mizani, M A; Baykal, N

2007-12-01

Paper-based privacy policies fail to resolve the new changes posed by electronic healthcare. Protecting patient privacy through electronic systems has become a serious concern and is the subject of several recent studies. The shift towards an electronic privacy policy introduces new ethical challenges that cannot be solved merely by technical measures. Structured Patient Privacy Policy (S3P) is a software tool assuming an automated electronic privacy policy in an electronic healthcare setting. It is designed to simulate different access levels and rights of various professionals involved in healthcare in order to assess the emerging ethical problems. The authors discuss ethical issues concerning electronic patient privacy policies that have become apparent during the development and application of S3P.

Grassroots origins, national engagement: exploring the professionalization of practicing healthcare ethicists in Canada.

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Frolic, Andrea

2012-09-01

Canadian ethicists have a long legacy of leadership in advocating for standards and quality in healthcare ethics. Continuing this tradition, a grassroots organization of practicing healthcare ethicists (PHEs) concerned about the lack of standardization in the field recently formed to explore potential options related to professionalization. This group calls itself "practicing healthcare ethicists exploring professionalization" (PHEEP). This paper provides a description of the process by which PHEEP has begun to engage the Canadian PHE community in the development of practice standards and related projects. By making our process and its ethical and cultural underpinnings transparent, we hope to prompt PHEs around the world to reflect on the importance of context, process and principles (not just outcomes) in the exploration of and possible movement towards professionalization. By sharing some of our key successes and challenges, we also hope to inspire our colleagues to recognize the value in developing practice standards and to contribute to this endeavor.

Ethics of medical records and professional communications.

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Recupero, Patricia R

2008-01-01

In child and adolescent psychiatry, medical records and professional communications raise important ethical concerns for the treating or consulting clinician. Although a distinction may be drawn between internal records (eg, medical records and psychotherapy notes) and external communications (eg, consultation reports and correspondence with pediatricians), several ethical principles apply to both types of documentation; however, specific considerations may vary, depending upon the context in which the records or communications were produced. Special care is due with regard to thoroughness and honesty, collaboration and cooperation, autonomy and dignity of the patient, confidentiality of the patient and family members, maintaining objectivity and neutrality, electronic communications media, and professional activities (eg, political advocacy). This article reviews relevant ethical concerns for child and adolescent psychiatrists with respect to medical records and professional communications, drawing heavily from forensic and legal sources, and offers additional recommendations for further reading for clarification and direction on ethical dilemmas.

Professional competence and palliative care: an ethical perspective.

NARCIS (Netherlands)

Olthuis, G.J.; Dekkers, W.J.M.

2003-01-01

The aim of this article is to explore an ethical view of professional competence by examining the professional competence of physicians in the context of palliative care. A discussion of the four dimensions of professional competence--knowledge, technical skills, relationships, and affective and

Healthcare professional versus patient goal setting in intermittent allergic rhinitis.

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O'Connor, J; Seeto, C; Saini, B; Bosnic-Anticevich, S; Krass, I; Armour, C; Smith, L

2008-01-01

To examine the impact of healthcare professional versus patient goal setting for the self-management of intermittent allergic rhinitis (AR) on symptom severity and quality of life. This was a 6 week, parallel group study. Group A participants, with pharmacist facilitation, nominated personally relevant goals and strategies relating to their AR. Group B participants had their goals and strategies set by the pharmacist. The main outcome measures used included perceived symptom severity and quality of life. In addition, goals and strategies data from participants of both groups were collected and analysed. Both groups demonstrated significant improvements in symptom severity and quality of life scores however Group B symptom severity scores improved more. Group B set a greater number of goals and strategies which were better structured and more task specific. This is the first study to investigate the impact of goal setting on patient behaviour in a chronic yet episodic illness. Our results suggest that self-management goals set by the healthcare professional which are clinically indicated but tailored to the patient's nominated symptoms yields better outcomes than goals nominated by the patient. A brief, structured intervention, tailored to patient symptoms, can enhance self-management of intermittent allergic rhinitis.

Certification ISO 9001 in clinical ethics consultation for improving quality and safety in healthcare.

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Tozzo, Pamela; Mazzi, Anna; Aprile, Anna; Rodriguez, Daniele; Caenazzo, Luciana

2018-03-24

This paper refers to the quality management process of the Laboratory of Clinical Bioethics (LCB) of the University of Padua (Italy), which has obtained the quality certification to ISO 9001:2008, as a Clinical Ethics Support Service. Its activities consist mainly in clinical ethics consultations and training services, addressed to those who are called to decisions with ethical implications in the clinical setting, proposing a structured approach to identify and analyze the ethical issues that may loom in the relationships between health professionals and patients, and participating in their solution. The expected benefits of the application of ISO 9001 were mainly the following: to formalize the procedure adopted for clinical ethics consultation and training, to obtain a controlled management of documents, information and data, to ensure and demonstrate the quality of the provided activities and to make methods and organization publicly available. The main results which have been achieved with the 'quality management project' are summarized as follows: the enunciation of LCB Mission and Quality Policy; the drafting of the procedure by which clinical ethics consultation is provided; the formalization of members' skills and the adoption of relevant process and outcome indicators. Our experience may be useful in promoting accountability for the quality of ethics consultation services. We consider the certification process as a tool for transparent and reliable management of one of the most critical tasks in the current context of healthcare, motivating similar facilities to undertake similar pathways, with the aim to provide quality control on their activities.

Measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective.

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Heggland, Liv-Helen; Mikkelsen, Aslaug; Øgaard, Torvald; Hausken, Kjell

2014-02-01

To develop, empirical test, and validate an instrument measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective. Since the advent of New Public Management in many Western countries, patient participation in healthcare decision-making has been considered to be a best practice. A common notion is that well-educated and well-informed public want to choose their own treatments and providers and want to ask questions about the quality of their health services. Survey. A self-report-measuring instrument was designed and administered to 620 healthcare professionals. Items were developed, validated and tested by 451 nurses and physicians working in six surgical wards in a University Hospital in Norway. A 16-item scale with the following four dimensions was developed: information dissemination, formulation of options, integration of information and control. Factor analysis procedures and reliability testing were performed. A one-way, between-groups analysis of variance was conducted to compare doctors' and nurses' opinions on four dimensions of patient participation in surgical treatment decision-making. This article shows that patient participation in surgical treatment decision-making can be measured by a 16-item scale and four distinct dimensions. The analysis demonstrated a reasonable level of construct validity and reliability. Nurses and physicians have a positive attitude towards patient participation overall, but the two groups differ in the extent to which they accept the idea of patient participation in treatment decision-making. The instrument can be a tool for managers and healthcare professionals in the implementation of patient participation in clinical practice. Data from the instrument can be useful to identify health services being provided and what areas that could strengthen patient participation. © 2013 Blackwell Publishing Ltd.

Knowledge, awareness and practice of ethics among doctors in tertiary care hospital.

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Singh, Surjit; Sharma, Pramod Kumar; Bhandari, Bharti; Kaur, Rimplejeet

2016-10-01

With the advancement of healthcare and medical research, doctors need to be aware of the basic ethical principles. This cross-sectional study is an attempt to assess the knowledge, awareness, and practice of health-care ethics among health-care professionals. After taking written informed consent, a standard questionnaire was administered to 117 doctors. No personal information was recorded on the questionnaire so as to ensure the confidentiality and anonymity of participants. Data analysis was done using SPSS version 21 (IBM Corp., Armonk, NY, USA). Statistically significant difference observed between the opinions of consultant and senior resident (SRs) on issues like, adherence to confidentiality; paternalistic attitude of doctors (doctors should do their best for the patient irrespective of patient's opinion); doctor's decision should be final in case of disagreement and interest in learning ethics ( P patient wishes, informing patient regarding wrongdoing, informing close relatives, seeking consent for children and patients' consent for procedures. Furthermore, no significant difference observed between the two with respect to the practice of health-care ethics. Surprisingly, the response of clinical and nonclinical faculty did not differ as far as awareness and practice of ethics were concerned. The significant difference is observed in the knowledge, awareness, and practice of ethics among consultants and SRs. Conferences, symposium, and workshops, on health-care ethics, may act as a means of sensitizing doctors and thus will help to bridge this gap and protect the well-being and confidentiality of the patients. Such an effort may bring about harmonious change in the doctor-patient relationship.

Mismatch between health-care professionals' and patients' views on a diabetes patient decision aid: a qualitative study.

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Lee, Ping Yein; Khoo, Ee Ming; Low, Wah Yun; Lee, Yew Kong; Abdullah, Khatijah Lim; Azmi, Syahidatul Akmal; Ng, Chirk Jenn

2016-04-01

Malaysia is an Asian country with population of diverse culture and health perceptions. Patient decision aid (PDA) is a new tool in Malaysia. Patients' and health-care professionals' (HCPs) expectation of a PDA is unknown. We aimed to explore patients' and health-care professionals'(HCPs) views on the information needed in a patient decision aid (PDA) on insulin initiation developed for patients with type 2 diabetes mellitus (T2DM). We used a qualitative design and thematic approach. Three main primary health-care settings in Malaysia: public university-based primary care clinics, public health-care clinics and private general practices. We conducted focus groups and one-to-one interviews with a purposive sample of health professionals and patients with type 2 diabetes. We interviewed 18 patients and 13 HCPs. Patients viewed the content of the PDA as simple and clear. However, HCPs felt the PDA might be difficult for patients with low literacy to understand. HCPs thought the PDA was too lengthy. Nevertheless, patients would prefer more information. HCPs tended to focus on benefits of insulin, while patients wanted to know the impact of insulin on their quality of life and practical issues regarding insulin and its side-effects. Patients preferred numbers to weigh the risks and benefits of treatment options. HCPs' views that presenting numbers in a PDA would be too complex for patients to understand. It is important to consider including issues related to psycho-social impact of treatment to patients when developing a patient decision aid. © 2015 John Wiley & Sons Ltd.

[Self-Awareness of Disease Stigma: Reflections of Healthcare Professionals].

Science.gov (United States)

Chen, Chih-Hsuan; Wang, Ying-Ting; Shu, Bih-Ching

2017-06-01

People who suffer from disease frequently experience disease-related stigmas. Stigma presents in daily life during normal human interactions. The stereotypes promoted by the media often impact public opinion significantly. Moreover, healthcare professionals may exacerbate stigmatization due to their misunderstanding of patients and their disease issues. Therefore, the reflection on stigma of healthcare professionals cannot be ignored. The present article illustrates the issue of stigmas held by healthcare professionals, their related stigmas, and their self-awareness. It is hoped that all healthcare professionals may cooperate to develop an anti-stigma strategy and to become true spokespersons for their patients.

Partnering with patients in translational oncology research: ethical approach.

Science.gov (United States)

Mamzer, Marie-France; Duchange, Nathalie; Darquy, Sylviane; Marvanne, Patrice; Rambaud, Claude; Marsico, Giovanna; Cerisey, Catherine; Scotté, Florian; Burgun, Anita; Badoual, Cécile; Laurent-Puig, Pierre; Hervé, Christian

2017-04-08

The research program CARPEM (cancer research and personalized medicine) brings together the expertise of researchers and hospital-based oncologists to develop translational research in the context of personalized or "precision" medicine for cancer. There is recognition that patient involvement can help to take into account their needs and priorities in the development of this emerging practice but there is currently no consensus about how this can be achieved. In this study, we developed an empirical ethical research action aiming to improve patient representatives' involvement in the development of the translational research program together with health professionals. The aim is to promote common understanding and sharing of knowledge between all parties and to establish a long-term partnership integrating patient's expectations. Two distinct committees were settled in CARPEM: an "Expert Committee", gathering healthcare and research professionals, and a "Patient Committee", gathering patients and patient representatives. A multidisciplinary team trained in medical ethics research ensured communication between the two committees as well as analysis of discussions, minutes and outputs from all stakeholders. The results highlight the efficiency of the transfer of knowledge between interested parties. Patient representatives and professionals were able to identify new ethical challenges and co-elaborate new procedures to gather information and consent forms for adapting to practices and recommendations developed during the process. Moreover, included patient representatives became full partners and participated in the transfer of knowledge to the public via conferences and publications. Empirical ethical research based on a patient-centered approach could help in establishing a fair model for coordination and support actions during cancer research, striking a balance between the regulatory framework, researcher needs and patient expectations. Our approach addresses

Ethical decision-making, passivity and pharmacy.

Science.gov (United States)

Cooper, R J; Bissell, P; Wingfield, J

2008-06-01

Increasing interest in empirical ethics has enhanced understanding of healthcare professionals' ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making. To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an under-researched professional group. 23 purposively sampled UK community pharmacists were asked, in semi-structured interviews, to describe ethical problems in their work and how they were resolved. Framework analysis of transcribed interviews utilised the four decision-making stages, together with constant comparative methods and deviant-case analysis. Pharmacists were often inattentive and constructed problems in legal terms. Ethical reasoning was limited, but examples of appeals to consequences, the golden rule, religious faith and common-sense experience emerged. Ethical intention was compromised by frequent concern about legal prosecution. Ethical inaction was common, typified by pharmacists' failure to report healthcare professionals' bad practices, and ethical passivity emerged to describe these negative examples of the four decision-making stages. Pharmacists occasionally described more ethically active decision-making, but this often involved ethical uncertainty. The four decision-making stages are a useful tool in considering how healthcare professionals try to resolve ethical problems in practice. They reveal processes often ignored in normative theories, and their recognition and the emergence of ethical passivity indicates the complexity of decision-making in practice. Ethical passivity may be deleterious to patients' welfare, and concerns emerge about improving pharmacists' ethical training and promoting ethical awareness and responsibility.

Medical Ethics Today. The BMA's Handbook of Ethics and Law

African Journals Online (AJOL)

ethics is and leads into a framework of good ethical practice in healthcare. This section also briefly explains the theories and principles pertinent to the practice of healthcare and assists ... patient re la tionship, types of relationships in modern medicine, ... be applied in any country and the legal guidance is particularly.

Assisted or Hastened Death: The Healthcare Practitioner’s Dilemma

Science.gov (United States)

MacLeod, Rod D; Wilson, Donna M; Malpas, Phillipa

2012-01-01

Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in most countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for the legalisation of euthanasia and assisted suicide has never been stronger. While some studies have documented the reluctance of medical and other healthcare professionals to be involved in the practice of assisted dying or euthanasia, there is still much open debate in the public domain. Those who have the most experience of palliative care are strongest in their opposition to hastening death. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisting death, including a focus on examining the concepts of autonomy for patients and healthcare practitioners. The role of the healthcare practitioner has clearly and undoubtedly changed over time with advances in healthcare practices but the duty of care has not changed. The dilemmas for healthcare practitioners thus who have competent patients requesting hastened death extends far beyond acting within a country’s laws as they go to the very heart of the relationship between the practitioner and patient. PMID:23121745

Ethics and Professionalism in Pathology

Directory of Open Access Journals (Sweden)

R Baral

2016-03-01

Full Text Available Pathologists spend most of their professional lives beyond direct view of the public, mostly inside the four walls of the lab. It is the clinicians who face the wrath of the public when something goes wrong. However, with the growing awareness of the public into the decisive role played by the Pathologists in the definitive diagnosis of the disease, the pathologists will soon be the target of the aggrieved patients and relatives.1 The issue of ethics can be dealt when professionalism comes before profession. "Professionalism in medicine requires that physician serve the interests of the patient above his or her own selfinterest." Professionalism aspires to philanthropy, answerability, excellence, duty, service and respect for others. "Professionalism in Pathology is based on the same tenets, but has additional dimensions."The qualities of professionalism for pathologists include 1. Communication with the patients and the clinicians. A small phone call with the clinician will solve most of the clinical mysteries not written in the lab requisition forms; 2. Empathy and Compassion towards patients', colleagues', and laboratory personnel's culture, age, gender, and disabilities; 3. Demonstration of passion, respect and understanding towards the patients; 4. Adherence to guidelines and regulations of the regulatory and accrediting bodies; and 5.Profeciency and knowledge in one's work is valued by the patients more than the credentials, which also enables one to identify deficiencies in peer performance. The basic competencies of professionalism are vital to every pathology report, which in turn is the mirror of the ethics practiced by the pathologist. Evaluating oneself is perhaps the most important tool in maintaining professionalism in the practice of pathology. One colleague recently defined professionalism as “all the things one does when no one is watching,” thus placing personal integrity at the top of the list.

Email for clinical communication between healthcare professionals.

Science.gov (United States)

Goyder, Clare; Atherton, Helen; Car, Mate; Heneghan, Carl J; Car, Josip

2015-02-20

Email is one of the most widely used methods of communication, but its use in healthcare is still uncommon. Where email communication has been utilised in health care, its purposes have included clinical communication between healthcare professionals, but the effects of using email in this way are not well known. We updated a 2012 review of the use of email for two-way clinical communication between healthcare professionals. To assess the effects of email for clinical communication between healthcare professionals on healthcare professional outcomes, patient outcomes, health service performance, and service efficiency and acceptability, when compared to other forms of communicating clinical information. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 9 2013), MEDLINE (OvidSP) (1946 to August 2013), EMBASE (OvidSP) (1974 to August 2013), PsycINFO (1967 to August 2013), CINAHL (EbscoHOST) (1982 to August 2013), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched November 2013). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies, and interrupted time series studies examining interventions in which healthcare professionals used email for communicating clinical information in the form of: 1) unsecured email, 2) secure email, or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two authors independently assessed studies for inclusion, assessed the included studies' risk of bias, and extracted data. We contacted study authors for additional information and have reported all measures as per the study report. The previous version of this review included one randomised controlled

Oncology healthcare professionals' perspectives on the psychosocial support needs of cancer patients during oncology treatment.

Science.gov (United States)

Aldaz, Bruno E; Treharne, Gareth J; Knight, Robert G; Conner, Tamlin S; Perez, David

2017-09-01

This study explored oncology healthcare professionals' perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients' acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients' experiences during oncology treatment.

Qualitative analysis of healthcare professionals' viewpoints on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas.

Science.gov (United States)

Marcus, Brian S; Shank, Gary; Carlson, Jestin N; Venkat, Arvind

2015-03-01

Ethics consultation is a commonly applied mechanism to address clinical ethical dilemmas. However, there is little information on the viewpoints of health care providers towards the relevance of ethics committees and appropriate application of ethics consultation in clinical practice. We sought to use qualitative methodology to evaluate free-text responses to a case-based survey to identify thematically the views of health care professionals towards the role of ethics committees in resolving clinical ethical dilemmas. Using an iterative and reflexive model we identified themes that health care providers support a role for ethics committees and hospitals in resolving clinical ethical dilemmas, that the role should be one of mediation, rather than prescription, but that ultimately legal exposure was dispositive compared to ethical theory. The identified theme of legal fears suggests that the mediation role of ethics committees is viewed by health care professionals primarily as a practical means to avoid more worrisome medico-legal conflict.

Patient obesity and the practical experience of the plain radiography professional: On everyday ethics, patient positioning and infelicitous equipment

International Nuclear Information System (INIS)

Woods, A.L.; Miller, P.K.; Sloane, C.

2016-01-01

Patient obesity is increasingly placing significant and multifaceted strain upon medical imaging departments, and professionals, in (particularly Western) healthcare systems. The majority of obesity-related studies in radiology are, however, primarily focused only upon the technical business of collecting diagnostically-efficacious images. This study, using Interpretative Phenomenological Analysis (IPA), qualitatively explores the everyday clinical experiences of eight expert UK diagnosticians working in plain radiography. Focus herein falls particularly upon (a) problems with patient positioning during examination, and (b) challenges arising around available equipment. In line with extant research, participants reported that difficulties with positioning obese patients could have negative impacts on image quality, and that insufficient table weight limits and widths, and inadequate detector sizes, can adversely affect examination. They also raised some more novel issues, such as how the impact of available gown sizes upon a patient's sense of dignity can cause practical and ethical dilemmas for a clinician in situ. The issue of how one might ‘train’ experience in positioning patients without bony landmarks as a reference point was also made salient, with strong implications for undergraduate radiography curricula. It is finally highlighted how the participating radiographers themselves seldom conceptualised any given problem as a purely ‘technical’ one, instead recurrently recognising the interlinking of material, socio-economic and moral matters in real healthcare contexts. By better understanding such nuance and complexity as lived by real radiographers, it is contended, a more context-sensitive and flexible path to effective training and guideline-production can be mapped. - Highlights: • Difficulties with positioning obese patients can have negative impacts on image quality. • Positioning patients without bony landmarks as a reference point is

Work motivation among healthcare professionals.

Science.gov (United States)

Kjellström, Sofia; Avby, Gunilla; Areskoug-Josefsson, Kristina; Andersson Gäre, Boel; Andersson Bäck, Monica

2017-06-19

Purpose The purpose of this paper is to explore work motivation among professionals at well-functioning primary healthcare centers subject to a national healthcare reform which include financial incentives. Design/methodology/approach Five primary healthcare centers in Sweden were purposively selected for being well-operated and representing public/private and small/large units. In total, 43 interviews were completed with different medical professions and qualitative deductive content analysis was conducted. Findings Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers' positive management was due to a unique combination of factors, such as clear direction of goals, a culture of non-hierarchical collaboration, and systematic quality improvement work. The financial incentives need to be translated in terms of quality patient care to provide clear direction for the professionals. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created. Practical implications Leaders need to consistently translate and integrate reforms with the professionals' drives and values. This is done by encouraging participation through teamwork, time for structured reflection, and quality improvement work. Social implications The design of the reforms and leadership are essential preconditions for work motivation. Originality/value The study offers a more complete picture of how reforms are managed at primary healthcare centers, as different medical professionals are included. The value also consists of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms.

