A Social Recognition Approach to Autonomy: The Role of Equality-Based Respect.

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Renger, Daniela; Renger, Sophus; Miché, Marcel; Simon, Bernd

2017-04-01

Inspired by philosophical reasoning about the connection between equality and freedom, we examined whether experiences of (equality-based) respect increase perceived autonomy. This link was tested with generalized experiences of respect and autonomy people make in their daily lives (Study 1) and with more specific experiences of employees at the workplace (Study 2). In both studies, respect strongly and independently contributed to perceived autonomy over and above other forms of social recognition (need-based care and achievement-based social esteem) and further affected (life/work) satisfaction. Study 3 experimentally confirmed the hypothesized causal influence of respect on perceived autonomy and demonstrated that this effect further translates into social cooperation. The respect-cooperation link was simultaneously mediated by perceived autonomy and superordinate collective identification. We discuss how the recognition approach, which differentiates between respect, care, and social esteem, can enrich research on autonomy.

Dependence and a Kantian conception of dignity as a value.

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Byers, Philippa

2016-02-01

Kantian moral concepts concerning respect for human dignity have played a central role in articulating ethical guidelines for medical practice and research, and for articulating some central positions within bioethical debates more generally. The most common of these Kantian moral concepts is the obligation to respect the dignity of patients and of human research subjects as autonomous, self-determining individuals. This article describes Kant's conceptual distinction between dignity and autonomy as values, and draws on the work of several contemporary Kantian philosophers who employ the distinction to make sense of some common moral intuitions, feelings, and norms. Drawing on this work, the article argues that the conceptual distinction between dignity and autonomy as values is indispensable in the context of considering our obligations to those who are dependent and vulnerable.

“Can’t you at least die with a little dignity?” The Right to Die Debates and Normative Dignity

Directory of Open Access Journals (Sweden)

Gandsman, Ari

2014-08-01

Full Text Available In recent decades, the right to die has emerged as one of the most divisive social and political questions in North America and Europe, one that involves the mobilization of numerous social actors and activists as well as several legal challenges. In Québec, the provincial legislature formed the “Select Committee on Dying with Dignity”, a group of legislators tasked with examining the issue. In their 2012 report, they recommend the legalization of “medical aid in dying” as an appropriate part of the continuum of care at the end of life. From a meta-analysis of the written and oral submissions collected by the Committee in different locations throughout the province, this article presents several competing meanings of what human dignity means at the end of life. Intrinsic definitions of dignity – whether religious or philosophical – often associate dignity with an acceptance of death. These definitions of dignity compete with more relative and contingent understandings of dignity. In such a view, dignity depends on the physical or mental condition of the individual. Here “dying with dignity” means dying without undue suffering or loss of autonomy. Whether “dying with dignity” is defined as having a peaceful or meaningful death or alternatively as an end-of-life without undue suffering or loss of autonomy, these normative calls all take for granted that human beings want to die with dignity. This article analyzes the multiple meanings of dignity in the right to die debate while challenging the assumption that a “good death” is necessary synonymous with “dying with dignity.”

An undignified side of death with dignity legislation.

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Plaisted, Dennis

2013-09-01

The primary justification for Death with Dignity legislation has been the principle of respect for autonomy. However, some have objected that if respect for autonomy is the reason for allowing physician-assisted suicide, then why not allow it for people with longer than six months to live? Defenders of the laws have responded that respect for autonomy must be balanced against the state's interest in the lives of its citizens. Persons with less than six months remaining have virtually no life left to protect; persons with more time have a meaningfully long segment of life remaining. The state can therefore overrule their autonomy interests to preserve their lives. This paper will argue that this response constitutes an ironic affront to the dignity of people with less than six months to live, for it implies that their lives are not worth enough for the state to prevent them from committing physician-assisted suicide.

Death with dignity from the Confucian perspective.

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Li, Yaming; Li, Jianhui

2017-02-01

Death with dignity is a significant issue in modern bioethics. In modern healthcare, the wide use of new technologies at the end of life has caused heated debate on how to protect human dignity. The key point of contention lies in the different understandings of human dignity and the dignity of death. Human dignity has never been a clear concept in Western ethical explorations, and the dignity of death has given rise to more confusions. Although there is no such term as "dignity" in Confucian ethics, there are discussions of a number of ideas related to human dignity and the dignity of death. Therefore, Confucian bioethics can offer a new perspective for understanding the theoretical difficulties associated with the dignity of death and new methods for solving them. In this article, we attempt to reconstruct Confucian views on human dignity and the dignity of death and, based on those views, to analyze the following issues: the relationship between the dignity of death and biological life, the relationship between the dignity of death and suffering, the relationship between the dignity of death and the autonomy of human beings, and the relationship between the dignity of death and social justice. This article will also compare the Confucian views on these issues with the views of Western philosophers. Confucian ethics can offer distinct answers to the above issues and help resolve some confusions concerning concepts and theories in Western research on the dignity of death.

Anagogy of autonomy.

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Boyd, A L

2000-07-01

The philosophical and ethical concept of autonomy is herein examined, ex post facto, using an existential lens to examine the process of a personal friend's dying. Anagogy, defined as interpretation of a word, passage, or text that finds beyond the literal, allegorical, and moral senses a fourth and ultimate spiritual or mystical sense, is intended to enlarge the understanding of the use of autonomy in this case. The idea of personhood linked inextricably to reason is, therefore, understood as empowering an individual to choose among various actions, to define and redefine life goals, and to give priority to selected values and moral tenants, which reveal a moral hermeneutic. Conditions and circumstances, existentially exposed, limit choice in unexpected ways, such that the predicted value of autonomy is vulnerable to misuse or misunderstanding. The intent to respect the dignity of every person is central to the philosophy of Respect for Persons ethics, and assumes that autonomy, as freedom of the moral agent, is a moral duty. Implicit reality of freedom is, in a practical sense, essential to being rational agents who can thereby exercise informed choice. The moral law, law of freedom, involves the autonomy of the will and an ultimate end to which all action is directed. Defined as the highest good, morality unites virtue and happiness by ascribing the ultimate end sought as God. The freedom to use rational will finds principles within its own rational nature. The ability to create maxims is autonomy of the will, which equates with the dignity of persons. My recent experience as a companion to a personal friend with a terminal illness inspired me to re-evaluate the concept of autonomy as it is too often interpreted in modern ethical discourse as a individualistic right of choice as opposed to the hermeneutic of dignity of person. This paper describes a shift of position in understanding the paradox of autonomy in this existential context.

Promoting Dignity: The Ethical Dimension of Health.

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Buchanan, David R

2016-01-01

The article examines the limitations of a strict scientific account of the causes of unhealthy behaviors, based on the standards promoted in evidence-based medicine, where randomized controlled trials are seen to provide the gold standard for establishing the validity of different explanations. The article critiques this account based on its disputed assumption that human free will does not exist, and thus, human autonomy and moral responsibility are an illusion. By denying human autonomy, the naturalistic paradigm also denies the possibility of human dignity. In contrast, the article describes and explains a humanistic account of human agency where human beings are characterized by the capacity to choose how to live their lives based on values that matter. Based on this humanistic framework, the article explains why dignity is an essential dimension of human health and well-being and describes key research challenges in moving the field of health promotion in a more humanistic direction. The article concludes with the recommendation to expand the goal of health promotion beyond physical fitness and to reorient the methods of research toward articulating values that matter and promoting human dignity. © The Author(s) 2016.

Does organ selling violate human dignity?

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Alpinar-Şencan, Zümrüt; Baumann, Holger; Biller-Andorno, Nikola

2017-11-01

Shortages in the number of donated organs after death and the growing number of end-stage organ failure patients on waiting lists call for looking at alternatives to increase the number of organs that could be used for transplantation purposes. One option that has led to a legal and ethical debate is to have regulated markets in human organs. Opponents of a market in human organs offer different arguments that are mostly founded on contingent factors that can be adjusted. However, some authors have asked the question whether we still have a reason to believe that there is something wrong with offering human organs for sale for transplantation purposes, even if the circumstances under which the practice takes place are improved. One prominent argument regarding this appeals to the notion of human dignity. It is argued that organ selling violates human dignity. This paper presents a systematic discussion of dignity-based arguments in the organ selling debate, and then develops a social account of dignity. It is argued that allowing the practice of organ selling inherently runs the risk of promoting the notion that some persons have less worth than others and that persons have a price, which is incompatible with dignity. The approach is defended against possible objections and it is shown that it can capture the notion that autonomy is linked to human dignity in important ways, while dignity at the same time can constrain the autonomous choices of persons with regards to certain practices.

["Dignity" at the end of life: ethical and deontologic reflections].

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Mazzon, Davide

2015-12-01

Bioethical reflection is often raised to qualify medical treatment in relation to the concept of "dignity" of the human being. In philosophy, the concept of human dignity is used to refer to the intrinsic value of every human being but it has been framed in many different ways depending on the theoretical matrix we refer to. According to Christian principles, the dignity of human beings resides on their being created in the image and likeness of God: hence, the holiness of life for the believer and the condemnation of all means of action intended to anticipate death from suicide to euthanasia. On the contrary, according to the liberal tradition, human dignity is especially expressed in the autonomy of every human being. The Italian and the German Constitutions recall the value of human dignity. In the article 32 of the Italian Constitution, the concept of dignity is taken into account when stating the autonomy of the individual decision-making about health treatment. This is confirmed by the Code of Medical Ethics (2014): the right to self-determination and the right of patients to decide for themselves in accordance with their own life plans, are at the core of the concept of "human dignity". For this reason, doctors should support and encourage the full right of every patient to be considered as an autonomous person until the end of life, affirming his dignity. The acronym ABCD (airway, breathing, circulation, drugs) synthetises the essentials of intensive care procedures in life-threatening events. The same acronym should guide our behavior in promoting dignity in clinical settings. Attitude: moving away from our certainties, to better understand the real nature of the sick person we are approaching. Behavior: always be inspired by kindness and respect. Compassion, that is, deep awareness of the suffering, coupled with the desire to bring relief. Dialogue, being open to know the human being "behind" disease. This approach, developed by Chochinov and called

Dying with dignity: the good patient versus the good death.

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Proulx, Kathryn; Jacelon, Cynthia

2004-01-01

Death is a unique experience for each human being, yet there is tremendous societal pressure on a dying person to be a "goodpatient " while trying to experience the "good death. " These pressures shape patient, caregiver, and family choices in end-of-life situations. The purpose of this literature review was twofold: first, to develop an understanding of "dying with dignity" to enhance the end-of-life care received by dying patients, and second, to contribute to a concept analysis of dignity to improve the clarity and consistency of future research related to dignity in aging individuals. Articles pertaining to dying with dignity from the disciplines of nursing, medicine, ethics, psychology, and sociology were reviewed using a matrix method. A dichotomy surrounding dying with dignity emerged from this review. The definition of dignity in dying identifies not only an intrinsic, unconditional quality of human worth, but also the external qualities of physical comfort, autonomy, meaningfulness, usefulness, preparedness, and interpersonal connection. For many elderly individuals, death is a process, rather than a moment in time, resting on a need for balance between the technology of science and the transcendence of spirituality.

The core meaning of human dignity | Steinmann | Potchefstroom ...

African Journals Online (AJOL)

It is widely accepted that these elements root in Kantian moral ethics which holds that man's autonomy is based upon universal dignity, as a result of which man should never be used as a means to an end, but only as a means in himself. Kant expressed this idea through formulation of a categorical imperative, namely that ...

Dignity realization of patients with stroke in hospital care: A grounded theory.

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Rannikko, Sunna; Stolt, Minna; Suhonen, Riitta; Leino-Kilpi, Helena

2017-01-01

Dignity is seen as an important but complex concept in the healthcare context. In this context, the discussion of dignity includes concepts of other ethical principles such as autonomy and privacy. Patients consider dignity to cover individuality, patient's feelings, communication, and the behavior of healthcare personnel. However, there is a lack of knowledge concerning the realization of patients' dignity in hospital care and the focus of the study is therefore on the realization of dignity of the vulnerable group of patients with stroke. The aim of the study was to create a theoretical construct to describe the dignity realization of patients with stroke in hospital care. Research design and participants: Patients with stroke (n = 16) were interviewed in 2015 using a semi-structured interview containing open questions concerning dignity. The data were analyzed using constant comparison of Grounded Theory. Ethical considerations: Ethical approval for the research was obtained from the Ethics Committee of the University. The permission for the research was given by the hospital. Informed consent was obtained from participants. The "Theory of Dignity Realization of Patients with Stroke in Hospital Care" consists of a core category including generic elements of the new situation and dignity realization types. The core category was identified as "Dignity in a new situation" and the generic elements as health history, life history, individuality and stroke. Dignity of patients with stroke is realized through specific types of realization: person-related dignity type, control-related dignity type, independence-related dignity type, social-related dignity type, and care-related dignity type. The theory has similar elements with the previous literature but the whole construct is new. The theory reveals possible special characteristics in dignity realization of patients with stroke. For healthcare personnel, the theory provides a frame for a better understanding and

Maintaining patients' dignity during clinical care: a qualitative interview study.

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Lin, Yea-Pyng; Tsai, Yun-Fang

2011-02-01

This article is a report of a study undertaken to understand how nurses maintain patients' dignity in clinical practice. Dignity is a core concept in nursing care and maintaining patients' dignity is critical to their recovery. In Western countries, measures to maintain dignity in patients' care include maintaining privacy of the body, providing spatial privacy, giving sufficient time, treating patients as a whole person and allowing patients to have autonomy. However, this is an under-studied topic in Asian countries. For this qualitative descriptive study, data were collected in Taiwan in 2009 using in-depth interviews with a purposive sample of 30 nurses from a teaching hospital in eastern Taiwan. The audiotaped interviews were transcribed verbatim and analysed using content analysis. Nurses' measures to maintain dignity in patient care were captured in five themes: respect, protecting privacy, emotional support, treating all patients alike and maintaining body image. Participants did not mention beneficence, a crucial element achieved through the professional care of nurses that can enhance the recovery of patients. In-service education to help nurses enhance dignity in patient care should emphasize emotional support, maintaining body image and treating all patients alike. Our model for maintaining dignity in patient care could be used to develop a clinical care protocol for nurses to use in clinical practice. © 2010 Blackwell Publishing Ltd.

Human dignity and bioethics

Directory of Open Access Journals (Sweden)

Marjanović Miloš

2013-01-01

Full Text Available By opening the field of bioethics followed a new wave of intense debate on the theological, philosophical and legal significance of the concept of human dignity . Exactly ten years ago (December 2003 American bioethicist Ruth Maclin has proposed to divest ourselves of the concept of human dignity because it is vague, useless and redundant and that, without any loss, we can replace it by the ethical principle of personal autonomy. Her article was followed by harsh reactions and opposite views. What is this term in so broad, almost inflationary and opposite use is not a reason to deprive him, but, on the contrary, it shows how important it is and that it should be determined at least outline. As universal values and general concept, the human dignity has no pre-defined and narrow, precise meaning. It is more an evaluation horizon, the guiding principle and regulatory ideas that must constantly define and codify by many guaranted human rights and fundamental freedoms. As generic notion of each reasonable law, it is their foundation and a common denominator, legitimising basis of natural but also of positive law. As intrinsic and static value which means the humaneness, the humanity it is absolute, inherent to every human being without distinction and conditioning, as a unique and unrepeatable creation. In this meaning, the dignity is the obligation and limitation of the state, society and each of us. As an ethical and dynamic category, it is not given to us, but it is assign to us, and it is not in us, but always before us, as a guide of our actions in accordance with virtues, to treat ourselves, each other and the nature in a human way. The century in which we live is named the century of molecular biology and genetic engineering because of the enormous potential but also risks to human dignity. Because of that human dignity has become a central principle in all international documents relating to the human genome, genetics and bioethics, adopted

Nurses' human dignity in education and practice: An integrated literature review.

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Parandeh, Akram; Khaghanizade, Morteza; Mohammadi, Eesa; Mokhtari-Nouri, Jamileh

2016-01-01

Human dignity, as a fundamental human right and a moral obligation, has been emphasized in different fields of nursing. The aim of the present integrative review was to explore the nature of nurses' human dignity in educational and clinical settings. A literature review was conducted on quantitative and qualitative research papers in English and Persian using the PubMed, ProQuest, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Google Scholar, SID, and Irandoc databases from the year 2000 to 2013. Keywords for the search included dignity, nursing, faculty, nurse clinicians, nursing student, and humanism. In total, 12 research papers met the inclusion criteria for the integrative review. From this review, four key themes emerged. The themes consisted of concept of human dignity (it was as an expression of the professional value in nursing settings), factors affecting human dignity (including respect, communication, autonomy and power, competency and ability, structure of the workplace, and value-based education), dimensions of human dignity (including intrinsic and professional domains), and consequences of human dignity [positive (individual and professional growth and caring professional behavior) and negative (loss of motivation, intention to leave the profession, and non-professional image of nursing in the minds of people)]. The small number of studies found for the review indicates the need for further research in the field of nurses' dignity. Recognizing nurses' dignity can help to improve the nursing practice and provide them a dignified workplace.

Nurses’ human dignity in education and practice: An integrated literature review

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Parandeh, Akram; Khaghanizade, Morteza; Mohammadi, Eesa; Mokhtari-Nouri, Jamileh

2016-01-01

Background: Human dignity, as a fundamental human right and a moral obligation, has been emphasized in different fields of nursing. The aim of the present integrative review was to explore the nature of nurses’ human dignity in educational and clinical settings. Materials and Methods: A literature review was conducted on quantitative and qualitative research papers in English and Persian using the PubMed, ProQuest, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Google Scholar, SID, and Irandoc databases from the year 2000 to 2013. Keywords for the search included dignity, nursing, faculty, nurse clinicians, nursing student, and humanism. In total, 12 research papers met the inclusion criteria for the integrative review. Results: From this review, four key themes emerged. The themes consisted of concept of human dignity (it was as an expression of the professional value in nursing settings), factors affecting human dignity (including respect, communication, autonomy and power, competency and ability, structure of the workplace, and value-based education), dimensions of human dignity (including intrinsic and professional domains), and consequences of human dignity [positive (individual and professional growth and caring professional behavior) and negative (loss of motivation, intention to leave the profession, and non-professional image of nursing in the minds of people)]. Conclusions: The small number of studies found for the review indicates the need for further research in the field of nurses’ dignity. Recognizing nurses’ dignity can help to improve the nursing practice and provide them a dignified workplace. PMID:26985216

Human dignity: intrinsic or relative value?

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Thiel, Marie-Jo

2010-09-01

Is human dignity an intrinsic value? Or is it a relative value, depending on the perception or assessment of quality of life? History had delineated some of its key features, but the advent of human rights and the Holocaust put special emphasis on this notion, particularly in the field of bioethics. But if modern medicine regards human dignity as crucial, it tends to support this notion while assessing and measuring it. The quality of life becomes the gauge for measuring human dignity, starting from a distinction between a viable and a non-viable existence, which may eventually lead to assisted death, or to letting die. This article argues that the concept of quality of life is of great relevant for medical practice, but on the condition of not being used as a standard to measure the dignity of the individual. Rather, the quality of life should be regarded as an imperative posed by human dignity, which is necessarily intrinsic. If the quality of life measures dignity, humankind is divided into two categories: lives worthy of living, and lives unworthy of living, and society becomes a jungle. Raising the quality of life as a requirement of the inherent human dignity does not solve automatically all problems and does not eliminate a feeling of unworthiness. But it ensures its 'human' value: the equal respect for every human being.

Human dignity and the profoundly disabled: a theological perspective.

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Matthews, Pia

2011-01-01

One challenge to the concept of human dignity is that it is a rootless notion invoked simply to mask inequalities that inevitably exist between human beings. This privileging of humans is speciesist and its weak point is the profoundly disabled human being. This article argues that far from being a weak point, the profoundly disabled person is a source of strength and witness to the intrinsic dignity that all human beings have by virtue of being human. The disabled represent the reality of human existence that is both strong and fragile. Although human dignity can be understood philosophically its depth is rooted in Christian theological insights. The profoundly disabled occupy a privileged position and share in a theology of mission since they testify to the interdependence of every human being and human dependence on God to a myopic world that only values strength, autonomy and independence.

Washing the patient: dignity and aesthetic values in nursing care

NARCIS (Netherlands)

Pols, J.

2013-01-01

Dignity is a fundamental concept, but its meaning is not clear. This paper attempts to clarify the term by analysing and reconnecting two meanings of dignity: humanitas and dignitas. Humanitas refers to citizen values that protect individuals as equal to one another. Dignitas refers to aesthetic

Washing the patient: dignity and aesthetic values in nursing care.

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Pols, Jeannette

2013-07-01

Dignity is a fundamental concept, but its meaning is not clear. This paper attempts to clarify the term by analysing and reconnecting two meanings of dignity: humanitas and dignitas. Humanitas refers to citizen values that protect individuals as equal to one another. Dignitas refers to aesthetic values embedded in genres of sociality that relate to differences between people. The paper explores these values by way of an empirical ethical analysis of practices of washing psychiatric patients in nursing care. Nurses legitimate the washing of reluctant patients with reference to dignity. The analysis shows the intertwinement of humanitas and dignitas that gives dignity its fundamental meaning. © 2013 John Wiley & Sons Ltd.

Frailty's Place in Ethics and Law: Some Thoughts on Equality and Autonomy and on Limits and Possibilities for Aging Citizens.

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McNally, Mary; Lahey, William

2015-01-01

Consideration of ethical and legal themes relating to frailty must engage with the concern that frailty is a pejorative concept that validates and reinforces the disadvantage and vulnerability of aging adults. In this chapter, we consider whether a greater focus on frailty may indeed be part of the solution to the disadvantages that aging adults face in achieving equality and maintaining their autonomy within systems that have used their frailty to deny them equality and autonomy. First, by examining equality both as an ethical norm and as a requirement for protections against discrimination, we raise questions about the grounds on which health providers and health systems can be required to give equal concern and respect to the needs of frail older persons. Second, we explore autonomy and identify the tension between meaningful self-determination and prevailing ethical and legal norms associated with informed choice. Third, we argue that a proper understanding of frailty is essential within both of these themes; it respects equality by enabling health providers and systems to identify and address the distinct care needs of aging adults and helps to align informed choice theory with appropriate processes for decision-making about those needs. 2015 S. Karger AG, Basel.

Dignity reevaluated: A theological examination of human dignity and the role of the Church in bioethics and end-of-life care.

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Genuis, Quentin I T

2016-02-01

Predominant among the terminological ambiguities that plague contemporary bioethics is confusion attending the meaning of the term "human dignity," particularly as it applies to so-called end-of-life discussions. This study surveys current trends in treatment of the concept of dignity, examining relevant thinkers who see dignity as redundant or as capability-dependent. These inadequate views are contrasted with an attitude, based theologically in Mark 5, that understands human dignity to represent an absolute characteristic that is donated graciously to all bearers of imago Dei . Human dignity must thus be affirmed as inviolable and independent of autonomy, rationality, or capability. A specific task of the Christian Church is to faithfully recognize and proclaim this dignity. This investigation is particularly relevant in the face of contemporary discussions regarding euthanasia and physician-assisted death. Lay Summary: Much of the polarization within the contemporary bioethical discussion proceeds out of confusion regarding how we ought to define the terms of the debate. If we may take the existing debates regarding euthanasia and physician-assisted death as an example, we may understand the vital need for a sensible definition of the term that stands at the heart of the arguments of both sides of the debate: "human dignity." As such, this study seeks to define dignity in a logical, theological, deeply personal, and highly practical fashion, and to outline the critical role of the Church within such an understanding. Sometimes, when I walk into the room, he ignores me. Sometimes he thinks I am someone else. Most often he is asleep, subjugated by drugs designed to prevent agitation, although "agitation" is the sterilized hospital word for what I would call unbridled panic, total disorientation. The night he had the stroke, they had to tie him to the bed just to keep him in the hospital. And they wouldn't let me see him because he had been calling my name. Very

Aruna Shanbaug and the right to die with dignity: the battle continues.

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Kishore, R R

2016-01-01

Aruna Shanbaug's protracted continuance in a persistent vegetative state (PVS) for nearly 42 years needs to be viewed seriously by all those who believe in a person's inalienable right to dignity in dying. A terminally ill and/or incapacitated individual is a helpless person confronted with perpetual risk of intrusion in to his autonomy by the moral paternalists, owing to false notion of human virtues. Legislative inadequacy coupled with judicial heterogeneity has exposed the decision making process to unwarranted ambiguity. Misapplication of moral and juristic principles is a global challenge. 29-year-old Brittany Maynard's recent act of ending her life by migrating from California to Oregon has ignited a fierce debate and nearly half of the states in the USA are contemplating enactment of death with dignity legislation. Across the Atlantic, the European Court of Human Rights judgment on June 5, 2015, endorsing Vincent Lambert's right to end medical support, is a resounding affirmation of an individual's right to die with dignity. This article is an attempt to explore various dimensions of one's right to dignity in dying, in the global as well as the Indian context.

In defense of the dignity of being human.