Caring for tomorrow's workforce: Moral resilience and healthcare ethics education.

Science.gov (United States)

Monteverde, Settimio

2016-02-01

Preparing tomorrow's healthcare workforce for managing the growing complexity of care places high demands on students, educators, and faculties. In the light of worrying data about study-related stress and burnout, understanding how students manage stressors and develop resilience has been identified as a priority topic of research. In addition to study-related stressors, also moral stressors are known to characterize the students' first clinical experiences. However, current debates show that it remains unclear how healthcare ethics education should address them. In order to clarify this issue, this study first develops the notion of moral resilience as a response to moral stressors involving both situations of moral complexity and moral wrongness. Second, it explores the potential of healthcare ethics education in fostering moral resilience. For this purpose, it defines moral resilience operationally as a reduction of moral distress in a given axis of time measured by a validated tool. The educational transferability was assessed within an explorative, quantitative pre-post interventional study with a purposive sample of 166 nursing students. The educational intervention comprised a lecture introducing the typology of moral stressors. Before and after the lecture, students were presented vignettes depicting morally stressful situations. The competent research ethics committee confirmed that no ethical approval was needed. Informed consent was obtained from participants. Three of four vignettes showed a modest but statistically significant reduction in measured levels of distress after the lecture (p ethics education in providing students with transformative knowledge that fosters moral resilience. In times of global scarcity of educational resources, healthcare ethics education has an important contribution to offer in the promotion of students' mental and physical health by strengthening the knowledge base of moral resilience. This legitimates its costs for

Investigation of the trust status of the nurse-patient relationship.

Science.gov (United States)

Ozaras, Gözde; Abaan, Süheyla

2016-09-07

Professional nurses provide holistic healthcare to people and deal with patients closely. Furthermore, patients need nurses to do self-care and patients trust them for their treatments. Therefore, trust is extremely important in a professional care relationship and in satisfactory patient outcomes. The aim of this study was to examine the patients' views on the trust status toward nurses and the factors important for the development of trust in a nurse-patient relationship. This research was planned as a descriptive cross-sectional study. The study was carried out between April and July 2014 at the oncology hospital of a university in Ankara, Turkey. The sample size was calculated by power analysis and was composed of 356 inpatients diagnosed with cancer. For data collection, a questionnaire and the "Trust in Nurses Scale" were used. FROM THE HOSPITAL AND WRITTEN INFORMED CONSENT OBTAINED FROM PARTICIPATING PATIENTS: Approval from the University Clinical Research Ethics Committee was obtained. Written approval was obtained from the hospital and consent letter from the patients. The average score on the scale was 24.5 ± 3.9, meaning that patients had a high level of trust toward nurses in this hospital. The patients who were in the 50-59 age group and men had statistically higher scores compared with other groups. Patients' answers revealed that themes of "Personal and Professional Characteristics" were important when developing trust, however "Mistreatment, Professional Incapability, and Communication Problem" were important causing mistrust toward the nurses. In this study, the nurses' professional competencies and interpersonal caring attributes emerged as most important in developing trust. This study paid attention to the values and attitudes that develop patients' trust toward nurses. Moreover, the findings raise ethical questions about how the patients' basic rights are to be protected and how their trust level can be heightened. Nurse managers need to

Relationship between ethical leadership and organisational commitment of nurses with perception of patient safety culture.

Science.gov (United States)

Lotfi, Zahra; Atashzadeh-Shoorideh, Foroozan; Mohtashami, Jamileh; Nasiri, Maliheh

2018-03-12

To determine the relationship between ethical leadership, organisational commitment of nurses and their perception of patient safety culture. Patient safety, organisational commitment and ethical leadership styles are very important for improving the quality of nursing care. In this descriptive-correlational study, 340 nurses were selected using random sampling from the hospitals in Tehran in 2016. Data were analysed using descriptive and inferential statistics in SPSS v.20. There was a significant positive relationship between the ethical leadership of nursing managers, perception of patient safety culture and organisational commitment. The regression analysis showed that nursing managers' ethical leadership and nurses' organisational commitment is a predictor of patient safety culture and confirms the relationship between the variables. Regarding the relationship between the nurses' safety performance, ethical leadership and organisational commitment, it seems that the optimisation of the organisational commitment and adherence to ethical leadership by administrators and managers in hospitals could improve the nurses' performance in terms of patient safety. Implementing ethical leadership seems to be one feasible strategy to improve nurses' organisational commitment and perception of patient safety culture. Efforts by nurse managers to develop ethical leadership reinforce organisational commitment to improve patient outcomes. Nurse managers' engagement and performance in this process is vital for a successful result. © 2018 John Wiley & Sons Ltd.

Ethical and legal perspectives on the medical practitioners use of social media.

Science.gov (United States)

Kubheka, Brenda

2017-04-25

Use of social media has increased exponentially throughout the world. Social media provides a platform for building social and professional relationships that can be used by all, including healthcare professionals. Alongside the benefits of creating networks and spreading information wider and faster than is possible with traditional communication channels, however, it presents ethical and legal challenges. For health professionals, it poses a threat to confidentiality and privacy owed to patients, colleagues and employers. It is vital for health professionals to acknowledge that the same ethical and legal standards apply both online and offline, and that they are accountable to professional bodies and the law for their online activities. This article seeks to explore the ethical and legal pitfalls facing health professionals using social media platforms. Importantly, it seeks to create awareness about the cyberpsychology phenomenon called the 'online disinhibition effect', responsible for lowering restraint during online activities.

Ethical and legal perspectives on the medical practitioners use of social media

Directory of Open Access Journals (Sweden)

Brenda Kubheka

2017-05-01

Full Text Available Use of social media has increased exponentially throughout the world. Social media provides a platform for building social and professional relationships that can be used by all, including healthcare professionals. Alongside the benefits of creating networks and spreading information wider and faster than is possible with traditional communication channels, however, it presents ethical and legal challenges. For health professionals, it poses a threat to confidentiality and privacy owed to patients, colleagues and employers. It is vital for health professionals to acknowledge that the same ethical and legal standards apply both online and offline, and that they are accountable to professional bodies and the law for their online activities. This article seeks to explore the ethical and legal pitfalls facing health professionals using social media platforms. Importantly, it seeks to create awareness about the cyberpsychology phenomenon called the ‘online disinhibition effect’, responsible for lowering restraint during online activities.

Perceptions of primary healthcare professionals towards their role in type 2 diabetes mellitus patient education in Brazil

Directory of Open Access Journals (Sweden)

Bodstein Regina CA

2010-09-01

Full Text Available Abstract Background The aim of the current study was to analyze the perceptions, knowledge, and practices of primary healthcare professionals in providing patient education to people with type 2 diabetes mellitus. Methods A total of 23 health professionals working in primary healthcare units in Belo Horizonte, Minas Gerais State, Brazil, participated in a focus group in order to discuss their patient education practices and the challenges for effective patient education in diabetes self-management. Results The results were categorized as follows: 1 lack of preparation and technical knowledge among the health professionals on some aspects of diabetes mellitus and the health professionals' patient education practices; 2 work conditions and organization; 3 issues related or attributed to the clientele themselves; and 4 diabetes care model. Conclusions This study highlights the importance of reorienting the patient education practices, health professionals' skills and work goals, and evaluation of the educational interventions, in order to establish strategies for health promotion and prevention and control of the disease. Descriptors Health Education; Prevention of Diabetes Mellitus; Primary Healthcare

Nurses' contributions to the resolution of ethical dilemmas in practice.

Science.gov (United States)

Barlow, Nichola Ann; Hargreaves, Janet; Gillibrand, Warren P

2018-03-01

Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Four major themes emerged: 'best for the patient', 'accountability', 'collaboration and conflict' and 'concern for others'. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing

Effects of Ethical Climate on Organizational Commitment, Professional Commitment, and Job Satisfaction of Auditor in Malaysia

Directory of Open Access Journals (Sweden)

Suhaiza Ismail

2015-08-01

Full Text Available The objective of this paper is to investigate the effect of the ethical climate on the organizational commitment, professional commitment and job satisfaction of Malaysian auditors. Using a survey questionnaire comprising instruments about the ethical climate, organizational commitment, professional commitment and job satisfaction, 263 usable responses were received. To achieve the objectives, mean scores, standard deviations, correlations and multiple regressions were performed. The study revealed that a significant positive influence of a caring ethical climate on professional and organizational commitment as well as job satisfaction existed. There was also a positive significant association between the law and code ethical climate and professional commitment. On the other hand, the study discovered that the instrumental ethical climate type had a significant negative relationship with organizational commitment and job satisfaction. A significant negative relationship was also revealed between the independent ethical climate type and organizational and professional commitment. A significant negative relationship between the rules ethical climate and job satisfaction was also discovered.

Maintaining professionalism in today's business environment: ethical challenges for the pain medicine specialist.

Science.gov (United States)

Lebovits, Allen

2012-09-01

There are many external influences in today's market force that impair the relationship between the pain medicine specialist and the patient, and ultimately prevent optimal quality of care. This article explores the ethical challenges facing the pain medicine specialist in today's increasingly "business" environment and will offer solutions for maintaining the professionalism of pain medicine. Four commonly encountered bioethical principles in the practice of pain medicine are reviewed: beneficence, nonmaleficence, justice, and autonomy. The following ethical challenges of the pain medicine specialist are reviewed: practicing outside ones specialty area, practice characteristics, the consultant role, the economic lure of aggressive intervention, not evaluating for and treating comorbid psychopathology, reimbursement pressures, workers' compensation, and use of unproven methods. Solutions offered include collegial associations, social responsibility, legislative initiatives, pain education, interdisciplinary evaluation and treatment, improved relationships with third-party payers, reduced racial disparities, and ethics education. Ethics is the "roadmap" that enables the pain medicine specialist to navigate the increasingly murky waters of practicing pain management today by maintaining the professionalism necessary to combat today's "business" pressures. Wiley Periodicals, Inc.

Ethical working relationships in patient care: challenges and possibilities.

Science.gov (United States)

Aroskar, M A

1998-06-01

This article traces the historical concern for building and maintaining effective working relationships between nurses and physicians on behalf of patients. The author takes the position that compassionate patient care requires collegial and collaborative working relationships both within nursing and between nursing and medicine. The development and support of such relationships is obligatory on the part of nursing, medicine, and administration. Selected studies and expert opinion are used to support this position. Practical and visionary models that guide interprofessional relationships are discussed with a goal of creating organizational structures which are supportive of ethical practice and benefit patients and caregivers.

Trust in telemedicine portals for rehabilitation care: an exploratory focus group study with patients and healthcare professionals.

Science.gov (United States)

Van Velsen, Lex; Wildevuur, Sabine; Flierman, Ina; Van Schooten, Boris; Tabak, Monique; Hermens, Hermie

2016-01-27

For many eServices, end-user trust is a crucial prerequisite for use. Within the context of Telemedicine, the role of trust has hardly ever been studied. In this study, we explored what determines trust in portals that facilitate rehabilitation therapy, both from the perspective of the patient and the healthcare professional. We held two focus groups with patients (total n = 15) and two with healthcare professionals (total n = 13) in which we discussed when trust matters, what makes up trust in a rehabilitation portal, what effect specific design cues have, and how much the participants trust the use of activity sensor data for informing treatment. Trust in a rehabilitation portal is the sum of trust in different factors. These factors and what makes up these factors differ for patients and healthcare professionals. For example, trust in technology is made up, for patients, mostly by a perceived level of control and privacy, while for healthcare professionals, a larger and different set of issues play a role, including technical reliability and a transparent data storage policy. Healthcare professionals distrust activity sensor data for informing patient treatment, as they think that sensors are unable to record the whole range of movements that patients make (e.g., walking and ironing clothes). The set of factors that affect trust in a rehabilitation portal are different from the sets that have been found for other contexts, like eCommerce. Trust in telemedicine technology should be studied as a separate subject to inform the design of reliable interventions.

Healthcare Practitioners' Personal and Professional Values

Science.gov (United States)

Moyo, Mpatisi; Goodyear-Smith, Felicity A.; Weller, Jennifer; Robb, Gillian; Shulruf, Boaz

2016-01-01

Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them…

The circumscribed quadrature of professional ethics

OpenAIRE

Nello, Antoni

2010-01-01

The circumscribed quadrature of professional ethics aimsto show the necessary shift from deontology to professional ethics, from deontological codes to ethical codes. While deontology and the deontological codes that materialise from it set their sights on professionals’ responsibilities, professional ethics and the ethical codes that should derive from it would set their sights on the professional act, on its successful performance. In this way, the stress comes to be placed not only on the ...

Quality care provision for older people: an interview study with patients and primary healthcare professionals

Science.gov (United States)

van de Pol, Marjolein Helena Johanna; Fluit, Cornelia Rita Maria Gertruda; Lagro, Joep; Niessen, Danielle; Rikkert, Marcellinus Gerardus Maria Olde; Lagro-Janssen, Antoinette Leonarda Maria

2015-01-01

Background In recent years, primary health care for the ageing population has become increasingly complex. Aim This study sought to explore the views and needs of healthcare professionals and older patients relating to primary care in order to identify focal areas for improving primary health care for older people. Design and setting This research was structured as a mixed interview study with focus groups and individual interviews. Participants were made up of primary healthcare professionals and older patients. Patients were recruited from five elderly care homes in a small city in the southern part of the Netherlands. Method All interviews were transcribed verbatim and analysed by two individual researchers applying constant comparative analysis. Data collection proceeded until saturation was reached. Results Participants in the study agreed about the need for primary care for older patients, and showed sympathy with one another’s perspectives. They did note, however, a number of obstacles hindering good healthcare provision. The major themes that arose were: ‘autonomy and independence’, ‘organisational barriers’, and ‘professional expertise’. Participants generally noted that it is important to clarify differences in perspectives about good care between patients and healthcare professionals. Conclusion Effective primary care intervention for older patients requires mutual understanding of the expectations and goals of all parties involved. There are a number of important requirements, especially accessible patient information in the form of care plans; specialist training for nurses and GPs on complex care and multimorbidity; and training on discussing autonomy, goal setting, and shared care. Further improvement in health care for older people and its evaluation research should focus on these requirements. PMID:26212845

Healthcare professional behaviour change using technological supports: A realist literature review

OpenAIRE

Chris Keyworth; Jo Hart; Chris A. Armitage

2015-01-01

Background Changing healthcare professional behaviour is fundamental to effective patient management. Recent systematic reviews examining healthcare professional behaviour change interventions (such as audit and feedback) suggest that technological support is likely to be crucial in helping healthcare professionals to improve patient outcomes. However we know little about the effectiveness of technological support interventions, and whether the design of technological support interventions...

BODIES WHICH ARE OPEN TO GIVE LIGHT

Directory of Open Access Journals (Sweden)

Vanessa Daniele de Moraes

2010-07-01

Full Text Available This article purposes a consideration on themes relevant to Jean-Luc Nancy’s theory, by means of two short-stories by Clarice Lispector, two poems – one by Manuel Bandeira and one by Cecília Meireles – and one movie by Alain Resnais. Concerning all these examples, the aim is to deal with issues related to meaning, body, absence, touch and the eroticism movement – and to investigate traces of the body denial as an absolute truth or as a closure of meaning in the female characters, since they sometimes behave themselves as saints, sometimes as whores. In Noli me tangere, an essay by Jean-Luc Nancy based on a Biblical episode, we become aware that the contact between resuscitated Jesus and Maria Magdalena does not actually happen – and this is a motive scene for composing a consideration on the chosen corpus.

Det stedløse fællesskab

DEFF Research Database (Denmark)

Andreasen, Torsten Arni Caleb

2009-01-01

Det værkløse, det uvedgåelige, det kommende fællesskab. I nr. 4 af tidsskriftet Aléa (1983) udkom første udgave af den franske filosof Jean-Luc Nancys artikel "La communauté désœuvrée" (Det værkløse fællesskab), der senere udkom med tilføjelser i bogen af samme navn (1986). Via en analyse af...

The Ethical and Legal Dilemma in Terminating the Physician-Patient Relationship.

Science.gov (United States)

Senderovitch, Helen

2016-05-01

A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.

Who cares? A critical discussion of the value of caring from a patient and healthcare professional perspective.

Science.gov (United States)

Flynn, Sandra

2016-02-01

This study was undertaken in order to discover and illuminate the essential caring behaviours valued by both patients and staff in an orthopaedic setting within a district general hospital in the United Kingdom. This descriptive study was undertaken in order to acquire a greater understanding of perceptions of caring from both patient and orthopaedic healthcare professional perspectives. A sample of 30 patients and 53 healthcare professionals consisting of doctors, nurses, physiotherapists and occupational therapists were asked to complete the Caring Behaviours Inventory (CBI) questionnaire (Wolf et al., 1994). Data were analysed using descriptive and inferential statistics. The findings revealed both similarities and differences relating to the importance of positive caring behaviours exhibited during caring interactions. Healthcare professionals working in the orthopaedic setting acknowledged the value of similar positive caring behaviours to those of the patient group but ranked the importance of these differently. Several important insights into perceptions of caring have been gained. These relate to an overall understanding of the caring behaviours that are considered of importance to patients and healthcare professionals; the differences that exist between the caring perceptions of both groups and the factors which influence these perceptions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Should palliative care patients' hope be truthful, helpful or valuable? An interpretative synthesis of literature describing healthcare professionals' perspectives on hope of palliative care patients

NARCIS (Netherlands)

Olsman, Erik; Leget, Carlo; Onwuteaka-Philipsen, Bregje; Willems, Dick

2014-01-01

Healthcare professionals' perspectives on palliative care patients' hope influence communication. However, these perspectives have hardly been examined. To describe healthcare professionals' perspectives on palliative care patients' hope found in the literature. The interpretative synthesis

Ethical Implications of the Electronic Health Record: In the Service of the Patient.

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Sulmasy, Lois Snyder; López, Ana María; Horwitch, Carrie A

2017-08-01

Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care and, as an essential component of that care, support the patient-physician relationship. Billing, regulatory, research, documentation, and administrative functions determined by the operational requirements of health care systems, payers, and others have resulted in EHRs that are better able to satisfy such external functions than to ensure that patient care needs are met. The profession has a responsibility to identify and address this mismatch. This position paper by the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee does not address EHR design, user variability, meaningful use, or coding requirements and other government and payer mandates per se; these issues are discussed in detail in ACP's Clinical Documentation policy. This paper focuses on EHRs and the patient-physician relationship and patient care; patient autonomy, privacy and confidentiality; and professionalism, clinical reasoning and training. It explores emerging ethical challenges and concerns for and raised by physicians across the professional lifespan, whose ongoing input is crucial to the development and use of information technology that truly serves patients.

Should palliative care patients' hope be truthful, helpful or valuable? An interpretative synthesis of literature describing healthcare professionals' perspectives on hope of palliative care patients

NARCIS (Netherlands)

Olsman, E.; Leget, C.; Onwuteaka-Philipsen, B.D.; Willems, D.

2014-01-01

Background: Healthcare professionals? perspectives on palliative care patients? hope influence communication. However, these perspectives have hardly been examined. Aim: To describe healthcare professionals? perspectives on palliative care patients? hope found in the literature. Design: The

Professional ethics in nursing: an integrative review.

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Kangasniemi, Mari; Pakkanen, Piiku; Korhonen, Anne

2015-08-01

To conduct an integrative review and synthesize current primary studies of professional ethics in nursing. Professional ethics is a familiar concept in nursing and provides an ethical code for nursing practice. However, little is known about how professional ethics has been defined and studied in nursing science. Systematic literature searches from 1948-February 2013, using the CINAHL, PubMed and Scopus electronic databases to look at previously published peer-reviewed studies. A modified version of Cooper's five-stage integrative review was used to review and synthesize current knowledge. Fourteen papers were included in this research. According to our synthesis, professional ethics is described as an intra-professional approach to care ethics and professionals commit to it voluntarily. Professional ethics consist of values, duties, rights and responsibilities, regulated by national legislation and international agreements and detailed in professional codes. Professional ethics is well established in nursing, but is constantly changing due to internal and external factors affecting the profession. Despite the obvious importance of professional ethics, it has not been studied much in nursing science. Greater knowledge of professional ethics is needed to understand and support nurses' moral decision-making and to respond to the challenges of current changes in health care and society. © 2015 John Wiley & Sons Ltd.

Need for ethics support in healthcare institutions: views of Dutch board members and ethics support staff.

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Dauwerse, Linda; Abma, Tineke; Molewijk, Bert; Widdershoven, Guy

2011-08-01

The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Most respondents see a need for ethics support. This need is related to the complexity of contemporary healthcare, the contribution of ethics support to the core business of the organisation and to the surplus value of paying structural attention to ethical issues. The need for ethics support is, however, not unconditional. Reasons for a lacking need include: aversion of innovations, negative associations with the notion of ethics support service, and organisational factors like resources and setting. There is a conditioned need for ethics support in Dutch healthcare institutions. The promotion of ethics support in healthcare can be fostered by focusing on formats which fit the needs of (practitioners in) healthcare institutions. The emphasis should be on creating a (culture of) dialogue about the complex situations which emerge daily in contemporary healthcare practice.

Ethical Issues of Social Media Usage in Healthcare

OpenAIRE

Denecke, Kerstin; Bamidis, Panagiotis D.; Bond, Carol; Gabarron, Elia; Househ, M; Lau, A. Y. S.; Mayer, Miguel A.; Merolli, Mark; Hansen, Margareth

2015-01-01

Accepted manuscript version. This article is not an exact copy of the original published article in The IMIA Yearbook of Medical Informatics. The definitive publisher-authenticated version of "Ethical Issues of Social Media Usage in Healthcare" is available online at http://doi.org/10.15265/IY-2015-001. OBJECTIVE: Social media, web and mobile technologies are increasingly used in healthcare and directly support patientcentered care. Patients benefit from disease self-management tools, ...

Patient Relationship Management: What the U.S. Healthcare System Can Learn from Other Industries.

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Poku, Michael K; Behkami, Nima A; Bates, David W

2017-01-01

As the U.S. healthcare system moves to value-based care, the importance of engaging patients and families continues to intensify. However, simply engaging patients and families to improve their subjective satisfaction will not be enough for providers who want to maximize value. True optimization entails developing deep and long-term relationships with patients. We suggest that healthcare organizations must build such a discipline of "patient relationship management" (PRM) just as companies in non-healthcare industries have done with the concept of customer relationship management (CRM). Some providers have already made strides in this area, but overall it has been underemphasized or ignored by most healthcare systems to date. As healthcare providers work to develop their dedicated PRM systems, tools, and processes, we suggest they may benefit from emulating companies in other industries who have been able to engage their customers in innovative ways while acknowledging the differences between healthcare and other industries.

Developing and teaching the virtue-ethics foundations of healthcare whistle blowing.

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Faunce, Thomas

2004-10-01

Healthcare whistle blowing, despite the benefits it has brought to healthcare systems in many developed countries, remains generally regarded as a pariah activity by many of the most influential healthcare professionals and regulatory institutions. Few if any medical schools or law department health law and bioethics classes, teach whistle blowing in a formal sense. Yet without exception, public inquiries initiated by healthcare whistle blowers have validated their central allegations and demonstrated that the whistle blowers themselves were sincere in their desire to implement the fundamental virtues and principles of medical ethics, bioethics and public health law. In many jurisdictions, the law, this time remarkably in advance of professional opinion, has offered legislative protection for reasonable allegations of whistleblowers made in good faith and in the public interest concerning a substantial and imminent threat to public safety. One reason for this paradoxical position, explored here, is that healthcare whistle blowing lacks a firm virtue-based theoretical bioethical and jurisprudential foundation. The hypothesis discussed is that the lack of this bioethical and jurisprudential substrate has contributed to a situation where healthcare whistle blowing suffers in terms of institutional support due to its lack of academic legitimacy. This article commences the process of redressing this imbalance by attempting to lay the theoretical foundations for healthcare whistle blowing. As a case study, this article concludes by discussing the Personal and Professional Development course at the ANU Medical School where healthcare whistle blowing is a formal part of a virtue-based curriculum that emphasises the foundational importance of conscience. Illustrative elements of that program are discussed.

Care as a mutual endeavour : experiences of a multiple sclerosis patient and her healthcare professionals

NARCIS (Netherlands)

Oeseburg, B.; Abma, T.A.

2006-01-01

In Dutch healthcare policy patients are seen as informed, autonomous experts and active decision makers with control over their illness and care. Healthcare professionals are expected to operate as providers of information. The purpose of this article is to argue that the consumerist approach of the

Online virtual patients - A driver for change in medical and healthcare professional education in developing countries?

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Dewhurst, David; Borgstein, Eric; Grant, Mary E; Begg, Michael

2009-08-01

The development of online virtual patients has proved to be an effective vehicle for pedagogical and technological skills transfer and capacity building for medical and healthcare educators in Malawi. A project between the University of Edinburgh and the University of Malawi has delivered more than 20 collaboratively developed, virtual patients, contextualised for in-country medical and healthcare education and, more significantly, a cadre of healthcare professionals skilled in developing digital resources and integrating these into their emerging curricula. The process of engaging with new approaches to teaching and delivering personalised, context sensitive content via a game-informed, technology-supported process has contributed to the ability of healthcare educators in Malawi to drive pedagogical change, meet the substantial challenges of delivering new curricula, cope with increasing student numbers and promote teacher professional development. This initial phase of the project has laid the foundation for a broader second phase that focuses on promoting curriculum change, developing educational infrastructure and in-country capacity to create, and integrate digital resources into education and training across multi-professional groups and across educational levels.

Relational autonomy in the care of the vulnerable: health care professionals' reasoning in Moral Case Deliberation (MCD).

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Heidenreich, Kaja; Bremer, Anders; Materstvedt, Lars Johan; Tidefelt, Ulf; Svantesson, Mia

2017-12-14

In Moral Case Deliberation (MCD), healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals' moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient's nebulous interests, and coping with the conflict between using coercion to achieve good while protecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient's autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients' influence and at the same time take responsibility for their needs as vulnerable humans.

On change of concepts: From teacher's occupational ethics to professional ethics

Institute of Scientific and Technical Information of China (English)

Tan Chuan-bao

2006-01-01

The transition from experience-based teachers to expertise-based ones has marked a significant phase in the history of human education.The conceptive transition from the general "occupational ethics" of teachers to "professional ethics"is actually an important aspect of the transition from experience-based to expertise-based teachers.The establishment of teachers' professional ethics bears the saree historical inevitability as the movement of teachers' professionalization.Complying with this trend,we ought to promote the establishment of teachers' professional ethics specifically in view of the improvement in their living conditions and professional development.

Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review.

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Rasoal, Dara; Skovdahl, Kirsti; Gifford, Mervyn; Kihlgren, Annica

2017-12-01

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a "bottom-up" perspective might give healthcare personnel opportunities to think and reflect more than a "top-down" perspective. A "bottom-up" approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a "top-down" approach risks removing such moral responsibility.

Ethical issues in healthcare financing.

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Maharaj, S R; Paul, T J

2011-07-01

The four goals of good healthcare are to relieve symptoms, cure disease, prolong life and improve quality of life. Access to healthcare has been a perpetual challenge to healthcare providers who must take into account important factors such as equity, efficiency and effectiveness in designing healthcare systems to meet the four goals of good healthcare. The underlying philosophy may designate health as being a basic human right, an investment, a commodity to be bought and sold, a political demand or an expenditure. The design, policies and operational arrangements will usually reflect which of the above philosophies underpin the healthcare system, and consequently, access. Mechanisms for funding include fee-for-service, cost sharing (insurance, either private or government sponsored) free-of-fee at point of delivery (payments being made through general taxes, health levies, etc) or cost-recovery. For each of these methods of financial access to healthcare services, there are ethical issues which can compromise the four principles of ethical practices in healthcare, viz beneficence, non-maleficence, autonomy and justice. In times of economic recession, providing adequate healthcare will require governments, with support from external agencies, to focus on poverty reduction strategies through provision of preventive services such as immunization and nutrition, delivered at primary care facilities. To maximize the effect of such policies, it will be necessary to integrate policies to fashion an intersectoral approach.

Sexuality in older age: essential considerations for healthcare professionals.

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Taylor, Abi; Gosney, Margot A

2011-09-01

This review describes the fact that many elderly people enjoy an active sex life and examines the evidence against the general perception of an 'asexual' old age. It offers an overview of the evidence for healthcare professionals who had not previously considered the sexuality of their older patients. It also describes some of the sexual problems faced by older people, especially the difficulties experienced in disclosing such problems to healthcare professionals. It examines why healthcare professionals routinely avoid discussing sexual problems with older patients, and how this can be improved. It also offers some recommendations for future research in the area, as well as a word of caution regarding the temptation of over-sexualising the ageing process.

The Moral of the Tale: Stories, Trust, and Public Engagement with Clinical Ethics via Radio and Theatre.

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Bowman, Deborah

2017-03-01

Trust is frequently discussed with reference to the professional-patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the "public" and "experts." Public engagement activity in healthcare ethics may invoke "trust" in analysing a moral question or problem but less frequently conceives of trust as integral to "public engagement" itself. This paper explores the relationship between trust and the ways in which questions of healthcare ethics are identified and negotiated by both "experts" and the public. Drawing on two examples from the author's "public engagement" work-a radio programme for the British Broadcasting Corporation and work with a playwright and theatre-the paper interrogates the ways in which "public engagement" is often characterized. The author argues that the common approach to public engagement in questions of ethics is unhelpfully constrained by a systemic disposition which continues to privilege the professional or expert voice at the expense of meaningful exchange and dialogue. By creating space for novel interactions between the "expert" and the "public," authentic engagement is achieved that enables not only the participants to flourish but also contributes to trust itself.

Attitude of patients, healthcare professionals, and noninjured lay persons towards online video instructions on mild traumatic brain injury: a cross-sectional study.

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Hoek, Amber E; Hamer, Maaike van den; Deelstra, Carianne K; Beeck, Ed F van; Dippel, Diederik W J; Haagsma, Juanita A; Rood, Pleunie P M

2017-12-01

The objective of this study was to determine the attitude of patients, healthcare professionals, and noninjured lay persons towards adding a video with discharge instructions to patient care for patients with mild traumatic brain injury (MTBI). A survey was conducted at the emergency department (ED). Participants consisted of MTBI patients (n = 50), healthcare professionals (n = 50), and noninjured lay persons (n = 50). The participants viewed a video with discharge instructions on MTBI and filled out a questionnaire that measured their attitude towards the use of a video as part of discharge instructions. Nearly all healthcare professionals (94%) and 70% of the noninjured lay persons considered the video to be a valuable addition to oral discharge instructions. For 84% of patients, verbal information from the doctor is of importance. And, 50% of patients would like to receive additional video discharge instructions. The majority of noninjured lay persons and healthcare professionals and half of the MTBI patients consider a video with discharge instructions to be a valuable addition to patient care. Video discharge instructions are a relative low-cost measure that could enhance patient care at the ED, provided that this does not compromise the personal contact between patient and healthcare professional.

Beyond a code of ethics: phenomenological ethics for everyday practice.

Science.gov (United States)

Greenfield, Bruce; Jensen, Gail M

2010-06-01

Physical therapy, like all health-care professions, governs itself through a code of ethics that defines its obligations of professional behaviours. The code of ethics provides professions with a consistent and common moral language and principled guidelines for ethical actions. Yet, and as argued in this paper, professional codes of ethics have limits applied to ethical decision-making in the presence of ethical dilemmas. Part of the limitations of the codes of ethics is that there is no particular hierarchy of principles that govern in all situations. Instead, the exigencies of clinical practice, the particularities of individual patient's illness experiences and the transformative nature of chronic illnesses and disabilities often obscure the ethical concerns and issues embedded in concrete situations. Consistent with models of expert practice, and with contemporary models of patient-centred care, we advocate and describe in this paper a type of interpretative and narrative approach to moral practice and ethical decision-making based on phenomenology. The tools of phenomenology that are well defined in research are applied and examined in a case that illustrates their use in uncovering the values and ethical concerns of a patient. Based on the deconstruction of this case on a phenomenologist approach, we illustrate how such approaches for ethical understanding can help assist clinicians and educators in applying principles within the context and needs of each patient. (c) 2010 John Wiley & Sons, Ltd.

Moral distress and the contemporary plight of health professionals.

Science.gov (United States)

Austin, Wendy

2012-03-01

Once a term used primarily by moral philosophers, "moral distress" is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? "Plight" encompasses not only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of "efficiency," is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals' moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim.

Professional Ethics for Digital Age Psychiatry: Boundaries, Privacy, and Communication.

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Sabin, James E; Harland, Jonathan Clark

2017-09-01

Internet and social media use continue to expand rapidly. Many patients and psychiatrists are bringing digital technologies into the treatment process, but relatively little attention has been paid to the ethical challenges in doing this. This review presents ethical guidelines for psychiatry in the digital age. Surveys demonstrate that patients are eager to make digital technologies part of their treatment. Substantial numbers search for professional and personal information about their therapists. Attitudes among psychiatrists about using digital technologies with patients range from dread to enthusiastic adoption. Digital technologies create four major ethical challenges for psychiatry: managing clinical boundaries; maintaining privacy and confidentiality; establishing realistic expectations regarding digital communications; and upholding professional ideals. Traditional ethical expectations are valid for the evolving digital arena, but guidance must be adapted for actual application in practice.

Negotiation best practices: what a healthcare professional needs to know today.

Science.gov (United States)

McGuigan, Patrick J

2015-01-01

This article reviews negotiation best practices while highlighting some of the factors that confound or enhance the ability to negotiate. Healthcare professionals will benefit by obtaining a set of practices that they can consistently apply to obtain more value from negotiation. In today's turbulent healthcare market, more relationships are governed by and through negotiated agreements, so it is imperative that healthcare professionals develop and sharpen their negotiating acumen.

Professional and Institutional Morality: Building Ethics Programmes on the Dual Loyalty of Academic Professionals

Science.gov (United States)

Nijhof, Andre; Wilderom, Celeste; Oost, Marlies

2012-01-01

Most professionals have the arduous task of managing their own dual loyalty: in one contextual relationship, they are members of a profession while simultaneously they are employed as members of a locally established organisation. This sense of a dual loyalty has to be taken into account when professional bureaucracies develop ethics programmes.…

The Life Esidimeni tragedy: Moral pathology and an ethical crisis

Directory of Open Access Journals (Sweden)

A Dhai

2018-04-01

Full Text Available The Life Esidimeni tragedy highlights several ethical transgressions. Health professionals’ ethics are put to the test when their own interests are balanced against competing claims. Core values of compassion, competence and autonomy, together with respect for fundamental human rights, serve as the foundation of ethical practice in healthcare. These values are increasingly being challenged by governments and other third parties. The duties conferred on healthcare practitioners require them to act responsibly and be accountable for their actions. Codes in healthcare serve as a source of moral authority. The Gauteng health authorities exerted tremendous power and created a culture of fear and disempowerment among healthcare practitioners. When health professionals choose to support state interests instead of those of patients, problematic dual-loyalty conflicts arise.

Levinas's ethics as a basis of healthcare - challenges and dilemmas.

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Nordtug, Birgit

2015-01-01

Levinas's ethics has in the last decades exerted a significant influence on Nursing and Caring Science. The core of Levinas's ethics - his analyses of how our subjectivity is established in the ethical encounter with our neighbour or the Other - is applied both to healthcare practice and in the project of building an identity of Nursing and Caring Science. Levinas's analyses are highly abstract and metaphysical, and also non-normative. Thus, his analyses cannot be applied directly to practical problems and questions. Theorists in Nursing and Caring Science are generally aware of this. Nevertheless, many of them use Levinas's analyses to explore and solve questions of practical and normative character. This article focuses on the challenges and dilemmas of using Levinas in this manner. The article is divided into two parts. The first part presents some central ideas of Levinas's ethics based on the latter part of his authorship. The main focus is on the radicalism of Levinas's critique of the symbolic order (which includes concepts, categories, knowledge, etc.) - or as he puts it 'the said' - as a basis for subjectivity and responsibility. Levinas's notions of saying, anarchy, and singularity accentuate this point of view. These notions refer to conditions in the language, which counteract the symbolic order in the ethical encounter to such an extent that it becomes an incomprehensible. Levinas gives the argumentation a metaphysical frame: The encounter with the incomprehensible is an encounter with the Holy, which is not the ontological God, but a metaphysical desire. It is a mystery as to what this means, and herein lies possibly the main challenge when using Levinas's ethics in science and research: How to maintain the radicalism of his critique of the symbolic order when this is to be communicated in a scientific context that expects clarification of statements and ideas? The second part of the article explores this question by examining how some theorists use

From therapeutic patient education principles to educative attitude: the perceptions of health care professionals – a pragmatic approach for defining competencies and resources

Directory of Open Access Journals (Sweden)

Pétré B

2017-03-01

Full Text Available Benoit Pétré,1 Remi Gagnayre,2 Vincent De Andrade,2 Olivier Ziegler,3 Michèle Guillaume1 1Department of Public Health, University of Liège, Liège, Belgium; 2Educations and Health Practices Laboratory (LEPS, (EA 3412, UFR SMBH, Paris 13 University, Sorbonne Paris Cite, Bobigny, 3Department of Diabetes, Metabolic diseases and Nutrition, Nancy University Hospital, Nancy, France Abstract: Educative attitude is an essential, if implicit, aspect of training to acquire competency in therapeutic patient education (TPE. With multiple (or nonexistent definitions in the literature, however, the concept needs clarification. The primary aim of this study was to analyze the representations and transformations experienced by health care professionals in the course of TPE training in order to characterize educative attitude. We conducted an exploratory qualitative study using several narrative research-based tools with participants of two TPE continuing education courses. We then performed an inductive thematic analysis. Thirty-three people participated in the study; the majority were women (n=29, nurses (n=17 working in a hospital setting (n=28. Seven categories of statements were identified: time-related (“the right moment, how much time it takes”, the benefits of TPE (to health care professionals’ personal well-being, emotions and feelings (quality of exchanges, sharing, the professional nature of TPE (educational competencies required, the holistic, interdisciplinary approach (complexity of the person and value of teamwork, the educational nature of the care relationship (education an integral part of care and the ethical dimension (introspection essential. The first three components appear fairly innovative, at least in formulation. The study’s originality rests primarily in its choice of participants – highly motivated novices who expressed themselves in a completely nontheoretical way. Health models see attitude as critical for adopting a

Building Bridges between healthcare professionals, patients and families: A coproduced and integrated approach to self-management support in stroke.

Science.gov (United States)

Jones, Fiona; Pöstges, Heide; Brimicombe, Lucinda

2016-10-14

Programmes providing self-management support for patients and families are gaining attention and have shown promising outcomes with regards to reducing long-term unmet needs post stroke. However, notions of what good self-management support looks like can differ depending on professional opinion, individual preferences, skills and experiences of patients and their families as well as on how care and rehabilitation is organised in a particular healthcare setting. This resonates with the perspective of patient-centred care, according to which the meaning of good care is not universal, but rather jointly shaped between healthcare professionals and patients in everyday interactions. While self-management support is continuously co-produced in care and rehabilitation practices, most self-management programmes are typically provided as an 'add-on' to existing statutory care. This paper aims to deepen the understanding of how self-management support can be made an integral part of everyday care and rehabilitation using Bridges methodology. The authors provide a self-reflective account on 'Bridges' an integrated approach to self-management support, which is used by healthcare professionals within acute and community stroke rehabilitation across the UK, and in some parts of New Zealand and Australia. Bridges is based on self-efficacy principles, but has a central aim of professionals sharing decision-making and expertise with patients and families in every healthcare interaction. Methodologically, the co-production of a Bridges support package with local healthcare professionals and patients is critical. The authors present the values articulated by the support package and how it engages professionals, patients and Bridges training facilitators in a continuous process of adjusting and re-adjusting situated self-management support practices. Our reflections reveal the need to consider development and implementation of self-management support as one and the same on

Turnover among healthcare professionals.

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Wood, Ben D

2009-01-01

Turnover among healthcare professionals is a costly consequence. The existing body of knowledge on healthcare professional turnover is correlated with job satisfaction levels. A landmark study differentiated 2 areas of job satisfaction categories: satisfiers and dissatisfiers (intrinsic and extrinsic motivators). The aim of this article is to examine existing research on precursors of turnover, such as burnout behaviors experienced by healthcare professionals, job satisfaction levels, employee organizational commitment, health complications which precede turnover, some current strategies to reduce turnover, and some effects CEO turnover has on employee turnover intentions.

Code of ethics: principles for ethical leadership.

Science.gov (United States)

Flite, Cathy A; Harman, Laurinda B

2013-01-01

The code of ethics for a professional association incorporates values, principles, and professional standards. A review and comparative analysis of a 1934 pledge and codes of ethics from 1957, 1977, 1988, 1998, 2004, and 2011 for a health information management association was conducted. Highlights of some changes in the healthcare delivery system are identified as a general context for the codes of ethics. The codes of ethics are examined in terms of professional values and changes in the language used to express the principles of the various codes.

Hospital Consumer Assessment of Healthcare Providers and Systems: An Ethical Leadership Dilemma to Satisfy Patients.

Science.gov (United States)

Piper, Llewellyn E; Tallman, Erin

2016-01-01

This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.

Creativity and Ethics: The Relationship of Creative and Ethical Problem-Solving.

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Mumford, Michael D; Waples, Ethan P; Antes, Alison L; Brown, Ryan P; Connelly, Shane; Murphy, Stephen T; Devenport, Lynn D

2010-02-01

Students of creativity have long been interested in the relationship between creativity and deviant behaviors such as criminality, mental disease, and unethical behavior. In the present study we wished to examine the relationship between creative thinking skills and ethical decision-making among scientists. Accordingly, 258 doctoral students in the health, biological, and social sciences were asked to complete a measure of creative processing skills (e.g., problem definition, conceptual combination, idea generation) and a measure of ethical decision-making examining four domains, data management, study conduct, professional practices, and business practices. It was found that ethical decision-making in all four of these areas was related to creative problem-solving processes with late cycle processes (e.g., idea generation and solution monitoring) proving particularly important. The implications of these findings for understanding the relationship between creative and deviant thought are discussed.