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Gaylin, W

1984-08-01

The concept of human dignity is examined in terms of the religious belief that man is created in God's image and from the Kantian viewpoint that man's autonomy gives special value to our species. The theory of psychic determinism and the prospect of genetic engineering of humans are seen as attacks on self determination. Five additional attributes that make humans "special" are explored: conceptual thought, the capacity for technology, our range of emotions, "Lamarckian" environmental genetics, and the freedom to change and modify ourselves.

Implementing a Death with Dignity program at a comprehensive cancer center.

Science.gov (United States)

Loggers, Elizabeth Trice; Starks, Helene; Shannon-Dudley, Moreen; Back, Anthony L; Appelbaum, Frederick R; Stewart, F Marc

2013-04-11

The majority of Death with Dignity participants in Washington State and Oregon have received a diagnosis of terminal cancer. As more states consider legislation regarding physician-assisted death, the experience of a comprehensive cancer center may be informative. We describe the implementation of a Death with Dignity program at Seattle Cancer Care Alliance, the site of care for the Fred Hutchinson-University of Washington Cancer Consortium, a comprehensive cancer center in Seattle that serves the Pacific Northwest. Institution-level data were compared with publicly available statewide data from Oregon and Washington. A total of 114 patients inquired about our Death with Dignity program between March 5, 2009, and December 31, 2011. Of these, 44 (38.6%) did not pursue the program, and 30 (26.3%) initiated the process but either elected not to continue or died before completion. Of the 40 participants who, after counseling and upon request, received a prescription for a lethal dose of secobarbital (35.1% of the 114 patients who inquired about the program), all died, 24 after medication ingestion (60% of those obtaining prescriptions). The participants at our center accounted for 15.7% of all participants in the Death with Dignity program in Washington (255 persons) and were typically white, male, and well educated. The most common reasons for participation were loss of autonomy (97.2%), inability to engage in enjoyable activities (88.9%), and loss of dignity (75.0%). Eleven participants lived for more than 6 months after prescription receipt. Qualitatively, patients and families were grateful to receive the lethal prescription, whether it was used or not. Overall, our Death with Dignity program has been well accepted by patients and clinicians.

Death with dignity

Science.gov (United States)

Allmark, P.

2002-01-01

The purpose of this article is to develop a conception of death with dignity and to examine whether it is vulnerable to the sort of criticisms that have been made of other conceptions. In this conception "death" is taken to apply to the process of dying; "dignity" is taken to be something that attaches to people because of their personal qualities. In particular, someone lives with dignity if they live well (in accordance with reason, as Aristotle would see it). It follows that health care professionals cannot confer on patients either dignity or death with dignity. They can, however, attempt to ensure that the patient dies without indignity. Indignities are affronts to human dignity, and include such things as serious pain and the exclusion of patients from involvement in decisions about their lives and deaths. This fairly modest conception of death with dignity avoids the traps of being overly subjective or of viewing the sick and helpless as "undignified". PMID:12161582

"A Lesson in Love": The Right to Autonomy of the Disabled

OpenAIRE

Fernanda Holanda Fernandes

2016-01-01

The International Convention on the Rights of Persons with Disabilities aims to promote the autonomy of these individuals. In this context, it guarantees the right to sexuality, family pool, legal recognition, civil and political rights, etc. From this perspective, the goal is to understand autonomy as an element of human dignity and the theoretical foundations of exercise for people with disabilities. As an example, presents the movie "I Am Sam" in the history of a parent with mental retarda...

Will Biomedical Enhancements Undermine Solidarity, Responsibility, Equality and Autonomy?

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Lev, Ori

2009-01-01

Prominent thinkers such as Jurgen Habermas and Michael Sandel are warning that biomedical enhancements will undermine fundamental political values. Yet, whether biomedical enhancements will undermine such values depends on how biomedical enhancements will function, how they will be administered and to whom. Since only few enhancements are obtainable, it is difficult to tell whether their predictions are sound. Nevertheless, such warnings are extremely valuable. As a society we must, at the very least, be aware of developments that could have harmful consequences. Indeed, if important values would be jeopardized, we should take appropriate measures to protect them. This paper focuses on four central values: solidarity, personal responsibility, equality and autonomy. It delineates the conditions under which biomedical enhancements would undermine these values. It also details the circumstances under which these values would be unaffected by enhancements as well as those under which they would be promoted. Specifying these conditions is valuable; it would enable society to prepare appropriate ethical guidelines and policy responses in advance. PMID:20002073

The relationship between dignity status and quality of life in iranian terminally ill patients with cancer

Directory of Open Access Journals (Sweden)

Abbas Hosseini

2017-01-01

Full Text Available Background: Palliative care is an approach that has been used to care for terminally ill patients. The current study was performed to assess the association between the status of patient dignity and quality of life (QOL in Iranian terminally ill patients with cancer. Materials and Methods: This descriptive correlational study was conducted on 210 end-stage cancer patients (102 men and 108 women who were referred to Seyed Al-Shohada Hospital, Isfahan, Iran, in 2015. To assess dignity status, we used the Patient Dignity Inventory. The Persian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was used for QOL assessment. Results: There was a significant negative association between total dignity status and QOL scales. In addition, significant negative relationship was observed between dignity-related domains (loss of worth sense: r = −0.50, P< 0.001; anxiety and uncertainty: r = −0.51, P< 0.001; symptom distress: r = −0.62, P< 0.001; and loss of autonomy: r = −0.61, P< 0.001 and functional scale and some subscales of the QOL scale. In contrast, a significant positive relationship was found between dignity-related domains, and total symptom scale and fatigue. No significant relationship was observed between different items of dignity and global health status/QOL scale. Conclusions: High dignity status in terminally ill patients was associated with higher QOL in terms of functional intactness and lower symptom distress. Further studies are necessary to shed light to our findings.

Dying with dignity

OpenAIRE

S P Kalantri

2003-01-01

The concept of dignity has beeen one of the ambiguous concepts in biomedical ethics. Thus the ambiguous nature of this concept has been extended to what it means to die with dignity. This research work is an investigation into the complexity in the understanding of "dying with dignity" in Applied Ethics.

Practical dignity in caring.

Science.gov (United States)

Shotton, L; Seedhouse, D

1998-05-01

It is difficult to understand the meaning of 'dignity' in human rights, bioethics and nursing literature because the word is used so vaguely. Unless dignity's meaning is spelt out it can disappear beneath more tangible priorities. In this article we define dignity and show how this can help health workers to maintain the dignity of people in their care.

Respect-Due and Respect-Earned: Negotiating Student-Teacher Relationships

Science.gov (United States)

Goodman, Joan F.

2009-01-01

Respect is a cardinal virtue in schools and foundational to our common ethical beliefs, yet its meaning is muddled. For philosophers Kant, Mill, and Rawls, whose influential theories span three centuries, respect includes appreciation of universal human dignity, equality, and autonomy. In their view children, possessors of human dignity, but…

Health equality, social justice and the poverty of autonomy.

Science.gov (United States)

Newdick, Christopher

2017-10-01

How does the concept of autonomy assist public responses to 'lifestyle' diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a 'nanny' state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.

"A Lesson in Love": The Right to Autonomy of the Disabled

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Fernanda Holanda Fernandes

2016-06-01

Full Text Available The International Convention on the Rights of Persons with Disabilities aims to promote the autonomy of these individuals. In this context, it guarantees the right to sexuality, family pool, legal recognition, civil and political rights, etc. From this perspective, the goal is to understand autonomy as an element of human dignity and the theoretical foundations of exercise for people with disabilities. As an example, presents the movie "I Am Sam" in the history of a parent with mental retardation and their legal battle for custody of their daughter.

God and Dignity of Labour in Nigeria: A Moral Perspective

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S. AWONIYI

2013-09-01

Full Text Available The concept labour can be viewed from different perspectives. In the first instance, it can be assessed in forms of work or vocation embarked upon as a source of livelihood either in a private or public affair of mankind. Also, it refers to work done for wages. Besides, it is equally a generic word for employees and trade unions as a collective. However, dignity of labour is fundamental to the nature of man because man often lifts himself when he does his work well. In line with this observation Pat Utomi writes that: The dignity of the human person is tied very closely to work. And when we work well, when we recognize the dignity of other human beings as they work, we essentially elevate the ordinary to the level of the engagement of   the divine (Utomi,2004:29.

Death, dignity, and moral nonsense.

Science.gov (United States)

Pullman, Daryl

2004-01-01

Although the concept of human dignity is widely invoked in discussions regarding end-of-life decision making, the content of the notion is ambiguous. Such ambiguity has led some to conclude that human dignity is a redundant or even useless concept that we would be better off without. This paper argues, to the contrary, that the concept of human dignity is indispensable to moral discourse. Far from dispensing with human dignity, we must work to clarify the concept. The paper outlines two distinct but related conceptions of dignity that are often conflated in contemporary moral discourse. These conceptions are labelled "basic dignity" and "personal dignity", respectively. It is argued that basic dignity functions as a universal meaning constraint on moral discourse in general. Hence, to dispense with the notion could reduce us to speaking moral nonsense. Throughout the discussion, some implications for our understanding of end-of-life decision making are explored.

Parliamentary debates on death with dignity in Argentina: the rights of terminal patients on the legislative agenda, 1996-2012.

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Alonso, Juan Pedro; Villarejo, Agustina; Brage, Eugenia

2017-01-01

This article examines the regulation on terminal patients' rights in Argentina at two points in time: the first attempts to regulate end-of-life rights (1996), and the "death with dignity" law passed by the National Congress (2011-2012). Comparative analysis allows us to observe variations among the individuals and situations included in the legislation, as well as in the conceptualization of autonomy and the interventions that is considered lawful refuse. The political context and the differential way that "death with dignity" entered the legislative agenda in each period determined the public's construction of the problem and thus the extent and result of the debates.

Death with dignity

OpenAIRE

Allmark, P.

2002-01-01

The purpose of this article is to develop a conception of death with dignity and to examine whether it is vulnerable to the sort of criticisms that have been made of other conceptions. In this conception "death" is taken to apply to the process of dying; "dignity" is taken to be something that attaches to people because of their personal qualities. In particular, someone lives with dignity if they live well (in accordance with reason, as Aristotle would see it). It follows that health care pr...

Autonomy and purity in Kant's moral theory

OpenAIRE

Benson, Carolyn Jane

2010-01-01

Kant believed that the moral law is a law that the rational will legislates. This thesis examines this claim and its broader implications for Kant’s moral theory. Many are drawn to Kantian ethics because of its emphasis on the dignity and legislative authority of the rational being. The attractiveness of this emphasis on the special standing and capacities of the self grounds a recent tendency to interpret Kantian autonomy as a doctrine according to which individual agents create binding ...

Human dignity, humiliation, and torture.

Science.gov (United States)

Luban, David

2009-09-01

Modern human rights instruments ground human rights in the concept of human dignity, without providing an underlying theory of human dignity. This paper examines the central importance of human dignity, understood as not humiliating people, in traditional Jewish ethics. It employs this conception of human dignity to examine and criticize U.S. use of humiliation tactics and torture in the interrogation of terrorism suspects.

Dignity and informed consent in the treatment of mature minors.

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Bello, Bidemi Ademola

2010-12-01

In today's world, as evinced in various human rights provisions, emphasis is placed on the assertion and protection of the entrenched rights of every human and particularly the dignity of humans and respect of human autonomy. Medical/health workers are concerned about protecting every patient's right to the dignity of his or her person. This led to the formulation of the concept of self determination and informed consent in medical diagnosis and treatments. However, serious concern is placed on these principles especially as it affects mature minors, a group of individuals who by conduct demand a level of respect but may at the same time be viewed as not capable of making the "best" informed decisions, especially about health. The following issues may arise as a result of the aforementioned concerns: --are mature young ones entitled to right of self determination and informed consent despite the alleged fear that they may lack capacity to make informed decisions? --if no, who should decide on their behalf--their parents, their medical/health provider or the society/government (especially since the 3 (three) interested groups may have different and conflicting stands on what is best for the child); --if the answer to the initial question is yes, to what extent should mature minors be informed of their medical choices and be allowed to exercise their right of self determination? --should they be guided? --and who should so guide them? In resolving the above issue, due consideration has been given not only to legal and bio-ethical provisions of some countries but also to international conventions which several countries are party to. Thereafter, it became clear that most authorities are of the view that mature minors should be fully informed and be allowed to have a say in health decisions, coaching them with few exceptions. Ultimately, because of the importance of respect for human dignity, autonomy and self determination along with medical disclosure in today

Re-establishing dignity

DEFF Research Database (Denmark)

Høy, Bente; Hall, E.O.C

2012-01-01

appearance’. The study documents that caring for older people is about creating small everyday circumstances in which patient dignity can flourish. Shortcomings of a secondary analysis are discussed and suggestions for future research, such as how older hospital patients experience caring and dignity...

A concept analysis of dignity for older adults.

Science.gov (United States)

Jacelon, Cynthia S; Connelly, Thomas W; Brown, Rana; Proulx, Kathy; Vo, Thuy

2004-10-01

Human dignity is an essential value of professional nursing education as well as a component of the American Nurses Association Code of Ethics. Nurses are exhorted to treat patients with dignity, and older adults want to be treated with dignity and die with dignity. Although dignity, particularly the dignity of older adults, is often discussed in the health care literature, its meaning is not always clear. The aim of this paper is to describe a concept analysis to develop a definition of dignity in older adults. Data were collected using a literature review and five focus groups composed of older adults. The literature provided data about professionals' ideas of dignity and the focus groups provided qualitative data about the nature of dignity in older people. The literature review and focus groups were carried out concurrently, followed by synthesis of the findings. Dignity is an inherent characteristic of being human, it can be subjectively felt as an attribute of the self, and is made manifest through behaviour that demonstrates respect for self and others. Dignity must be learned, and an individual's dignity is affected by the treatment received from others. A behavioural definition of dignity was constructed and this could provide the theoretical basis for nurses to develop interventions that foster dignity for older people.

(Re)Discovering University Autonomy

DEFF Research Database (Denmark)

This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter......-relationships between stakeholders and policies which can reinforce and equally pull in opposite directions. The holistic view is expressed in a model of institutional university autonomy that brings together the traditional basic four pillars of autonomy, and five interfaces: government–university; university......–university staff; academic staff–students; university–business; and university–internationalisation. This model is explored through international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are complex, interactive and genuinely...

Human dignity in concept and practice

Science.gov (United States)

Mattson, D.J.; Clark, S.G.

2011-01-01

Dignity seems to be something that virtually all people want. It is a seminal expression of the human experience that gains authority through the convergent demands of people worldwide. Even so, the human dignity concept is in unhelpful disarray. Dignity is variously viewed as an antecedent, a consequence, a value, a principle, and an experience, from philosophical, legal, pragmatic, psychological, behavioral, and cultural perspectives. We ask which if any of these human dignity concepts will likely serve our global common interests best, as both common ground and policy diagnostic? We examine four broad themes: dignity as (1) a metaphysical justification for human rights and duties, (2) virtuous comportment or behavior, (3) a perspective of "other," and (4) a subjective experience of the individual, contingent on a broad and equitable sharing of values. We recommend viewing dignity as a commonwealth of individually assessed well-being, shaped by relationships with others, affected by the physical world, and framed in terms of values. Viewed this way, the idea of dignity accommodates the priorities of both individualistic and communitarian cultures. Conceiving of human dignity as a commonwealth of subjectively experienced value production and enjoyment has many practical policy implications. ?? 2011 Springer Science+Business Media, LLC (outside the USA).

Rawls: The Problem of Autonomy and Coherentism

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Elnora Gondim

2010-12-01

Full Text Available The transformation of the idea of autonomy into that of justice as equality modifies the work of Rawls taken as a whole. Thus, while in the Theory of Justice, a Kantian- type of autonomy is adopted, in Political Liberalism, autonomy is extended to the sphere of the political.

The rights of personality in the search of dignity to live and die: the right to death (with dignity as corollary of the right to life (with dignity

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Riva Sobrado de Freitas

2016-02-01

Full Text Available This paper aims to analyze if the rights of personality, primarily the right to own body, the right to psychophysical integrity, and, deeply, the right to life with dignity, can base the right to death with dignity, embodied in the anticipation of death in terminal patients. Therefore, it was realized an exploratory-explanatory bibliographical research, qualitative, using the hypothetical-deductive method. The obtained conclusion is that, although the right to life must be preserved, must since with dignity, and, being the death (with dignity part of the life (with dignity process, it must not be promptly rejected, for preserving the own rights of personality.

Dignity and the use of body parts.

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Foster, Charles

2014-01-01

This paper contends that the conventional ethical and legal ways of analysing the wrong involved in the misuse of human body parts are inadequate, and should be replaced with an analysis based on human dignity. It examines the various ways in which dignity has been understood, outlines many of the criticisms made of those ways (agreeing with many of the criticisms), and proposes a new way of seeing dignity which is exegetically consonant with the way in which dignity has been historically understood, and yet avoids the pitfalls which have led to dignity being dismissed by many as hopelessly amorphous or incurably theological. The account of dignity proposed is broadly Aristotelian. It defines dignity in terms of human thriving, and presupposes that it is possible, at least in principle, to determine empirically what makes humans thrive. It contends that humans are quintessentially relational animals, and that it is not possible (and certainly not ethically desirable) to define humans as atomistic entities. One important corollary of this is that when using dignity/thriving as a criterion for determining the ethical acceptability of a proposed action or inaction, one should ask not merely how the dignity interests of the patient (for instance) would be affected, but how the dignity interests of all stakeholders would be affected. The business of ethics is then the business of auditing all those interests, and determining the course of action which would maximise the amount of thriving in the world.

"Death with dignity" in the Japanese context.

Science.gov (United States)

Shimoda, Motomu

2005-01-01

In Japan, "death with dignity" is a widely known term that is distinguished from "euthanasia." It is generally defined as "the act of letting a terminally ill or a patient in a persistent vegetative state die by withdrawing life-sustaining treatment on request in the form of a living will." Most Japanese people consider death with dignity a desirable way of terminating one's life and it is therefore acceptable as a "natural death" or "humane death." Originally, death with dignity was regarded as a passive intervention, but since the 1990s, its connotations have changed in western countries; people claim that voluntary active euthanasia and physician-assisted suicide should be legalized as death with dignity or the "right to die." In this paper, I examine the points and problems of this new type of death with dignity and propose an alternative version of death with dignity especially for the Japanese context, i.e. the end-of-life care process in support of terminal living with dignity.

Dying with dignity: a concept analysis.

Science.gov (United States)

Hemati, Zeinab; Ashouri, Elaheh; AllahBakhshian, Maryam; Pourfarzad, Zahra; Shirani, Farimah; Safazadeh, Shima; Ziyaei, Marziyeh; Varzeshnejad, Maryam; Hashemi, Maryam; Taleghani, Fariba

2016-05-01

This article is a report of an analysis of the concept of dying with dignity. Dignity is an important component of providing care for dying patients and their families. Nevertheless, given that this concept is poorly defined, concept analysis is one of the best ways to define and clarify the concept of death with dignity with the aim to enhance its application in clinical practice, research and education. A search of multiple nursing and social sciences databases was undertaken, including Academic Search Complete, Science Direct, ProQuest, Scopus, Medline, PubMed, EBSCO, Ovid, Noormage, Cinahl, Magiran, PsycINFO and SID. After an extensive review of the literature from 1998-2014, about 14 related articles were included in the study. Based on these articles, the applications, attributes and experimental results of and references to death with dignity were recorded. Based on this analysis, the most important attributes of this concept included respect for privacy, respect, spiritual peace and hope. The antecedents of this concept included consideration of moral values during caregiving, preservation of human dignity as a patient right and professional ethics, and belief in the dignity of self and others, consideration of culture in providing end-of-life care. The consequences of this concept included a sense of peace in the patient and their family, peaceful death and provision of patient privacy and comfort. The concept of patient dignity has been referred to in many contexts. However, considering the dignity of dying patients commensurate with their culture is the most important component of care provided by nurses to facilitate a peaceful death. Respecting the dignity of the patient results in the reduction of her/his suffering and prepares her/him for a comfortable death. © 2016 John Wiley & Sons Ltd.

The Challenge of University Autonomy

DEFF Research Database (Denmark)

Reilly, John; Turcan, Romeo V.; Bugaian, Larisa

2016-01-01

The authors introduce the reader to the book, providing a historical perspective and a current understanding of university autonomy. While appreciating the central role of the four dimensions of university autonomy – organisational, financial, human resource, and academic – the authors conjecture...... that a fuller understanding of university autonomy can only be obtained through a holistic view of the complex inter-relationships between stakeholders and policies which can reinforce and, equally, pull in opposite directions. This holistic view is represented in a model of institutional university autonomy......, which is discussed at length in the chapter. The authors conclude by presenting international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are genuinely global....

Death and dignity in Catholic Christian thought.

Science.gov (United States)

Sulmasy, Daniel P

2017-12-01

This article traces the history of the concept of dignity in Western thought, arguing that it became a formal Catholic theological concept only in the late nineteenth century. Three uses of the word are distinguished: intrinsic, attributed, and inflorescent dignity, of which, it is argued, the intrinsic conception is foundational. The moral norms associated with respect for intrinsic dignity are discussed briefly. The scriptural and theological bases for adopting the concept of dignity as a Christian idea are elucidated. The article concludes by discussing the relevance of this concept of dignity to the spiritual and ethical care of the dying.

Characterizing 18 Years of the Death With Dignity Act in Oregon.

Science.gov (United States)

Blanke, Charles; LeBlanc, Michael; Hershman, Dawn; Ellis, Lee; Meyskens, Frank

2017-10-01

Numerous states have pending physician-aided dying (PAD) legislation. Little research has been done regarding use of PAD, or ways to improve the process and/or results. To evaluate results of Oregon PAD, the longest running US program; to disseminate results; and to determine promising PAD research areas. A retrospective observational cohort study of 991 Oregon residents who had prescriptions written as part of the state's Death with Dignity Act. We reviewed publicly available data from Oregon Health Authority reports from 1998 to 2015, and made a supplemental information request to the Oregon Health Authority. Number of deaths from self-administration of lethal medication versus number of prescriptions written. A total of 1545 prescriptions were written, and 991 patients died by using legally prescribed lethal medication. Of the 991 patients, 509 (51.4%) were men and 482 (48.6%) were women. The median age was 71 years (range, 25-102 years). The number of prescriptions written increased annually (from 24 in 1998 to 218 in 2015), and the percentage of prescription recipients dying by this method per year averaged 64%. Of the 991 patients using lethal self-medication, 762 (77%) recipients had cancer, 79 (8%) had amyotrophic lateral sclerosis, 44 (4.5%) had lung disease, 26 (2.6%) had heart disease, and 9 (0.9%) had HIV. Of 991 patients, 52 (5.3%) were sent for psychiatric evaluation to assess competence. Most (953; 96.6%) patients were white and 865 (90.5%) were in hospice care. Most (118, 92.2%) patients had insurance and 708 (71.9%) had at least some college education. Most (94%) died at home. The estimated median time between medication intake and coma was 5 minutes (range, 1-38 minutes); to death it was 25 minutes (range, 1-6240 minutes). Thirty-three (3.3%) patients had known complications. The most common reasons cited for desiring PAD were activities of daily living were not enjoyable (89.7%) and losses of autonomy (91.6%) and dignity (78.7%); inadequate pain

Calvin and human dignity

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J.M. Vorster

2010-07-01

Full Text Available Human dignity has become a major moral directive in the contemporary ethical reflection on human rights and bio-ethics. This article examines the theological foundations laid by the reformer Calvin regarding the inherent dignity of people, and his influence on post-World War ethical reflection about the violations of human rights. In this article his views on the “imago dei” and common grace, the “lex naturae” and the obligations of the civil authority are investigated in order to illuminate his ideas about the dignity of human beings. The article then deals with the influence of these ideas in the influential works of the twentieth century’s reformed theologians Barth, Berkhouwer and Moltmann.

Factors affecting dignity of patients with multiple sclerosis.

Science.gov (United States)

Sharifi, Simin; Borhani, Fariba; Abbaszadeh, Abbas

2016-12-01

MS is one of the most common chronic diseases of the nervous system. Apart from disease progression, other complications such as unemployment, separation and divorce could potentially threat patients' dignity. Most of the previous studies have been done of maintaining patients' dignity in interaction with healthcare team, but studies on affecting factors of dignity in chronic patients in the society and in interaction with usual people are scarce. We aimed to investigate factors affecting dignity of Iranian patients with MS in daily living and in interaction of them with the society. In this qualitative study, 13 patients with multiple sclerosis were chosen by purposive sampling and semi-structured interviews were conducted until data saturation. The study was done in Tehran, the capital city of Iran. Factors affecting dignity were classified as 'personal factors' and 'social factors'. Personal factors consist of the following subcategories: patients' communication with self, patients' knowledge, patients' values and beliefs and patients' resources. Social factors include others' communication with patients, social knowledge, social values and beliefs and social resources. Multiple personal and social factors interfere in perceived patient dignity. In fact, interaction between personal and social factors can be influential in final perceived dignity. By focusing on whole aspects of the patients' lives, we can identify dignity-promoting or dignity-threatening factors and help patients maintain their dignity by taking appropriate measures for moderating threatening factors and improving dignity enhancing ones. © 2016 Nordic College of Caring Science.