Attitudes of consumers and healthcare professionals towards the patient package inserts - a study in Palestine

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Al-Ramahi R

2012-03-01

Full Text Available Reading the patient package inserts (PPIs is a key source of information about medications for patients. They should be clear and understandable to the general population. Objectives: The aims of this study were to obtain base-line data on the extent of reading PPIs by consumers and possible factors that might affect this; to explore the attitude of the Palestinian public and healthcare professionals towards the patient package inserts (PPIs; and to review a random sample of PPIs for the availability of different information.Methods: The first part of the study was a cross-sectional self-administered questionnaire. The questionnaire for consumers included 15 items. The questionnaire for healthcare professionals included 10 items and it was very similar to that of consumers with some modifications. In the second part, a random sample of PPIs was reviewed. In our community pharmacies, where medications are arranged according to their producing company, a researcher was asked to choose randomly 10-15 medications for every company to check for the availability of pharmacological, pharmaceutical and clinical information. Results: A total of 304 healthcare professionals out of 320 (95.0% and 223 consumers out of 240 (92.9% accepted to answer the survey. Forty five percent consumers reported that they always read the PPIs, and 29.3% said that they read the PPIs most of the times. Increased rate of reading the leaflet was found among females (P = 0.047. The preferred language for the PPIs was Arabic for most of the consumers (89.6% while it was English for most of the healthcare professionals (80.8%. 35.9% of the consumers and 43.6% of the healthcare professionals found the font size suitable. 42.3% of the consumers and 25.5% of the healthcare professionals said that they found the information in the PPIs useful and enough. The PPIs of 135 randomly sampled medications were reviewed. Many important sections were not found in the PPIs' sample. Conclusion

Organ donation and transplantation: Awareness and roles of healthcare professionals-A systematic literature review.

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Jawoniyi, Oluwafunmilayo; Gormley, Kevin; McGleenan, Emma; Noble, Helen Rose

2018-03-01

To examine the role of healthcare professionals in the organ donation and transplantation process. Globally, there remains a perennial disequilibrium between organ donation and organ transplantation. Several factors account for this disequilibrium; however, as healthcare professionals are not only strategically positioned as the primary intermediaries between organ donors and transplant recipients, but also professionally situated as the implementers of organ donation and transplantation processes, they are often blamed for the global organ shortage. Mixed-method systematic review using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 checklist. Databases were searched including CINAHL, MEDLINE, Web of Science and EMBASE using the search terms "organ donation," "healthcare professionals," "awareness" and "roles" to retrieve relevant publications. Thirteen publications met the inclusion criteria. The global organ shortage is neither contingent upon unavailability of suitable organs nor exclusively dependent upon healthcare professionals. Instead, the existence of disequilibrium between organ donation and transplantation is necessitated by a web of factors. These include the following: healthcare professionals' attitudes towards, and experience of, the organ donation and transplantation process, underpinned by professional education, specialist clinical area and duration of professional practice; conflicts of interests; ethical dilemmas; altruistic values towards organ donation; and varied organ donation legislations in different legal jurisdictions. This review maintains that if this web of factors is to be adequately addressed by healthcare systems in different global and legal jurisdictions, there should be sufficient organs voluntarily donated to meet all transplantation needs. There is a suggestion that healthcare professionals partly account for the global shortage in organ donation, but there is a need to examine how

Solicitude: balancing compassion and empowerment in a relational ethics of hope-an empirical-ethical study in palliative care

NARCIS (Netherlands)

Olsman, Erik; Willems, Dick; Leget, Carlo

2016-01-01

The ethics of hope has often been understood as a conflict between duties: do not lie versus do not destroy hope. However, such a way of framing the ethics of hope may easily place healthcare professionals at the side of realism and patients at the side of (false) hope. That leaves unexamined

Professional Ethics and Organizational Commitment Among the Education Department Staff of Tabriz University of Medical Sciences

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Ali Imani

2017-06-01

Full Text Available Background: Concepts such as organizational commitment and employees’ and managers’ ethics provide decision-makers and policy makers with potentially useful information which can result in increasing organizational efficiency and effectiveness. This study aimed to explore the relationship between professional ethics and organizational commitment among the staff working in the education departments of Tabriz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2015. The study population consisted of all staff working as educational experts in the education departments of Tabriz University of Medical Sciences (N = 65. Data collection instruments used in this study were two standard questionnaires on professional ethics and organizational commitment. SPSS software version 21 was used to analyze the data. Results: According to the results, mean scores obtained for professional ethics and organizational commitment were (91.57± 9.13 (95% CI, 89.23-93.91 and (64.89 ± 10.37 (95% CI, 62.2367.54, respectively. A significant relationship was observed between professional ethics and organizational commitment among the educational experts working in Tabriz University of Medical Sciences (correlation coefficient = 0.405 (P = 0.001 (at 95% confidence level. Furthermore, there was a significant relationship between professional ethics and work experience (P = 0.043. The highest level of professional ethics observed was associated with those participants having a work experience of ranging from 6 to 10 years. Individuals with fulltime employment scored the highest in organizational commitment. Conclusion: Educational experts possessed a high level of professional ethics. The finding provides the grounds for promoting organizational commitment, which will lead to higher levels of organizational effectiveness.

Relational ethics and psychosomatic assessment.

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Barbosa, António

2012-01-01

The main ethical perspective in the clinical relationship takes into consideration the vulnerability of the clinical condition before threats and risks that can undermine the integrity and dignity of the person. Psychosomatic medicine faces complex cases whose ethical problems cannot only be solved by applying top-down deontological or utilitarian approaches, principlism, which is limited mainly to easing ethical tensions, or a bottom-up approach, the casuistic model, case-based reasoning. In introducing vulnerability as the core of ethical questioning as a principle ontological priority over other principles, relational ethics refers to the appreciation of the responsibility of health professionals through which a health care professional and the patient 'together' can construct more reasonable and prudential courses of action with, for, and by the patient. The model of relational ethics is based on three main aspects, clinically integrated approach, science/philosophy partnership, and deliberative process, that when taken together, form an intermediate model that ensures prudent and reasonable decision-making. The three structural elements and characteristics of relational ethics create and maintain a responsible relationship between the professional and the patient being aware that the mutual vulnerability of health professional and the patient has a moral value and recognizing that their relationship will allow for personal development of each. I conceptualized the model of relational ethics as one that embraces the meta-ethical principles of vulnerability, dignity, responsibility, and respect for autonomy as they are considered by many international declarations or conventions. This model integrates three key polarities: ensure conditions of authenticity, facilitate a process of cooperative mutuality, and promote opportunities for growth and development. Relational ethics can be used to solve major ethical problems in psychosomatic medicine, capacity

Ethical reflections on Evidence Based Medicine

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S. Corrao

2013-05-01

Full Text Available BACKGROUND According to Potter’s point of view, medical ethics is the science of survival, a bridge between humanistic and scientific culture. The working out of judgements on right or wrong referred to the human being are studied by this science. Methodological quality is fundamental in clinical research, and several technical issues are of paramount importance in trying to answer to the final question “what is the true, the right thing?”. We know they are essential aspects as in medical ethics as in evidence based practice. AIM OF THE STUDY The aim of this paper is to talk about relationships and implications between ethical issues and Evidence Based Medicine (EBM. DISCUSSION EBM represents a new paradigm that introduces new concepts to guide medical-decision making and health-care planning. Its principles are deeply rooted in clinical research methodology since information are derived from sound studies of strong quality. Health-care professionals have to deal with methodological concepts for critical appraisal of literature and implementation of evidences in clinical practice and healthcare planning. The central role of EBM in medical ethics is obvious, but a risk could be possible. The shift from Hippocratic point of view to community-centred one could lose sight of the centrality of the patient. CONCLUSION Both EBM principles and the needs to adequately response to economic restrictions urge a balance between individual and community ethics. All this has to represent an opportunity to place the patient at the centre of medical action considering at the same time community ethics as systemic aim, but without forgetting the risk that economic restrictions push towards veterinary ethics where herd is central and individual needs do not exist.

Islamic Work Ethics and Audit Opinions: Audit Professionalism and Dysfunctional

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Tulus Suryanto

2016-02-01

Full Text Available This study examines the relationship between Islamic work ethics and auditors' opinion, focusing on the aspects of audit professionalism and dysfunctional behavior  as intervening  variables. The research involved in Internal Auditors working of Islamic Banking industry in Sumatra Island. A questionnaire was used for data collection. The study represents the empirical test employing census sampling. The data collected were analysed using Amos.  The results of the study confirmed the three hypotheses examined: there is a positive corelation between Islamic work ethics and auditors' opinions; auditors’ professionalism is an intervening variable of the correlation between Islamic work ethics and auditors’ opinions and dysfunctional behavior is a negative intervening variable of the correlation between Islamic Work Ethics and auditors' opinionsDOI: 10.15408/aiq.v8i1.1864

Parent's use of the Internet in the search for healthcare information and subsequent impact on the doctor-patient relationship.

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Harvey, S; Memon, A; Khan, R; Yasin, F

2017-11-01

The Internet is an unavoidable source of healthcare information. This information, both reliable and unreliable, has previously been shown to influence carer's decisions. Our aim was to evaluate this information seeking behavior among parents and its subsequent potential impact on the doctor-patient relationship. We undertook a cross-sectional questionnaire-based survey of paediatric outpatients. Enrollment took place over 4 weeks in March 2015. There were no inclusion or exclusion criteria and enrollment was voluntary. In total 100 questionnaires were completed. General Practitioners were the most common source of healthcare information. The Internet ranked third as a reliable source of healthcare information. The Internet was commonly used as an educational resource to learn about causes, treatment, and medications. A significant percentage of our population expressed concern regarding Internet information reliability. A small percentage of parents were concerned that disclosing Internet usage may worsen the relationship with their doctor. Parents showed a willingness to learn about diseases and treatments, and felt that the Internet was a good resource to do so. This study shows that open discussion about Internet usage between parents and doctors is not common and carers feel at risk of judgment should they admit to Internet usage. The Internet should be seen as a positive adjunct to patient education which can improve understanding, thus strengthening the doctor-patient relationship. The Internet will never replace the role of healthcare professionals but must be seen as an integral part of a multi-disciplinary approach.

Understanding healthcare professionals' self-efficacy to resolve interprofessional conflict.

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Sexton, Martha; Orchard, Carole

2016-05-01

Conflict within interprofessional healthcare teams, when not effectively resolved, has been linked to detrimental consequences; however, effective conflict resolution has been shown to enhance team performance, increase patient safety, and improve patient outcomes. Alarmingly, knowledge of healthcare professionals' ability to resolve conflict has been limited, largely due to the challenges that arise when researchers attempt to observe a conflict occurring in real time. Research literature has identified three central components that seem to influence healthcare professional's perceived ability to resolve conflict: communication competence, problem-solving ability, and conflict resolution education and training. The purpose of this study was to investigate the impact of communication competence, problem-solving ability, and conflict resolution education and training on healthcare professionals' perceived ability to resolve conflicts. This study employed a cross-sectional survey design. Multiple regression analyses demonstrated that two of the three central components-conflict resolution education and training and communication competence-were found to be statistically significant predictors of healthcare professionals' perceived ability to resolve conflict. Implications include a call to action for clinicians and academicians to recognize the importance of communication competence and conflict resolution education and training as a vital area in interprofessional pre- and post-licensure education and collaborative practice.

Undergraduate healthcare ethics education, moral resilience, and the role of ethical theories.

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Monteverde, Settimio

2014-06-01

This article combines foundational and empirical aspects of healthcare education and develops a framework for teaching ethical theories inspired by pragmatist learning theory and recent work on the concept of moral resilience. It describes an exemplary implementation and presents data from student evaluation. After a pilot implementation in a regular ethics module, the feasibility and acceptance of the novel framework by students were evaluated. In addition to the regular online module evaluation, specific questions referring to the teaching of ethical theories were added using simple (yes/no) and Likert rating answer formats. At the Bern University of Applied Sciences, a total of 93 students from 2 parallel sub-cohorts of the bachelor's program in nursing science were sent the online survey link after having been exposed to the same modular contents. A total of 62% of all students participated in the survey. The survey was voluntary and anonymous. Students were free to write their name and additional comments. Students consider ethical theories-as taught within the proposed framework-as practically applicable, useful, and transferable into practice. Teaching ethical theories within the proposed framework overcomes the shortcomings described by current research. Students do not consider the mutually exclusive character of ethical theories as an insurmountable problem. The proposed framework is likely to promote the effectiveness of healthcare ethics education. Inspired by pragmatist learning theory, it enables students to consider ethical theories as educative playgrounds that help them to "frame" and "name" the ethical issues they encounter in daily practice, which is seen as an expression of moral resilience. Since it does not advocate a single ethical theory, but is open to the diversity of traditions that shape ethical thinking, it promotes a culturally sensitive, ethically reflected healthcare practice. © The Author(s) 2013.

Ethical violations in the clinical setting: the hidden curriculum learning experience of Pakistani nurses.

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Jafree, Sara Rizvi; Zakar, Rubeena; Fischer, Florian; Zakar, Muhammad Zakria

2015-03-19

The importance of the hidden curriculum is recognised as a practical training ground for the absorption of medical ethics by healthcare professionals. Pakistan's healthcare sector is hampered by the exclusion of ethics from medical and nursing education curricula and the absence of monitoring of ethical violations in the clinical setting. Nurses have significant knowledge of the hidden curriculum taught during clinical practice, due to long working hours in the clinic and front-line interaction with patients and other practitioners. The means of inquiry for this study was qualitative, with 20 interviews and four focus group discussions used to identify nurses' clinical experiences of ethical violations. Content analysis was used to discover sub-categories of ethical violations, as perceived by nurses, within four pre-defined categories of nursing codes of ethics: 1) professional guidelines and integrity, 2) patient informed consent, 3) patient rights, and 4) co-worker coordination for competency, learning and patient safety. Ten sub-categories of ethical violations were found: nursing students being used as adjunct staff, nurses having to face frequent violence in the hospital setting, patient reluctance to receive treatment from nurses, the near-absence of consent taken from patients for most non-surgical medical procedures, the absence of patient consent taking for receiving treatment from student nurses, the practice of patient discrimination on the basis of a patient's socio-demographic status, nurses withdrawing treatment out of fear for their safety, a non-learning culture and, finally, blame-shifting and non-reportage of errors. Immediate and urgent attention is required to reduce ethical violations in the healthcare sector in Pakistan through collaborative efforts by the government, the healthcare sector, and ethics regulatory bodies. Also, changes in socio-cultural values in hospital organisation, public awareness of how to conveniently report ethical

Ethical Concerns and Procedural Pathways for Patients Who are Incapacitated and Alone: Implications from a Qualitative Study for Advancing Ethical Practice.

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Moye, Jennifer; Catlin, Casey; Kwak, Jennifer; Wood, Erica; Teaster, Pamela B

2017-06-01

Adults who are incapacitated and alone, having no surrogates, may be known as "unbefriended." Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for "public guardianship" or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: (1) work to restore capacity; (2) find previously unknown surrogates; (3) work with agencies to obtain surrogates; and (4) access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient's values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population.

Medical Ethics Code: an Analysis from Ethical-Disciplinary Cases Against Medical Professionals within the Specialty of Psychiatry

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Giselle Crosara Gracindo

2018-02-01

Full Text Available Objective: To identify the nature of infractions committed by doctors working within the field of psychiatry, between 2010 and 2016, from the scope of appeals within ethical-disciplinary cases judged at the Plenary Tribunal of the Federal Medical Council, based on the medical ethics code, and to list some elements that make it possible to outline the professional profile of those involved. Method: This was a document-based investigation in the form of a retrospective and descriptive study. Data were gathered using the Federal Medical Council (CFM database and from consultation of judgments issued by the Plenary Body of the Medical Ethics Tribunal (TSEM, of the CFM. The investigation used a sample consisting of 206 appeals and 19 referrals, totaling 224 appeals by doctors who underwent trials. We took into account cases judged between April 13, 2010 and August 3, 2016. Three databases were used in the investigation: cases (224; doctors facing charges (191 and cases/penalties (146. Based on the records of the 191 doctors charged, the ethical-disciplinary cases of seven doctors working in psychiatry were analyzed specifically for the present study, whether or not they had a specialist title. Characterization of infractions committed encompassed references to the articles of the medical ethics code most frequently infringed in the field of psychiatry, along with a survey of the motives for these infractions and some characteristics relating to these professionals’ profile. Results: Among the findings from this investigation, infractions of the articles of the medical ethics code can be highlighted, such as article 30 “[...] Use of the profession to corrupt customs and to commit or favor crime [...]” and article 40 “[...] Taking advantage of situations arising from the doctor-patient relationship to obtain physical, emotional, financial or any other advantage [...]”. The professional profile of those involved in these cases was also shown

[Is there room for improvement in the field of dental ethics?].

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Billaud, Adelin; Pirnay, Philippe

2015-01-01

Dental ethics, enforced by the Dental Board, are defined in the Code of Conduct for dentists included in the French Public Health Code. Dentist-patient relationships are changing, while scientific progress advances more rapidly than dental ethics. Are dental ethics still adapted to the practice of dentistry? This study was based on the Institut BVA “The French and patients’ rights” survey conducted in September 2013, together with a systematic review of the literature using the Medline, Legifrance, Lexisnexis, and Elnet.fr databases and the Paris Descartes University medical library website. Five essential principles were identified and a total of 210 articles were included. The results indicate that there is room for improvement in pain management, respect of human dignity, information and consent concerning healthcare, and free choice of a practitioner. Dental ethics have evolved, but further improvement is required to adapt the dentist-patient relationship to scientific progress and the patients’ expectations. To ensure a truly informed choice, this article shows that dental ethics cannot vary in response to surveys or fashions, as dental practice must remain essentially based on an ethical approach that cannot be rigidly defined in a code of professional conduct.

Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study.

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Jose Manuel Trujillo Gómez

Full Text Available The use of information and communication technologies (ICTs in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking.To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose.A qualitative, descriptive-interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer's notes. Data were analyzed with the ATLAS TI 6.0 programme.Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers.Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not

Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study.

Science.gov (United States)

Trujillo Gómez, Jose Manuel; Díaz-Gete, Laura; Martín-Cantera, Carlos; Fábregas Escurriola, Mireia; Lozano Moreno, Maribel; Burón Leandro, Raquel; Gomez Quintero, Ana María; Ballve, Jose Luis; Clemente Jiménez, María Lourdes; Puigdomènech Puig, Elisa; Casas More, Ramón; Garcia Rueda, Beatriz; Casajuana, Marc; Méndez-Aguirre, Marga; Garcia Bonias, David; Fernández Maestre, Soraya; Sánchez Fondevila, Jessica

2015-01-01

The use of information and communication technologies (ICTs) in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking. To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose. A qualitative, descriptive-interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer's notes. Data were analyzed with the ATLAS TI 6.0 programme. Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers. Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not substitute personal

Doctor-patient relationships (DPR) in China.

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Ma, Shaozhuang; Xu, Xuehu; Trigo, Virginia; Ramalho, Nelson J C

2017-03-20

Purpose The purpose of this paper is twofold: first, to develop and test theory on how commitment human resource (HR) practices affect hospital professionals' job satisfaction that motivates them to generate desirable patient care and subsequently improve doctor-patient relationships (DPR) and second, to examine how commitment HR practices influence hospital managers and clinicians in different ways. Design/methodology/approach Using a cross-sectional survey, the authors collected data from 508 clinicians and hospital managers from 33 tertiary public hospitals in China. Structural equation model was employed to test the relationships of the variables in the study. Findings Commitment HR practices positively affect the job satisfaction of the healthcare professionals surveyed and a positive relationship is perceived between job satisfaction and DPR. Overall, the model shows a reversal on the strongest path linking job satisfaction and DPR whereby managers' main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic satisfaction only. Practical implications DPR might be improved by applying commitment HR practices to increase healthcare professional's intrinsic and extrinsic satisfaction. In addition, while recognizing the importance of compensation and benefits to address the underpayment issue of Chinese healthcare professionals, empowerment and autonomy in work, and the use of subjects' expertise and skills may serve as stronger motivators for clinicians rather than hard economic incentives in achieving DPR improvements. Originality/value This study contributes to the small but growing body of research on human resource management (HRM) in the healthcare sector with new evidence supporting the link between commitment HR practice and work attitudes, as well as work attitudes and patient care from the perspective of clinicians and hospital managers. This study represents an initial attempt to examine the associations

Knowledge of Pharmacogenetics among Healthcare Professionals ...

African Journals Online (AJOL)

Background: Pharmacogenetics has a potential for optimizing drug response and identifying risk of toxicity for patients. Pharmacogenetics knowledge of healthcare professionals and the unmet need for pharmacogenetics education in health training institutions are some of the challenges of integrating pharmacogenetics ...

Care relationships at stake? Home healthcare professionals’ experiences with digital medicine dispensers – a qualitative study

OpenAIRE

Nakrem, Sigrid; Solbjør, Marit; Pettersen, Ida Nilstad; Kleiven, Hanne Hestvik

2018-01-01

Background Although digital technologies can mitigate the burdens of home healthcare services caused by an ageing population that lives at home longer with complex health problems, research on the impacts and consequences of digitalised remote communication between patients and caregivers is lacking. The present study explores how home healthcare professionals had experienced the introduction of digital medicine dispensers and their influence on patient-caregiver relationships. Methods...

Teacher’s Professional Ethics

Institute of Scientific and Technical Information of China (English)

岑文玲

2014-01-01

Teachers play an important role in society, whose career is considered to be the most glorious one under the sun. They have deep and lifelong influence on students and the prosperity of a country and even the bright future of the whole world. Teacher should be a person with great virtue that sets good examples for the students. However, nowadays, there exist various problems about teacher’s ethics due to complex social, economical, cultural or personal issues. It’s urgent and imperative for teachers to learn and improve professional ethics to be a better mentor. This paper begins with the definition of ethics, emphasizes the importance of teachers’professional ethics, talks about current situation in this area, analyzes the reasons why there are im-moral problems about teachers and suggests some practical strategies on how to improve it.

Why Caldwell-Luc and nasoantral window procedures fail in patients with chronic sinusitis

International Nuclear Information System (INIS)

Zinreich, S.J.; Kennedy, D.W.; Rosenbaum, A.E.; Kumar, A.J.; Stammberger, H.

1986-01-01

CT was performed on 80 patients with recurrent symptoms of chronic sinusitis after Caldwell-Luc and/or nasoantral window procedures. In each case there was anterior ethmoid sinus inflammatory disease with obstruction of the normal ipsilateral maxillary sinus drainage, the ostiomeatal unit. When the ipsilateral frontal sinus was also diseased, the anterior ethmoid sinus inflammatory process was found to block the frontal recess. These findings indicate that patients who have chronic sinusitis after Caldwell-Luc and/or nasoantral window procedures fail because of persistent disease. The disease is characteristically situated in the anterior ethmoid cells, with blockage of mucociliary clearance from the maxillary and frontal sinuses. Therefore, the cure is predicated on surgical procedures directed to restoring patency of the ostiomeatal unit and frontal recess

ETHICAL MODELS OF PHYSICIAN--PATIENT RELATIONSHIP REVISITED WITH REGARD TO PATIENT AUTONOMY, VALUES AND PATIENT EDUCATION.

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Borza, Liana Rada; Gavrilovici, Cristina; Stockman, René

2015-01-01

The present paper revisits the ethical models of patient--physician relationship from the perspective of patient autonomy and values. It seems that the four traditional models of physician--patient relationship proposed by Emanuel & Emanuel in 1992 closely link patient values and patient autonomy. On the other hand, their reinterpretation provided by Agarwal & Murinson twenty years later emphasizes the independent expression of values and autonomy in individual patients. Additionally, patient education has been assumed to join patient values and patient autonomy. Moreover, several authors have noted that, over the past few decades, patient autonomy has gradually replaced the paternalistic approach based on the premise that the physician knows what is best for the patient. Neither the paternalistic model of physician-patient relationship, nor the informative model is considered to be satisfactory, as the paternalistic model excludes patient values from decision making, while the informative model excludes physician values from decision making. However, the deliberative model of patient-physician interaction represents an adequate alternative to the two unsatisfactory approaches by promoting shared decision making between the physician and the patient. It has also been suggested that the deliberative model would be ideal for exercising patient autonomy in chronic care and that the ethical role of patient education would be to make the deliberative model applicable to chronic care. In this regard, studies have indicated that the use of decision support interventions might increase the deliberative capacity of chronic patients.

Research Integrity and Research Ethics in Professional Codes of Ethics: Survey of Terminology Used by Professional Organizations across Research Disciplines

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Komić, Dubravka; Marušić, Stjepan Ljudevit; Marušić, Ana

2015-01-01

Professional codes of ethics are social contracts among members of a professional group, which aim to instigate, encourage and nurture ethical behaviour and prevent professional misconduct, including research and publication. Despite the existence of codes of ethics, research misconduct remains a serious problem. A survey of codes of ethics from 795 professional organizations from the Illinois Institute of Technology’s Codes of Ethics Collection showed that 182 of them (23%) used research integrity and research ethics terminology in their codes, with differences across disciplines: while the terminology was common in professional organizations in social sciences (82%), mental health (71%), sciences (61%), other organizations had no statements (construction trades, fraternal social organizations, real estate) or a few of them (management, media, engineering). A subsample of 158 professional organizations we judged to be directly involved in research significantly more often had statements on research integrity/ethics terminology than the whole sample: an average of 10.4% of organizations with a statement (95% CI = 10.4-23-5%) on any of the 27 research integrity/ethics terms compared to 3.3% (95% CI = 2.1–4.6%), respectively (Pethics concepts used prescriptive language in describing the standard of practice. Professional organizations should define research integrity and research ethics issues in their ethics codes and collaborate within and across disciplines to adequately address responsible conduct of research and meet contemporary needs of their communities. PMID:26192805

Survey the relationship between professional ethics and improve the quality of care with nurses, staff empowerment of the perspective of Ayatollah Rouhani hospital of Babol

Directory of Open Access Journals (Sweden)

Hamed Hosseinzadeh

2016-08-01

Full Text Available Ethics, how to live and how to behave in a professional style and in a professional environment, both individual and organizational sets. In this regard, the present study was to determine the relationship between the ethics of the profession and improve the quality of care with nurses, hospital staff empowerment from the perspective of Ayatollah Rouhani was performed. The study was a descriptive one. The population consisted of nurses Ayatollah spiritual Babylon, which uses random sampling method, 163 samples were selected and evaluated. Collection tool was a questionnaire, content validity of the questionnaire in consultation with experts confirmed the reliability of the test-retest on 10% of the total of 2-week interval was calculated, and Cronbach's alpha for the whole questionnaire 0.85respectively. To analyze the data, structural equation modeling was used. The results showed that relations professional ethics to improve the quality of care (P <0.01 and staff empowerment (P <0.01 was significant. The ability of the staff as well as improve the quality of care (P <0.05 there was a significant relationship. Based on the results of research, professional ethics directly and indirectly improve the quality of nursing care was effective (P<0.05. In general it can be said that rely on moral and ethical management, increases the effectiveness of the approach is to improve the quality of care and sense of empowerment among nurses.

Toward an Ethics of Professional Understanding

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Tanchuk, Nicolas; Scramstad, Carly; Kruse, Marc

2016-01-01

In this paper, we advance a novel conception of normative ethics and draw out its implications within the domain of professional ethics. We argue that all moral agents, and thus professionals, share a fundamental and constitutive normative interest in correctly conceiving of their ends. All professionals, we claim, by virtue of their positions of…

Impact of CAre-related Regret Upon Sleep (ICARUS) cohort study: protocol of a 3-year multicentre, international, prospective cohort study of novice healthcare professionals.

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Cheval, Boris; Cullati, Stéphane; Pihl-Thingvad, Jesper; Mongin, Denis; Von Arx, Martina; Chopard, Pierre; Courvoisier, Delphine S

2018-03-27

Healthcare professionals are particularly at risk of developing numerous physical and psychological health problems. The experiences of emotional burden associated with providing healthcare, notably care-related regret, have been associated with these health problems, but only using cross-sectional data so far. Evidence of a causal impact of regret has not been assessed. The Impact of CAre-related Regret Upon Sleep (ICARUS) study is the first prospective and international cohort study established to examine how newly practising healthcare professionals adapt to their challenging job by assessing the impact of care-related regret on sleep and job quitting. The ICARUS cohort study will include newly practising healthcare professionals working in acute care hospitals and clinics recruited between May 2017 and November 2019. Data collection, which will begin as soon as the participant starts working with patients, will consist of a 1-year weekly assessment using a secure web survey. Follow-up data will be collected at 6, 12, 18 and 24 months after the end of the first year. We will collect detailed information on the experience of care-related regret (ie, highest regret intensity, accumulation of regrets and coping strategies related to regrets), sleep problems and job quitting. Moreover, quality of life, health status and burnout will be assessed during the follow-up. Several confounders factors, including sociodemographic characteristics, personality, night shifts and work environment characteristics, will be assessed. The study was approved by the Ethics Committee of Geneva Canton, Switzerland (CCER2016-02041), the Ethics Committee of London South Bank University (HSCSEP/17/06) and the University Research Ethics Committee of Bedfordshire (UREC106). Other study centres deemed local ethical approval unnecessary since the main ethics committee (Geneva) had already accepted the project. Results will be published in relevant scientific journals and be disseminated in

Research Integrity and Research Ethics in Professional Codes of Ethics: Survey of Terminology Used by Professional Organizations across Research Disciplines.

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Komić, Dubravka; Marušić, Stjepan Ljudevit; Marušić, Ana

2015-01-01

Professional codes of ethics are social contracts among members of a professional group, which aim to instigate, encourage and nurture ethical behaviour and prevent professional misconduct, including research and publication. Despite the existence of codes of ethics, research misconduct remains a serious problem. A survey of codes of ethics from 795 professional organizations from the Illinois Institute of Technology's Codes of Ethics Collection showed that 182 of them (23%) used research integrity and research ethics terminology in their codes, with differences across disciplines: while the terminology was common in professional organizations in social sciences (82%), mental health (71%), sciences (61%), other organizations had no statements (construction trades, fraternal social organizations, real estate) or a few of them (management, media, engineering). A subsample of 158 professional organizations we judged to be directly involved in research significantly more often had statements on research integrity/ethics terminology than the whole sample: an average of 10.4% of organizations with a statement (95% CI = 10.4-23-5%) on any of the 27 research integrity/ethics terms compared to 3.3% (95% CI = 2.1-4.6%), respectively (Porganizations should define research integrity and research ethics issues in their ethics codes and collaborate within and across disciplines to adequately address responsible conduct of research and meet contemporary needs of their communities.

[Considering body ethics in the healthcare profession].

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Wang, Shin-Yun

2014-10-01

This article uses the theory of body phenomenology and Watson's caring theory to develop and apply body ethics to the clinical healthcare profession. This attempt is meant to facilitate deep, humanistic experiences for healthcare personnel. The analysis of body phenomenology reveals that the soul is banished from her familiar and comfortable "at-home" status when illness and pain invade the body. In such situations, the body becomes an external object that is self-alienated. This experience induces experiences such as solitude and violence. However, it also holds the potential to expose the original morality of the body. Additionally, this article discusses popular tools used in clinical ethics such as principalism and virtual-based ethics, which are based on moral reasoning and moral feeling. In contrast to these, body ethics seek a more profound and humble level of sensibility that is able to implant authenticity into the ethics. Finally, we offer some suggestions related to Watson's caring theory.

Codes of Ethics and Teachers' Professional Autonomy

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Schwimmer, Marina; Maxwell, Bruce

2017-01-01

This article considers the value of adopting a code of professional ethics for teachers. After having underlined how a code of ethics stands to benefits a community of educators--namely, by providing a mechanism for regulating autonomy and promoting a shared professional ethic--the article examines the principal arguments against codes of ethics.…

Perceptions and attitudes of community pharmacists toward professional ethics and ethical dilemmas in the workplace.

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Vuković Rodríguez, Jadranka; Juričić, Živka

2018-05-01

Formal training in pharmacy ethics is relatively new in Croatia, and the professional code of ethics is more than 20 years old. Very little is known about how practicing pharmacists implement ethical considerations and relevant professional guidelines in their work. This study aimed to provide the first description of the perceptions and attitudes of Croatian community pharmacists toward ethics in pharmacy practice, how often they face certain ethical dilemmas and how they resolve them. A cross-sectional survey of 252 community pharmacists, including community pharmacists and pre-licensing trainees, was conducted in Zagreb, Croatia. This group accounts for 18% of licensed pharmacists in Croatia. The survey questions included four sections: general sociodemographic information, multiple-choice questions, pre-defined ethical scenarios, and ethical scenarios filled in by respondents. More than half of pharmacists (62.7%) face ethical dilemmas in everyday work. Nearly all (94.4%) are familiar with the current professional code of ethics in Croatia, but only 47.6% think that the code reflects the changes that the pharmacy profession faces today. Most pharmacists (83.3%) solve ethical dilemmas on their own, while nearly the same proportion (75.4%) think that they are not adequately trained to deal with ethical dilemmas. The pre-defined ethical scenarios experienced by the largest proportion of pharmacists are being asked to dispense a drug to someone other than the patient (93.3%), an unnecessary over-the-counter medicine (84.3%), a generic medicine clinically equivalent to the prescribed one (79.4%), or hormonal contraception over the counter (70.4%). The results demonstrate a need to improve formal pharmacy ethics education and training in how to assess ethical issues and make appropriate decisions, which implies the need for stronger collaboration between pharmacists and their professional association. Our results also highlight an urgent need to revise and update the

What is good medical ethics? A clinician's perspective.

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Kong, Wing May

2015-01-01

Speaking from the perspective of a clinician and teacher, good medical ethics needs to make medicine better. Over the past 50 years medical ethics has helped shape the culture in medicine and medical practice for the better. However, recent healthcare scandals in the UK suggest more needs to be done to translate ethical reasoning into ethical practice. Focusing on clinical practice and individual patient care, I will argue that, to be good, medical ethics needs to become integral to the activities of health professionals and healthcare organisations. Ethics is like a language which brings a way of thinking and responding to the world. For ethics to become embedded in clinical practice, health professionals need to progress from classroom learners to fluent social speakers through ethical dialogue, ethical reflection and ethical actions. I will end by discussing three areas that need to be addressed to enable medical ethics to flourish and bring about change in everyday clinical care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Patient participation as discursive practice-A critical discourse analysis of Danish mental healthcare.

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Joergensen, Kim; Praestegaard, Jeanette

2018-04-01

Patient participation is one of the most prevalent focus areas in the Danish healthcare debate. Patient participation is generally presented as a fundamental democratic right, and is stated in an objective language with legal requirements for healthcare professionals to ensure that patients systematically participate in their own courses of care and treatment. In the research literature, it is not clear what is meant by 'patient participation', and several discourses on patient participation exist side by side. This study explores how discourses of patient participation unfold and are at play in the articulations in official legal and political documents and patient records relating to a Danish psychiatric context. The documents and patient records have been analyzed using a Fairclough-inspired critical discourse approach which is concerned with how power is exercised through language. The research findings show that patient participation within Danish psychiatric healthcare is governed within a neoliberal discourse where underlying discourses; discourse of biomedicine, paternalism, management, evidence and ethics of care are embedded, and a discourse that seems to ascribe stigmatizing traits to mentally ill patients. © 2017 John Wiley & Sons Ltd.

The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

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Allott, Kelly; Lloyd, Susan

2009-07-01

Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

Healthcare professionals' views of the experiences of individuals living with Crohn's Disease in Spain. A qualitative study.

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García-Sanjuán, Sofía; Lillo-Crespo, Manuel; Richart-Martínez, Miguel; Sanjuán-Quiles, Ángela

2018-01-01

Crohn's Disease (CD) in Spain lacks of a unified National Clinical Pathway and not even any early detection program and professional follow-up outpatient attention once it has been diagnosed. Little is known about the Spanish health professionals' views of the experiences of individuals living with Crohn's Disease nationwide and also about how the Spanish Health System faces this situation. A qualitative research method was conducted to explore this topic through in-depth interviews with eleven healthcare professionals, who represented different clinics treating people with CD from the province of Alicante (Spain). Three topics and seven sub-topics were derived from the analysis of the content emerging from the interviews. The three main topics were: the healthcare system as a hindrance for ongoing treatment of CD, the impact of the disease, support networks. The knowledge of CD gained by healthcare professionals, in the contexts studied here within, with regards to the psychosocial aspects and the experience of those living with the disease and their immediate circles, is poor, if not null on an academic level, becoming experiential on their incorporation into the professional field. Additionally, a priori, they lack the tools to address the doubts and concerns of patients from the moment of diagnosis through the ongoing care of the patient. Organizational hindrances, such as the lack of time and consensual guidelines for adequately monitoring CD patients in Alicante (Spain), further restrict the patient-professional relationship. Due to the consensus established by the National Agency regulating the contents of the Health Professions' Education and Training across the country, we are assuming that the phenomenon highlighted may be similar in other parts of Spain. Therefore, it can be said that healthcare professionals have a limited understanding of the impact of CD on the day-to-day life of those affected, not being considered a part of the CD patients' formal

A situation analysis of inter-professional education and practice for ethics and professionalism training at Makerere University College of Health Sciences.

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Byakika-Kibwika, Pauline; Kutesa, Annet; Baingana, Rhona; Muhumuza, Christine; Kitutu, Freddy Eric; Mwesigwa, Catherine; Chalo, Rose Nabirye; Sewankambo, Nelson K

2015-10-23

Students at Makerere University College of Health Sciences (MakCHS) are introduced to ethics and professionalism using the inter-professional education (IPE) model. Ethics and professionalism should be running themes throughout succeeding years of study during which students are expected to develop qualities and skills for future inter-professional practice (IPP). We performed a situation analysis of IPE and IPP among students and teaching health professionals at MakCHS to guide development of a relevant training curriculum of ethics and professionalism. A cross sectional study with quantitative and qualitative methods which included questionnaires, focus group discussions and key informant interviews. We interviewed 236 undergraduate students (148, 63 % male) and 32 teaching health professionals (25, 78 % male). Two hundred fifteen (91 %) students indicated they had joint learning activities with students of other professions and 166 (70 %) stated there was benefit in having an IPE model training curriculum. Most students (140, 59 %) strongly agreed that learning with other students will make them more effective members of the health team. Whereas the respondents reported inter professionalism as being well articulated in their course curricula, more than half said IPE is only implemented in the pre-clinical years of study. They noted that IPE and IPP concepts were not well programmed, health professionals engaged in teaching had poor attitudes towards IPE and IPP, there were limited numbers of skilled health care workers to implement IPP and there was poor communication between students and teaching health professionals. Majority of teaching health professionals noted challenges in implementation of IPE such as poor coordination and large student population and major factors influencing ethics and professionalism in healthcare such as limited government support, low pay for the health care workers, disrespect and lack of appreciation of the health workers by the

Professionals learning together with patients: An exploratory study of a collaborative learning Fellowship programme for healthcare improvement.

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Myron, Rowan; French, Catherine; Sullivan, Paul; Sathyamoorthy, Ganesh; Barlow, James; Pomeroy, Linda

2018-05-01

Improving the quality of healthcare involves collaboration between many different stakeholders. Collaborative learning theory suggests that teaching different professional groups alongside each other may enable them to develop skills in how to collaborate effectively, but there is little literature on how this works in practice. Further, though it is recognised that patients play a fundamental role in quality improvement, there are few examples of where they learn together with professionals. To contribute to addressing this gap, we review a collaborative fellowship in Northwest London, designed to build capacity to improve healthcare, which enabled patients and professionals to learn together. Using the lens of collaborative learning, we conducted an exploratory study of six cohorts of the year long programme (71 participants). Data were collected using open text responses from an online survey (n = 31) and semi-structured interviews (n = 34) and analysed using an inductive open coding approach. The collaborative design of the Fellowship, which included bringing multiple perspectives to discussions of real world problems, was valued by participants who reflected on the safe, egalitarian space created by the programme. Participants (healthcare professionals and patients) found this way of learning initially challenging yet ultimately productive. Despite the pedagogical and practical challenges of developing a collaborative programme, this study indicates that opening up previously restricted learning opportunities as widely as possible, to include patients and carers, is an effective mechanism to develop collaborative skills for quality improvement.

Business Entity Selection: Why It Matters to Healthcare Practitioners. Part III--Nonprofits, Ethics, Practice Implications, and Conclusions.

Science.gov (United States)

Nithman, Robert W

2015-01-01

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvantages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with organizational mission or vision statements, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.

The business of ethics: gender, medicine, and the professional codification of the American Physiotherapy Association, 1918-1935.

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Linker, Beth

2005-07-01

The history of codes of ethics in health care has almost exclusively been told as a story of how medical doctors developed their own professional principles of conduct. Yet telling the history of medical ethics solely from the physicians' perspective neglects not only the numerous allied health care workers who developed their own codes of ethics in tandem with the medical profession, but also the role that gender played in the writing of such professional creeds. By focusing on the predominantly female organization of the American Physiotherapy Association (APA) and its 1935 "Code of Ethics and Discipline," I demonstrate how these women used their creed to at once curry favor from and challenge the authority of the medical profession. Through their Code, APA therapists engaged in a dynamic dialogue with the male physicians of the American Medical Association (AMA) in the name of professional survival. I conclude that, contrary to historians and philosophers who contend that professional women have historically operated under a gender-specific ethic of care, the physiotherapists avoided rhetoric construed as feminine and instead created a "business-like" creed in which they spoke solely about their relationship with physicians and remained silent on the matter of patient care.

Curriculum evaluation of ethical reasoning and professional responsibility.