[Surrogate Motherhood and Woman Dignity].

Science.gov (United States)

Aparisi Miralles, Ángela

2017-01-01

Motherhood by subrogation is an issue that directly affects human rights and, ultimately, human dignity. Therefore, if we want to give an adequate response to this issue, it is essential to reflect on how this practice affects the dignity and rights of the people involved in it and, more specifically, the pregnant mother. This study tries to show how in relation to the latter, maternity by subrogation directly contradicts some basic requirements of human dignity, since it reifies, instrumentalizes, convert into an object of commerce, and disregards the personal uniqueness of pregnant women.

The elderly patients' dignity

DEFF Research Database (Denmark)

Høy, Bente; Hall, E.O.C.; Wagner, L.

2007-01-01

the principles of nursing practice, protecting, enhancing and promoting the elderly patient's health potential. It is suggested that these themes of dignity provide a frame of reference in elder care; they shape the understanding of when health issues become a concern for health-promoting care for the elderly...... patient and what goals should be defined. Key words: Dignity, elderly patient, phenomenological hermeneutical method....

Personal Dignity in the European Legal Culture

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Lyudmila V. Butko

2017-09-01

Full Text Available The article presents the genesis of the origins of forming the legal mechanisms to protect the personal dignity in the European legal culture. It is noted that the legal content of dignity is predetermined by the moral aspect of consideration. In addition, the definition of "dignity" was transformed under the influence of the development of legal norms, doctrine and practice of protecting a person's rights and freedoms, the foundations of civil society and legal awareness. The chronological period of research was limited to the XIII-XIX centuries, within which the authors, using a comparative legal method, defined the directions of conceptualization and formalization of the personal dignity by scientists and legislation in the European countries. As a conclusion, it is shown that the observance of the right to personal dignity by the state will not only promote the exaltation of human dignity, but also simultaneously initiate the expansion of public law compensated by increasing the subjective rights.

[Respect of patient's dignity in the hospital].

Science.gov (United States)

Duguet, A-M

2010-12-01

Every code of ethics of health professionals in France considers the respect of dignity as a fundamental duty. The French 2002 Law on patient rights says that the person has the right to respect of dignity and of private life. After a presentation of the articles of ethics codes regarding dignity, this paper presents recommendations to deliver medical care in situations where dignity might be endangered such as for patients hospitalized in psychiatric services without consent, or for medical examination of prisoners or medical care to vulnerable patients unable to express their will, especially in palliative care or at the end of life. Respect of dignity after death is illustrated by the reflection conducted by the Espace Ethique de l'AP-HP (Paris area hospitals) and in the Chart of the mortuary yard. A survey of the patients' letters of complaint received by the emergency service of the Toulouse University Hospital showed that, in five years, there were 188 letters and 18 pointed out infringements to the dignity of the person. The health professional team is now aware of this obligation, and in the accreditation of the hospitals, the respect of dignity is one of the indicators of the quality of medical care.

Protecting the dignity of displaced Syrians

Directory of Open Access Journals (Sweden)

Kholoud Mansour

2018-02-01

Full Text Available What does dignity mean to Syrian refugees and practitioners? And what can humanitarian organisations do – or abstain from doing – to help Syrians preserve and protect their dignity?

Maintaining dignity. The perspective of nursing home residents

DEFF Research Database (Denmark)

Høy, Bente

2016-01-01

body image; feeling recognised and valued as a person of worth; Abilities and opportunities for changing of lifevalues; to exert control; to form and maintain meaningful relationships and to participation in meaningful activity. Conclusion. Although there is no one way to maintain dignity, the themes...... dignity is maintained. Background. Elderly living in nursing homes are vulnerable which appeal to nursing care ethics and emphasise the importance of care for human dignity. There have been several attempts to define dignity as a theoretical concept, but few studies on how dignity is maintained from...... was used to understand the meaning of the narrated text. Findings. The residents’ experiences revealed one main theme and seven sub-themes contributing to maintain dignity. The overall theme was: Coping with vulnerability and the subthemes were: Attention and care for basic needs; preserving a positive...

Human Dignity in Contemporary Ethics

African Journals Online (AJOL)

In this strictly academic book, David. Kirchhoffer processes the complex issues surrounding the concept of human dignity through a clearly defined ethical method. At the outset, he questions whether it is possible to use human dignity as a normative criterion, when empirical research has shown there is no evidence that an ...

Loss of Dignity in Severe Chronic Obstructive Pulmonary Disease.

Science.gov (United States)

Solomon, Brahm K; Wilson, Keith G; Henderson, Peter R; Poulin, Patricia A; Kowal, John; McKim, Douglas A

2016-03-01

The maintenance of dignity is an important concept in palliative care, and the loss of dignity is a significant concern among patients with advanced cancer. The goals of this study were to examine whether loss of dignity is also a concern for patients receiving interdisciplinary rehabilitation for Stage III or IV chronic obstructive pulmonary disease. We examined the prevalence and correlates of loss of dignity and determined whether it improves with treatment. Inpatients underwent a structured interview inquiry around their sense of dignity and completed measures of pulmonary, physical, and psychological function at admission (n = 195) and discharge (n = 162). Loss of dignity was identified as a prominent ongoing concern for 13% of patients. It was correlated with measures of depression and anxiety sensitivity, but not with pulmonary capacity or functional performance. A robust improvement in loss of dignity was demonstrated, with 88% of those who reported a significant problem at admission no longer reporting one at discharge. The prevalence of a problematic loss of dignity among patients with severe chronic obstructive pulmonary disease is at least as high as among those receiving palliative cancer care. Loss of dignity may represent a concern among people with medical illnesses more broadly, and not just in the context of "death with dignity" at the end of life. Furthermore, interdisciplinary care may help to restore a sense of dignity to those individuals who are able to participate in rehabilitation. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A taxonomy of dignity: a grounded theory study

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Jacobson Nora

2009-02-01

Full Text Available Abstract Background This paper has its origins in Jonathan Mann's insight that the experience of dignity may explain the reciprocal relationships between health and human rights. It follows his call for a taxonomy of dignity: "a coherent vocabulary and framework to characterize dignity." Methods Grounded theory procedures were use to analyze literature pertaining to dignity and to conduct and analyze 64 semi-structured interviews with persons marginalized by their health or social status, individuals who provide health or social services to these populations, and people working in the field of health and human rights. Results The taxonomy presented identifies two main forms of dignity–human dignity and social dignity–and describes several elements of these forms, including the social processes that violate or promote them, the conditions under which such violations and promotions occur, the objects of violation and promotion, and the consequences of dignity violation. Together, these forms and elements point to a theory of dignity as a quality of individuals and collectives that is constituted through interaction and interpretation and structured by conditions pertaining to actors, relationships, settings, and the broader social order. Conclusion The taxonomy has several implications for work in health and human rights. It suggests a map to possible points of intervention and provides a language in which to talk about dignity.

Discipline: Impact on Access to Equal Educational Opportunities

Science.gov (United States)

Joubert, Rika; de Waal, Elda; Rossouw, JP

2004-01-01

Complying with the founding values (human dignity, equality and freedom) of the South African Constitution is one of the most important challenges of creating and maintaining a safe, disciplined environment where effective teaching and learning can take place. All school principals, educators and school governing bodies--bearing in mind the…

What is dignity in prehospital emergency care?

Science.gov (United States)

Abelsson, Anna; Lindwall, Lillemor

2017-05-01

Ethics and dignity in prehospital emergency care are important due to vulnerability and suffering. Patients can lose control of their body and encounter unfamiliar faces in an emergency situation. To describe what specialist ambulance nurse students experienced as preserved and humiliated dignity in prehospital emergency care. The study had a qualitative approach. Data were collected by Flanagan's critical incident technique. The participants were 26 specialist ambulance nurse students who described two critical incidents of preserved and humiliated dignity, from prehospital emergency care. Data consist of 52 critical incidents and were analyzed with interpretive content analysis. Ethical considerations: The study followed the ethical principles in accordance with the Declaration of Helsinki. The result showed how human dignity in prehospital emergency care can be preserved by the ambulance nurse being there for the patient. The ambulance nurses meet the patient in the patient's world and make professional decisions. The ambulance nurse respects the patient's will and protects the patient's body from the gaze of others. Humiliated dignity was described through the ambulance nurse abandoning the patient and by healthcare professionals failing, disrespecting, and ignoring the patient. It is a unique situation when a nurse meets a patient face to face in a critical life or death moment. The discussion describes courage and the ethical vision to see another human. Dignity was preserved when the ambulance nurse showed respect and protected the patient in prehospital emergency care. The ambulance nurse students' ethical obligation results in the courage to see when a patient's dignity is in jeopardy of being humiliated. Humiliated dignity occurs when patients are ignored and left unprotected. This ethical dilemma affects the ambulance nurse students badly due to the fact that the morals and attitudes of ambulance nurses are reflected in their actions toward the patient.

Death with Dignity: The Developing Debate Among Health Care Professionals.

Science.gov (United States)

Oakman, Brittany N; Campbell, Hope E; Runk, Lindsay M

2015-06-01

The right-to-die movement-known variously as death with dignity, physician-assisted suicide, or aid in dying-remains controversial. The recently publicized death of 29-year-old Brittany Maynard, who chose to end her life through physician-assisted suicide, forced many health care professionals to evaluate or re-evaluate their stance on the issue. Currently, only five states have aid-in-dying laws, but many others have bills under consideration. The legalized process for physician-assisted suicide has a strict set of procedures that physicians and patients must follow to ensure the competency and safety of all parties involved. Opposition against legalizing physician-assisted suicide encompasses more than simply moral, religious, or ethical differences. While some individuals believe that physician-assisted suicide gives patients autonomy in their end-of-life care, health care professionals also may have reservations about the liability of the situation. Pharmacists, in particular, play a pertinent role in the dispensing of, and counseling about, the medications used to assist patients in hastening their death. It is imperative that pharmacists be aware of the intended use of the particular medication so that they can make informed decisions about their participation and ensure that they perform all the necessary steps required to remain compliant with the laws or statutes in their jurisdiction. This practice places an increased burden on pharmacists to evaluate their opinion on the concept of death with dignity and whether or not they want to participate.

Realizing dignity as a part of intercultural competence

DEFF Research Database (Denmark)

Breunig, Steven

2014-01-01

in intercultural encounters with cognitive, behavioral and affective competence. Dignity contributes to intercultural competence by enabling persons to view the social world anew. In this paper, dignity is conceptualized as the development and self-expression of persons free from social categorization, while...... for effective and appropriate interaction between a Self and a culturally dissimilar Other. Accordingly, it is proposed that emotional regulation is essential for realizing dignity as an aspect of intercultural competence. Research on social dynamics and identity and the emotions is not without its precedence...... within intercultural communication. This project contributes to the objectives of intercultural communication and competence by theorizing how awareness of social dynamics and emotional regulation may support the realization of dignity during intercultural encounters. Dignity may complement other...

Granting death with dignity: patient, family and professional perspectives.

Science.gov (United States)

Leung, Doris

2007-04-01

Dignity is a complex construct lacking clear meaning. While conceptualizing dignity as a basic right is useful in determining and justifying social and economic costs of health care, it is insufficient in considerations of personal dignity at the end of life. There is a dissonance between how dignity is shown to matter to healthcare professionals compared to patients. Furthermore, dignity is not clearly linked in the empirical literature to variables of quality of life and to a dignified death. Current studies about the construct of dignity enhance understanding of how we extrinsically construct moral worth, but not of how individuals interpret intrinsic moral worth through maintaining their personal integrity and attitudes of being cared for. References to key qualitative studies illuminate how clinicians ethically negotiate a creation of dying with dignity. As one's personal integrity fades, caregivers (i.e. healthcare providers, family and friends) are challenged to recognise and attend to the individual's vulnerability. I suggest that caregivers nurture personal integrity - through gestures that remember and honour aspects of the other as he/she was once known. Perhaps only through others can dying people be granted death with a sense of personal dignity.

Development of the Attributed Dignity Scale.

Science.gov (United States)

Jacelon, Cynthia S; Dixon, Jane; Knafl, Kathleen A

2009-07-01

A sequential, multi-method approach to instrument development beginning with concept analysis, followed by (a) item generation from qualitative data, (b) review of items by expert and lay person panels, (c) cognitive appraisal interviews, (d) pilot testing, and (e) evaluating construct validity was used to develop a measure of attributed dignity in older adults. The resulting positively scored, 23-item scale has three dimensions: Self-Value, Behavioral Respect-Self, and Behavioral Respect-Others. Item-total correlations in the pilot study ranged from 0.39 to 0.85. Correlations between the Attributed Dignity Scale (ADS) and both Rosenberg's Self-Esteem Scale (0.17) and Crowne and Marlowe's Social Desirability Scale (0.36) were modest and in the expected direction, indicating attributed dignity is a related but independent concept. Next steps include testing the ADS with a larger sample to complete factor analysis, test-retest stability, and further study of the relationships between attributed dignity and other concepts.

Natural Good Theories and the Value of Human Dignity.

Science.gov (United States)

Muders, Sebastian

2016-04-01

One of the widely recognized facts about human dignity is its vastly divergent applicability-from highly controversial issues in bioethics to broader topics in political philosophy. A group of theories that this article subsumes under the header "natural good theories" appears to be especially fitted for normatively multifaceted notions like dignity. However, the heavy normative weight the concept of dignity has to bear due to the central position it occupies within these theories creates its own difficulties. As is shown in a discussion of Martha Nussbaum's capability conception of dignity, dignity appears to be unable to mirror the special normative relevance people want to assign to it in cases of great moral misconduct. The article provides a suggestion on how to solve this problem by means of paradigmatic cases that work as material constraints regarding the exact boundaries of dignity violations.

Dignity Impact as a Primary Outcome Measure for Dignity Therapy.

Science.gov (United States)

Scarton, Lisa; Oh, Sungho; Sylvera, Ashley; Lamonge, Ralph; Yao, Yingwei; Chochinov, Harvey; Fitchett, George; Handzo, George; Emanuel, Linda; Wilkie, Diana

2018-01-01

Feasibility of dignity therapy (DT) is well established in palliative care. Evidence of its efficacy, however, has been inconsistent and may stem from DT's primary effects differing from the outcomes measured in previous studies. We proposed that DT effects were in the spiritual domain and created a new outcome measure, Dignity Impact Scale (DIS), from items previously used in a large randomized controlled trial (RCT). The purpose of this secondary analysis study was to examine properties of a new measure of dignity impact. Using the DIS, we conducted reanalysis of posttest data from a large 3-arm, multi-site RCT study. Participants were receiving hospice/palliative care (n = 326, 50.6% female, mean age = 65.1 years, 89.3% white, all with a terminal illness with 6 months or less life expectancy). They had been randomized to standard palliative care (n = 111), client-centered care (n = 107), or DT (n = 108). The 7-item DIS was derived from selected items in a posttest DT Patient Feedback Questionnaire. The DIS had strong internal consistency (α = 0.85). The DT group mean DIS score (21.4 ± 5.0) was significantly higher than the usual care group mean score (17.7 ± 5.5; t = 5.2, df = 216, P death, and life completion tasks. We propose that the DIS be used as the primary outcome measure in evaluating the effects of DT.

Clarifying appeals to dignity in medical ethics from an historical perspective.

Science.gov (United States)

Van Der Graaf, Rieke; Van Delden, Johannes Jm

2009-03-01

Over the past few decades the concept of (human) dignity has deeply pervaded medical ethics. Appeals to dignity, however, are often unclear. As a result some prefer to eliminate the concept from medical ethics, whereas others try to render it useful in this context. We think that appeals to dignity in medical ethics can be clarified by considering the concept from an historical perspective. Firstly, on the basis of historical texts we propose a framework for defining the concept in medical debates. The framework shows that dignity can occur in a relational, an unconditional, a subjective and a Kantian form. Interestingly, all forms relate to one concept since they have four features in common: dignity refers, in a restricted sense, to the 'special status of human beings'; it is based on essential human characteristics; the subject of dignity should live up to it; and it is a vulnerable concept, it can be lost or violated. We argue that being explicit about the meaning of dignity will prevent dignity from becoming a conversation-stopper in moral debate. Secondly, an historical perspective on dignity shows that it is not yet time to dispose of dignity in medical ethics. At least Kantian and relational dignity can be made useful in medical ethics.

Patient's dignity in intensive care unit: A critical ethnography.

Science.gov (United States)

Bidabadi, Farimah Shirani; Yazdannik, Ahmadreza; Zargham-Boroujeni, Ali

2017-01-01

Maintaining patient's dignity in intensive care units is difficult because of the unique conditions of both critically-ill patients and intensive care units. The aim of this study was to uncover the cultural factors that impeded maintaining patients' dignity in the cardiac surgery intensive care unit. The study was conducted using a critical ethnographic method proposed by Carspecken. Participants and research context: Participants included all physicians, nurses and staffs working in the study setting (two cardiac surgery intensive care units). Data collection methods included participant observations, formal and informal interviews, and documents assessment. In total, 200 hours of observation and 30 interviews were performed. Data were analyzed to uncover tacit cultural knowledge and to help healthcare providers to reconstruct the culture of their workplace. Ethical Consideration: Ethical approval for the study from Ethics committee of Isfahan University of Medical Sciences was obtained. The findings of the study fell into the following main themes: "Presence: the guarantee for giving enough attention to patients' self-esteem", "Instrumental and objectified attitudes", "Adherence to the human equality principle: value-action gap", "Paternalistic conduct", "Improper language", and "Non-interactive communication". The final assertion was "Reductionism as a major barrier to the maintaining of patient's dignity". The prevailing atmosphere in subculture of the CSICU was reductionism and paternalism. This key finding is part of the biomedical discourse. As a matter of fact, it is in contrast with dignified care because the latter necessitate holistic attitudes and approaches. Changing an ICU culture is not easy; but through increasing awareness and critical self-reflections, the nurses, physicians and other healthcare providers, may be able to reaffirm dignified care and cure in their therapeutic relationships.

Deprivation of Dignity in Nursing Home Residents

DEFF Research Database (Denmark)

Høy, Bente

2016-01-01

deepened knowledge in how to maintain and promote dignity in nursing home residents. The purpose of this paper is to present results concerning the question: How is nursing home residents’ dignity maintained or deprived from the perspective of close family caregivers? In this presentation we only focus...... on deprivation of dignity. Methodology: The overall design of this study is modified clinical application research. The study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods were individual research interviews. All together the sample consisted of 28...

The Autonomy Activity Status of Multinational Subsidiaries

DEFF Research Database (Denmark)

Dzikowska, Marlena; Gammelgaard, Jens; Jindra, Björn

Research concerning the autonomy of subsidiaries has been concentrated on the possession of decision-making rights. Building on the definitional and empirical argumentation, we claim that so understood autonomy has a prospective character, is not equal to the implementation of actual actions (or...... lack of thereof) and neglects the issue of the scope of potential actions. This paper aims to fill in the current literature gap by offering a holistic stance in which we assert that subsidiaries can be meaningfully differentiated according to their levels of autonomy and corresponding actions. We base...... this argumentation on the findings of real option theory and competitive dynamics perspective, develop a typology specific to a subsidiary’s autonomy activity status (the position of a subsidiary in terms of its autonomy level confronted with the extent of actions taken in a corresponding area). We evaluate...

Euthanasia and death with dignity in Japanese law.

Science.gov (United States)

Kai, Katsunori

2010-12-01

In Japan, there are no acts and, specific provisions or official guidelines on euthanasia, but recently, as I will mention below, an official guideline on "death with dignity" has been made. Nevertheless in fact, this guideline provides only a few rules of process on terminal care. Therefore the problems of euthanasia and "death with dignity" are mainly left to the legal interpretation by literatures and judicial precedents of homicide (Article 199 of the Criminal Code; where there is no distinction between murder and manslaughter) and of homicide with consent (Article 202 of the Criminal Code). Furthermore, there are several cases on euthanasia or "death with dignity" as well as borderline cases in Japan. In this paper I will present the situation of the latest discussions on euthanasia and "death with dignity" in Japan from the viewpoint of medical law. Especially, "death with dignity" is seriously discussed in Japan, therefore I focus on it.

Vincent Lambert, Dignity in Dying and the European Court: A Critical Evaluation and the Global Reflections.

Science.gov (United States)

Kishore, R R

2016-04-01

In this article I analyse the verdict of the European Court of Human Rights in the Case of Lambert and Others v. France, delivered on 5 June 2015, affirming the Conseil d'État's decision holding that the withdrawal of artificial nutrition and hydration from Vincent Lambert, a French national lying in tetraplegia and persistent vegetative state, was consistent with French domestic law and the European Convention for the Protection of Human Rights and Fundamental Freedoms. In order to make a comparative evaluation I give an account of judicial decisions across the world and find that the European Court's decision is an affirmative pronouncement, in the prevailing milieu of judicial heterogeneity, as it recognizes a person's right to die with dignity in the face of conflicting claims and arguments, by giving supremacy to a person's autonomy and right of self-determination over the deep-rooted religious beliefs and undue paternalistic postures. I conclude that right to die with dignity is a profound area where judge-made law is not the answer. The situation calls for greater consensus and uniformity by evolving suitable legislative strategies.

Dignity and the death penalty in the United States Supreme Court

OpenAIRE

Malkani, Bharat

2016-01-01

The US Supreme Court has repeatedly invoked the idea of dignity in its Eighth Amendment jurisprudence, particularly in cases involving capital punishment. However, it has never articulated a clear and consistent conception of dignity. The first half of this paper examines the Court's inconsistent use, and highlights how various justices have used different conceptions of human dignity, communitarian dignity, and institutional dignity to uphold the constitutionality of capital punishment. This...

Exploring nurses' personal dignity, global self-esteem and work satisfaction.

Science.gov (United States)

Sturm, Bonnie A; Dellert, Jane C

2016-06-01

This study examines nurses' perceptions of dignity in themselves and their work. Nurses commonly assert concern for human dignity as a component of the patients' experience rather than as necessary in the nurses' own lives or in the lives of others in the workplace. This study is exploratory and generates potential relationships for further study and theory generation in nursing. What is the relationship between the construct nurses' sense of dignity and global self-esteem, work satisfaction, and identified personal traits? This cross-sectional correlation study used a stratified random sample of nurses which was obtained from a US University alumni list from 1965 to 2009 (N = 133). University Institutional Review Board approval was achieved prior to mailing research questionnaire packets to participants. Participation was optional and numerical codes preserved confidentiality. Statistical results indicated a moderately strong association between the nurse's sense of personal dignity and self-esteem (rx = .62, p = .000) with areas of difference clarified and discussed. A positive but moderate association between nurses' personal dignity and nurses' work satisfaction (rx = .37, p = .000) and a similar association between self-esteem and nurses' work satisfaction (rs = .29, p = .001) were found. A statistically significant difference was found (F = 3.49 (df = 4), p = .01) for dignity and categories of spiritual commitment and for nurses' personal dignity when ratings of health status were compared (F = 21.24 (df = 4), p = .000). Personal sense of dignity is discussed in relation to conceptual understandings of dignity (such as professional dignity) and suggests continued research in multiple cultural contexts. The relationships measured show that nurses' sense of dignity has commonalities with self-esteem, workplace satisfaction, spiritual commitment, and health status; the meaning of the findings has ramifications for the welfare of nurses internationally. © The

Human dignity and biomedical ethics from a Christian theological ...

African Journals Online (AJOL)

The argument of human dignity plays an important role in current debates on human rights and their relevance in modern biomedicine. When discussing the contribution of Christian theology to current debates on human dignity and human rights the thesis is not that the modern idea of human dignity depends on a ...

Universalism, particularism and the ethics of dignity.

Science.gov (United States)

Pullman, Daryl

2001-12-01

This paper explores the problem of universalism and particularism in contemporary ethics, and its relationship to Christian bioethics in particular. An ethic of human dignity is outlined, which, it is argued, constrains moral discourse in the broad sense--thus meeting the demands of universalism--but which is at the same time amenable to a variety of particularist interpretations--thus acknowledging the current shift toward historicism, traditionalism, and culture. The particularist interpretations that are of central concern here are those provided by historic Christianity. The eventual goal is to indicate how a Christian conception of human dignity can have universal normative relevance both as a standard against which to assess competing particularist conceptions, and as a practical guide for everyday living. A Christian conception of dignity will in turn have significant implications when addressing contemporary issues in bioethics. These are ambitious goals, and a full explication of the ideas presented will not be possible in this context. Nevertheless, there is value in getting a bird's-eye view of the landscape before one goes about scaling the mountains and exploring the valleys. The present essay is intended as a general geography of the moral terrain in which an ethic of dignity in general, and a Christian perspective on dignity in particular, can provide normative guidance.

[Right to die with dignity?].