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Christie, Carole R; Bowen, Denise M; Paarmann, Carlene S

2003-01-01

This exploratory study evaluated curricular content and evaluation mechanisms related to ethics and professionalism in the baccalaureate dental hygiene program at Idaho State University. Competency-based education requires enhanced student preparation in ethical reasoning, critical thinking, and decision-making. Graduates must integrate concepts, beliefs, principles, and values to fulfill ethical and professional responsibilities. Methods included 1) development of five supporting competencies defining ethics and professionalism to provide a framework for curricular evaluation; 2) assessment of all course content and evaluation methods for each supporting competency; 3) evaluation of students' clinical performance based on professional judgment grades; and 4) survey of junior (n=30) and senior (n=27) students' attitudes about dental hygiene practice related to ethics and professionalism. Results revealed that most courses include content and evaluation related to at least one supporting competency; however, authentic evaluation is weak. Clinical instructors rarely relate evaluations to ethical principles or values. Surveys showed significant differences between junior and senior students' attitudes about ethics and professionalism in six of thirty-four areas (the six were laws and regulations; communication and interpersonal skills; problem solving; professional activities/programs; integrity; and safe work environment). This article shares one approach for evaluating curricular content and evaluation methods designed to develop student competence in ethical reasoning and professionalism. Based upon the study's findings, recommendations are made for curricular enhancement via authentic evaluation and faculty training.

What Are the Professional, Political, and Ethical Challenges of Co-Creating Health Care Systems?

Science.gov (United States)

Singh, Guddi; Owens, John; Cribb, Alan

2017-11-01

Co-creation is seen by many as a means of meeting the multiple challenges facing contemporary health care systems by involving institutions, professionals, patients, and stakeholders in new roles, relationships, and collaborative practices. While co-creation has the potential to positively transform health care systems, it generates a number of political and ethical challenges that should not be overlooked. We suggest that those involved in envisioning and implementing co-creation initiatives pay close attention to significant questions of equity, power, and justice and to the fundamental challenge of securing a common vision of the aims of and agendas for health care systems. While such initiatives present significant opportunities for improvement, they need to be viewed in light of their accompanying professional, political, and ethical challenges. © 2017 American Medical Association. All Rights Reserved.

Group supervision for healthcare professionals within primary care for patients with psychosomatic health problems: a pilot intervention study.

Science.gov (United States)

Bullington, Jennifer; Cronqvist, Agneta

2018-03-01

In primary health care, efficacious treatment strategies are lacking for these patients, although the most prominent symptoms accounting for consultation in primary care often cannot be related to any biological causes. The aim was to explore whether group supervision from a specific phenomenological theory of psychosomatics could provide healthcare professionals treating patients with psychosomatic health issues within primary care a deeper understanding of these conditions and stimulate profession-specific treatment strategies. Our research questions were as follows: (i) What is the healthcare professionals' understanding of psychosomatics before and after the intervention? (ii) What are the treatment strategies for this group of patients before and after the intervention? The study was an explorative qualitative intervention pilot study. The six participants from a primary healthcare setting in a medium-sized city in Sweden participated in the study. A supervision group was formed, based on a mix of professions, age, gender and years of clinical experience. Supervision consisted of one 75-minutes meeting every month during the course of 6 months. Participants were interviewed before and after the supervision intervention. The study showed two distinct categories emerged from the data. One category of healthcare professionals espoused a psycho-educative approach, while the other lacked a cohesive approach. The supervision improved the second category of healthcare professionals' understanding of psychosomatics. The psycho-educative group did not change their understanding of psychosomatics, although they felt strengthened in their approach by the supervision. Profession-specific strategies were not developed. This pilot study indicates that a relatively short supervision intervention can aid clinicians in their clinical encounters with these patients; however, further research is necessary to ascertain the value of the specific phenomenologically based

Ethics Education for Professionals in Japan: A Critical Review

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Maruyama, Yasushi; Ueno, Tetsu

2010-01-01

Ethics education for professionals has become popular in Japan over the last two decades. Many professional schools now require students to take an applied ethics or professional ethics course. In contrast, very few courses of professional ethics for teaching exist or have been taught in Japan. In order to obtain suggestions for teacher education,…

Healthcare professionals' self-reported experiences and preferences related to direct healthcare professional communications : a survey conducted in the Netherlands

NARCIS (Netherlands)

Piening, Sigrid; Haaijer-Ruskamp, Flora M.; de Graeff, Pieter A.; Straus, Sabine M. J. M.; Mol, Peter G. M.

2012-01-01

Background: In Europe, Direct Healthcare Professional Communications (DHPCs) are important tools to inform healthcare professionals of serious, new drug safety issues. However, this tool has not always been successful in effectively communicating the desired actions to healthcare professionals.

Taking on organizational ethics. To do so, ethics committees must first prepare themselves.

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Weber, L J

1997-01-01

Healthcare ethics committees which have focused almost entirely on clinical ethics, now need to prepare to deal with organizational ethics, a field that is attracting increasing attention. As they did with clinical ethics, ethics committees members must educate themselves in the demands of the newer field. As before, they must respect the perspectives of the actual decision makers while maintaining an independent framework for analyzing the issues at stake. They must ensure that management is properly represented on the committee if they need guidance from a professional ethicist they should seek one with a strong background in business ethics and social justice. Healthcare organizations are likely to need help with a wide range of ethical issues involving patient services (rationing of resources, for example), business and service plans (mergers and joint ventures, for example), business and professional integrity (conflicts of interest, for example), employee rights and responsibilities (downsizing, for example), and the organization's role in in the community (advocacy and lobbying, for example). To be helpful to the organization, the ethics committee must be prepared to say when cost factors trump other considerations and when they do not. An ethics committee will often be asked to give advice on specific occasions-a proposed new policy, for instance. The most important part of its response is its analysis of the issue. Finally, an ethics committee should view its organization as part of the larger social context.

Self-reported receipt of healthcare professional?s weight management counselling is associated with self-reported weight management behaviours of type 2 diabetes mellitus patients

OpenAIRE

Mogre, Victor; Wanaba, Peter; Apala, Peter; Nsoh, Jonas A.

2016-01-01

Background Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviours to lose weight. This study determined the association between self-reported receipt of healthcare professional?s weight management counselling and the weight management behaviours of type 2 diabetes patients. Methods This cross-sectional study was conducted among 378 type 2 ...

Assessing palliative care needs: views of patients, informal carers and healthcare professionals.

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McIlfatrick, Sonja

2007-01-01

This paper reports a study to assess the palliative care needs of the adult population served by a healthcare provider organization in Northern Ireland from the perspectives of patients, informal carers and healthcare providers. Assessing palliative care need is a key factor for health service planning. Traditionally, palliative care has been associated with end-of-life care and cancer. More recently, the concept has been extended to include care for both cancer and non-cancer populations. Various approaches have been advocated for assessing need, including the exploration of professional provider and user perspectives of need. Semi-structured qualitative interviews were undertaken with a purposive sample of patients and lay carers receiving palliative care services (n = 24). Focus groups were also conducted with multi-professional palliative care providers (n = 52 participants) and face to face interviews were undertaken with key managerial stakeholders in the area (n = 7). The focus groups and interviews concentrated on assessment of palliative care need. All the interviews were transcribed verbatim and analysed using Burnard's framework. Professional providers experienced difficulty in defining the term palliative care. Difficulties in communication and information exchange, and fragmented co-ordination between services were identified. The main areas of need identified by all participants were social and psychological support; financial concerns; and the need for choice and information. All participants considered that there was inequity between palliative care service provision for patients with cancer and non-cancer diseases. All patients, regardless of diagnosis, should be able to access palliative care appropriate to their individual needs. For this to happen in practice, an integrated approach to palliative care is essential. The study methodology confirms the value of developing a comprehensive approach to assessing palliative care need.

Notas sobre el proceso de conocimiento antropológico

OpenAIRE

Devillard, María José

2002-01-01

"Pensar Europa en sus fronteras", como ya en 1992 proponían un grupo de filósofos de la Universidad de Estrasburgo -Denis Guénoun, Philippe Lacoue-Labarthe, Jean-Luc Nancy, Daniel Payot-, significa considerar qué es eso de la "geofilosofía de Europa" como una cuestión imprescindible que conlleva toda reflexión veraz en torno a la idea de Europa. El debate al que invitaron a una serie diversa de colegas y amigos, procedentes de diferentes naciones, planteaba la posibilidad misma de una identif...

"Professional Helper" or "Helping Professional?" The Patient-Physician Relationship in the Chronic Pain Setting, With Special Reference to the Current Opioid Debate.

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Bäckryd, Emmanuel

2016-01-01

There seems to be a strong cultural expectation among patients for effective pain relief. As a result, physicians often find themselves trying to bridge the gap between the chronic pain patient's expectations and harsh biomedical reality. The typology of Emanuel and Emanuel of four models for the patient-physician relationship is used in this article as a conceptual tool to examine the possible roles of physicians in the context of chronic noncancer pain. Their typology is reconceptualized as a "pathway" along which the physician is able to walk more or less far, starting from the "information" end of the path. The other end of the pathway is "caring deliberation." I then propose that, in pain medicine today, consumerism is a powerful incentive for physicians to stay at the information end of the spectrum. Against this background, I discuss the current opioid epidemic in the United States and the need for what has been called a new medical professionalism. I conclude by challenging educators involved in pain medicine continuing professional development to not only design adequate biomedical-educational programs, but also consider issues like professionalism, personal development, critical self-reflection, and the ethics of engaging in caring deliberation with chronic pain patients.

[Patient safety culture based on a non-punitive response to error and freedom of expression of healthcare professionals].

Science.gov (United States)

Mahjoub, Mohamed; Bouafia, Nabiha; Cheikh, Asma Ben; Ezzi, Olfa; Njah, Mansour

2016-11-25

This study provided an overview of healthcare professionals’ perception of patient safety based on analysis of the concept of freedom of expression and non-punitive response in order to identify and correct errors in our health system. This concept is a cornerstone of the patient safety culture among healthcare professionals and plays a central role in the quality improvement strategy..

Reconsidering 'ethics' and 'quality' in healthcare research: the case for an iterative ethical paradigm.

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Stevenson, Fiona A; Gibson, William; Pelletier, Caroline; Chrysikou, Vasiliki; Park, Sophie

2015-05-08

UK-based research conducted within a healthcare setting generally requires approval from the National Research Ethics Service. Research ethics committees are required to assess a vast range of proposals, differing in both their topic and methodology. We argue the methodological benchmarks with which research ethics committees are generally familiar and which form the basis of assessments of quality do not fit with the aims and objectives of many forms of qualitative inquiry and their more iterative goals of describing social processes/mechanisms and making visible the complexities of social practices. We review current debates in the literature related to ethical review and social research, and illustrate the importance of re-visiting the notion of ethics in healthcare research. We present an analysis of two contrasting paradigms of ethics. We argue that the first of these is characteristic of the ways that NHS ethics boards currently tend to operate, and the second is an alternative paradigm, that we have labelled the 'iterative' paradigm, which draws explicitly on methodological issues in qualitative research to produce an alternative vision of ethics. We suggest that there is an urgent need to re-think the ways that ethical issues are conceptualised in NHS ethical procedures. In particular, we argue that embedded in the current paradigm is a restricted notion of 'quality', which frames how ethics are developed and worked through. Specific, pre-defined outcome measures are generally seen as the traditional marker of quality, which means that research questions that focus on processes rather than on 'outcomes' may be regarded as problematic. We show that the alternative 'iterative' paradigm offers a useful starting point for moving beyond these limited views. We conclude that a 'one size fits all' standardisation of ethical procedures and approach to ethical review acts against the production of knowledge about healthcare and dramatically restricts what can be

Professional virtue and professional self-awareness: a case study in engineering ethics.

Science.gov (United States)

Stovall, Preston

2011-03-01

This paper articulates an Aristotelian theory of professional virtue and provides an application of that theory to the subject of engineering ethics. The leading idea is that Aristotle's analysis of the definitive function of human beings, and of the virtues humans require to fulfill that function, can serve as a model for an analysis of the definitive function or social role of a profession and thus of the virtues professionals must exhibit to fulfill that role. Special attention is given to a virtue of professional self-awareness, an analogue to Aristotle's phronesis or practical wisdom. In the course of laying out my account I argue that the virtuous professional is the successful professional, just as the virtuous life is the happy life for Aristotle. I close by suggesting that a virtue ethics approach toward professional ethics can enrich the pedagogy of professional ethics courses and help foster a sense of pride and responsibility in young professionals.

Implementing augmentative and alternative communication in critical care settings: Perspectives of healthcare professionals.

Science.gov (United States)

Handberg, Charlotte; Voss, Anna Katarina

2018-01-01

To describe the perspectives of healthcare professionals caring for intubated patients on implementing augmentative and alternative communication (AAC) in critical care settings. Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalisation and rehabilitation. Little is known about the use of AAC in critical care settings. The design was informed by interpretive descriptive methodology along with the theoretical framework symbolic interactionism, which guided the study of healthcare professionals (n = 48) in five different intensive care units. Data were generated through participant observations and 10 focus group interviews. The findings represent an understanding of the healthcare professionals' perspectives on implementing AAC in critical care settings and revealed three themes. Caring Ontology was the foundation of the healthcare professionals' profession. Cultural Belief represented the actual premise in the interactions during the healthcare professionals' work, saving lives in a biomedical setting whilst appearing competent and efficient, leading to Triggered Conduct and giving low priority to psychosocial issues like communication. Lack of the ability to communicate puts patients at greater risk of receiving poorer treatment, which supports the pressuring need to implement and use AAC in critical care. It is documented that culture in biomedical paradigms can have consequences that are the opposite of the staffs' ideals. The findings may guide staff in implementing AAC strategies in their communication with patients and at the same time preserve their caring ontology and professional pride. Improving communication strategies may improve patient safety and make a difference in patient outcomes. Increased knowledge of and familiarity with AAC strategies may provide healthcare professionals

No thank you, not today": Supporting Ethical and Professional Relationships in Large Qualitative Studies

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Lisa J. Blodgett

2005-09-01

Full Text Available Based on an ongoing research study of the development of self-regulation in early childhood (BOYER, 2005a, 2005b; BOYER, BLODGETT, & TURK, 2004, this work explores both the ethical and professional considerations of participant sampling in a large qualitative study. The study involved 146 families of preschool children and 15 educators across 7 preschools. Data collection included 30-45 minute audiotaped individual interviews, twenty-eight 90-120 minute audiotaped focus group sessions, and 30 minute videotaped footage of each child's natural play. The challenge of gaining informed consent and ongoing participation within a large study has been considered in the literature (GALL, GALL, & BORG, 2005. In qualitative studies the participants are selected purposefully because they will be par­ticularly informative about the topic (CRESWELL, 2002. This is a challenge for qualitative re­searchers seeking maximal participation and large sample sizes because volunteer participants "tend to be better educated, higher socioeconomically, more intelligent, more in need of social approval, more sociable, more unconventional, less auth­ori­tarian, and less conforming than nonvolunteers" (MCMILLAN, 2004, p.116. This paper provides a response to these sampling challenges and ad­vo­cates for the building of community relationships based on ethical, interpersonal and professional foundations. URN: urn:nbn:de:0114-fqs0503353

The interdependent roles of patients, families and professionals in cystic fibrosis: a system for the coproduction of healthcare and its improvement.

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Sabadosa, Kathryn A; Batalden, Paul B

2014-04-01

A quality healthcare system is coproduced by patients, families and healthcare professionals working interdependently to cocreate and codeliver care. Cystic fibrosis (CF) patients and families rely on healthcare professionals to provide the best possible care and timely, accurate information. They know that the care at home and in clinical settings needs to be seamless, using shared information and decisions. A parent's journey of better care begins with her son's diagnosis and moves to her involvement to improve the systems and processes of care for others. She reflects on this work and identifies five elements that contributed to the coproduction of improved care: (1) mental and emotional readiness to engage; (2) curiosity and the search for insight; (3) reframe challenges into opportunities for improvement; (4) listen and learn from everyone, bringing home what is relevant; and (5) personal participation. Joined with the reflections of an improvement scientist, they note that chronic care relies on informed, activated patients and prepared, proactive healthcare professionals working together and that it is more than 'patient-centric'. They propose a model for the coimprovement of systems of care.

Ethics and professional responsibility: Essential dimensions of planned home birth.

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McCullough, Laurence B; Grünebaum, Amos; Arabin, Birgit; Brent, Robert L; Levene, Malcolm I; Chervenak, Frank A

2016-06-01

Planned home birth is a paradigmatic case study of the importance of ethics and professionalism in contemporary perinatology. In this article we provide a summary of recent analyses of the Centers for Disease Control database on attendants and birth outcomes in the United States. This summary documents the increased risks of neonatal mortality and morbidity of planned home birth as well as bias in Apgar scoring. We then describe the professional responsibility model of obstetric ethics, which is based on the professional medical ethics of two major figures in the history of medical ethics, Drs. John Gregory of Scotland and Thomas Percival of England. This model emphasizes the identification and careful balancing of the perinatologist's ethical obligations to pregnant, fetal, and neonatal patients. This model stands in sharp contrast to one-dimensional maternal-rights-based reductionist model of obstetric ethics, which is based solely on the pregnant woman's rights. We then identify the implications of the professional responsibility model for the perinatologist's role in directive counseling of women who express an interest in or ask about planned home birth. Perinatologists should explain the evidence of the increased, preventable perinatal risks of planned home birth, recommend against it, and recommend planned hospital birth. Perinatologists have the professional responsibility to create and sustain a strong culture of safety committed to a home-birth-like experience in the hospital. By routinely fulfilling these professional responsibilities perinatologists can help to prevent the documented, increased risks planned home birth. Copyright © 2016 Elsevier Inc. All rights reserved.

Healthcare quality improvement work: a professional employee perspective.

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Gadolin, Christian; Andersson, Thomas

2017-06-12

Purpose The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work. Design/methodology/approach Qualitative case study based on interviews ( n=27) and observations ( n=10). Findings The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute. Practical implications Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed. Originality/value Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.

Examining the relationship between burnout and empathy in healthcare professionals: A systematic review.

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Wilkinson, Helen; Whittington, Richard; Perry, Lorraine; Eames, Catrin

2017-09-01

Empathy and burnout are two related yet distinct constructs that are relevant to clinical healthcare staff. The nature of their relationship is uncertain and this review aimed to complete a rigorous, systematic exploration of the literature investigating the relationship between burnout and empathy in healthcare staff. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Search terms (Burnout OR Burn-out OR "Burn out") AND (Empathy OR Empath*) enabled identification of studies investigating burnout and empathy in healthcare staff, using five electronic data bases (MEDLINE, PsycINFO, CINAHL Plus, PubMed, and SCOPUS). Manual searching amongst reference lists of eligible articles was also completed. Databases were searched for studies published in the English language, from inception to February 2017. Key inclusion criteria were: 1) participants who were nurses or medical professionals, 2) full written manuscript in English, 3) use of the Maslach Burnout Inventory to assess burnout and a standardized outcome measure for empathy, 4) quantitative methodology exclusively. Ten eligible studies were reviewed. Of those, seven were conducted in countries where English was not the first language. Eight of the studies provided empirical support for a negative relationship between empathy and burnout. One study provided support for a positive relationship between burnout and empathy. One study reported contradictory evidence with positive and negative correlations between different subscales of the empathy and burnout measures. In general, the quality of the studies was assessed to be good. However, some of the studies failed to provide information pertaining to sample size, with the reporting of data less than adequate from one study. There was consistent evidence for a negative association between burnout and empathy. This review avoided a common English-speaking country bias of some

Ethics and professionalism in public relations

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Krstić Ana

2009-01-01

Full Text Available The subjects of this paper are ethics and professionalism, topics closely linked in contemporary theory, and especially in practice of public relations, whose significance is increasingly coming to the spotlight of experts from this area. Several definitions, classification, the historical development and principles of theories of ethics most frequently used in ethical decision-making within a business environment, have been presented in the first chapter in the endeavor to ascertain the concept of ethics. The next chapter concerns the duties a public relations expert must pay attention to while carrying out his or her activities. Those are: duty towards oneself, towards the organization, society and profession, within which, in the case of a conflict of interest, the duty towards society (so-called social responsibility, or professional duty, must prevail. The chapter that follows concerns ethical problems in the contemporary practice of public relations: the competence of practitioners, possible conflicts of interest and the very sensitive area of media relations. The chapter on models of ethical decision-making involves concrete experts' advice on decision making which are firmly based on ethical principles. Next section concerns professionalism and professional education in public relations. Recommendations concerning topics which should be included in the university education in this area are also presented. The focus is on the following: the absence of standards that would establish who can work in public relations and under which conditions; the lack of a specified educational minimum and expertise which a practitioner should possess; the need for practitioners to be the members of professional associations, as well as to adhere to a required ethical codex. Some of the most significant world public relations associations are mentioned and at the end, and a review of the state of public relations in Serbia is given.

Breast cancer genetic counseling among Dutch patients from Turkish and Moroccan descent: participation determinants and perspectives of patients and healthcare professionals.