Science.gov (United States)

Ruiz, Alvaro

2008-06-01

The right to die with dignity is an ill-defined concept, with multiple, often inappropriate, interpretations. The current proposition is that the physician take full responsibility for protecting the patients rights, for ensuring a rational use of resources and for overseeing the decision-making process such that the information is adequate and the steps proportioned. This responsibility extends not only to the health status of the patient situation, to the patients prognosis, and to his/her expectations and wishes, but also to the benefits foreseen and to the cost-benefit ratio. Emphasis is placed on two aspects of this relationship. First, dignity can be interpreted in many ways and sometimes, in the name of dignity, the patient is exposed (or exposes him/herself) to suffering, pain and complications that can be avoided. Second, when no reasonable probability of survival is present and a better quality of life is impossible, efforts are better redirected to offering a better quality of death.

Debating death: religion, politics, and the Oregon Death With Dignity Act.

Science.gov (United States)

Purvis, Taylor E

2012-06-01

In 1994, Oregon passed the Oregon Death With Dignity Act, becoming the first state in the nation to allow physician-assisted suicide (PAS). This paper compares the public discussion that occurred in 1994 and during the Act's implementation in 1997 and examines these debates in relation to health care reform under the Obama administration. I argue that the 1994 and 1997 Oregon PAS campaigns and the ensuing public debate represent the culmination of a growing lack of deference to medical authority, concerns with the doctor-patient relationship, and a desire for increased patient autonomy over decisions during death. The public debate over PAS in Oregon underscored the conflicts among competing religious, political, and personal interests. More visible and widespread than any other American debate on PAS, the conflict in Oregon marked the beginning of the now nationwide problem of determining if and when a terminally ill person can choose to die.

Identifying care actions to conserve dignity in end-of-life care.

Science.gov (United States)

Brown, Hilary; Johnston, Bridget; Ostlund, Ulrika

2011-05-01

Community nurses have a central role in the provision of palliative and end-of-life care; helping people to die with dignity is an important component of this care. To conserve dignity, care should comprise a broad range of actions addressing the distress that might impact on the patient's sense of dignity. These care actions need to be defined. This study aims to suggest care actions that conserve dignity at the end of life based on evidence from local experience and community nursing practice. Data were collected by focus group interviews and analysed by framework analysis using the Chochinov model of dignity as a predefined framework. Suggestions on care actions were given in relation to all themes. As part of a multi-phase project developing and testing a dignity care pathway, this study might help community nurses to conserve dying patients' dignity.

Complex contradictions in conceptualisations of 'dignity' in palliative care.

Science.gov (United States)

Williams, Lisa; Trussardi, Gabriella; Black, Stella; Moeke-Maxwell, Tess; Frey, Rosemary; Robinson, Jackie; Gott, Merryn

2018-01-02

Internationally, increasing attention is being paid to understanding patient experiences of health care. Within palliative care, the Views of Informal Carers - Evaluation of Services (VOICES) questionnaire is commonly used for this purpose. Among its objectives is to ask family members if their relatives were treated with dignity at the end of life. This is regarded as useful for understanding the quality of the health care received. To highlight the differences between family members' reports of dignity in the care provided to their relatives at the end of life, as reported in the VOICES questionnaire, and their narratives about the care their relatives received. A total of 21 cognitive interviews were conducted during a New Zealand pilot of the VOICES questionnaire. Discrepancies between ratings of dignity and the lived experience of care suggest that lay understandings of dignity may not be congruent with that of health care providers. Bereaved family members' self-reports of dignity in end-of-life care captured using survey methods alone are inadequate to understand the complex ways in which individuals conceptualise and experience dignity within a health care context. The authors advocate consideration of multiple, complementary approaches to gathering consumer experiences of end-of-life care, as well as research which enables service users to interrogate what dignity in care means in an end-of-life context.

Exploring the value of dignity in the work-life of nurses.

Science.gov (United States)

Lawless, Jane; Moss, Cheryle

2007-04-01

In this paper the authors draw attention to the value of nurse dignity in the work-life of nurses. How does the profession currently understand this as a concept and construct? How might the valuing of worker dignity in the workplace affect the wellbeing of the workforce? A review of nursing literature and a theoretical lens on worker dignity derived from recent work by Hodson (2001) was used to explore these questions. In the context of current and international workforce issues associated with recruitment and retention, analysis of the construct of worker dignity within the profession takes on a strong imperative. The large existing body of research into nursing workplace environments highlights concern that nurses have in understanding and improving work-life quality. Findings of this inquiry reveal that while there is a degree of coherence between the nursing research and elements of Hodson's (2001) research on worker dignity, the dignity of nurses, as a specific construct and as an intrinsic human and worker right has received little explicit attention. Reasons for this may lie partly in approaches that privilege patient dignity over nurse dignity and which rely on the altruism and self-sacrifice of nurses to sustain patient care in environments dominated by cost-control agendas. The value of dignity in the work-life of nurses has been under-explored and there is a critical need for further theoretical work and research. This agenda goes beyond acceptance of dignity in the workplace as a human right towards the recognition that worker dignity may be a critical factor in sustaining development of healthy workplaces and healthy workforces. Directing explicit attention to nurse dignity may benefit the attainment of both nurse and organisational goals. Hodson's (2001) framework offers a new perspective on dignity in the workplace and leads to new insights and a slightly different view of a 'road well travelled' in nursing literature.

Death with "dignity": the wedge that divides the disability rights movement from the right to die movement.

Science.gov (United States)

Behuniak, Susan M

2011-01-01

Much of the American debate over physician assisted death (PAD) is framed as an ideological split between conservatives and liberals, pro life and pro choice advocates, and those who emphasize morality versus personal autonomy. Less examined, but no less relevant, is a split within the ranks of progressives--one that divides those supporting a right to die in the name of human rights from disability rights activists who invoke human rights to vehemently oppose euthanasia. This paper reviews how "dignity" serves both as a divisive wedge in this debate but also as a value that can span the divide between groups and open the way to productive discourse. Supporters of legalized euthanasia use "dignity" to express their position that some deaths might indeed be accelerated. At the same time, opponents adopt the concept to argue that physician assisted suicide stigmatizes life with a disability. To bridge this divide, the worldviews of two groups, Compassion & Choices and Not Dead Yet, are studied. The analysis concludes that the two organizations are more parallel than contrary--a finding that offers opportunities for dialogue and perhaps even advances in public policy.

Dignity and the ownership and use of body parts.

Science.gov (United States)

Foster, Charles

2014-10-01

Property-based models of the ownership of body parts are common. They are inadequate. They fail to deal satisfactorily with many important problems, and even when they do work, they rely on ideas that have to be derived from deeper, usually unacknowledged principles. This article proposes that the parent principle is always human dignity, and that one will get more satisfactory answers if one interrogates the older, wiser parent instead of the younger, callow offspring. But human dignity has a credibility problem. It is often seen as hopelessly amorphous or incurably theological. These accusations are often just. But a more thorough exegesis exculpates dignity and gives it its proper place at the fountainhead of bioethics. Dignity is objective human thriving. Thriving considerations can and should be applied to dead people as well as live ones. To use dignity properly, the unit of bioethical analysis needs to be the whole transaction rather than (for instance) the doctor-patient relationship. The dignity interests of all the stakeholders are assessed in a sort of utilitarianism. Its use in relation to body part ownership is demonstrated. Article 8(1) of the European Convention of Human Rights endorses and mandates this approach.

The Women's Center.

Science.gov (United States)

Stimpson, Catharine R.; And Others

Barnard College has created a Women's Center that devotes itself to the task of reaffirming the dignity, autonomy, and equality of women. For too long society has held that women are less rational than men, less capable than men, and thus that educating women is less useful than educating men. Replacing myth with fact is the responsibility of…

Death with dignity in Washington patients with amyotrophic lateral sclerosis.

Science.gov (United States)

Wang, Leo H; Elliott, Michael A; Jung Henson, Lily; Gerena-Maldonado, Elba; Strom, Susan; Downing, Sharon; Vetrovs, Jennifer; Kayihan, Paige; Paul, Piper; Kennedy, Kate; Benditt, Joshua O; Weiss, Michael D

2016-11-15

To describe the amyotrophic lateral sclerosis (ALS) patients who sought medication under the Washington State Death with Dignity (DWD) Act since its inception in 2009. Chart review at 3 tertiary medical centers in the Seattle/Puget Sound region and comparison to publicly available data of ALS and all-cause DWD cohorts from Washington and Oregon. In Washington State, 39 patients with ALS requested DWD from the University of Washington, Virginia Mason, and Swedish Medical Centers beginning in 2009. The median age at death was 65 years (range 46-86). Seventy-seven percent of the patients used the prescriptions. All of the patients who used the medications passed away without complications. The major reasons for patients to request DWD as reported by participating physicians were loss of autonomy and dignity and decrease in enjoyable activities. Inadequate pain control, financial cost, and loss of bodily control were less commonly indicated. These findings were similar to those of the 92 patients who sought DWD in Oregon. In Washington and Oregon, the percentage of patients with ALS seeking DWD is higher compared to the cancer DWD cohort. Furthermore, compared to the all-cause DWD cohort, patients with ALS are more likely to be non-Hispanic white, married, educated, enrolled in hospice, and to have died at home. Although a small number, ALS represents the disease with the highest proportion of patients seeking to participate in DWD. Patients with ALS who choose DWD are well-educated and have access to palliative or life-prolonging care. The use of the medications appears to be able to achieve the patients' goals without complications. © 2016 American Academy of Neurology.

Psychological autonomy and hierarchical relatedness as organizers of developmental pathways

OpenAIRE

Keller, Heidi

2016-01-01

The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize d...

Equal is as equal does: challenging Vatican views on women.

Science.gov (United States)

1995-01-01

The authors of this piece are women from the Roman Catholic tradition who are critical of the Vatican position on women's rights. The Report of the Holy See in Preparation for the Fourth World Conference on Women reveals a religious fundamentalism that misuses tradition and anthropology to limit women's roles and rights. The Vatican is itself a self-proclaimed state that offers women neither opportunities nor protections within its own organization, and there is no evidence of women's participation in the preparation of its report. The Vatican document constructs a vision of women and men in which men are normative persons, whose dignity is conferred by their humanity, and women are the variant other, defined by and granted dignity by their reproductive and mothering functions. The Vatican document is anti-feminist. It criticizes the "radical feminists" of the 1960s for trying to deny sexual differences, and accuses today's Western feminists of ignoring the needs of women in developing countries while pursuing selfish and hedonistic goals. It makes no recognition of the work of feminists to improve the lives of women worldwide. The Vatican document claims to support women's equality, but it qualifies each statement of equality with a presumption of difference. The document defines women as vulnerable without naming men as responsible for the oppression and violence to which women are vulnerable. It ridicules as feminist cant the well-documented fact that the home is the setting of most violence against women. The Vatican decries the suffering families undergo as a result of cumpulsory birth control and abortion policies, while it would deny families sex education, contraceptives, and safe abortion, thereby making pregnancy cumpulsory. A new vision of social justice is needed, one that: 1) rests on a radical equality, in which both women and men are expected to contribute to work, education, culture, morality, and reproduction; 2) accepts a "discipleship of equals

Dignity-conserving care actions in palliative care: an integrative review of Swedish research.

Science.gov (United States)

Harstäde, Carina Werkander; Blomberg, Karin; Benzein, Eva; Östlund, Ulrika

2018-03-01

Previous research has proposed that persons in need of palliative care often have a loss of functions and roles that affects social and existential self-image. Moreover, these individuals also commonly suffer from complex multisymptoms. This, together with the situation of facing an impending death, can lead to a loss of dignity. Therefore, supporting these persons' dignity is a crucial challenge for professional nurses. The 'Dignity Care Intervention' addresses the multidimensionality of dignity by identifying patients' dignity-related concerns and suggests care actions to address them. At the present, the Dignity Care Intervention is adapted for implementation in Swedish care settings. Because expressions of dignity are influenced by culture, and an overview of care actions in a Swedish context is lacking, this integrative review aimed to find suggestions from Swedish research literature on what kind of care actions can preserve dignity. An integrative literature review was conducted using the databases SwePub and SweMed+. Articles published from 2006 to 2015 and theses published from 2000 to 2015 were searched for using the terms 'dignity' and 'palliative care'. Result sections of articles and theses were reviewed for dignity-conserving care actions synthesised by thematic analysis and categorised under themes and subthemes in Chochinov's model of dignity. Fifteen articles and 18 theses were included together providing suggestions of care actions in all themes and subthemes in the dignity model. Suggested care actions included listening, communication, information, symptom control, facilitating daily living and including patients in decision-making. Additionally, nurses' perceptiveness towards the patients was a core approach. The review offers culturally relevant suggestions on how to address specific dignity-related concerns. The adapted Dignity Care Intervention will be a way for Swedish nurses to provide person-centred palliative care that will conserve

Respecting dignity in forensic care: the challenge faced by nurses of maintaining patient dignity in clinical caring situations.

Science.gov (United States)

Gustafsson, L-K; Wigerblad, A; Lindwall, L

2013-02-01

We must recognize the importance of increased understanding for maintaining patient dignity to expand earlier formulated knowledge about caring ethics. Illuminations of this topic can create conditions for changing and developing care, as well as making caregivers' preservation of dignity evident. The aim was to illuminate the meaning of maintenance of patient dignity in forensic care. A qualitative design with a phenomenological-hermeneutic approach was used to analyse and interpret focus group interviews with nurses in forensic care. In the text the meaning of maintenance of patient dignity was protection and respect but also brotherly humanity. Protection was shown outwards to cover or screen the patient and to guard against danger. The inner form was described as protecting the patients' needs and arousing the patients' protection resources. Respect was shown outwards to take the patient seriously and to show others that patients are to be reckoned with, inwards in teaching patients to create respect and in teaching patients to expect respect from others. Meeting patients with human brotherhood was shown in doing 'the little extra' and demonstrating human similarity. The new understanding will enable nurses to plan and provide professional care, based on caring science. © 2012 Blackwell Publishing.

Human Dignity – Constitutional Principle of Fundamental Human Rights

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Lucian Pop

2011-07-01

Full Text Available As a constitutional principle of the human rights, the human dignity is a supreme value, a norm and a right, thus that the reconfiguration of protection standards of fundamental human rights is made by cohesion of the legal, social and moral dimensions of human dignity. With this article, the author argues that legal meaning, social meaning and moral meaning of human dignity, are centerpiece of protection of freedom under law.

The concept of human dignity in the ethics of genetic research.

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Chan, David K

2015-05-01

Despite criticism that dignity is a vague and slippery concept, a number of international guidelines on bioethics have cautioned against research that is contrary to human dignity, with reference specifically to genetic technology. What is the connection between genetic research and human dignity? In this article, I investigate the concept of human dignity in its various historical forms, and examine its status as a moral concept. Unlike Kant's ideal concept of human dignity, the empirical or relational concept takes human dignity as something that is affected by one's circumstances and what others do. I argue that the dignity objection to some forms of genetic research rests on a view of human nature that gives humans a special status in nature - one that is threatened by the potential of genetic research to reduce individuals to their genetic endowment. I distinguish two main philosophical accounts of human nature. One of these, the Aristotelian view, is compatible with the use of genetic technology to help humans realize their inherent potential to a fuller extent. © 2014 John Wiley & Sons Ltd.

The question of autonomy in maternal health in Africa: a rights-based consideration.

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Amzat, Jimoh

2015-06-01

Maternal mortality is still very high in Africa, despite progress in control efforts at the global level. One elemental link is the question of autonomy in maternal health, especially at the household level where intrinsic human rights are undermined. A rights-based consideration in bioethics is an approach that holds the centrality of the human person, with a compelling reference to the fundamental human rights of every person. A philosophical and sociological engagement of gender and the notion of autonomy within the household reveals some fundamental rights-based perplexities for bioethical considerations in maternal health. The right to self-determination is undermined, and therefore women's dignity, freedom and autonomy, capacities, and choices are easily defiled. This study applies a rights-based approach to maternal health and demonstrates how rights concerns are associated with negative outcomes in maternal health in Africa. The discussion is situated at the household level, which is the starting point in health care. The paper submits that beyond legal and political rights within the context of the state, rights-based issues manifest at the household level. Many of those rights issues, especially relating to women's autonomy, are detrimental to maternal health in Africa. Therefore, a rights-based approach in the social construction of maternal health realities will contribute to alleviating the burden of maternal mortality in Africa.

[Philosophy of human dignity and the ethics of psychiatry].

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Stoecker, Ralf

2014-07-01

Current moral philosophy has serious problems with the concept of human dignity. Although it seems to be an almost inevitable ingredient of every day moral judgments, philosophers have difficulties to find an analysis of the concept that could support this central role. One way out of these difficulties consists in a closer look at the various areas where the concept is used so widely and naturally, in the attempt to extract inductively an adequate understanding of human dignity from these contexts. In the article, this strategy is used to glean features of human dignity from the history of psychiatry, condense them into a plausible understanding of human dignity and finally sketch some practical implications for modern psychiatric ethics. © Georg Thieme Verlag KG Stuttgart · New York.

Characterization, conservation and loss of dignity at the end-of- life in the emergency department. A qualitative protocol.

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Fernández-Sola, Cayetano; Granero-Molina, José; Díaz-Cortés, María Del Mar; Jiménez-López, Francisca Rosa; Roman-López, Pablo; Saez-Molina, Encarnación; Aranda-Torres, Cayetano José; Muñoz-Terrón, José María; García-Caro, María Paz; Hernández-Padilla, José Manuel

2018-06-01

To explore and understand the experiences of terminally ill patients and their relatives regarding dignity during end-of-life care in the emergency department. The respect given to the concept of dignity is significantly modifying the clinical relationship and the care framework involving the end-of-life patient in palliative care units, critical care units, hospices and their own homes. This situation is applicable to in-hospital emergency departments, where there is a lack of research which takes the experiences of end-of-life patients and their relatives into account. A phenomenological qualitative study. The protocol was approved in December 2016 and will be carried out from December 2016-December 2020. The Gadamer's philosophical underpinnings will be used in the design and development of the study. The data collection will include participant observation techniques in the emergency department, in-depth interviews with terminally ill patients and focus groups with their relatives. For the data analysis, the field notes and verbatim transcriptions will be read and codified using ATLAS.ti software to search for emerging themes. Emerging themes that contribute to comprehending the phenomenon of dignity in end-of-life care in the emergency department are expected to be found. This study's results could have important implications in the implementation of new interventions in emergency departments. These interventions would be focused on improving: the social acceptance of death, environmental conditions, promotion of autonomy and accompaniment and assumption (takeover) of dignified actions and attitudes (respect for human rights). © 2018 John Wiley & Sons Ltd.

[Human dignity, human rights and bioethics: what is the connection?].

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Andorno, Roberto

2010-12-01

Human rights are closely related to the notion of human dignity, to such a point that it is very difficult, if not impossible, to promote them without appealing, at least implicitly, to the idea that each individual has intrinsic worth simply by virtue of being human. This relationship between dignity and rights is even stronger in the field of bioethics, which deals directly with some of the most basic human rights, such as the rights to life and to physical integrity. It is therefore not by chance that the international norms relating to bioethics give a central role to the concept of human dignity. However, one should not expect from dignity more than it can offer; dignity is a "principle", not a "rule"; it embodies a fundamental value, but it alone does not determine the content of a particular decision.

Human dignity and human rights in bioethics: the Kantian approach.

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Rothhaar, Markus

2010-08-01

The concept of human dignity plays an important role in the public discussion about ethical questions concerning modern medicine and biology. At the same time, there is a widespread skepticism about the possibility to determine the content and the claims of human dignity. The article goes back to Kantian Moral Philosophy, in order to show that human dignity has in fact a determinable content not as a norm in itself, but as the principle and ground of human rights and any deontological norms in biomedical ethics. When it comes to defining the scope of human dignity, i.e., the question which entities are protected by human dignity, Kant clearly can be found on the "pro life"-side of the controversy. This, however, is the result of some specific implications of Kant's transcendental approach that may be put into question.

Nurses’ commitment to respecting patient dignity

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Raee, Zahra; Abedi, Heidarali; Shahriari, Mohsen

2017-01-01

Background: Although respecting human dignity is a cornerstone of all nursing practices, industrialization has gradually decreased the attention paid to this subject in nursing care. Therefore, the present study aimed to investigate nurses’ commitment to respecting patient dignity in hospitals of Isfahan, Iran. Methods: This descriptive-analytical study was conducted in hospitals of Isfahan. Overall, 401 inpatients were selected by cluster sampling and then selected simple random sampling from different wards. Data were collected through a questionnaire containing the components of patient dignity, that is, patient-nurse relationships, privacy, and independence. All items were scored based on a five-point Likert scale. The collected data were analyzed using descriptive statistics and Chi-square tests. P < 0.05 were considered significant in all analyses. Findings: Most patients (91%) scored their relationships with nurses as good. Moreover, 91.8% of the participants described privacy protection as moderate/good. Only 6.5% of the subjects rated it as excellent. The majority of the patients (84.4%) believed their independence was maintained. These subjects also approved of taking part in decision-making. Conclusion: According to our findings, nurses respected patient dignity to an acceptable level. However, the conditions were less favorable in public hospitals and emergency departments. Nursing authorities and policy makers are thus required to introduce appropriate measures to improve the existing conditions. PMID:28546981

Nurses' commitment to respecting patient dignity.

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Raee, Zahra; Abedi, Heidarali; Shahriari, Mohsen

2017-01-01

Although respecting human dignity is a cornerstone of all nursing practices, industrialization has gradually decreased the attention paid to this subject in nursing care. Therefore, the present study aimed to investigate nurses' commitment to respecting patient dignity in hospitals of Isfahan, Iran. This descriptive-analytical study was conducted in hospitals of Isfahan. Overall, 401 inpatients were selected by cluster sampling and then selected simple random sampling from different wards. Data were collected through a questionnaire containing the components of patient dignity, that is, patient-nurse relationships, privacy, and independence. All items were scored based on a five-point Likert scale. The collected data were analyzed using descriptive statistics and Chi-square tests. P < 0.05 were considered significant in all analyses. Most patients (91%) scored their relationships with nurses as good. Moreover, 91.8% of the participants described privacy protection as moderate/good. Only 6.5% of the subjects rated it as excellent. The majority of the patients (84.4%) believed their independence was maintained. These subjects also approved of taking part in decision-making. According to our findings, nurses respected patient dignity to an acceptable level. However, the conditions were less favorable in public hospitals and emergency departments. Nursing authorities and policy makers are thus required to introduce appropriate measures to improve the existing conditions.

Educating student midwives around dignity and respect.

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Hall, Jenny S; Mitchell, Mary

2017-06-01

There is currently limited information available on how midwifery students learn to provide care that promotes dignity and respect. In recent years the importance of dignity in healthcare and treating people with respect has received considerable emphasis in both a national and international context. The aim of this discussion paper is to describe an educational workshop that enables learning to promote dignity and respect in maternity care. An interactive workshop, using different creative methods as triggers for learning will be described. Provision of learning opportunities for students around dignity and respect is important to ensure appropriate care is provided in practice. The use of creative methods to inspire has contributed to deep learning within participants. An evaluation of the workshop illustrated how learning impacted on participants practice. Data to support this is presented in this paper. The use of creative teaching approaches in a workshop setting appears to provide an effective learning opportunity around dignified and respectful care. These workshops have evoked a deep emotional response for some participants, and facilitators must be prepared for this outcome to ensure a safe space for learning. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Human Dignity in Law – A Case Study of the Polish Legal System

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Magdalena Butrymowicz

2016-09-01

Full Text Available Human dignity is one of the most fundamental ideas in the entire international human rights system. As from the Universal Declaration of Human Rights, in 1948, the concept of the human dignity become used as a tool to protect the basic needs of humans. The other formal instruments of international human rights also make reference to dignity. Whereas international law widely accepted the inherence of dignity, controversies still arise around the source of the dignity. Polish lawmakers, on the other hand, have no doubt about the fact the concept of dignity comes from natural law. Poland, in her Constitution, refers to the teaching of John Paul II about the source, value and meaning of human dignity. There is no doubt that concept of human dignity, even when it is controversial, is the most widely accepted by all religions and political society in the world.

Ignorance, information and autonomy.

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Harris, J; Keywood, K

2001-09-01

People have a powerful interest in genetic privacy and its associated claim to ignorance, and some equally powerful desires to be shielded from disturbing information are often voiced. We argue, however, that there is no such thing as a right to remain in ignorance, where a fight is understood as an entitlement that trumps competing claims. This does not of course mean that information must always be forced upon unwilling recipients, only that there is no prima facie entitlement to be protected from true or honest information about oneself. Any claims to be shielded from information about the self must compete on equal terms with claims based in the rights and interests of others. In balancing the weight and importance of rival considerations about giving or withholding information, if rights claims have any place, rights are more likely to be defensible on the side of honest communication of information rather than in defence of ignorance. The right to free speech and the right to decline to accept responsibility to take decisions for others imposed by those others seem to us more plausible candidates for fully fledged rights in this field than any purported right to ignorance. Finally, and most importantly, if the right to autonomy is invoked, a proper understanding of the distinction between claims to liberty and claims to autonomy show that the principle of autonomy, as it is understood in contemporary social ethics and English law, supports the giving rather than the withholding of information in most circumstances.

In defense of posthuman dignity.

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Bostrom, Nick

2005-06-01

Positions on the ethics of human enhancement technologies can be (crudely) characterized as ranging from transhumanism to bioconservatism. Transhumanists believe that human enhancement technologies should be made widely available, that individuals should have broad discretion over which of these technologies to apply to themselves, and that parents should normally have the right to choose enhancements for their children-to-be. Bioconservatives (whose ranks include such diverse writers as Leon Kass, Francis Fukuyama, George Annas, Wesley Smith, Jeremy Rifkin, and Bill McKibben) are generally opposed to the use of technology to modify human nature. A central idea in bioconservativism is that human enhancement technologies will undermine our human dignity. To forestall a slide down the slippery slope towards an ultimately debased 'posthuman' state, bioconservatives often argue for broad bans on otherwise promising human enhancements. This paper distinguishes two common fears about the posthuman and argues for the importance of a concept of dignity that is inclusive enough to also apply to many possible posthuman beings. Recognizing the possibility of posthuman dignity undercuts an important objection against human enhancement and removes a distortive double standard from our field of moral vision.

Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy

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Rostbøll, Christian F.

2009-01-01

is understood as something we should presume everyone possesses, it provides a strong basis for equal respect among people from diverse cultures. A Kantian conception of autonomy can justify the right to freedom of expression while it at the same time requires that we in the exercise of freedom of expression......Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more...... complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disrespect for diversity only when it is understood as a character ideal that must be promoted as an end in itself. If it by contrast...

Dignity and Dawn: Libya’s Escalating Civil War

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Daveed Gartenstein-Ross

2015-02-01

Full Text Available In this Research Paper, ICCT Associate Fellow Dr. Daveed Gartenstein-Ross and Nathaniel Barr provides a detailed examination of the armed conflict in Libya between the Operation Dignity and Libya Dawn military coalitions. The conflict erupted in May 2014, when Dignity leader Khalifa Hifter announced the launch of his campaign, which was aimed at ridding eastern Libya of Islamist militias, beginning with Benghazi. This offensive shattered a fragile status quo. Revolutionary forces concentrated in the city of Misrata and Islamist politicians perceived Hifter’s offensive as a direct affront and, following parliamentary elections that these factions lost, the Misrata-Islamist bloc announced the launch of the Libya Dawn offensive, aimed at driving pro-Dignity forces out of Tripoli. More broadly, the Dawn offensive was an effort to change facts on the ground in order to ensure that the Misrata-Islamist bloc retained political influence. The Dignity and Dawn offensives have contributed to the continuing political and geographic fragmentation of Libya. Libya now has two separate parliaments and governments, while much of the country has been carved into spheres of influence by warring factions. The Dignity-Dawn conflict has also caused a deterioration of security, which has played into the hands of a variety of violent non-state actors, including al-Qaeda and Islamic State affiliates that have capitalized on Libya’s security vacuum to establish bases of operation. This report provides a blow-by-blow account of the military conflict between Dignity and Dawn forces, then assesses the implications of the Libyan civil war on regional security and potential policy options for Western states.

Human dignity in religion-embedded cross-cultural nursing.

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Cheraghi, Mohammad A; Manookian, Arpi; Nasrabadi, Alireza N

2014-12-01

Although human dignity is an unconditional value of every human being, it can be shattered by extrinsic factors. It is necessary to discover the authentic meaning of patients' dignity preservation from different religious perspectives to provide professional cross-cultural care in a diverse setting. This article identifies common experiences of Iranian Muslim and Armenian Christian patients regarding dignified care at the bedside. This is a qualitative study of participants' experiences of dignified care elicited by individual in-depth semi-structured interviews. A purposeful sample of 10 participants (five Iranian Muslims and five Iranian Armenians) from various private and governmental hospital settings was chosen. This study was approved by the ethics committee of Tehran University of Medical Sciences. All the participants were provided with information about the purpose and the nature of the study, the voluntary condition of their participation in this study, and the anonymous reporting of recorded interviews. The common experiences of Christian and Muslim patients regarding dignity preservation emerged as "exigency of respecting human nobility" and "providing person-centered care." It is essential to recognize the humanness and individuality of each patient to preserve and promote human dignity in diverse cross-cultural settings. The findings support and expand current understanding about the objective and subjective nature of dignity preservation in cross-cultural nursing. © The Author(s) 2014.

Dignity, religion and freedom of expression in South Africa

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Jacobus C.W. van Rooyen

2011-04-01

Full Text Available The issue that this article dealt with is whether, in South African law, speech that infringes upon the religious feelings of an individual is protected by the dignity clause in the Constitution of the Republic of South Africa. The Constitution, as well as the Broadcasting Code, prohibits language that advocates hatred, inter alia, based on religion and that constitutes incitement to cause harm. Dignity, which is a central Constitutional right, relates to the sense of self worth which a person has. A Court has held that religious feelings, national pride and language do not form part of dignity, for purposes of protection in law. The Broadcasting Complaints Commission has, similarly, decided that a point of view seriously derogatory of ‘Calvinistic people’ blaming (some of them as being hypocritical and even acting criminally is not protected by dignity. It would have to be accompanied by the advocacy of hatred as defined previously. The author, however, pointed out that on occasion different facts might found a finding in law that religion is so closely connected to dignity, that it will indeed be regarded as part thereof.

Human dignity and biomedical ethics from a Christian theological perspective

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Ulrich H.J. Körtner

2011-07-01

Full Text Available The argument of human dignity plays an important role in current debates on human rights and their relevance in modern biomedicine. When discussing the contribution of Christian theology to current debates on human dignity and human rights the thesis is not that the modern idea of human dignity depends on a theological grounding. Also, it is not the task of theology to legitimate rights as Christian a posteriori. We do not need to deduce modern human rights from theological doctrines. The theological challenge is to find an access for Christians from their belief to the modern idea of human rights and human dignity and to discuss the contribution which theology and the churches can make to further development of human rights. The Christian image of man, which serves as the foundation for the church position on bioethical topics in the German-speaking context, is a mix of biblical motives, a Kantian interpretation of the concept of human dignity and an interpretation of the German constitutional law inspired by the Catholic tradition of natural law. The following presented theological understanding of human dignity, in contrast, was inspired by the insights of the Pauline doctrine of justification and its Protestant reinterpretation.

Patient’s autonomy from a biethical perspective.

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Adriana Ribeiro-Alves

2012-12-01

Full Text Available Even though the conflicts arising in the field of Bioethics are generated by biomedical advances, these problems are meta-medical, that is they are transverse to all disciplines with scope in the human health. In this context, the application of bioethical principles such as the principle of autonomy, is considered a starting point, crucial to decision making referring to the exercise of medical and dental practice. In this sense, it is necessary to increase efforts through health policies and formation at the highest level for professionals in health disciplines in order to guide them to reduce violations of bioethical principles, as indeed happens in the day by day practice, in health services, both public and private, clinics or hospitals in order to get a health system with a more humanistic commitment. Thus, bioethics must be the base on which lay the foundations of a necessary dialogue that tends to resolve the observed conflicts, seeking to have the human being, and dignity of life as essential issues of their actions. The aim of this review is not to propose a definition of the Principle of Autonomy, that everyone already handle, but invite to a reflexion which contributes to size it and apply it in the field of dental practice in a bioethical context linked to the human person.

Self-ownership, relational dignity, and organ sales.

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Hershenov, David

2018-06-19

Material property has traditionally been conceived of as separable from its owner and thus alienable in an exchange. So it seems that you could sell your watch or even your kidney because it can be removed from your wrist or abdomen and transferred to another. However, if we are each identical to a living human animal, self-ownership is impossible for self-separation is impossible. We thus cannot sell our parts if we don't own the whole that they compose. It would be incoherent to own all of your body's parts but not the whole body; and it would be arbitrary to own some but not all of your removable parts. These metaphysical obstacles to organ sales do not apply to the selling of the organs of the deceased. The human being goes out of existence at death and is not identical to the body's remains. Any objections to selling the organs of the deceased must instead be due to dignity rather than metaphysical or conceptual considerations. But the remains lack the intrinsic dignity of the human being, instead possessing, at best, relational dignity. Relational dignity would not provide sufficient reason to prohibit life-saving sales. © 2018 John Wiley & Sons Ltd.

The Death Penalty and Human Dignity: An Existential Fallacy

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Susan Nagelsen

2016-06-01

Full Text Available Proponents of capital punishment in the United States frequently cite the evolution from electrocution and hanging to lethal injection as an indication that the evolving standards of decency exhibited by such a transition demonstrate a respect for human dignity. This essay examines that claim by evaluating two standards for assessing whether an act comports with accepted definitions of human dignity: a personal-achievement model, based on work by economist Amartya Sen of Harvard University, and a universal and intrinsic approach to human dignity articulated by criminologist Robert Johnson of the American University. We evaluate Sen’s capabilities model through the lens of a condemned prisoner’s ability to achieve self-defined goals. We then assess Johnson’s claim that preserving human dignity requires an elimination of the death penalty, irrespective of any prisoner’s ability to lead a restricted, albeit goal-directed, existence.

Human dignity according to international instruments on human rights

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José Pablo Alzina de Aguilar

2011-01-01

Full Text Available According to international instruments on human rights, the dignity of the human person is the foundation of human rights, and both human dignity and human rights are inherent to the human being, universal and inviolable. This understanding of human dignity is not a fruitless truism, but the solid foundation on which to build a world community under the rule of the new ius gentium: the International Law for Humankind. Moreover, it is the clue to answer many questions raised by the new world of globalization and of the exponential growth of international rules.Consequently, there is a need to a common doctrine on a notion of human dignity which will allow the implementation and adjudication of the aforementioned instruments, at the service of the human person and in conformity with the juridical conscience which they reflect. Philosophy of Law concepts which can be traced back to Aristotle provide that notion. According to these concepts, the demanding nature of “human dignity” sustains the notion of “legal personhood”, and both notions pertain to the realm of Law and Right, not of Morale and Values. Thus, human dignity and human rights are and must be, respectively, a basic principle and a necessary part of any Law system, including international law

Practices in Human Dignity in Palliative Care: A Qualitative Study.

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Akin Korhan, Esra; Üstün, Çağatay; Uzelli Yilmaz, Derya

Respecting and valuing an individual's existential dignity forms the basis of nursing and medical practice and of nursing care. The objective of the study was to determine the approach to human dignity that nurses and physicians have while providing palliative care. This qualitative study was performed using a phenomenological research design. In-depth semistructured interviews were conducted in 9 nurses and 5 physicians with human dignity approach in palliative care. Following the qualitative Colaizzi method of analyzing the data, the statements made by the nurses and physicians during the interviews were grouped under 8 categories. Consistent with the questionnaire format, 8 themes and 43 subthemes of responses were determined describing the human dignity of the nurse and the physicians. The results of the study showed that in some of the decisions and practices of the nurses giving nursing care and physicians giving medical care to palliative care patients, while they displayed ethically sensitive behavior, on some points, they showed approaches that violated human dignity and showed lack of awareness of ethical, medical, and social responsibilities.

Autonomy and reason: treatment choice in breast cancer.

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Twomey, Mary

2012-10-01

The practice of offering choice to those women with breast cancer for whom either breast conserving surgery or mastectomy would be equally beneficial has come to be seen as an important aspect of medical care. As well as improving satisfaction with treatment, this is seen as satisfying the ethical principle of respect for autonomy. A number of studies, however, show that women are not always comfortable with such choice, preferring to leave treatment decisions to their surgeons. A question then arises as to the extent that these women can be seen as autonomous or as exercising autonomy. This paper argues, however, that the understanding of autonomy which is applied in current approaches to breast cancer care does not adequately support the exercise of autonomy, and that the clinical context of care means that women are not able to engage in the kind of reasoning that might promote the exercise of autonomy. Where respect for autonomy is limited to informed consent and choice, there is a danger that women's interests are overlooked in those aspects of their care where choice is not appropriate, with very real, long-term consequences for some women. Promoting the exercise of autonomy, it is argued, needs to go beyond the conception of autonomy as rational individuals making their own decisions, and clinicians need to work with an understanding of autonomy as relational in order to better involve women in their care. © 2012 Blackwell Publishing Ltd.

Human Dignity and the Ethics and Regulation of Technology

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Duwell, M.

2017-01-01

This chapter investigates how human dignity might be understood as a normative concept for the regulation of technologies. First, various distinctions that are relevant for the way human dignity can be understood are discussed. It is argued that it is particularly important that we should see human

Defining dignity in end-of-life care in the emergency department.

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Fernández-Sola, Cayetano; Cortés, María Mar Díaz; Hernández-Padilla, José Manuel; Torres, Cayetano José Aranda; Terrón, José María Muñoz; Granero-Molina, José

2017-02-01

Respecting dignity is having a profound effect on the clinical relationship and the care framework for terminally ill patients in palliative care units, hospices and their own homes, with particular consequences for the emergency department. However, dignity is a vague and multifaceted concept that is difficult to measure. The aim of this study is to define the attributes of dignity in end-of-life care in the emergency department, based on the opinions of physicians and nurses. A hermeneutic phenomenological approach utilising Gadamer's philosophical underpinnings guided the study. Participants and research context: This research was conducted in Spain in 2013-2014. Participants included 10 physicians and 16 nurses with experience working in the emergency department. Two focus groups and 12 in-depth interviews were carried out. Ethical considerations: The study was approved by the Research Centre Ethical Committee (Andalusian Health Service, Spain). The results point to the person's inherent value, socio-environmental conditions and conscious actions/attitudes as attributes of dignity when caring for a dying patient in the emergency department. Dying with dignity is a basic objective in end-of-life care and is an ambiguous but relevant concept for physicians and nurses. In line with our theoretical framework, our results highlight care environment, professional actions and socio-family context as attributes of dignity. Quality care in the emergency department includes paying attention to the dignity of people in the process of death. The dignity in the care of a dying person in the emergency department is defined by acknowledging the inherent value in each person, socio-environmental conditions and social and individual acceptance of death. Addressing these questions has significant repercussions for health professionals, especially nurses.

Evaluating a dignity care intervention for palliative care in the community setting: community nurses' perspectives.

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McIlfatrick, Sonja; Connolly, Michael; Collins, Rita; Murphy, Tara; Johnston, Bridget; Larkin, Philip

2017-12-01

To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions. Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. A mixed methods study using online survey and focus group interviews and thematic analysis to examine data. Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015. The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared. Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care. Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care. © 2017 John Wiley & Sons Ltd.

Markets & Myths: Autonomy in Public & Private Schools

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Sandra Rubin Glass

1997-01-01

Full Text Available

School choice is the most controversial education policy issue of the 1990s. John Chubb and Terry Moe's Politics, Markets and America's Schools stimulated this investigation. They concluded that teacher and administrator autonomy was the most important influence on student achievement. They assumed that the organization of private schools offered greater autonomy resulting in higher student achievement and that the bureaucracy of public schools stifles autonomy limiting student achievement. The research undertaken here elaborates, elucidates, and fills in the framework of teacher and principal autonomy in public and private secondary schools. Interviews of more than thirty teachers and administrators in six high schools, observations, field notes, and analysis of documents collected in the field form the empirical base of this work. The sites included three private, independent, nondenominational secondary schools which are college preparatory and three public secondary schools noted for high graduation rates and offering numerous advanced placement courses.

The feelings expressed by both public and private school participants in this study testify to equally high degrees of autonomy. Issues that emerged from data analysis in this study which mitigate and shape autonomy include the following: conflicting and contradictory demands, shared beliefs, layers of protection, a system of laws, funding constraints and matters of size of the institution. These issues challenge oversimplified assertions that differences of any importance exist between the autonomy experienced by professionals in public and private high schools. This study reveals the complexity of the concept of autonomy and challenges the myth that teachers and principals in private schools enjoy autonomy and freedom from democratic bureaucracy that their public school counterparts do not.

The History of Human Freedom and Dignity in Western Civilization

DEFF Research Database (Denmark)

Jacobsen, Anders-Christian

2016-01-01

Kort introduktion til et europæisk forskningsprojekt "The History of Human Freedom and Dignity in Western Civilisation'......Kort introduktion til et europæisk forskningsprojekt "The History of Human Freedom and Dignity in Western Civilisation'...

Patients’ Dignity and Its Relationship with Contextual Variables: A Cross-Sectional Study

Science.gov (United States)

Zirak, Mohammad; Ghafourifard, Mansour; Aliafsari Mamaghani, Ebrahim

2017-01-01

Introduction: Dignity is considered as fundamental human needs and recognized as one of the central concepts in nursing science. The aim of this study was to assess the extent to which patients’ dignity is respected and to evalutae its relationship with contextual variables. Methods: This cross-sectional study was conducted on 256 hospitalized patients in the two teaching hospitals affiliated to Zanjan University of medical sciences, Iran. Data were collected by a questionnaire consist of two sections: (a) demographic characteristics, and (b) patient dignity including 32 questions. Data were analyzed by SPSS (ver.13) software using independent t-test, ANOVA and Pearson correlation. Results: The result showed that the mean (standard deviation) of total score of patient’s dignity was 108.17 (25.28). According to the result, the majority of the respondents (76.2%) were not aware of patient’s rights. There was a significant difference in mean scores of total dignity between single and married persons, living in city or village, and hospitalization in Moosavi and Valiasr hospital. Conclusion: Health care systems should take the provision of the patients' dignity into account through using a comprehensive educational program for informing of patient, family members, and health professionals about patients’ dignity. PMID:28299297

Patients' Dignity and Its Relationship with Contextual Variables: A Cross-Sectional Study.

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Zirak, Mohammad; Ghafourifard, Mansour; Aliafsari Mamaghani, Ebrahim

2017-03-01

Introduction: Dignity is considered as fundamental human needs and recognized as one of the central concepts in nursing science. The aim of this study was to assess the extent to which patients' dignity is respected and to evalutae its relationship with contextual variables. Methods: This cross-sectional study was conducted on 256 hospitalized patients in the two teaching hospitals affiliated to Zanjan University of medical sciences, Iran. Data were collected by a questionnaire consist of two sections: (a) demographic characteristics, and (b) patient dignity including 32 questions. Data were analyzed by SPSS (ver.13) software using independent t-test, ANOVA and Pearson correlation. Results: The result showed that the mean (standard deviation) of total score of patient's dignity was 108.17 (25.28). According to the result, the majority of the respondents (76.2%) were not aware of patient's rights. There was a significant difference in mean scores of total dignity between single and married persons, living in city or village, and hospitalization in Moosavi and Valiasr hospital. Conclusion: Health care systems should take the provision of the patients' dignity into account through using a comprehensive educational program for informing of patient, family members, and health professionals about patients' dignity.

Patients’ Dignity and Its Relationship with Contextual Variables: A Cross-Sectional Study

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Mohammad Zirak

2017-03-01

Full Text Available Introduction: Dignity is considered as fundamental human needs and recognized as one of the central concepts in nursing science. The aim of this study was to assess the extent to which patients’ dignity is respected and to evalutae its relationship with contextual variables. Methods: This cross-sectional study was conducted on 256 hospitalized patients in the two teaching hospitals affiliated to Zanjan University of medical sciences, Iran. Data were collected by a questionnaire consist of two sections: (a demographic characteristics, and (b patient dignity including 32 questions. Data were analyzed by SPSS (ver.13 software using independent t-test, ANOVA and Pearson correlation. Results: The result showed that the mean (standard deviation of total score of patient’s dignity was 108.17 (25.28. According to the result, the majority of the respondents (76.2% were not aware of patient’s rights. There was a significant difference in mean scores of total dignity between single and married persons, living in city or village, and hospitalization in Moosavi and Valiasr hospital. Conclusion: Health care systems should take the provision of the patients' dignity into account through using a comprehensive educational program for informing of patient, family members, and health professionals about patients’ dignity.

Dignity in nursing care: What does it mean to student nurses?

OpenAIRE

Mullen, Rosemary.; Fleming, Anne.; McMillan, Laura.; Kydd, Angela.

2017-01-01

Background: Despite growing interest in the potential of nursing education to enhance dignity in nursingcare, relatively little is known about what dignity means to nursing students.Research question: What meaning does dignity in nursing care have for nursing students?Research design: Photo-elicitation was embedded within a Nominal Group Technique and responseswere analysed by qualitative and quantitative content analysis.Participants and research context: Participants were recruited from eac...

Ethics needs principles—four can encompass the rest—and respect for autonomy should be "first among equals"

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Gillon, R

2003-01-01

It is hypothesised and argued that "the four principles of medical ethics" can explain and justify, alone or in combination, all the substantive and universalisable claims of medical ethics and probably of ethics more generally. A request is renewed for falsification of this hypothesis showing reason to reject any one of the principles or to require any additional principle(s) that can't be explained by one or some combination of the four principles. This approach is argued to be compatible with a wide variety of moral theories that are often themselves mutually incompatible. It affords a way forward in the context of intercultural ethics, that treads the delicate path between moral relativism and moral imperialism. Reasons are given for regarding the principle of respect for autonomy as "first among equals", not least because it is a necessary component of aspects of the other three. A plea is made for bioethicists to celebrate the approach as a basis for global moral ecumenism rather than mistakenly perceiving and denigrating it as an attempt at global moral imperialism. PMID:14519842

Ethics needs principles--four can encompass the rest--and respect for autonomy should be "first among equals".

Science.gov (United States)

Gillon, R

2003-10-01

It is hypothesised and argued that "the four principles of medical ethics" can explain and justify, alone or in combination, all the substantive and universalisable claims of medical ethics and probably of ethics more generally. A request is renewed for falsification of this hypothesis showing reason to reject any one of the principles or to require any additional principle(s) that can't be explained by one or some combination of the four principles. This approach is argued to be compatible with a wide variety of moral theories that are often themselves mutually incompatible. It affords a way forward in the context of intercultural ethics, that treads the delicate path between moral relativism and moral imperialism. Reasons are given for regarding the principle of respect for autonomy as "first among equals", not least because it is a necessary component of aspects of the other three. A plea is made for bioethicists to celebrate the approach as a basis for global moral ecumenism rather than mistakenly perceiving and denigrating it as an attempt at global moral imperialism.

[Death with dignity - dignity life. A debate].

Science.gov (United States)

Medina Morales, Diego

2013-01-01

Since 2010 in the Autonomous Community of Andalusia passed into law ″derechos y garantías de la dignidad de las personas en el proceso de muerte″. At national level, in Spain, it's disputed the need to legalize this delicate aspect therefore already been made some projects for legalization. This advised to review the pros and cons of some legislative implementation experiences and case mix in countries where it has already occurred. This paper undertakes the study of the implementation of the Death with Dignity Act in Oregon and highlight is what were the immediate consequences and risks that has produced a law of this nature.

Dignity and the challenge of dying in nursing homes: the residents' view.

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Pleschberger, Sabine

2007-03-01

human dignity is discussed in almost all public debates on the care of the dying, as well as in international policies for health and social care of older people. Because nursing homes are gaining importance as places where residents live out their lives in modern western societies and since there is evidence that end-of-life care in nursing homes lacks quality, there is a growing discussion on introducing improved end-of-life care in these institutions. In order to accomplish this, the view of those who are most affected is of utmost importance. to explore the meaning of dignity with regard to end-of-life issues from the perspective of older nursing home residents in western Germany. this qualitative study is based on the Grounded Theory Approach, and the design included three steps of data generation; narrative interviews with residents of nursing homes constitute the main data pool (n = 20) of the results presented in this paper. Theoretical sampling was aimed at maximising the variety of organisational as well as residents' characteristics. Analysis of the transcripts was supported by Atlas/ti program and followed several different coding procedures and aimed at generating a concept of dignity. dignity was differentiated into intrapersonal dignity and relational dignity, socially constructed by the act of recognition. Social relations and encounters are a prerequisite for relational dignity, which underlines the vulnerability of nursing home residents' who increasingly lack social networks. A broad spectrum of attitudes and behaviour, which aimed at recognising dignity, was bundled under the category 'not being a burden'. In this light, dignity was challenged most by the threat of illness and having care needs. This was fostered by the perception of insufficient care in the nursing homes. In the light of this concept, death with dignity meant 'death at the right time', though the residents in the sample did not want to comment on the time of death, other than

Human Dignity in Healthcare: A Virtue Ethics Approach.

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Jones, David Albert

The term ‘dignity’ is used in a variety of ways but always to attribute or recognize some status in the person. The present paper concerns not the status itself but the virtue of acknowledging that status. This virtue, which Thomas Aquinas calls ‘observantia’, concerns how dignity is honoured, respected, or observed. By analogy with justice (of which it is a part) observantia can be thought of both as a general virtue and as a special virtue. As a general virtue observantia refers to that respect for human dignity that is implicit in all acts of justice. As a special virtue it concerns the specific way we show esteem for people. Healthcare represents a challenge to observantia because those in need of healthcare are doubly restricted in expressing their dignity in action: in the first place by their ill health, and in the second place by the conditions required by healthcare (hence the sick are termed ‘patients’ rather than ‘agents’). To be understood properly, especially in the context of healthcare, the virtue of observantia needs both to qualify and to be qualified by the virtue of misericordia, empathy, or compassion for affliction. The unity of the virtues requires a simultaneous recognition of the common dignity and common neediness of human existence.