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Baars, J E; van Dulmen, A M; Velthuizen, M E; van Riel, E; Ausems, M G E M

2017-04-01

Lower participation rates in cancer genetic counseling are observed among different ethnic minorities. The goal of our study is to gain insight into determinants of Turkish and Moroccan patients' participation in breast cancer genetic counseling and DNA testing, from the point of view of healthcare professionals and patients. Questionnaire-based telephone interviews about awareness, perceptions, and reasons for (non-) participation in cancer genetic counseling were conducted with 78 Dutch breast cancer patients from Turkish and Moroccan descent. The interviews were held in Arabic, Berber, Turkish, or Dutch by bilingual research assistants. Additionally, 14 breast cancer patients participated in one of two focus group meetings, and two focus groups were held with 11 healthcare professionals. SPSS and QSR Nvivo were used to examine the quantitative and qualitative data, respectively. Half of the total group of patients (N = 78) and 79% of patients eligible for genetic counseling and testing (N = 33) were aware of the possibility of genetic counseling. The most important determinants for nonparticipation in genetic counseling were experienced difficulties in patient-doctor communication, cultural factors (e.g., social norms), limited health literacy, limited knowledge of the family cancer history, and anxiety about cancer. Religious beliefs and knowing personal and family members' breast cancer risks were motives to obtain genetic counseling. Despite the fact that our study showed that Moroccan and Turkish women reported several personal motives to obtain genetic counseling and testing (GCT), patients and healthcare professionals experience significant language and health literacy difficulties, which make it harder to fully access health care such as genetic counseling and testing.

European Cinema and the Postheroic Narrative: Jean-Luc Nancy, Claire Denis, and 'Beau Travail'

NARCIS (Netherlands)

Elsaesser, T.

2012-01-01

What is European cinema? First: European cinema does not exist, except as a bureaucratic dream or a promotional tool for national producers and distributors of art house films. Second: insofar as it is willed into existence, European cinema has over the past three decades been funded mainly by

INSISTÊNCIAS DEMOCRÁTICAS: ENTREVISTA COM MIGUEL ABENSOUR, JEAN-LUC NANCY & JACQUES RANCIÈRE

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Vinícius Nicastro Honesko

2015-07-01

Full Text Available Realizada por Stany Grelet, Jérôme Lèbre & Sophie Wahnich. Traduzida do francês por Vinícius Nicastro Honesko.NB: A entrevista foi originalmente publicada na revista Vacarme (n. 48, verão de 2009 e está disponível no endereço: http://www.vacarme.org/article1772.html.

INSISTÊNCIAS DEMOCRÁTICAS: ENTREVISTA COM MIGUEL ABENSOUR, JEAN-LUC NANCY & JACQUES RANCIÈRE

Directory of Open Access Journals (Sweden)

Vinícius Nicastro Honesko

2015-07-01

Full Text Available Realizada por Stany Grelet, Jérôme Lèbre & Sophie Wahnich. Traduzida do francês por Vinícius Nicastro Honesko. NB: A entrevista foi originalmente publicada na revista Vacarme (n. 48, verão de 2009 e está disponível no endereço: http://www.vacarme.org/article1772.html.

Nursing Ethics: A Lifelong Commitment.

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Gibbons, Susanne W; Jeschke, E Ann

2016-01-01

Over the past 30 years, the health-care context as well as the roles and responsibilities of nurses have drastically changed. Leaders in nursing around the world recognize that the health-care system is stressed and the well-being of the nursing workforce plagued by the pressures and challenges it faces in everyday practice. We do not intend to make a strong normative argument for why nursing ethics education should be done in a certain way, but instead show from where we have come and to where we can go, so that educators are positioned to address some of the current shortcomings in ethics education. Our goal is to provide an illustration of ethics education as an interwoven, ongoing, and essential aspect of nursing education and professional development. By developing professional identity as character, we hope that professional nurses are given the skills to stand in the face of adversity and to act in a way that upholds the core competencies of nursing. Ultimately, health-care organizations will thrive because of the support they provide nurses and other health-care professionals.

Comparing the importance of quality measurement themes in juvenile idiopathic inflammatory myositis between patients and families and healthcare professionals.

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Tory, Heather O; Carrasco, Ruy; Griffin, Thomas; Huber, Adam M; Kahn, Philip; Robinson, Angela Byun; Zurakowski, David; Kim, Susan

2018-04-19

A standardized set of quality measures for juvenile idiopathic inflammatory myopathies (JIIM) is not in use. Discordance has been shown between the importance ascribed to quality measures between patients and families and physicians. The objective of this study was to assess and compare the importance of various aspects of high quality care to patients with JIIM and their families with healthcare providers, to aid in future development of comprehensive quality measures. Surveys were developed by members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Juvenile Dermatomyositis Workgroup through a consensus process and administered to patients and families through the CureJM Foundation and to healthcare professionals through CARRA. The survey asked respondents to rate the importance of 19 items related to aspects of high quality care, using a Likert scale. Patients and families gave generally higher scores for importance to most of the quality measurement themes compared with healthcare professionals, with ratings of 13 of the 19 measures reaching statistical significance (p quality of life, timely diagnosis, access to rheumatology, normalization of functioning/strength, and ability for self care. Despite overall differences in the rating of importance of quality indicators between patients and families and healthcare professionals, the groups agreed on the most important aspects of care. Recognizing areas of particular importance to patients and families, and overlapping in importance with providers, will promote the development of standardized quality measures with the greatest potential for improving care and outcomes for children with JIIM.

Healthcare professionals' self-reported experiences and preferences related to direct healthcare professional communications: a survey conducted in the Netherlands

OpenAIRE

Piening, Sigrid; Haaijer-Ruskamp, Flora M.; de Graeff, Pieter A.; Straus, Sabine M. J. M.; Mol, Peter G. M.

2012-01-01

Background: In Europe, Direct Healthcare Professional Communications (DHPCs) are important tools to inform healthcare professionals of serious, new drug safety issues. However, this tool has not always been successful in effectively communicating the desired actions to healthcare professionals. Objective: The aim of this study was to explore healthcare providers' experiences and their preferences for improvement of risk communication, comparing views of general practitioners (GPs), internists...

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.

Science.gov (United States)

Leuter, Cinzia; Petrucci, Cristina; Mattei, Antonella; Tabassi, Gianpietro; Lancia, Loreto

2013-05-01

Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.

Effectiveness of faculty training to enhance clinical evaluation of student competence in ethical reasoning and professionalism.

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Christie, Carole; Bowen, Denise; Paarmann, Carlene

2007-08-01

This study evaluated the short- and long-term effectiveness of faculty training to enhance clinical evaluation of ethical reasoning and professionalism in a baccalaureate dental hygiene program. Ethics, values, and professionalism are best measured in contexts comparable to practice; therefore, authentic evaluation is desirable for assessing these areas of competence. Methods were the following: 1) a faculty development workshop implementing a core values-based clinical evaluation system for assessing students' professional judgment; 2) subsequent evaluation of the clinical faculty's use of core values for grading and providing written comments related to students' professional judgment during patient care for three academic years; and 3) evaluation of program outcomes assessments regarding clinical learning experiences related to ethics and professionalism domains. Results revealed the clinical faculty's evaluation of professional judgment during patient care was enhanced by training; written comments more frequently related to core values defined in the American Dental Hygienists' Association (ADHA) Code of Ethics; and faculty members reported more confidence and comfort evaluating professional judgment after implementation of this evaluation system and receiving training in its application. Students were more positive in outcomes assessments about their competency and learning experiences related to professionalism and ethics. This article shares one approach for enhancing clinical faculty's authentic evaluation of student competence in ethical reasoning and professionalism.

Human Connections and Their Roles in the Occupational Well-being of Healthcare Professionals: A Study on Loneliness and Empathy

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Jorge Soler-Gonzalez

2017-08-01

Full Text Available Human connections are key to the promotion of health and prevention of illness; moreover, illness can cause deterioration of human connections. Healthcare professional–patient relationships are key to ensuring the preservation of adequate human connections. It is important for healthcare professionals to develop their ability to foster satisfactory human connections because: (i they represent social support for patients; and (ii they prevent work-related stress. In this study we assessed the relationship between absence (loneliness and presence (empathy of human connections with the occupational well-being of healthcare professionals. The Scale of Collateral Effects, which measures somatization, exhaustion, and work alienation; the Jefferson Scale of Empathy; and the Social and Emotional Loneliness Scale for Adults, were mailed to 628 healthcare professionals working in Spanish public healthcare institutions. The following explanatory variables were used to evaluate work well-being: (a empathy, as a professional competence; (b loneliness, age, and family burden, as psychological indicators; and (c professional experience, work dedication, and salary, as work indicators. Comparison, correlation, and regression analyses were performed to measure the relationships among these variables and occupational well-being. Of 628 surveys mailed, 433 (69% response rate were returned fully completed. Adequate reliability was confirmed for all instruments. The entire sample was divided into four groups, based on the combined variable, “occupation by sex.” Comparative analyses demonstrated differences among “occupation by sex” groups in collateral effects (p = 0.03 and empathy (p = 0.04, but not loneliness (p = 0.84. Inverse associations between empathy and collateral effects were confirmed for somatization (r = -0.16; p < 0.001, exhaustion (r = -0.14; p = 0.003, and work alienation (r = -0.16; p < 0.001. Furthermore, loneliness was positively

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life.

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Haeny, Angela M

2014-07-01

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association's (APA's) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA's Ethics Code or current research.

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life

Science.gov (United States)

Haeny, Angela M.

2014-01-01

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA’s Ethics Code or current research. PMID:25342876

The technological singularity and exponential medicine

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Iraj Nabipour

2016-01-01

Full Text Available The "technological singularity" is forecasted to occur in 2045. It is a point when non-biological intelligence becomes more intelligent than humans and each generation of intelligent machines re-designs itself smarter. Beyond this point, there is a symbiosis between machines and humans. This co-existence will produce incredible impacts on medicine that its sparkles could be seen in healthcare industry and the future medicine since 2025. Ray Kurzweil, the great futurist, suggested that three revolutions in science and technology consisting genetic and molecular science, nanotechnology, and robotic (artificial intelligence provided an exponential growth rate for medicine. The "exponential medicine" is going to create more disruptive technologies in healthcare industry. The exponential medicine shifts the paradigm of medical philosophy and produces significant impacts on the healthcare system and patient-physician relationship.   

The challenge of promoting professionalism through medical ethics and humanities education.

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Doukas, David J; McCullough, Laurence B; Wear, Stephen; Lehmann, Lisa S; Nixon, Lois LaCivita; Carrese, Joseph A; Shapiro, Johanna F; Green, Michael J; Kirch, Darrell G

2013-11-01

Given recent emphasis on professionalism training in medical schools by accrediting organizations, medical ethics and humanities educators need to develop a comprehensive understanding of this emphasis. To achieve this, the Project to Rebalance and Integrate Medical Education (PRIME) II Workshop (May 2011) enlisted representatives of the three major accreditation organizations to join with a national expert panel of medical educators in ethics, history, literature, and the visual arts. PRIME II faculty engaged in a dialogue on the future of professionalism in medical education. The authors present three overarching themes that resulted from the PRIME II discussions: transformation, question everything, and unity of vision and purpose.The first theme highlights that education toward professionalism requires transformational change, whereby medical ethics and humanities educators would make explicit the centrality of professionalism to the formation of physicians. The second theme emphasizes that the flourishing of professionalism must be based on first addressing the dysfunctional aspects of the current system of health care delivery and financing that undermine the goals of medical education. The third theme focuses on how ethics and humanities educators must have unity of vision and purpose in order to collaborate and identify how their disciplines advance professionalism. These themes should help shape discussions of the future of medical ethics and humanities teaching.The authors argue that improvement of the ethics and humanities-based knowledge, skills, and conduct that fosters professionalism should enhance patient care and be evaluated for its distinctive contributions to educational processes aimed at producing this outcome.

The patient-centered medical home: an ethical analysis of principles and practice.

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Braddock, Clarence H; Snyder, Lois; Neubauer, Richard L; Fischer, Gary S

2013-01-01

The patient-centered medical home (PCMH), with its focus on patient-centered care, holds promise as a way to reinvigorate the primary care of patients and as a necessary component of health care reform. While its tenets have been the subject of review, the ethical dimensions of the PCMH have not been fully explored. Consideration of the ethical foundations for the core principles of the PCMH can and should be part of the debate concerning its merits. The PCMH can align with the principles of medical ethics and potentially strengthen the patient-physician relationship and aspects of health care that patients value. Patient choice and these ethical considerations are central and at least as important as the economic and practical arguments in support of the PCMH, if not more so. Further, the ethical principles that support key concepts of the PCMH have implications for the design and implementation of the PCMH. This paper explores the PCMH in light of core principles of ethics and professionalism, with an emphasis both on how the concept of the PCMH may reinforce core ethical principles of medical practice and on further implications of these principles.

The main indicators for iranian hospital ethical accreditation

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SEYED ALI ENJOO

2015-07-01

Full Text Available Introduction: The application of organizational ethics in hospitals is one of the novel ways to improve medical ethics. Nowadays achieving efficient and sufficient ethical hospital indicators seems to be inevitable. In this connection, the present study aims to determine the best indicators in hospital accreditation. Methods: 69 indicators in 11 fields to evaluate hospital ethics were achieved through a five-step qualitative and quantitative study including literature review, expert focus group, Likert scale survey, 3 rounded Delphi, and content validity measurement. Expert focus group meeting was conducted, employing Nominal Group Technique (NGT. After running NGT, a three rounded Delphi and parallel to Delphi and a Likert scale survey were performed to obtain objective indicators for each domain. The experts were all healthcare professionals who were also medical ethics researchers, teachers, or Ph.D students. Content validity measurements were computed, using the viewpoints of two different expert groups, some ethicists, and some health care professionals (n=46. Results: After conducting NGT, Delphi, Likert survey, 11 main domains were listed including: Informed consent, Medical confidentiality, Physician-patient economic relations, Ethics consultation policy in the hospital, Ethical charter of hospital, Breaking bad medical news protocol, Respect for the patients’ rights, Clinical ethics committee, Spiritual and palliative care unit programs in the hospitals, Healthcare professionals’ communication skills, and Equitable access to the healthcare. Also 71 objective indicators for these 11 domains were listed in 11 tables with 5 to 8 indicators per table. Content Validity Ratio (CVR measurements were done and 69 indicators were highlighted. Conclusion: The domains listed in this study seem to be the most important ones for evaluating hospital ethics programs and services. Healthcare organizations’ accreditation and ranking are crucial for

What Outcomes do Dutch Healthcare Professionals Perceive as Important Before Participation in Moral Case Deliberation?

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de Snoo-Trimp, Janine; Widdershoven, Guy; Svantesson, Mia; de Vet, Riekie; Molewijk, Bert

2017-05-01

There has been little attention paid to research on the outcomes of clinical ethics support (CES) or critical reflection on what constitutes a good CES outcome. Understanding how CES users perceive the importance of CES outcomes can contribute to a better understanding, use of and normative reflection on CES outcomes. To describe the perceptions of Dutch healthcare professionals on important outcomes of moral case deliberation (MCD), prior to MCD participation, and to compare results between respondents. This mixed-methods study used both the Euro-MCD instrument and semi-structured interviews. Healthcare professionals who were about to implement MCD were recruited from nursing homes, hospitals, psychiatry and mentally disabled care institutions. 331 healthcare professionals completed the Euro-MCD instrument, 13 healthcare professionals were interviewed. The outcomes perceived as most important were 'more open communication', 'better mutual understanding', 'concrete actions', 'see the situation from different perspectives', 'consensus on how to manage the situation' and 'find more courses of action'. Interviewees also perceived improving quality of care, professionalism and the organization as important. Women, nurses, managers and professionals in mentally disabled care rated outcomes more highly than other respondents. Dutch healthcare professionals perceived the MCD outcomes related to collaboration as most important. The empirical findings can contribute to shared ownership of MCD and a more specific use of MCD in different contexts. They can inform international comparative research on different CES types and contribute to normative discussions concerning CES outcomes. Future studies should reflect upon important MCD outcomes after having experienced MCD. © 2017 John Wiley & Sons Ltd.

Between professional values, social regulations and patient preferences: medical doctors' perceptions of ethical dilemmas.

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Bringedal, Berit; Isaksson Rø, Karin; Magelssen, Morten; Førde, Reidun; Aasland, Olaf Gjerløv

2018-04-01

We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice. The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded (78%). We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so. Conceptually, dilemmas arise because of tensions between two or more of four doctor roles: the patient's advocate, a steward of societal interests, a member of a profession and a private individual. 27 of the potential dilemmas were considered dilemmas by at least 50% of the respondents. For more than half of the dilemmas, the anticipated course of action varied substantially within the professional group, with at least 20% choosing a different course than their colleagues, indicating low consensus in the profession. Doctors experience a large range of ethical dilemmas, of which many have been given little attention by academic medical ethics. The less-discussed dilemmas are characterised by a low degree of consensus in the profession about how to handle them. There is a need for medical ethicists, medical education, postgraduate courses and clinical ethics support to address common dilemmas in clinical practice. Viewing dilemmas as role conflicts can be a fruitful approach to these discussions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The ethics of the medical-pharmaceutical relationship.

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Vashi, Neelam A; Latkowski, Jo-Ann M

2012-01-01

Physician interaction with the pharmaceutical industry raises many ethical concerns. This relationship is complex, owing to a pluralism of beliefs held by physicians, patients, and third parties. As a result, determining whether physicians fulfill their responsibilities to both the professional and public communities is an arduous endeavor. In an effort to clarify the situation and provide transparency to this complex relationship, medical and pharmaceutical organizations have enacted their own respective codes and guidelines. Even with adherence to these guidelines, questions remain regarding the codependent relationship that interweaves the pharmaceutical industry with the medical community. Owing to the ever-changing landscape enmeshing product development, scientific advancement, corporate realities and patient care, the proper choice for physicians is rarely obvious; however, to operate to the highest standards, those in the medical community must be candid about relations with the pharmaceutical industry and transparent in their financial interests. Further undertakings should focus not on the eradication of physician-pharmaceutical interaction, but instead on the education of physicians about industry marketing strategies and the delineation of boundaries of these interactions to benefit not the individual physician, but our patients. Copyright © 2012. Published by Elsevier Inc.

Introduction to the article collection 'Translation in healthcare: ethical, legal, and social implications'.

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Morrison, Michael; Dickenson, Donna; Lee, Sandra Soo-Jin

2016-11-14

New technologies are transforming and reconfiguring the boundaries between patients, research participants and consumers, between research and clinical practice, and between public and private domains. From personalised medicine to big data and social media, these platforms facilitate new kinds of interactions, challenge longstanding understandings of privacy and consent, and raise fundamental questions about how the translational patient pathway should be organised.This editorial introduces the cross-journal article collection "Translation in healthcare: ethical, legal, and social implications", briefly outlining the genesis of the collection in the 2015 Translation in healthcare conference in Oxford, UK and providing an introduction to the contemporary ethical challenges of translational research in biology and medicine accompanied by a summary of the papers included in this collection.

Smoking prevalence, knowledge and attitudes among primary healthcare professionals: a study from Jordan.

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Alkhatatbeh, M J; Alefan, Q; Alzghool, M

2017-02-01

This was a questionnaire-based cross-sectional study of 400 healthcare professionals recruited from primary healthcare centres in northern Jordan between April and October 2015. The questionnaire included questions about smoking behaviour, risks, opinions and providing anti-smoking counselling. More than 80% of participants reported that smoking-free policies were not enforced at primary healthcare centres. Compared to hospitals and the general population, smoking was less prevalent among primary healthcare professionals and more prevalent in men. More than 90% of participants believed that smoking was dangerous and associated with cardiovascular and respiratory diseases. Around 92% believed that they should set a good example to patients by not smoking and advise them about smoking cessation. Only 15.3% of participants felt well prepared when counselling patients about smoking and 92.8% believed that they needed training. This study suggests that primary healthcare professionals should act as anti-smoking role models after receiving professional training.

Occupational therapy, professional development and ethics

DEFF Research Database (Denmark)

Dige, Morten

2009-01-01

The article's aim is to reflect on and contribute to developing occupational therapy as a profession. I propose an ethical interpretation of health and helping professions in general and occupational therapy in particular. According to this ethical interpretation, the essential function and mission...... principles and guidelines; it contributes to building up and preserving a shared professional identity; it puts emphasis on a client-centred perspective on professional work; and it provides a constructive framework for inter-professional co-operation....

Ethical, legal, and social issues in the translation of genomics into health care.

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Badzek, Laurie; Henaghan, Mark; Turner, Martha; Monsen, Rita

2013-03-01

The rapid continuous feed of new information from scientific discoveries related to the human genome makes translation and incorporation of information into the clinical setting difficult and creates ethical, legal, and social challenges for providers. This article overviews some of the legal and ethical foundations that guide our response to current complex issues in health care associated with the impact of scientific discoveries related to the human genome. Overlapping ethical, legal, and social implications impact nurses and other healthcare professionals as they seek to identify and translate into practice important information related to new genomic scientific knowledge. Ethical and legal foundations such as professional codes, human dignity, and human rights provide the framework for understanding highly complex genomic issues. Ethical, legal, and social concerns of the health provider in the translation of genomic knowledge into practice including minimizing harms, maximizing benefits, transparency, confidentiality, and informed consent are described. Additionally, nursing professional competencies related to ethical, legal, and social issues in the translation of genomics into health care are discussed. Ethical, legal, and social considerations in new genomic discovery necessitate that healthcare professionals have knowledge and competence to respond to complex genomic issues and provide appropriate information and care to patients, families, and communities. Understanding the ethical, legal, and social issues in the translation of genomic information into practice is essential to provide patients, families, and communities with competent, safe, effective health care. © 2013 Sigma Theta Tau International.