Dignity in the care of older people – a review of the theoretical and empirical literature

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Jones Ian

2008-07-01

Full Text Available Abstract Background Dignity has become a central concern in UK health policy in relation to older and vulnerable people. The empirical and theoretical literature relating to dignity is extensive and as likely to confound and confuse as to clarify the meaning of dignity for nurses in practice. The aim of this paper is critically to examine the literature and to address the following questions: What does dignity mean? What promotes and diminishes dignity? And how might dignity be operationalised in the care of older people? This paper critically reviews the theoretical and empirical literature relating to dignity and clarifies the meaning and implications of dignity in relation to the care of older people. If nurses are to provide dignified care clarification is an essential first step. Methods This is a review article, critically examining papers reporting theoretical perspectives and empirical studies relating to dignity. The following databases were searched: Assia, BHI, CINAHL, Social Services Abstracts, IBSS, Web of Knowledge Social Sciences Citation Index and Arts & Humanities Citation Index and location of books a chapters in philosophy literature. An analytical approach was adopted to the publications reviewed, focusing on the objectives of the review. Results and discussion We review a range of theoretical and empirical accounts of dignity and identify key dignity promoting factors evident in the literature, including staff attitudes and behaviour; environment; culture of care; and the performance of specific care activities. Although there is scope to learn more about cultural aspects of dignity we know a good deal about dignity in care in general terms. Conclusion We argue that what is required is to provide sufficient support and education to help nurses understand dignity and adequate resources to operationalise dignity in their everyday practice. Using the themes identified from our review we offer proposals for the direction of

A resource-based version of the argument that cloning is an affront to human dignity.

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McDougall, R

2008-04-01

The claim that human reproductive cloning constitutes an affront to human dignity became a familiar one in 1997 as policymakers and bioethicists responded to the announcement of the birth of Dolly the sheep. Various versions of the argument that reproductive cloning is an affront to human dignity have been made, most focusing on the dignity of the child produced by cloning. However, these arguments tend to be unpersuasive and strongly criticised in the bioethical literature. In this paper I put forward a different argument that reproductive cloning is an affront to human dignity, one that looks beyond the dignity of the child produced. I suggest that allocating funds to such a pursuit can affront human dignity by diverting resources away from those existing people who lack sufficient health to enable them to exercise basic rights and liberties. This version of the argument posits cloning as an affront to human dignity in particular circumstances, rather than claiming the technology as intrinsically inconsistent with human dignity.

Human cloning laws, human dignity and the poverty of the policy making dialogue.

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Caulfield, Timothy

2003-07-29

The regulation of human cloning continues to be a significant national and international policy issue. Despite years of intense academic and public debate, there is little clarity as to the philosophical foundations for many of the emerging policy choices. The notion of "human dignity" is commonly used to justify cloning laws. The basis for this justification is that reproductive human cloning necessarily infringes notions of human dignity. The author critiques one of the most commonly used ethical justifications for cloning laws - the idea that reproductive cloning necessarily infringes notions of human dignity. He points out that there is, in fact, little consensus on point and that the counter arguments are rarely reflected in formal policy. Rarely do domestic or international instruments provide an operational definition of human dignity and there is rarely an explanation of how, exactly, dignity is infringed in the context reproductive cloning. It is the author's position that the lack of thoughtful analysis of the role of human dignity hurts the broader public debate about reproductive cloning, trivializes the value of human dignity as a normative principle and makes it nearly impossible to critique the actual justifications behind many of the proposed policies.

Learning from dying patients during their final days: life reflections gleaned from dignity therapy.

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Hack, Thomas F; McClement, Susan E; Chochinov, Harvey M; Cann, Beverley J; Hassard, Thomas H; Kristjanson, Linda J; Harlos, Mike

2010-10-01

Dignity therapy is a novel therapeutic approach designed to decrease suffering, enhance quality of life and bolster a sense of dignity for patients approaching death. The benefits of dignity therapy were previously documented in a sample of 100 terminally ill patients. One of the products of dignity therapy is a transcript of the edited therapy session(s). In this qualitative study, 50 of the 100 (17 from Winnipeg, Manitoba, Canada, and 33 from Perth, Australia) dignity therapy transcripts were randomly drawn, and independently coded and analysed by three investigators using a grounded theory approach. The transcripts revealed that dignity therapy serves to provide a safe, therapeutic environment for patients to review the most meaningful aspects of their lives in such a manner that their core values become apparent. The most common values expressed by the patients included 'Family', 'Pleasure', 'Caring', 'A Sense of Accomplishment', 'True Friendship', and 'Rich Experience'. Exemplars of each of these values illustrate the pervasive, defining role of values in our lives. The findings are discussed in terms of values theory, the role of dignity therapy, and consideration of values clarification in clinicians' efforts to enhance the dignity of terminally ill patients.

Maintaining dignity in vulnerability

DEFF Research Database (Denmark)

Høy, Bente

2016-01-01

to understand the meaning of the narrated text. Results. The meaning of maintaining dignity was constituted in a sense of vulnerability to the self, and elucidated in three major interrelated themes: Being involved as a human being, being involved as the person one is and strives to become, and being involved...

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.

Is the creation of admixed embryos "an offense against human dignity"?

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Jones, David Albert

2010-01-01

The controversy over the creation of admixed human-nonhuman embryos, and specifically of what have been termed "cybrids," involves a range of ethical and political issues. It is not reducible to a single question. This paper focuses on one question raised by that controversy, whether creating admixed human-nonhuman entities is "an offense against human dignity. "In the last decade there has been sustained criticism of the use of the concept of human dignity within bioethics. The concept has been criticized as "vague" and "useless." Nevertheless, the concept continues to be invoked in bioethical discussion and in international instruments. This paper defends a concept of human dignity that is coherent but that is wider than contemporary post-Kantian approaches. "Human dignity" is best regarded as having a set of analogically related meanings, more than one of which is relevant to the field of bioethics. A more subtle understanding of the concept of human dignity can help identify what is ethically problematic in human-nonhuman combinations and so shed light on one aspect of the admixed embryo debate.

Feasibility, acceptability, and potential effectiveness of dignity therapy for people with motor neurone disease.

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Brenda Bentley

Full Text Available BACKGROUND: Motor neurone disease (MND practice guidelines suggest developing interventions that will promote hope, meaning, and dignity to alleviate psychological distress, but very little research has been done. This study begins to address this need by exploring the use of dignity therapy with people with MND. Dignity therapy is a brief psychotherapy that promotes hope, meaning and dignity, and enhances the end of life for people with advanced cancer. The aims of this study are to assess the feasibility, acceptability, and potential effectiveness of dignity therapy for people with MND. METHODS/DESIGN: This cross-sectional feasibility study used a one-group pre-test post-test design with 29 people diagnosed with MND. Study participants completed the following self-report questionnaires: Herth Hope Index, FACIT-sp, Patient Dignity Inventory, ALS Assessment Questionnaire, ALS Cognitive Behavioural Screen, and a demographic and health history questionnaire. Acceptability was measured with a 25-item feedback questionnaire. Feasibility was assessed by examining the length of time taken to complete dignity therapy and how symptoms common in MND affected the intervention. Generalised linear mixed models and reliable change scores were used to analyse the data. RESULTS: There were no significant pre-test post-test changes for hopefulness, spirituality or dignity on the group level, but there were changes in hopefulness on the individual level. The results of the feedback questionnaire indicates dignity therapy is highly acceptable to people with MND, who report benefits similar to those in the international randomised controlled trial on dignity therapy, a population who primarily had end-stage cancer. Benefits include better family relationships, improved sense of self and greater acceptance. Dignity therapy with people with MND is feasible if the therapist can overcome time and communication difficulties. CONCLUSIONS: Dignity therapy for people with

The significance of meaningful and enjoyable activities for nursing home resident's experiences of dignity

DEFF Research Database (Denmark)

Slettebø, Åshild; Saeteren, Berit; Caspari, Synnøve

2017-01-01

BACKGROUND: Living in a nursing home may be challenging to the residents' experience of dignity. Residents' perception of how their dignity is respected in everyday care is important. AIM: To examine how nursing home residents experience dignity through the provision of activities that foster...... meaning and joy in their daily life. METHOD: A qualitative design was used and 28 individual semistructured interviews conducted with nursing home residents from six nursing homes in Denmark, Norway and Sweden. The data were analysed with qualitative content analysis. Independent ethical committees in all...... participating countries granted their approval for the study. FINDINGS: The participants highlight two dimensions of the activities that foster experiences of dignity in nursing homes in Scandinavia. These two categories were (i) fostering dignity through meaningful participation and (ii) fostering dignity...

The Limits of Existential Autonomy and the Fundamental Law Duties of Preserving Inconscious People Lives

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Ana Stela Vieira Mendes Câmara

2016-12-01

Full Text Available In the face of factual, conceptual and scientific uncertainties surrounding the finitude of life, and assuming the search for the ideal of a dignified, natural and proper death without prepayments or undue extensions, this research has the scope to investigate the reasonableness of the parameters that establish limitations on existential autonomy, due to the preservation of life of unconscious people. Identifies, based on heteronomous component of human dignity, the existence of a bundle of basic legal duties of protection of these individuals whose ownership rests with the family and the state. The methodology is qualitative, interdisciplinary bibliographic and documentary, in which it is used hypothetical-deductive approach.

Fostering dignity in the care of nursing home residents through slow caring

DEFF Research Database (Denmark)

Lohne, Vibeke; Høy, Bente; Lillestø, Britt

2017-01-01

Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has...... personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach....... a hermeneutic design. Participants and research context: In all, 40 healthcare personnel from six nursing homes in Scandinavia participated in focus group interviews in this study. Ethical considerations: This study has been evaluated and approved by the Regional Ethical Committees and the Social Science Data...

Autonomy is a Right, Not a Feat: How Theoretical Misconceptions have Muddled the Debate on Dynamic Consent to Biobank Research.

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Johnsson, Linus; Eriksson, Stefan

2016-09-01

Should people be involved as active participants in longitudinal medical research, as opposed to remaining passive providers of data and material? We argue in this article that misconceptions of 'autonomy' as a kind of feat rather than a right are to blame for much of the confusion surrounding the debate of dynamic versus broad consent. Keeping in mind two foundational facts of human life, freedom and dignity, we elaborate three moral principles - those of autonomy, integrity and authority - to better see what is at stake. Respect for autonomy is to recognize the other's right to decide in matters that are important to them. Respect for integrity is to meet, in one's relationship with the other, their need to navigate the intersection between private and social life. Respect for authority is to empower the other - to help them to cultivate their responsibility as citizens. On our account, to force information onto someone who does not want it is not to respect that person's autonomy, but to violate integrity in the name of empowerment. Empowerment, not respect for autonomy, is the aim that sets patient-centred initiatives employing a dynamic consent model apart from other consent models. Whether this is ultimately morally justified depends on whether empowerment ought to be a goal of medical research, which is questionable. © 2016 John Wiley & Sons Ltd.

Dignity of older people in a nursing home: narratives of care providers.

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Jakobsen, Rita; Sørlie, Venke

2010-05-01

The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in as not supportive. They also thought they were not being seen and heard in situations where they disagree with the basic values of the organization. The results are discussed in terms of Habermas's understanding of modern society. Care settings for elderly people obviously present ethical challenges, particularly in the case of those suffering from dementia. The care provider participants in this study expressed frustration and feelings of powerlessness. It is possible to understand their experiences in terms of Habermas's theory of modern society and the concept of the system's colonization of the life world.

Human cloning laws, human dignity and the poverty of the policy making dialogue

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Caulfield Timothy

2003-07-01

Full Text Available Abstract Background The regulation of human cloning continues to be a significant national and international policy issue. Despite years of intense academic and public debate, there is little clarity as to the philosophical foundations for many of the emerging policy choices. The notion of "human dignity" is commonly used to justify cloning laws. The basis for this justification is that reproductive human cloning necessarily infringes notions of human dignity. Discussion The author critiques one of the most commonly used ethical justifications for cloning laws – the idea that reproductive cloning necessarily infringes notions of human dignity. He points out that there is, in fact, little consensus on point and that the counter arguments are rarely reflected in formal policy. Rarely do domestic or international instruments provide an operational definition of human dignity and there is rarely an explanation of how, exactly, dignity is infringed in the context reproductive cloning. Summary It is the author's position that the lack of thoughtful analysis of the role of human dignity hurts the broader public debate about reproductive cloning, trivializes the value of human dignity as a normative principle and makes it nearly impossible to critique the actual justifications behind many of the proposed policies.

Human cloning laws, human dignity and the poverty of the policy making dialogue

Science.gov (United States)

Caulfield, Timothy

2003-01-01

Background The regulation of human cloning continues to be a significant national and international policy issue. Despite years of intense academic and public debate, there is little clarity as to the philosophical foundations for many of the emerging policy choices. The notion of "human dignity" is commonly used to justify cloning laws. The basis for this justification is that reproductive human cloning necessarily infringes notions of human dignity. Discussion The author critiques one of the most commonly used ethical justifications for cloning laws – the idea that reproductive cloning necessarily infringes notions of human dignity. He points out that there is, in fact, little consensus on point and that the counter arguments are rarely reflected in formal policy. Rarely do domestic or international instruments provide an operational definition of human dignity and there is rarely an explanation of how, exactly, dignity is infringed in the context reproductive cloning. Summary It is the author's position that the lack of thoughtful analysis of the role of human dignity hurts the broader public debate about reproductive cloning, trivializes the value of human dignity as a normative principle and makes it nearly impossible to critique the actual justifications behind many of the proposed policies. PMID:12887735

Biotechnologies and Human Dignity

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Sweet, William; Masciulli, Joseph

2011-01-01

In this article, the authors review some contemporary cases where biotechnologies have been employed, where they have had global implications, and where there has been considerable debate. The authors argue that the concept of dignity, which lies at the center of such documents as the 2005 Universal Declaration on Bioethics and Human Rights, the…

[Dignity or integrity - does the genetic modification of animals require new concepts in animal ethics?].

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Schmidt, Kirsten

2008-01-01

Animal genetic engineering seems to point at a normative gap beyond pathocentric welfare theories in animal ethics. Recently developed approaches aim to bridge this gap by means of new normative criteria such as animal dignity and animal integrity. The following comparison of dignity and integrity in the context of animal ethics shows that the dignity concept faces serious problems because of its necessarily anthroporelational character and the different functions of contingent and inherent dignity within ethical reasoning. Unlike animal dignity the concept of animal integrity could prove to be a useful enhancement for pathocentric approaches.

Nurses' human dignity in education and practice: An integrated literature review

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Akram Parandeh

2016-01-01

Conclusions: The small number of studies found for the review indicates the need for further research in the field of nurses' dignity. Recognizing nurses' dignity can help to improve the nursing practice and provide them a dignified workplace.

[Architecture, budget and dignity].

Science.gov (United States)

Morel, Etienne

2012-01-01

Drawing on its dynamic strengths, a psychiatric unit develops various projects and care techniques. In this framework, the institute director must make a number of choices with regard to architecture. Why renovate the psychiatry building? What financial investments are required? What criteria should be followed? What if the major argument was based on the respect of the patient's dignity?

Dignity as an empirical lifeworld construction-in the field of surgery in Denmark.

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Rasmussen, Tina Seidelin; Delmar, Charlotte

2014-01-01

Patient dignity is a complex yet central phenomenon. Disrespect for dignity can mean retention of sick role, loss of self-care and control, decreased participation and therefore influence healing. At the same time, nurses have an obligation to respect dignity, and patients expect it. In clinical practice, with the focus on efficiency and economy, dignity can be compromised. The surgical patient may be particularly vulnerable to loss of dignity, when focus is solely on surgical procedure, efficiency, and productivity. The aim of the article is to describe the characteristics of the importance of dignity perceived by four surgical patients at a university hospital in Denmark. The hermeneutic phenomenological approach of Van Manen is used to analyse and interpret data collected from in-depth semi-structured interviews. The interviews explored the lived experience with two women and two men who had undergone a surgical intervention in a Danish vascular surgery department. The thematic analysis led to the basic theme: "To be an important person" illustrated by the themes: "Being a co-player," "Over exposure," and "To swallow the bitter pill." The findings provide a better understanding of patient's perspective of dignity, which is characterized by a complex interaction of several factors. Nurses should be concerned with balancing expectations, values, and opinions to maintain dignity in nursing and create a common platform for collaboration. This collaboration makes it possible for patients to be involved and have a voice in relation to nursing, treatment, and administering of time even though it could be at the expense of the terms of the system.

HUMAN DIGNITY AND PROPORTIONALITY ANALYSIS / A DIGNIDADE HUMANA E A ANÁLISE DA PROPORCIONALIDADE

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Robert Alexy

2016-02-01

Full Text Available The relation between proportionality analysis and human dignity is one of the most contested questions in the debate about the normative structure of human dignity. Two conceptions stand in opposition: an absolute and a relative conception. According to the absolute conception, the guarantee of human dignity counts as a norm that takes precedence over all other norms in all cases. Taking precedence over all other norms in all cases implies that balancing is precluded. This, in turn, means that each and every interference with human dignity is a violation of human dignity. Thus, justified interference with human dignity becomes impossible. By contrast, proportionality analysis is intrinsically connected to the distinction between justified and unjustified interferences. A proportional interference is justified and is, therefore, constitutional. The opposite applies in the case of disproportional interference. The absolute conception is incompatible with this conceptual framework. For this reason, it is incompatible with proportionality analysis. According to the relative conception, precisely the opposite is true. The relative conception says that the question of whether human dignity is violated is a question of proportionality. With this, the relative conception is not only compatible with proportionality analysis, it presupposes it.

Dignity in maternal health service delivery : Cross sectional survey on factors that promote or compromise dignity in maternal health service delivery: Perspectives of Women and Midwives from Southern Malawi.

OpenAIRE

Chigwenembe, Lucy

2011-01-01

Background and Objective The concept of dignity is broad and complex as its interpretation is based on culture and social norms of a particular setting. According to the United Nations General Assembly and the World Health Organization (WHO), human dignity is the understanding of human rights and the foundation for patients’ rights. A number of international instruments have been developed to promote patients’ rights and dignity. Such instruments include the Universal Declaration on Human ...

Protection of honour and dignity in criminal law

OpenAIRE

Diāna Hamkova

2009-01-01

Annotation As it is not possible to analyze categories „honour” and „dignity” only from one point of view, the research is made in philosophical, legal and bioethical aspects. Legal analysis of corpus delicti – defamation and demeaning of the dignity is made in the research, as well as nuances of protection of honour and dignity in criminal and civil law are analyzed. In order to reach the objective of the research wide range of international regulations is dealt with as well as comparativ...

Living and dying with dignity: a qualitative study of the views of older people in nursing homes.

Science.gov (United States)

Hall, Sue; Longhurst, Susan; Higginson, Irene

2009-07-01

most older people living in nursing homes die there. An empirically based model of dignity has been developed, which forms the basis of a brief psychotherapy to help promote dignity and reduce distress at the end of life. to explore the generalisability of the dignity model to older people in nursing homes. qualitative interviews were used to explore views on maintaining dignity of 18 residents of nursing homes. A qualitative descriptive approach was used. The analysis was both deductive (arising from the dignity model) and inductive (arising from participants' views). the main categories of the dignity model were broadly supported: illness-related concerns, social aspects of the illness experience and dignity conserving repertoire. However, subthemes relating to death were not supported and two new themes emerged. Some residents saw their symptoms and loss of function as due to old age rather than illness. Although residents did not appear to experience distress due to thoughts of impending death, they were distressed by the multiple losses they had experienced. these findings add to our understanding of the concerns of older people in care homes on maintaining dignity and suggest that dignity therapy may bolster their sense of dignity.

Dignity as an empirical lifeworld construction—In the field of surgery in Denmark

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Tina Seidelin Rasmussen

2014-07-01

Full Text Available Patient dignity is a complex yet central phenomenon. Disrespect for dignity can mean retention of sick role, loss of self-care and control, decreased participation and therefore influence healing. At the same time, nurses have an obligation to respect dignity, and patients expect it. In clinical practice, with the focus on efficiency and economy, dignity can be compromised. The surgical patient may be particularly vulnerable to loss of dignity, when focus is solely on surgical procedure, efficiency, and productivity. The aim of the article is to describe the characteristics of the importance of dignity perceived by four surgical patients at a university hospital in Denmark. The hermeneutic phenomenological approach of Van Manen is used to analyse and interpret data collected from in-depth semi-structured interviews. The interviews explored the lived experience with two women and two men who had undergone a surgical intervention in a Danish vascular surgery department. The thematic analysis led to the basic theme: “To be an important person” illustrated by the themes: “Being a co-player,” “Over exposure,” and “To swallow the bitter pill.” The findings provide a better understanding of patient's perspective of dignity, which is characterized by a complex interaction of several factors. Nurses should be concerned with balancing expectations, values, and opinions to maintain dignity in nursing and create a common platform for collaboration. This collaboration makes it possible for patients to be involved and have a voice in relation to nursing, treatment, and administering of time even though it could be at the expense of the terms of the system.

Dignity in health-care: a critical exploration using feminism and theories of recognition.

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Aranda, Kay; Jones, Andrea

2010-09-01

Growing concerns over undignified health-care has meant the concept of dignity is currently much discussed in the British National Health Service. This has led to a number of policies attempting to reinstate dignity as a core ethical value governing nursing practice and health-care provision. Yet these initiatives continue to draw upon a concept of dignity which remains reliant upon a depoliticised, ahistorical and decontexualised subject. In this paper, we argue the need to revise the dignity debate through the lens of feminism and theories of recognition. Postmodern feminist theories provide major challenges to what remain dominant liberal approaches as they pay attention to the contingent, reflexive, and affective aspects of care work. Theories of recognition provide a further critical resource for understanding how moral obligations and responsibilities towards others and our public and private responses to difference arise. This re-situates dignity as a highly contested and politicised concept involving complex moral deliberations and diverse political claims of recognition. The dignity debate is thus moved beyond simplistic rational injunctions to care, or to care more, and towards critical discussions of complex politicised, moral practices infused with power that involve the recognition of difference in health-care.

Basing Science Ethics on Respect for Human Dignity.

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Aközer, Mehmet; Aközer, Emel

2016-12-01

A "no ethics" principle has long been prevalent in science and has demotivated deliberation on scientific ethics. This paper argues the following: (1) An understanding of a scientific "ethos" based on actual "value preferences" and "value repugnances" prevalent in the scientific community permits and demands critical accounts of the "no ethics" principle in science. (2) The roots of this principle may be traced to a repugnance of human dignity, which was instilled at a historical breaking point in the interrelation between science and ethics. This breaking point involved granting science the exclusive mandate to pass judgment on the life worth living. (3) By contrast, respect for human dignity, in its Kantian definition as "the absolute inner worth of being human," should be adopted as the basis to ground science ethics. (4) The pathway from this foundation to the articulation of an ethical duty specific to scientific practice, i.e., respect for objective truth, is charted by Karl Popper's discussion of the ethical principles that form the basis of science. This also permits an integrated account of the "external" and "internal" ethical problems in science. (5) Principles of the respect for human dignity and the respect for objective truth are also safeguards of epistemic integrity. Plain defiance of human dignity by genetic determinism has compromised integrity of claims to knowledge in behavioral genetics and other behavioral sciences. Disregard of the ethical principles that form the basis of science threatens epistemic integrity.

The dignity of the nursing profession: a meta-synthesis of qualitative research.

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Sabatino, Laura; Stievano, Alessandro; Rocco, Gennaro; Kallio, Hanna; Pietila, Anna-Maija; Kangasniemi, Mari K

2014-09-01

Nursing continues to gain legitimation epistemologically and ontologically as a scientific discipline throughout the world. If a profession gains respect as a true autonomous scientific profession, then this recognition has to be put in practice in all environments and geographical areas. Nursing professional dignity, as a self-regarding concept, does not have a clear definition in the literature, and it has only begun to be analyzed in the last 10 years. The purpose of this meta-synthesis was to determine the various factors that constitute the notion of nursing professional dignity. The target was to create a tentative model of the concept. The research design was a meta-synthesis (N = 15 original articles) of nursing professional dignity described in the literature, based on the guidelines by Noblit and Hare. Original studies were sought out from electronic databases and manual searches. The selection of literature was conducted on stages based on titles (n = 2595), abstracts (n = 70), and full-texts (n = 15) according to the inclusion and exclusion criteria. From this analysis, a clear definition of nursing professional dignity emerged that underscored two main macro-dimensions constituting this intertwined, multidimensional, and complex notion: characteristics of the human beings and workplace elements. The recognition of nursing professional dignity could have a positive impact on patients because the results clearly showed that nurses are more prone to foster patients' dignity, patients' safety, and a better quality of care if their own dignity is respected. If nurses are uncomfortable, humiliated, or not seen in their professional role, it is difficult to give to others good care, good support, or good relationships. © The Author(s) 2014.

Tweeting dignity: A practical theological reflection on Twitter’s normative function

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Jan Albert Van den Berg

2017-08-01

Full Text Available Social media makes an important contribution to a rapidly changing world in which various domains of meaning are described anew. The evolving nature and dynamic character of social media therefore provides for a rich praxis terrain with which to interact from a practical theological orientation. More specifically associated with the theme of this contribution, the social media sphere also provides an excellent space not only to rethink but also to reenact expressions of dignity in society. The research is facilitated from a practical theological orientation, with particular focus on a normative dimension as embodied in aspects of dignity. Through the use of an interdisciplinary approach and methodology, some contours of dignity specifically associated with South African politics as well as the so-called Charlie Hebdo attacks in 2015 in Paris expressed on the social media platform, Twitter, are described and discussed. From this empirical analysis, description and discussion, a practical theological reflection is offered in which aspects of dignity associated with a normativity function are described. Some practical theological perspectives contributing to future relevant tweeting on dignity are also formulated and provided in conclusion.

Nursing home staff's views on residents' dignity: a qualitative interview study

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Oosterveld-Vlug, Mariska G.; Pasman, H. Roeline W.; van Gennip, Isis E.; Willems, Dick L.; Onwuteaka-Philipsen, Bregje D.

2013-01-01

Maintaining dignity is an important element of end-of-life care and also of the care given in nursing homes. Factors influencing personal dignity have been studied from both nursing home residents' and staff's perspective. Little is however known about the way nursing home staff perceive and promote

Student nurses' experiences of preserved dignity in perioperative practice - Part I.

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Blomberg, Ann-Catrin; Willassen, Elin; von Post, Iréne; Lindwall, Lillemor

2015-09-01

In recent years, operating theatre nurse students' education focussed on ethical value issues and how the patient's dignity is respected in the perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient's care during surgery. The objective of this study was to present what operating theatre nurse students experienced and interpreted as preserved dignity in perioperative practice. The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan's critical incident technique. Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation. The study was conducted accordance with the Declaration of Helsinki and approved by a local University Ethics Research Committee. The findings revealed that students experienced that operating theatre nurses perserved patient's dignity in perioperative practice by being present for each other and making themselves known to the patient. Operating theatre nurses caring for the patient by being compassionate and preserved the patient privacy. The new understanding that emerged was that the operating theatre nurse students understood that the operating theatre nurse wanted to care for the patient like a human being. In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. Preserved dignity is an ethical and caring act. Ethical questions and how to preserve dignity in perioperative practice should be discussed more both in educations of healthcare professionals and in clinical practice. © The Author(s) 2014.

Developing child autonomy in pediatric healthcare: towards an ethical model.

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Martakis, Kyriakos; Brand, Helmut; Schröder-Bäck, Peter

2018-06-01

The changes initiated by the new National Civil and Commercial Code in Argentina underline the pediatric task to empower children's and adolescents' developing autonomy. In this paper, we have framed a model describing autonomy in child healthcare. We carried out a literature review focusing on i) the concept of autonomy referring to the absolute value of the autonomous individual, and ii) the age-driven process of competent decisionmaking development. We summarized our findings developing a conceptual model that includes the child, the pediatrician and the parents. The pediatricianchild relationship is based on different forms of guidance and cooperation, resulting in varying levels of activity and passivity. Parental authority influences the extent of autonomy, based on the level of respect of the child's moral equality. Contextual, existential, conceptual, and socialethical conditions shall be considered when applying the model to facilitate dialogue between pediatricians, children, parents and other actors. Sociedad Argentina de Pediatría.

Human dignity in the Nazi era: implications for contemporary bioethics

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O'Mathúna Dónal P

2006-03-01

Full Text Available Abstract Background The justification for Nazi programs involving involuntary euthanasia, forced sterilisation, eugenics and human experimentation were strongly influenced by views about human dignity. The historical development of these views should be examined today because discussions of human worth and value are integral to medical ethics and bioethics. We should learn lessons from how human dignity came to be so distorted to avoid repetition of similar distortions. Discussion Social Darwinism was foremost amongst the philosophies impacting views of human dignity in the decades leading up to Nazi power in Germany. Charles Darwin's evolutionary theory was quickly applied to human beings and social structure. The term 'survival of the fittest' was coined and seen to be applicable to humans. Belief in the inherent dignity of all humans was rejected by social Darwinists. Influential authors of the day proclaimed that an individual's worth and value were to be determined functionally and materialistically. The popularity of such views ideologically prepared German doctors and nurses to accept Nazi social policies promoting survival of only the fittest humans. A historical survey reveals five general presuppositions that strongly impacted medical ethics in the Nazi era. These same five beliefs are being promoted in different ways in contemporary bioethical discourse. Ethical controversies surrounding human embryos revolve around determinations of their moral status. Economic pressures force individuals and societies to examine whether some people's lives are no longer worth living. Human dignity is again being seen as a relative trait found in certain humans, not something inherent. These views strongly impact what is taken to be acceptable within medical ethics. Summary Five beliefs central to social Darwinism will be examined in light of their influence on current discussions in medical ethics and bioethics. Acceptance of these during the Nazi

Human dignity in the Nazi era: implications for contemporary bioethics.

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O'Mathúna, Dónal P

2006-03-14

The justification for Nazi programs involving involuntary euthanasia, forced sterilisation, eugenics and human experimentation were strongly influenced by views about human dignity. The historical development of these views should be examined today because discussions of human worth and value are integral to medical ethics and bioethics. We should learn lessons from how human dignity came to be so distorted to avoid repetition of similar distortions. Social Darwinism was foremost amongst the philosophies impacting views of human dignity in the decades leading up to Nazi power in Germany. Charles Darwin's evolutionary theory was quickly applied to human beings and social structure. The term 'survival of the fittest' was coined and seen to be applicable to humans. Belief in the inherent dignity of all humans was rejected by social Darwinists. Influential authors of the day proclaimed that an individual's worth and value were to be determined functionally and materialistically. The popularity of such views ideologically prepared German doctors and nurses to accept Nazi social policies promoting survival of only the fittest humans.A historical survey reveals five general presuppositions that strongly impacted medical ethics in the Nazi era. These same five beliefs are being promoted in different ways in contemporary bioethical discourse. Ethical controversies surrounding human embryos revolve around determinations of their moral status. Economic pressures force individuals and societies to examine whether some people's lives are no longer worth living. Human dignity is again being seen as a relative trait found in certain humans, not something inherent. These views strongly impact what is taken to be acceptable within medical ethics. Five beliefs central to social Darwinism will be examined in light of their influence on current discussions in medical ethics and bioethics. Acceptance of these during the Nazi era proved destructive to many humans. Their widespread

Darwin and Lincoln: their legacy of human dignity.

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Earls, Felton

2010-01-01

The legacy of Charles Darwin and Abraham Lincoln is to champion the dignity inherent in every human being. The moment of the bicentennial of their births provides an opportunity to celebrate and reflect on ways they have shaped our understanding and commitment to human rights. The naturalist and the constitutional lawyer, so different in circumstance and discipline, were morally allied in the mission to eradicate slavery. The profound lessons to be extracted from the lives of these two icons bind us to the agonizing reality that nearly 150 years after Gettysburg and the publication of the Descent of Man, and Selection in Relation to Sex, there remains much work to do toward advancing the security, respect, and equality of our species. This article describes how Darwin and Lincoln's inspiring legacies guided the author's personal choices as a scientist and activist. The essay concludes with a set of questions and challenges that confront us, foremost among which is the need to balance actions in response to the violation of negative rights by actions in the pursuit of positive rights.

The experiences on dignity from the perspective of the elderly in nursing homes

DEFF Research Database (Denmark)

Høy, Bente

2016-01-01

The aim of the study was to explore nursing home residents’ practice experiences on dignity in caring situations and everyday life in order to illuminate the significance for a life in dignity. Elderly living in nursing homes are vulnerable which appeal to nursing care ethics and emphasise....... From the literature we have knowledge of how dignity is violated among persons who are sick, weak and helpless; however, the knowledge is limited on how dignity is maintained among vulnerable elderly in nursing homes. A hermeneutic approach was used to interpret the material, which was gathered during...... semi-structured interviews with elderly living in six nursing homes in Scandinavian. A total of 28 interviews were transcribed. The findings will be presented at the conference....

Autonomy of the child in the South African context: is a 12 year old of sufficient maturity to consent to medical treatment?

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Ganya, Wandile; Kling, Sharon; Moodley, Keymanthri

2016-11-02

A child is a developing person with evolving capacities that include autonomy, mental (decisional) capacity and capacity to assume responsibility. Hence, children are entitled to participatory (autonomy) rights in South Africa as observed in the Children's Act 38 of 2005. According to section 129 of the Act a child may consent to his or her own medical treatment provided that he or she is over the age of 12 years and is of sufficient maturity and decisional capacity to understand the various implications of the treatment including the risks and benefits thereof. However, the Act does not provide a definition for what qualifies as 'sufficient maturity' nor does it stipulate how health professionals ought to assess the decisional capacity of a child. In addition, South Africa is a culturally diverse country. The Western liberal notion of autonomy may not necessarily find equal prominence in the mores of people with a different worldview. Hence we demonstrate a few salient comparisons between legal liberal moral theory and African communitarianism as pertinent to the autonomy of the child. Children are rights-holders by virtue of their humanity. Their dignity as individual human persons affords them the entitlement to human rights as contemplated under the Constitution of the Republic of South Africa. However, contrary to the traditional Western notion of individual autonomous persons African societies hold a communalistic notion of person hence there is less regard for individual autonomy and rights with more emphasis on the communal good and maintaining the continuity of relationships and interdependencies shared within a community. A child considered in this view is not regarded as a full person. This implies that decisions concerning the child, including consent to medical treatment are discussed and determined by the community to which the child belongs. Lastly, in this article, we draw on the notion of capacity for responsibility to produce a pragmatic

Adult education and reflexive activation: prioritising recognition, respect, dignity and capital accumulation

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Séamus Ó Tuama

2016-03-01

Full Text Available The economic crisis that emerged in 2008 put great stress on the so-called European project. The economic downturn put additional pressure on economically and educationally marginalised populations, who continue to experience high levels of unemployment and lower levels of access to societal goods. Activation is seen as one of the main strategies to combat unemployment. The EU also recognises a systemic shift in the nature of work, such that individuals will have several transitions between work and education during their careers. This is a significant societal level challenge that will likely pose greater stress on groups and individuals that are marginalised socially, educationally and economically. To deliver better long-term outcome it is necessary to adopt reflexive activation approaches. Reflexive activation is one in which unemployed people actively co-design the proposed resolutions. It is also embedded in a societal context. It is cognisant of citizenship, autonomy and human rights and leans towards traditional adult education values. The model of reflexive activation explored here is infused with understandings emerging from Schuller's three types of capital and theories of recognition, respect and dignity developed by Honneth and others.

[Dignity in the care of terminal ill and dying patients. Definitions and supportive interventions in palliative care].

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Mehnert, A; Schröder, A S; Puhlmann, K; Müllerleile, U; Koch, U

2006-11-01

Most patients, family members, health care professional as well as volunteers would agree that dignified care and being allowed to die with dignity are superior and unquestionable goals of palliative care. Although the majority of people have a more or less vague concept of dignity and despite its significance for palliative care, only a few empirical approaches to describe the sense of dignity from patients' and health care professionals' perspectives have been undertaken. However, individual descriptions of the dignity concept and definitions can serve as an impetus to improve the current palliative care practice by the development and evaluation of psychotherapeutic interventions for patients near the end of life and the allocation of resources. This article considers an internationally developed empirical-based model of dignity in severe and terminal ill patients by Chochinov et al. Furthermore, it illustrates the understanding of dignity as well as self-perceived exertions of influence on a patient's dignity from the perspective of health care professionals and volunteers. Psychotherapeutic interventions and strategies are introduced that can help conserve the sense of dignity of patients during palliative care.

Autonomy and the principle of respect for autonomy.

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Gillon, R

1985-06-15

Autonomy is defined as the capacity to think, decide, and act freely and independently on the basis of such thought and decisions. Three types of autonomy are distinguished: autonomy of thought, which embraces the wide range of human intellectual activities called "thinking for oneself"; autonomy of will, or the capacity to decide to do things on the basis of one's deliberations; and autonomy of action, the absence of which is illustrated by the situation of a patient whose voluntary muscles are paralyzed by curariform drugs and who thus cannot tell the surgeon that the anesthetist has forgotten the nitrous oxide. Autonomy is viewed as a prerequisite for all the virtues, rather than as a virtue in its own right. The arguments of Immanuel Kant and John Stuart Mill concerning the principle of respect for autonomy are summarized as exemplars respectively of the deontological and utilitarian philosophical approaches.

A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care

DEFF Research Database (Denmark)

Houmann, Lise Jul; Chochinov, Harvey M; Kristjanson, Linda J

2014-01-01

questionnaires were completed when patients received the generativity document (T1) and 2 weeks later (T2). Changes from baseline (T0) were measured in sense of dignity, Structured Interview for Symptoms and Concerns items, Patient Dignity Inventory, Hospital Anxiety and Depression Scale and European...... and will to live. Quality of life decreased (mean = -9 (95% confidence interval: -14.54; -2.49)) and depression increased (mean = 0.31 (0.06; 0.57)) on one of several depression measures. At T2 (n = 31), sense of dignity (mean = -0.52 (-1.01; -0.02)) and sense of being a burden to others (mean = -0.26 (-0.49; -0......Background:Dignity Therapy is a brief, psychosocial intervention for patients with incurable disease.Aim:To investigate participation in and evaluation of Dignity Therapy and longitudinal changes in patient-rated outcomes.Design:A prospective (pre/post) evaluation design was employed. Evaluation...

[Dignity of the elderly].

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Ribera Casado, José Manuel

2015-01-01

A discussion is presented on what is understood by «dignity» when applied to the elderly, highlighting it universal character and contrasting it with the greater risks of suffering «indignities» to which the elderly are exposed. The discussion is divided into 3 sections. In the first, the risk factors in this sense could lead to physiological losses and illnessess, which in in the physical, mental and social sense are associated with ageing. In the second, the question of discrimination of the elderly as a form of aggression due to age, and is so widespread and infrequently studied. Lastly, it is discussed how to interpret the advice of the United Nations on how to promote active ageing as a defence system against indignities. It concludes with the message that neither the limitations that accompany the ageing process, nor the different forms of aggression that the elderly may be subjected to, provide sufficient argument neither for a loss of individual nor collective dignity. This is something which we all must endeavour to achieve and which must be maintained and be respected by individuals and by society at all times. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

Patient perspectives of maintaining dignity in Indonesian clinical care settings: A qualitative descriptive study.

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Asmaningrum, Nurfika; Tsai, Yun-Fang

2018-03-01

To gain an understanding towards the perspectives of hospitalized inpatients in Indonesia regarding maintaining dignity during clinical care. Dignity is a basic human right that is crucial for an individual's well-being. Respect for a person as a valuable human is a concept that is comparable to treating a person with dignity. Maintaining patient's dignity is an ethical goal of nursing care. Nevertheless, the concept is highly dependent on cultural context. This issue has not been well studied in Indonesia. This study used a qualitative descriptive design. Thirty-five participants were recruited by purposive sampling from medical to surgical wards of six public hospitals in Eastern Java, Indonesia. Data were collected in 2016 through individual face-to-face semi-structured interviews. Inductive content analysis was applied to the data. Four major categories which described qualities of nursing care essential for maintaining a patient's dignity in clinical care settings were revealed: (1) responsiveness; (2) respectful nurse-patient relationships; (3) caring characteristics and (4) personalized service. Our findings provide a cultural viewpoint of dignity for care recipients in Indonesia. The findings provide empirical support for linking dignified care and person-centred care principles with regards to cultural sensitivity. Nurses must not only be clinically competent but also culturally competent. The ability to provide culturally competent care is important for nurses as a strategy to maintain patient dignity during hospitalized care. © 2017 John Wiley & Sons Ltd.

Human dignity as a component of a long-lasting and widespread conceptual construct.

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Baertschi, Bernard

2014-06-01

For some decades, the concept of human dignity has been widely discussed in bioethical literature. Some authors think that this concept is central to questions of respect for human beings, whereas others are very critical of it. It should be noted that, in these debates, dignity is one component of a long-lasting and widespread conceptual construct used to support a stance on the ethical question of the moral status of an action or being. This construct has been used from Modernity onward to condemn slavery and torture as violations of human dignity. In spelling it out, we can come to a better understanding of what "dignity" means and become aware that there exists a quite useful place for this notion in our ethical thought, albeit a modest one.

Attitudes of Korean adults towards human dignity: a Q methodology approach.

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Jo, Kae Hwa; An, Gyeong-Ju; Doorenbos, Ardith Z

2012-06-01

The aim of this study was to identify the perceived attitudes of Korean adults towards human dignity in order to determine the relationship of human dignity to its social and cultural background. The Q methodology research technique was used to explore perceived attitude typology on the basis of the respondents' ranking order for different statements. A convenience sampling method was used to select 40 Korean adults who were interested in human dignity to create statements. From the questionnaires, in-depth interviews, and a literature review, a total of 158 statements was obtained. The final 34 Q samples were selected from a review by two nursing professors and a Q methodology expert. Moreover, 38 respondents participated as P samples by sorting 34 Q statements on a nine-point normal distribution scale. The data were analyzed by using the QUANL software package. The following four types of attitudes about human dignity were identified in Korea: a happiness-oriented-self-pursuit type, relationship-oriented-self-recognition type, reflection-oriented-self-unification type, and discrimination-oriented-self-maintenance type. The results indicate that approaches to developing human dignity education need to take this typology into account and the characteristics of the participants who fall into each category. These results provide general guidelines to understand Korean values for professional practice in various healthcare settings. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

[Does the right to die with dignity exist?].

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Toro Flores, Rafael

2008-12-01

Death is one of the few certainties in human beings. This reality generates uneasiness regarding how death will occur especially in circumstances of loneliness or suffering which can become agony. In this report, the author first analyzes the existence of the right to die with dignity as a human right which takes on the nature of being a subjective right. In continuation, the author describes the existing problematic in the application of this right to die in relationship to the so-called double effect mechanism and euthanasia. The author concludes this article by proposing previous instructions or anticipated desires as ideal measures to make the right to die with dignity valid.

The Right to Dignity and Restorative Justice in Schools

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M Reyneke

2011-10-01

Full Text Available A retributive and punitive approach is normally adopted in dealing with misbehavior in South African schools. Despite the legal abolition of corporal punishment, more than 50 percent of schools still administer it. Other forms of punishment generally applied are also punitive in nature. The right to dignity of all of the parties affected by misbehaviour in schools is considered in this analysis. The possibility of adopting restorative justice as an alternative disciplinary approach is examined as a way of protecting, promoting and restoring the dignity of the victims of such misbehaviour.

Human Dignity, Misthanasia, Public Health and Bioethics in Brazil

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Anna Silvia Penteado Setti da Rocha

2017-10-01

Full Text Available This paper aims to reflect on human dignity and misthanasia in the public health system in Brazil. For this, concepts, document reviews and public data about the condition of the Brazilian population’s access to public health were all used. The indicators show the health inequalities in the country, with the north and northeast at a disadvantage both in terms of access to health and the number of available professionals. Thus, the most underserved population tends to continue to be excluded from society and impaired with respect to their human dignity.

Dignity and the factors that influence it according to nursing home residents: a qualitative interview study

NARCIS (Netherlands)

Oosterveld-Vlug, Mariska G.; Pasman, H. Roeline W.; van Gennip, Isis E.; Muller, Martien T.; Willems, Dick L.; Onwuteaka-Philipsen, Bregje D.

2014-01-01

To gain insight in the way nursing home residents experience personal dignity and the factors that preserve or undermine it. Nursing home residents are exposed to diverse factors which may be associated with the loss of personal dignity. To help them maintain their dignity, it is important to

From Legal to Effective Recognition of Equal Dignity as a Right of the Individual with Intellectual and Developmental Disabilities. A Process that Challenges us

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Tatiana URIEN ORTIZ

2017-01-01

Full Text Available This article analyzes the ethical implications of acknowledging disability as a human rights issue. The most common way to understand disability is inspired by a welfarist structure where collective needs trump the wishes of the individual. This new conceptualization, inspired by influential philosophers, such as Dworkin and Margalit, understands dignity as the individual’s right to have their life unfold in an inclusive context that creates self-respect.

Maternal autonomy and attitudes towards gender norms: associations with childhood immunization in Nigeria.

Science.gov (United States)

Singh, Kavita; Haney, Erica; Olorunsaiye, Comfort

2013-07-01

Globally 2.5 million children under-five die from vaccine preventable diseases, and in Nigeria only 23 % of children ages 12-23 months are fully immunized. The international community is promoting gender equality as a means to improve the health and well-being of women and their children. This paper looks at whether measures of gender equality, autonomy and individual attitudes towards gender norms, are associated with a child being fully immunized in Nigeria. Data from currently married women with a child 12-23 months from the 2008 Nigeria demographic and health survey were used to study the influence of autonomy and gender attitudes on whether or not a child is fully immunized. Multivariate logistic regression was used and several key socioeconomic variables were controlled for including wealth and education, which are considered key inputs into gender equality. Findings indicated that household decision-making and attitudes towards wife beating were significantly associated with a child being fully immunized after controlling for socioeconomic variables. Ethnicity, wealth and education were also significant factors. Programmatic and policy implications indicate the potential for the promotion of gender equality as a means to improve child health. Gender equality can be seen as a means to enable women to access life-saving services for their children.

THE ROLE OF HUMAN DIGNITY IN THE ASSESSMENT OF FAIR COMPENSATION FOR UNFAIR DISMISSALS

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Stella Vettori

2012-11-01

Full Text Available South African labour law is concerned with the attainment of fairness for both the employer and the employee. In weighing up the interests of the respective parties it is of paramount importance to ensure that a delicate balance is achieved so as to give credence to commercial reality as well as an individual's right to dignity. In other words the attainment of fairness in the employment relationship must give cognisance not only to surrounding socio-economic reality but also to human rights. The environment within which the world of work operates has at its core a free enterprise economy. Ultimately, an employer should generally not be penalised to the extent that it is crippled and unable to continue operating. It is argued in this article that in ascertaining what constitutes appropriate compensation for an unfair dismissal, the underlying reality that labour law operates in a free enterprise system must be and is given cognisance to by the legislation and the courts. At the same time in ascertaining what constitutes fair compensation for unfair dismissal due regard must be had not only to the labour rights contained in the Constitution but also to other rights protected in terms of the Constitution, most importantly, the rights to dignity and equality. The fact that the basis of the employment relationship is commercial and an employer is entitled and even encouraged to make profits is reflected in our law by the fact that there are caps on the amount of compensation for unfair dismissal in the interests of business efficiency and certainty. However, an analysis of relevant case law demonstrates that this can never be at the expense of a person's dignity. Hence the notion that the employment relationship is relational. This is reflected by the interpretation given to the legislation by the courts. Where there has been discrimination or an impairment of the employee's dignity, there are no such limits as to the amount of compensation a court

R Ebert and RMJ Oduor The Concept of Human Dignity in German ...

African Journals Online (AJOL)

R Ebert and RMJ Oduor

concept of human dignity in the two constitutions, each one of us from his ... We shall try to approach and circumscribe this ... Human dignity was introduced as the fundamental value of a new Germany when ..... involve] the degradation of the person to a thing, which can, in its entirety, be ..... The struggle for women's rights,.

The particularity of dignity: relational engagement in care at the end of life

NARCIS (Netherlands)

Pols, J.; Pasveer, B.; Willems, D.

This paper articulates dignity as relational engagement in concrete care situations. Dignity is often understood as an abstract principle that represents inherent worth of all human beings. In actual care practices, this principle has to be substantiated in order to gain meaning and inform care

The development of a model of dignity in illness based on qualitative interviews with seriously ill patients.

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van Gennip, Isis E; Pasman, H Roeline W; Oosterveld-Vlug, Mariska G; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-08-01

While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine patients' dignity, and that is applicable to a wide patient population. Qualitative interview study. 34 patients with either cancer, early stage dementia, or a severe chronic illness were selected from an extensive cohort study into advance directives. In-depth interviews were carried out exploring the experiences of seriously ill patients with regard to their personal dignity. The interview transcripts were analyzed using thematic analysis and a conceptual model was constructed based on the resulting themes. We developed a two-step dignity model of illness. According to this model, illness related conditions do not affect patients' dignity directly but indirectly by affecting the way patients perceive themselves. We identified three components shaping self-perception: (a) the individual self: the subjective experiences and internally held qualities of the patient; (b) the relational self: the self within reciprocal interaction with others; and, (c) the societal self: the self as a social object in the eyes of others. The merits of the model are two-folded. First, it offers an organizing framework for further research into patients' dignity. Secondly, the model can serve to facilitate care for seriously ill patients in practice by providing insight into illness and dignity at the level of the individual patient where intervention can be effectively targeted. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Dignity of human life: euthanasia and suicide].