Health professional networks as a vector for improving healthcare quality and safety: a systematic review.

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Cunningham, Frances C; Ranmuthugala, Geetha; Plumb, Jennifer; Georgiou, Andrew; Westbrook, Johanna I; Braithwaite, Jeffrey

2012-03-01

While there is a considerable corpus of theoretical and empirical literature on networks within and outside of the health sector, multiple research questions are yet to be answered. To conduct a systematic review of studies of professionals' network structures, identifying factors associated with network effectiveness and sustainability, particularly in relation to quality of care and patient safety. The authors searched MEDLINE, CINAHL, EMBASE, Web of Science and Business Source Premier from January 1995 to December 2009. A majority of the 26 unique studies identified used social network analysis to examine structural relationships in networks: structural relationships within and between networks, health professionals and their social context, health collaboratives and partnerships, and knowledge sharing networks. Key aspects of networks explored were administrative and clinical exchanges, network performance, integration, stability and influences on the quality of healthcare. More recent studies show that cohesive and collaborative health professional networks can facilitate the coordination of care and contribute to improving quality and safety of care. Structural network vulnerabilities include cliques, professional and gender homophily, and over-reliance on central agencies or individuals. Effective professional networks employ natural structural network features (eg, bridges, brokers, density, centrality, degrees of separation, social capital, trust) in producing collaboratively oriented healthcare. This requires efficient transmission of information and social and professional interaction within and across networks. For those using networks to improve care, recurring success factors are understanding your network's characteristics, attending to its functioning and investing time in facilitating its improvement. Despite this, there is no guarantee that time spent on networks will necessarily improve patient care.

[Is a strategy of bio-socio-ethic necessary?].

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Alonso Trujillo, Federico; López Medel, Raquel; Asensio Fernández, Inmaculada; Pinzón Pulido, Sandra; González Montero, M Carmen

2016-01-01

The aim of this paper is to assess the need for a common ethics strategy shared by 2 of the cornerstones of human welfare: the healthcare and social services sectors. An observational cross-sectional descriptive study was performed by surveying social services and healthcare professionals. A purposive sampling technique was used. The questionnaire consisted of 10 questions about ethical conflicts in professional practice and respondents' views on a proposed shared approach to bioethics and ethics in social intervention. 124 professionals completed the questionnaire, 56% of the health sector and 44% of the social services sector. About 90% professionals surveyed had had to make difficult ethical decisions in their work and would welcome a common approach to ethics in the social services and healthcare sectors. 75% said that conflicts are occurring more frequently in both sectors simultaneously and that they were resolved preferably individually and independently. The survey respondents believe that a common approach to tackling ethical conflicts in professional practice is required. Nevertheless, it is still rare for ethics committees to intervene in the conflict resolution process and for decision-making support and evaluation tools to be used. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

[Healthcare Provider Professional Secrecy: an Issue for Public Health Democracy somewhere between Immanence and Alienation.

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Pautier, Silvère

2017-09-01

For a long time considered as total and absolute, healthcare professional secrecy is today difficult to reconcile with care practices. Lots of paradoxes question its preservation in favour of general interest and public order against the protection of private interest within an individualistic normative society. Exploring this interrogation, the article's objective is to initiate an ethical discussion from a professional caregiver secrecy's historical and sociological evolution perspective. Thus, with the help of theoretical understandings, especially those by Michel Foucault, medical secrecy is considered a defense of rationality specific to populations' government. This conceptualization finds arguments through social collective norms attached to an alienating biopower at the expense of secrecy integrated as an individualistic and immanent social norm. However, beyond the well-known debate on the absolute necessity for change, evolution… the distance from the Socratic and Hippocratic principles engage people and society in real democratic decisions about Health. Also, health professionals, patients, usgers and society must consider the limits that would lead to medical confidentiality.

A blended-learning programme regarding professional ethics in physiotherapy students.

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Aguilar-Rodríguez, Marta; Marques-Sule, Elena; Serra-Añó, Pilar; Espí-López, Gemma Victoria; Dueñas-Moscardó, Lirios; Pérez-Alenda, Sofía

2018-01-01

In the university context, assessing students' attitude, knowledge and opinions when applying an innovative methodological approach to teach professional ethics becomes fundamental to know if the used approach is enough motivating for students. To assess the effect of a blended-learning model, based on professional ethics and related to clinical practices, on physiotherapy students' attitude, knowledge and opinions towards learning professional ethics. Research design and participants: A simple-blind clinical trial was performed (NLM identifier NCT03241693) (control group, n = 64; experimental group, n = 65). Both groups followed clinical practices for 8 months. Control group performed a public exposition of a clinical case about professional ethics. By contrast, an 8-month blended-learning programme regarding professional ethics was worked out for experimental group. An online syllabus and online activities were elaborated, while face-to-face active participation techniques were performed to discuss ethical issues. Students' attitudes, knowledge and opinions towards learning professional ethics were assessed. Ethical considerations: The study was approved by the University Ethic Committee of Human Research and followed the ethical principles according to the Declaration of Helsinki. After the programme, attitudes and knowledge towards learning professional ethics of experimental group students significantly improved, while no differences were observed in control group. Moreover, opinions reported an adequate extension of themes and temporization, importance of clinical practices and interest of topics. Case study method and role playing were considered as the most helpful techniques. The blended-learning programme proposed, based on professional ethics and related to clinical practices, improves physiotherapy students' attitudes, knowledge and opinions towards learning professional ethics.

Discourses of healthcare professionals about health surveillance actions for Tuberculosis control

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Fernando Mitano

Full Text Available Abstract OBJECTIVE To analyze the meanings produced in the Health Surveillance actions for tuberculosis control, carried out by healthcare professionals in Mozambique. METHOD Qualitative study using the theoretical and methodological framework of the French Discourse Analysis. RESULTS A total of 15 healthcare professionals with more than one year of experience in disease control actions participated in the study. Four discursive blocks have emerged from the analysis: tuberculosis diagnosis process; meeting, communication and discussion of treatment; local strategies for tuberculosis control; involvement of family and community leaders in the tuberculosis control. CONCLUSION The statements of the healthcare professionals suggest, as Health Surveillance actions, practices that include collecting sputum in the patient's home and sending it to the laboratory; deployment of the medical team with a microscope for tuberculosis testing; and testing for diseases that may be associated with tuberculosis. In this context, the actions of Health Surveillance for tuberculosis control involve valuing all actors: family, community leaders, patients and health professionals.

Shared communication processes within healthcare teams for rare diseases and their influence on healthcare professionals' innovative behavior and patient satisfaction

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Budych Karolina

2011-04-01

Full Text Available Abstract Background A rare disease is a pattern of symptoms that afflicts less than five in 10,000 patients. However, as about 6,000 different rare disease patterns exist, they still have significant epidemiological relevance. We focus on rare diseases that affect multiple organs and thus demand that multidisciplinary healthcare professionals (HCPs work together. In this context, standardized healthcare processes and concepts are mainly lacking, and a deficit of knowledge induces uncertainty and ambiguity. As such, individualized solutions for each patient are needed. This necessitates an intensive level of innovative individual behavior and thus, adequate idea generation. The final implementation of new healthcare concepts requires the integration of the expertise of all healthcare team members, including that of the patients. Therefore, knowledge sharing between HCPs and shared decision making between HCPs and patients are important. The objective of this study is to assess the contribution of shared communication and decision-making processes in patient-centered healthcare teams to the generation of innovative concepts and consequently to improvements in patient satisfaction. Methods A theoretical framework covering interaction processes and explorative outcomes, and using patient satisfaction as a measure for operational performance, was developed based on healthcare management, innovation, and social science literature. This theoretical framework forms the basis for a three-phase, mixed-method study. Exploratory phase I will first involve collecting qualitative data to detect central interaction barriers within healthcare teams. The results are related back to theory, and testable hypotheses will be derived. Phase II then comprises the testing of hypotheses through a quantitative survey of patients and their HCPs in six different rare disease patterns. For each of the six diseases, the sample should comprise an average of 30 patients with

The "ACA Code of Ethics": Articulating Counseling's Professional Covenant

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Ponton, Richard F.; Duba, Jill D.

2009-01-01

The "ACA Code of Ethics" (American Counseling Association, 2005) is an articulation of the ever-changing relationship between counseling professionals and society. It provides clear parameters of behaviors to meet the changing needs of the people counselors are called to serve. This article reviews the 2005 "Code" as both a statement of counselor…

The use of electronic devices for communication with colleagues and other healthcare professionals - nursing professionals' perspectives.

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Koivunen, Marita; Niemi, Anne; Hupli, Maija

2015-03-01

The aim of the study is to describe nursing professionals' experiences of the use of electronic devices for communication with colleagues and other healthcare professionals. Information and communication technology applications in health care are rapidly expanding, thanks to the fast-growing penetration of the Internet and mobile technology. Communication between professionals in health care is essential for patient safety and quality of care. Implementing new methods for communication among healthcare professionals is important. A cross-sectional survey was used in the study. The data were collected in spring 2012 using an electronic questionnaire with structured and open-ended questions. The target group comprised the nursing professionals (N = 567, n = 123) in one healthcare district who worked in outpatient clinics in publically funded health care in Finland. Nursing professionals use different electronic devices for communication with each other. The most often used method was email, while the least used methods were question-answer programmes and synchronous communication channels on the Internet. Communication using electronic devices was used for practical nursing, improving personnel competences, organizing daily operations and administrative tasks. Electronic devices may speed up the management of patient data, improve staff cooperation and competence and make more effective use of working time. The obstacles were concern about information security, lack of technical skills, unworkable technology and decreasing social interaction. According to our findings, despite the obstacles related to use of information technology, the use of electronic devices to support communication among healthcare professionals appears to be useful. © 2014 John Wiley & Sons Ltd.

Will Nursing Continue as the Most Trusted Profession? An Ethical Overview.

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Milton, Constance L

2018-01-01

Trust-mistrust is a paradoxical rhythm found in all healthcare disciplines. The discipline of nursing has traditionally been regarded as the most trusted. What are the ethical obligations for professional nurses in establishing community relationships of trust according to societal needs and desires? Specifically, the author seeks to conceptualize and discern potential implications for fiduciary trust and the future of nursing as a healthcare discipline.

Relationship between the Physical Properties and Hand of Jean Fabric

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Kawamura Atsushi

2016-09-01

Full Text Available We investigated the distinctive characteristics of jean fabrics (denim fabrics obtained from jeans and compared the physical properties and the hand. We used 13 kinds of jean fabric from commercial jeans and 26 other fabric types. The physical properties were measured using the Kawabata evaluation system, and the fabric hand was evaluated by 20 subjects using a semantic differential method. To characterise the hand of jean fabrics compared with other fabrics, we used principal component analysis and obtained three principal components. We found that jean fabrics were characterised by the second principal component, which was affected by feelings of thickness and weight. We further characterised the jean fabrics according to ‘softness & smoothness’ and ‘non-fullness’, depending on country of origin and type of manufacturer. The three principal components were analysed using multiple linear regression to characterise the components according to the physical properties. We explained the hand of fabrics including jean fabrics using its association with physical properties.

Healthcare professionals' self-reported experiences and preferences related to direct healthcare professional communications: a survey conducted in the Netherlands.

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Piening, Sigrid; Haaijer-Ruskamp, Flora M; de Graeff, Pieter A; Straus, Sabine M J M; Mol, Peter G M

2012-11-01

In Europe, Direct Healthcare Professional Communications (DHPCs) are important tools to inform healthcare professionals of serious, new drug safety issues. However, this tool has not always been successful in effectively communicating the desired actions to healthcare professionals. The aim of this study was to explore healthcare providers' experiences and their preferences for improvement of risk communication, comparing views of general practitioners (GPs), internists, community pharmacists and hospital pharmacists. A questionnaire was developed and pilot tested to assess experiences and preferences of Dutch healthcare professionals with DHPCs. The questionnaire and two reminders were sent to a random sample of 3488 GPs, internists and community and hospital pharmacists in the Netherlands. Descriptive statistics were used to describe demographic characteristics of the respondents. Chi squares, ANOVAs and the Wilcoxon signed rank test were used, when appropriate, to compare healthcare professional groups. The overall response rate was 34% (N = 1141, ranging from 24% for internists to 46% for community pharmacists). Healthcare providers trusted safety information more when provided by the Dutch Medicines Evaluation Board (MEB) than by the pharmaceutical industry. This was more the case for GPs than for the other healthcare professionals. Respondents preferred safety information to be issued by the MEB, the Dutch Pharmacovigilance Center or their own professional associations. The preferred alternative channels of drug safety information were e-mail, medical journals and electronic prescribing systems. Safety information of drugs does not always reach healthcare professionals through DHPCs. To improve current risk communication of drug safety issues, alternative and/or additional methods of risk communication should be developed using electronic methods and medical journals. Moreover, (additional) risk communication coming from an independent source such as the

THE RELATIONSHIP BETWEEN PEDAGOGICAL FORMATION TRAINING CERTIFICATE PROGRAM PROSPECTIVE TEACHERS' CRITICAL THINKING ATTITUDES AND THEIR PERCEPTIONS ON PROFESSIONAL ETHICAL PRINCIPLES

OpenAIRE

Birsel Aybek; Serkan Aslan

2017-01-01

This research aims to analyze the relationship between pedagogical formation training certificate program prospective teachers’ critical thinking attitudes and their perceptions on professional ethical principles. The study used relational screening model and convenience sampling method which is one of the purposeful sampling methods. The participants consisted of 393 prospective teachers from different majors such as mathematics, physics, chemistry, health, biology, philosophy, religious cul...

Medication practice and feminist thought: a theoretical and ethical response to adherence in HIV/AIDS.

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Broyles, Lauren M; Colbert, Alison M; Erlen, Judith A

2005-08-01

Accurate self-administration of antiretroviral medication therapy for HIV/AIDS is a significant clinical and ethical concern because of its implications for individual morbidity and mortality, the health of the public, and escalating healthcare costs. However, the traditional construction of patient medication adherence is oversimplified, myopic, and ethically problematic. Adherence relies on existing social power structures and western normative assumptions about the proper roles of patients and providers, and principally focuses on patient variables, obscuring the powerful socioeconomic and institutional influences on behaviour. Some professionals advocate for alternate approaches to adherence, but many of the available alternatives remain conceptually underdeveloped. Using HIV/AIDS as an exemplar, this paper presents medication practice as a theoretical reconstruction and explicates its conceptual and ethical evolution. We first propose that one of these alternatives, medication practice, broadens the understanding of individuals' medication-taking behaviour, speaks to the inherent power inequities in the patient-provider interaction, and addresses the ethical shortcomings in the traditional construal. We then integrate medication practice with feminist thought, further validating individuals' situated knowledge, choices, and multiple roles; more fully recognizing the individual as a multidiminsional, autonomous human being; and reducing notions of obedience and deference to authority. Blame is thus extricated from the healthcare relationship, reshaping the traditionally adversarial components of the interaction, and eliminating the view of adherence as a patient problem in need of patient-centred interventions.

Everyday ethics: ethical issues and stress in nursing practice.

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Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

Respecting patient autonomy versus protecting the patient's health: a dilemma for healthcare providers.

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Badger, James M; Ladd, Rosalind Ekman; Adler, Paul

2009-01-01

A 74-year-old man with multiple chronic medical problems was hospitalized for respiratory distress. He experienced recurrent aspiration and required frequent suctioning and endotracheal intubation on several occasions. The patient was deemed competent and steadfastly refused feeding tube placement. The patient demanded that he be allowed to eat a normal diet despite being told that it could lead to his death. The patient wanted to go home, but there was no one there to care for him. Additionally, neither a nursing home nor hospice would accept him in his present condition. The case is especially interesting because of the symbolic value of food and the plight of the patient who has no alternative to hospitalization. The hospital staff experienced considerable stress at having to care for him. They were uncertain whether their obligation was to respect his autonomy and continue to provide food or to protect his health by avoiding aspiration, pneumonia, and possible death by denying him food. This ethical dilemma posed by the professionals' duty to do what is in the patient's best interest versus the patient's right to decide treatment serves as the focus for this case study. Ethical, legal, and healthcare practitioners' considerations are explored. The case study concludes with specific recommendations for treatment.

Use of a Nationwide Personally Controlled Electronic Health Record by Healthcare Professionals and Patients: A Case Study with the French DMP.

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Seroussi, Brigitte; Bouaud, Jacques

2017-01-01

If the wide adoption of electronic health records (EHRs) is necessary to address health information sharing and care coordination issues, it is not sufficient. In order to address health information sharing, some countries, among which, France, have implemented a centralized framework with "new" nationwide care records. The French DMP is a centralized, nationally shared, electronic medical record, created according to the opt-in model. More than five years after the launching of the DMP project, DMPs have been created for 1.5% of the target population, which demonstrates the poor adoption of the tool by healthcare professionals. Among the 583,997 existing DMPs in June 2016, 41% were empty, and 24% of non-empty DMPs were actually accessed. If these "active" DMPs were equally accessed by both healthcare professionals and patients, patients accessed DMP documents four times more than healthcare professionals.

Ethical and professional standards compliance among practicing ...

African Journals Online (AJOL)

This study investigated ethical and professional standards compliance among practicing librariansin university libraries in Benue State. The purpose of the study was todetermine the extent to which librarians in university libraries comply with ethics and professional standards in librarianship. The study adopted a descriptive ...

Psycho-cognitive predictors of burnout in healthcare professionals working in emergency departments.

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Masiero, Marianna; Cutica, Ilaria; Russo, Selena; Mazzocco, Ketti; Pravettoni, Gabriella

2018-07-01

Healthcare professionals working in emergency departments commonly experience high work pressure and stress due to witnessing human suffering and the unpredictable nature of the work. Several studies have identified variables that affect burnout syndrome, but poor data are available about the predictors of the different dimensions of burnout (depersonalisation, emotional exhaustion, professional inefficacy and disillusionment). Some research has suggested that alexithymia, coping style and decision-making style may predict burnout. We conducted a noninterventional study to investigate whether and how alexithymia, coping style and decision-making style are associated with the different dimensions of burnout. We recruited a convenience sample of 93 healthcare professionals working in an Italian emergency departments. Participants completed a questionnaire assessing their level of burnout (the Link Burnout Questionnaire), and possible burnout predictors: decision-making style, alexithymia and the coping style. Four bivariate linear regressions were performed to define the predictors that characterised the dimensions of burnout. We found that an avoidant decision-making style and a difficulty to identify and describe feelings (a difficulty close to alexithymia even though not as severe) are strong predictors of some burnout dimensions. Individuals who experience relational depersonalisation are more likely to turn to religion as a way to cope. Our research shows that, to some extent, difficulties in emotion regulation and the attitude to avoid or postpone decisions characterised burnout. These results might be used to develop tailored psycho-educational interventions. This might help healthcare professionals to develop personal skills to cope with the critical conditions that characterise their work and to enable them to recognise potential risk factors that favour burnout. This has pivotal implications for the maintenance of the patient-healthcare professional

ECONOMIC ETHICS: APPLIED AND PROFESSIONAL CHARACTER

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Ella Gordova

2012-01-01

Full Text Available In given article economic ethics are considered as set of norms of behavior of the businessman, the requirements shown by a cultural society to its style of work, to character of dialogue between participants of business, to their social shape. The conclusion becomes that economic ethics have applied character in relation to theoretical, to obschenormativnoy ethics, hence, represent section of applied ethics. On the other hand, the specific standard maintenance characterizes economic ethics as ethics professional.

Cultural diversity training for UK healthcare professionals: a comprehensive nationwide cross-sectional survey.

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Bentley, Paul; Jovanovic, Ana; Sharma, Pankaj

2008-10-01

Healthcare inequalities within the UK based on patients' ethnicity have been found over the last five years in a large number of medical specialties. One possible explanation for this lies in ignorance of ethnic minority healthcare needs among professionals. Cultural diversity programmes have been shown to improve patient outcomes including compliance, yet these are not as yet requirements for any UK healthcare professionals with the exception of psychiatrists. This paper documents the frequency, regional variation, characteristics and motivations for cultural diversity training through a questionnaire survey of the educational leads of every UK medical school, postgraduate deanery and schools of nursing, physiotherapy, occupational therapy, speech and language therapy, and pharmacy. The results showed a wide variation in teaching practices between healthcare professions and geographical regions. This study provides evidence for the need for national guidelines to incorporate cultural competency training by all UK healthcare professional training bodies.

Business Entity Selection: Why It Matters to Healthcare Practitioners. Part II--Corporations, Limited Liability Companies, and Professional Entities.

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Nithman, Robert W

2015-01-01

The Bureau of Labor statistics indicates only a 50% four-year survivability rate among businesses classified as "education and health services." Gaining knowledge of IRS business entities can result in cost savings, operational efficiency, reduced liability, and enhanced sustainability. Each entity has unique disadvantages, depending on size, diversity of ownership, desire to expand, and profitability. Business structures should be compatible with organizational mission or vision statements, services and products, and professional codes of ethics. Healthcare reform will require greater business acumen. We have an ethical duty to disseminate and acquire the knowledge to properly establish and manage healthcare practices to ensure sustainable services that protect and serve the community.