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Niebrój, Lesław

2005-07-01

Euthanasia is commonly considered as a form of suicide. The study aims to explore if such a presumption could be justified. Philosophical analysis of concepts of "human being", "human person", "biological life" and "life of human person", undertaken in this article, proved that the effective cause of suicide is obviously different from such a cause of euthanasia. Suicide aims to destruct life of a human person which is considered deprived of its dignity. Euthanasia's effective cause is to protect the dignity of such a life which is threatened by low quality of biological life caused both by the disease as well as by the applied treatment even if palliative only. On the basis of these considerations the main conclusion is drawn: suicide and euthanasia having different moral (material) subjects should be also ethically evaluated in a different way.

Child’s dignity in suffering and death.

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Cepuch, Grażyna; Kruszecka-Krówka, Agnieszka

The magnitude of unfair, absurd, pointless suffering we cannot accept or understand makes it a phenomenon which defies human logic - especially when it concerns children. The source of suffering of a dying child is pain, fear, failure to satisfy the basic human needs and concern about the parents. It is also heightened by medical procedures, including treatments aimed at preventing the unavoidable death. Such actions, resulting from the fear of death and a lack of acceptance of death as the end of life burdened with suffering, pose a risk to the child’s fundamental rights and violate the source of human freedom - one’s inalienable dignity. Our priority should be to unconditionally respect the children’s rights postulated by Korczak, to ensure that while providing holistic care for a dying child, their dignity is always considered the greatest good.

The development of a model of dignity in illness based on qualitative interviews with seriously ill patients

NARCIS (Netherlands)

van Gennip, Isis E.; Pasman, H. Roeline W.; Oosterveld-Vlug, Mariska G.; Willems, Dick L.; Onwuteaka-Philipsen, Bregje D.

2013-01-01

While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine

The development of a model of dignity in illness based on qualitative interviews with seriously ill patients

NARCIS (Netherlands)

van Gennip, I.E.; Pasman, H.R.W.; Oosterveld-Vlug, M.G.; Willems, D.L.; Onwuteaka-Philipsen, B.D.

2013-01-01

Background: While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. Objective: To develop a conceptual model of dignity that illuminates the process by which serious

The Usefulness of the Legal Concept of Human Dignity in the Human Rights Discourse: Literature Review

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Borja Fernandez Burgueño

2016-04-01

Full Text Available This paper will evaluate the convenience of using the legal concept of human dignity in the human rights discourse and its effectiveness to address injustice in a twenty-first century democratic society. This article will argue that the difficulty of defining human dignity does not diminish its merits and allows it to be both solid and adaptable to new challenges. Then, this paper will argue that human dignity is a powerful concept due to its capacity to bring change and modernise society and will conclude that there is a strong relationship between time, human dignity, human rights and democracy.

Psychological autonomy and hierarchical relatedness as organizers of developmental pathways.

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Keller, Heidi

2016-01-19

The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize different conceptions of autonomy and relatedness that are adaptive in two different environmental contexts with very different affordances and constraints. Western middle-class children are socialized towards psychological autonomy, i.e. the primacy of own intentions, wishes, individual preferences and emotions affording a definition of relatedness as psychological negotiable construct. Non-Western subsistence farmer children are socialized towards hierarchical relatedness, i.e. positioning oneself into the hierarchical structure of a communal system affording a definition of autonomy as action oriented, based on responsibility and obligations. Infancy can be regarded as a cultural lens through which to study the different socialization agendas. Parenting strategies that aim at supporting these different socialization goals in German and Euro-American parents on the one hand and Nso farmers from North Western Cameroon on the other hand are described. It is concluded that different pathways need to be considered in order to understand human psychology from a global perspective. © 2015 The Author(s).

1 HUMAN DIGNITY - OUR SUPREME CONSTITUTIONAL VALUE ...

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5) Is our understanding of the concept/value/idea of human dignity not too ... second, it informs the scope and meaning of all the rights and guarantees of the .... describing the significance of group solidarity on survival issues so central to.

Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study.

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Mariska G Oosterveld-Vlug

Full Text Available BACKGROUND: Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. AIM: To investigate if and how nursing home residents' personal dignity changes over the course of time, and what contributes to this. DESIGN: A longitudinal qualitative study. METHODS: Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. RESULTS: From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1 finding a way to cope with one's situation; 2 getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3 physical improvement (with or without an electric wheelchair; 4 being socially involved with nursing home staff, other residents and relatives; and 5 being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. CONCLUSION: Although the direction in which a resident's personal dignity develops is also dependent on one's character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person.

Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study.

Science.gov (United States)

Oosterveld-Vlug, Mariska G; Pasman, H Roeline W; van Gennip, Isis E; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-01-01

Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. To investigate if and how nursing home residents' personal dignity changes over the course of time, and what contributes to this. A longitudinal qualitative study. Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1) finding a way to cope with one's situation; 2) getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3) physical improvement (with or without an electric wheelchair); 4) being socially involved with nursing home staff, other residents and relatives; and 5) being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. Although the direction in which a resident's personal dignity develops is also dependent on one's character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person.

The end-of-life phase of high-grade glioma patients: dying with dignity?

NARCIS (Netherlands)

Sizoo, Eefje M.; Taphoorn, Martin J. B.; Uitdehaag, Bernard; Heimans, Jan J.; Deliens, Luc; Reijneveld, Jaap C.; Pasman, H. Roeline W.

2013-01-01

In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as

How individuals with dementia in nursing homes maintain their dignity through life storytelling - a case study.

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Heggestad, Anne Kari Tolo; Slettebø, Åshild

2015-08-01

The aim of this article was to present and discuss findings on what individuals with dementia do by themselves to maintain or promote their dignity of identity when they live in a nursing home. The majority of residents living in Norwegian nursing homes suffer from dementia. Individuals who suffer from dementia are particularly vulnerable, and their dignity of identity is at risk. It is therefore of great importance to explore how we can maintain their dignity of identity. The study builds on a phenomenological and hermeneutic design. The article reports three cases or life stories based on participant observation in two different nursing homes and interviews with five residents with dementia living in these nursing homes. Fifteen residents with dementia from these nursing home wards were included in the overall study. Individuals with dementia living in nursing homes may use life storytelling or narratives to manage chaos and to find safety in their lives. Storytelling is also used as a way to present and maintain identity. We can see this as a way of maintaining dignity of identity or social dignity. Life storytelling can be seen as an important way of preserving dignity for people with dementia. It is of great importance that health care professionals are open to and listen to the life stories people with dementia tell. As nurses we have an obligation to ensure that dignity is enhanced in care for people with dementia. Knowledge about how residents with dementia use life storytelling as a way to maintain dignity is therefore of great importance to health care workers in nursing homes. © 2015 John Wiley & Sons Ltd.

The Relation between Law and Fraternity as a Promotional Instrument for Human Dignity in Labor Law

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Guilherme Domingos de Luca

2015-12-01

Full Text Available Examine in this study as a problem, the relationship of law and Fraternity as a promotional instrument of Human Dignity in Labour Law, pointing out the means by which positive law has constitutionalized the fundamental guarantees of man labor law. Understand the relationship of human labor versus the dignity of the human person, and the idea of fraternity as a promotional function. The research was based on bibliographic compared. The main object is to understand the role of the fraternity and the right to promote dignity in labor law. Specifically, to understand the role of the principle of brotherhood and human dignity in the protection of labor Fundamental Rights. It is a guided research in the hypothetical-deductive research method, starting from the hypothesis that the community contributes to the correct application of the law as the dignity of labor instrument.

Woolf’s Weighty Gifts: The Measure of Modernist Autonomy

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Rebecca Colesworthy

2017-07-01

Full Text Available This paper argues that Virginia Woolf’s A Room of One’s Own (1929 provides a critical counterpoint to a cluster of recent discourses on the gift, autonomy, and the changing nature of labor in the contemporary creative economy. From Lewis Hyde’s best-selling The Gift to neo-Marxist accounts of post-Fordism, these discourses routinely adopt modernist notions of autonomy in order to characterize creative labor today. Woolf’s feminist vision of autonomy in A Room of One’s Own at once dovetails with and complicates these discourses. In suggesting that feminine creative power, or “gifts,” both are and are not measurable by a monetary standard, she reinforces a familiar tension between gifts and commodities. But in her attentiveness to the material conditions of creativity, she also refuses to let the ideal of autonomy become an alibi for precarity, as is so often the case with feminized labor in our own creative economy. Ultimately, I argue that A Room of One’s Own reads as notes toward the possibility of a measure of the value of the gift as a gift—a measure that need not come at the expense of economic equality.

Living and dying with dignity in Chinese society: perspectives of older palliative care patients in Hong Kong.

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Ho, Andy Hau Yan; Chan, Cecilia Lai Wan; Leung, Pamela Pui Yu; Chochinov, Harvey Max; Neimeyer, Robert A; Pang, Samantha Mei Che; Tse, Doris Man Wah

2013-07-01

the empirical Dignity Model has profoundly influenced the provision of palliative care for older terminally ill patients in the West, as it provides practical guidance and intervention strategies for promoting dignity and reducing distress at the end-of-life. to examine the concept of 'living and dying with dignity' in the Chinese context, and explore the generalisability of the Dignity Model to older terminal patients in Hong Kong. using qualitative interviews, the concept of dignity was explored among 16 older Chinese palliative care patients with terminal cancer. Framework analysis with both deductive and inductive methods was employed. the three major categories of themes of the Dignity Model were broadly supported. However, the subtheme of death anxiety was not supported, while two subthemes of generativity/legacy and resilience/fighting spirit manifested differently in the Chinese context. Furthermore, four new emergent themes have been identified. They include enduring pain, moral transcendence, spiritual surrender and transgenerational unity. these findings highlight both a cultural and a familial dimension in the construct of dignity, underline the paramount importance of cultural awareness and competence for working with ethnically diverse groups, and call for a culturally sensitive and family oriented approach to palliative care interventions with older Chinese terminal patients.

Perspectives of newly diagnosed advanced cancer patients receiving dignity therapy during cancer treatment.

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Dose, Ann Marie; Rhudy, Lori M

2018-01-01

Dignity therapy is a psychosocial intervention that has been used primarily at the end of life to improve quality of life and other patient outcomes, but many individuals are unable to complete it due to health decline and death. The purpose of this study was to identify what individuals with advanced pancreatic or lung cancer with limited life expectancy, undergoing active cancer treatment describe during the dignity therapy intervention as important to them when not immediately facing end of life. Twenty patients undergoing chemotherapy for advanced cancer participated in a dignity therapy intervention study. Initial interviews were analyzed using descriptive content analysis. Family provided the overall context and background for emerging themes of defining events, accomplishments, and God's plan, which led to lessons learned, and resulted in messages of hope. Interviews were often autobiographical in nature and contained much reminiscence, consistent with dignity therapy's intent. Few participants spoke about their cancer diagnoses during the interview. This study adds unique insight into the use of dignity therapy for those still receiving active cancer treatment, different from work by others in which it was offered only at end of life. As part of supportive care, clinicians need to validate the importance of family to those with advanced cancer and to provide opportunities for patients to share what they have learned throughout life and to impart messages of hope to those closest to them.

Autonomy and autonomy competencies: a practical and relational approach.

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Atkins, Kim

2006-10-01

This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals' formation of choices. In response to this problem, I will present a brief overview of Diana Meyers's account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical 'self-reading'. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills.

Development and evaluation of the Dignity Talk question framework for palliative patients and their families: A mixed-methods study.

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Guo, Qiaohong; Chochinov, Harvey Max; McClement, Susan; Thompson, Genevieve; Hack, Tom

2018-01-01

Effective patient-family communication can reduce patients' psychosocial distress and relieve family members' current suffering and their subsequent grief. However, terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. To develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk, explore anticipated benefits and challenges of using Dignity Talk, and solicit suggestions for protocol improvement. A convergent parallel mixed-methods design. Dignity Talk, a self-administered question list, was designed to prompt end-of-life conversations, adapted from the Dignity Therapy question framework. Participants were surveyed to evaluate the Dignity Talk question framework. Data were analyzed using qualitative and quantitative methods. A total of 20 palliative patients, 20 family members, and 34 healthcare providers were recruited from two inpatient palliative care units in Winnipeg, Canada. Most Dignity Talk questions were endorsed by the majority of patients and families (>70%). Dignity Talk was revised to be convenient and flexible to use, broadly accessible, clearly stated, and sensitively worded. Participants felt Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business. Participants suggested that patients and family members be given latitude to respond only to questions that are meaningful to them and within their emotional capacity to broach. Dignity Talk may provide a gentle means of facilitating important end-of-life conversations.

Resourcifying human bodies--Kant and bioethics.

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Miyasaka, Michio

2005-01-01

This essay roughly sketches two major conceptions of autonomy in contemporary bioethics that promote the resourcification of human body parts: (1) a narrow conception of autonomy as self-determination; and (2) the conception of autonomy as dissociated from human dignity. In this paper I will argue that, on the one hand, these two conceptions are very different from that found in the modern European tradition of philosophical inquiry, because bioethics has concentrated on an external account of patient's self-determination and on dissociating dignity from internal human nature. However, on the other hand, they are consistent with more recent European philosophy. In this more recent tradition, human dignity has gradually been dissociated from contextual values, and human subjectivity has been dissociated from objectivity and absolutized as never to be objectified. In the concluding part, I will give a speculative sketch in which Kant's internal inquiry of maxim of ends, causality and end, and dignity as iirreplaceability is recombined with bioethics' externalized one and used to support an extended human resourcification.

Women at CERN: the Laboratory's Equal Opportunities Policy in numbers

CERN Multimedia

2001-01-01

On 16 March, eight days after International Women's Day, CERN is organizing a discussion on its Equal Opportunities Policy. This is a new chance for all at CERN to find out about the programme, and to get up to date with the position of women at CERN. This year CERN will mark International Women's Day with a special event on Friday 16 March: a chance for all at CERN to meet members of the Equal Opportunities Advisory Panel. You have probably already heard about the Panel, but you may have wondered what the Equal Opportunities Programme actually does to ensure fair treatment in the recruitment and career development of men and women, and to allow all to work in an atmosphere of safety, dignity, and mutual respect. Daniella Moraes of the Federal University of Rio de Janeiro at work on electronics for the LHCb experiment. By attending this meeting CERN people will have the chance to learn about the work of the Panel, its recommendations to Management, and the subsequent actions taken by the Organization. The m...

Care home manager attitudes to balancing risk and autonomy for residents with dementia.

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Evans, Elizabeth A; Perkins, Elizabeth; Clarke, Pam; Haines, Alina; Baldwin, Ashley; Whittington, Richard

2018-02-01

To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents' dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

Changes in the Personal Dignity of Nursing Home Residents: A Longitudinal Qualitative Interview Study

NARCIS (Netherlands)

Oosterveld-Vlug, M.G.; Pasman, H.R.W.; van Gennip, I.E.; Willems, D.L.; Onwuteaka-Philipsen, B.D.

2013-01-01

Background:Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable.Aim:To

Human dignity and the future of the voluntary active euthanasia debate in South Africa.

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Jordaan, Donrich W

2017-04-25

The issue of voluntary active euthanasia was thrust into the public policy arena by the Stransham-Ford lawsuit. The High Court legalised voluntary active euthanasia - however, ostensibly only in the specific case of Mr Stransham-Ford. The Supreme Court of Appeal overturned the High Court judgment on technical grounds, not on the merits. This means that in future the courts can be approached again to consider the legalisation of voluntary active euthanasia. As such, Stransham-Ford presents a learning opportunity for both sides of the legalisation divide. In particular, conceptual errors pertaining to human dignity were made in Stransham-Ford, and can be avoided in future. In this article, I identify these errors and propose the following three corrective principles to inform future debate on the subject: (i) human dignity is violable; (ii) human suffering violates human dignity; and (iii) the 'natural' causes of suffering due to terminal illness do not exclude the application of human dignity.

Human dignity and the future of the voluntary active euthanasia debate in South Africa

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Donrich W Jordaan

2017-05-01

Full Text Available The issue of voluntary active euthanasia was thrust into the public policy arena by the Stransham-Ford lawsuit. The High Court legalised voluntary active euthanasia – however, ostensibly only in the specific case of Mr Stransham-Ford. The Supreme Court of Appeal overturned the High Court judgment on technical grounds, not on the merits. This means that in future the courts can be approached again to consider the legalisation of voluntary active euthanasia. As such, Stransham-Ford presents a learning opportunity for both sides of the legalisation divide. In particular, conceptual errors pertaining to human dignity were made in Stransham-Ford, and can be avoided in future. In this article, I identify these errors and propose the following three corrective principles to inform future debate on the subject: (i human dignity is violable; (ii human suffering violates human dignity; and (iii the ‘natural’ causes of suffering due to terminal illness do not exclude the application of human dignity.

Black theology in South Africa – A theology of human dignity and black identity

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Timothy van Aarde

2016-08-01

Full Text Available Black theology in South Africa is still relevant 20 years after the apartheid regime ended. It is a theology that gave to Black South Africans human dignity and a black identity. Black theology in South Africa confronted the imbalances of power and abusive power structures through an affirmation of human dignity and the uniqueness of the identity of black people. The biblical narrative of the Exodus is a definitive narrative in American black theology and liberation theology in overcoming oppression understood as political victimisation. Black theology in South Africa is not primarily about power and economics but also about the rediscovery of human dignity and black identity and to a lesser extent about victimisation. A third generation of black theology in South Africa will gain impetus through a rediscovery of human dignity and identity as its core values instead of a Black American liberation theology of victimisation or a Marxist liberation theology of the eradication of all power or economic imbalances.

Multicultural long-term care nurses’ perceptions of factors influencing patient dignity at the end of life.

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Periyakoil, Vyjeyanthi S; Stevens, Marguerite; Kraemer, Helena

2013-03-01

The goal of this mixed-methods study was to characterize the perceptions of multicultural long-term care nurses about patient dignity at the end-of-life (EOL). The study was conducted in a large, urban, long-term care (LTC) facility. Participants were 45 long-term care nurses and 26 terminally ill nursing home residents. Nurses completed an openended interview about their perceptions of the concept of dying with dignity, and the data were analyzed using grounded theory methods. Main themes identified as promoting resident dignity at the EOL included treating them with respect, helping them prepare for the EOL, promoting shared decision-making, and providing high-quality care. The nurses’ cultural and religious backgrounds influenced their perceptions of what constitutes dignity-conserving care. Foreign-born nurses stressed the need for EOL rituals, but this was strikingly absent in the statements of U.S.-born nurses. Foreign-born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Nurses and terminally ill individuals completed the Dignity Card-sort Tool (DCT). A comparison of the DCT responses of the LTC nurses cohort with those of the terminally ill participants revealed that the nurses felt patient dignity was eroded when patient wishes were not followed and when they were treated without respect. In contrast, dying LTC residents felt that poor medical care and loss of ability to choose care options were the most important factors leading to erosion of dignity.

'This is my story, how I remember it': In-depth analysis of Dignity Therapy documents from a study of Dignity Therapy for people with early stage dementia.

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Johnston, Bridget; Lawton, Sally; Pringle, Jan

2017-07-01

Dementia is a progressive condition that impacts on individuals, families and care professionals. Maintaining quality of life through engagement with the person with dementia is an important part of their care. Dignity Therapy is an interactive, psychotherapeutic intervention that uses a trained dignity therapist to guide the person with dementia through an interview that then creates a written legacy called a generativity document. This can provide knowledge to inform care, as the condition progresses. Generativity documents were analysed using framework analysis. Main themes from the analysis were origin of values, essence and affirmation of self, forgiveness and resolution and existentialism/ meaning of life. These themes provide evidence of the type, scope and contribution that information generated from Dignity Therapy can make to the care and support of people with dementia. They provide information about the values, self-identity and the people and events that have been important to them and influenced their lives.

Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study

NARCIS (Netherlands)

Oosterveld-Vlug, Mariska G.; Pasman, H. Roeline W.; van Gennip, Isis E.; Willems, Dick L.; Onwuteaka-Philipsen, Bregje D.

2013-01-01

Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. To investigate if and how

Advanced Cancer Patients' Perceptions of Dignity: The Impact of Psychologically Distressing Symptoms and Preparatory Grief.

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Kostopoulou, Sotiria; Parpa, Efi; Tsilika, Eleni; Katsaragakis, Stylianos; Papazoglou, Irene; Zygogianni, Anna; Galanos, Antonis; Mystakidou, Kyriaki

2018-04-01

The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory-Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS). Moderate to strong statistically significant correlations were found between the 4 subscales of PDI-Gr (psychological distress, body image and role identity, self-esteem, and social support) with G-HADS, G-SAHD, and PGAC ( P dignity among patients with advanced cancer. Clinicians should assess and attend to dignity-distressing factors in the care of patients with advanced cancer.

Evaluation of the Dignity Care Pathway for community nurses caring for people at the end of life.

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Johnston, Bridget; Östlund, Ulrika; Brown, Hilary

2012-10-01

People nearing the end of life fear loss of dignity, and a central tenet of palliative care is to help people die with dignity. The Dignity Care Pathway (DCP) is an intervention based on the Chochinov theoretical model of dignity care. It has four sections: a manual, a Patient Dignity Inventory, reflective questions, and care actions. The feasibility and acceptability of the DCP were evaluated using a qualitative design with a purposive sample of community nurses. Data was collected from April to October 2010 using in-depth interviews, reflective diaries, and case studies and then analysed using framework analysis. The DCP was acceptable to the community nurses, helped them identify when patients were at the end of life, identified patients' key concerns, and aided nurses in providing holistic end-of-life care. It requires the nurse to have excellent communication skills. Some of the nurses found it hard to initiate a conversation on dignity-conserving care. The DCP helps nurses to deliver individualised care and psychological care, which has previously been identified as a difficult area for community nurses. All of the nurses wished to continue to use the DCP and would recommend it to others.

The Evolution of Autonomy.

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Stammers, Trevor

2015-01-01

There can be little doubt, at least in the Western world, that autonomy is theruling principle in contemporary bioethics. In spite of its 'triumph' however,the dominance of the utilitarian concept of autonomy is being increasinglyquestioned. In this paper, I explore the nature of autonomy, how it came todisplace the Hippocratic tradition in medicine and how different conceptsof autonomy have evolved. I argue that the reduction of autonomy to'the exercise of personal choice' in medicine has led to a 'tyranny of autonomy' which can be inimical to ethical medical practice rather than conducive to it.I take the case of Kerrie Wooltorton as an illustration of how misplacedadherence to respect for patient autonomy can lead to tragic consequences.An analysis of autonomy based on the work of Rachel Haliburton isdescribed and applied to the role of autonomy in a recent bioethicaldebate--that arising from Savulescu's proposal that conscientious objection by health-care professionals should not be permitted in the NHS. Inconclusion, I suggest Kukla's concept of conscientious autonomy as onepromising pathway to circumvent both the limitations and adverse effectsof the dominance of current (mis)understandings of autonomy in biomedical ethics.

Vulnerabilidade do doente versus autonomia individual The vulnerability of the patient versus individual autonomy

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Inês Motta de Morais

2010-12-01

Full Text Available A autonomia é um conceito ético e individual, ao passo que a vulnerabilidade pressupõe a existência de relações desiguais entre indivíduos ou grupos. Tal desigualdade pode estar relacionada a questões sócio-econômicas. Muitas vezes os desprivilegiados têm dificuldades ou, mesmo impossibilidade de decidir. Portanto, é importante o reconhecimento dessa vulnerabilidade para garantir o direito à autonomia e respeito à dignidade de indivíduos, principalmente quando se trata de pesquisas na área da saúde. Este estudo procura analisar a importância do conceito de vulnerabilidade e seu alcance na relação com a autonomia individual. O estudo conclui que a consciência de vulnerabilidade é importante para alimentar a razão crítica que fundamenta a autonomia. Não pretende de forma alguma propor mais uma definição de autonomia individual e vulnerabilidade do doente, e sim apresentar os resultados do levantamento bibliográfico sobre o tema demonstrando os pontos convergentes e divergentes de diversos expoentes literários.Autonomy is and ethical and individual concept, while vulnerability presupposes the existence of unequal relations between individuals or groups. Such inequality may be related to socio-economic issues. The underprivileged often have difficulty in making decisions or find it impossible to do so. It is, therefore, important to recognize this vulnerability in order to ensure the right to autonomy and respect for the dignity of the individual, especially in the case of health research. This study investigates the importance of the concept of vulnerability and the extent to which it is related to individual autonomy. The study concludes that awareness of vulnerability is important in fuelling the critical reason that is the foundation of autonomy. The intention here is certainly not to put forward yet another definition of individual autonomy and patient vulnerability, but rather to present the results of a

Autonomy: Life and Being

Science.gov (United States)

Williams, Mary-Anne

This paper uses robot experience to explore key concepts of autonomy, life and being. Unfortunately, there are no widely accepted definitions of autonomy, life or being. Using a new cognitive agent architecture we argue that autonomy is a key ingredient for both life and being, and set about exploring autonomy as a concept and a capability. Some schools of thought regard autonomy as the key characteristic that distinguishes a system from an agent; agents are systems with autonomy, but rarely is a definition of autonomy provided. Living entities are autonomous systems, and autonomy is vital to life. Intelligence presupposes autonomy too; what would it mean for a system to be intelligent but not exhibit any form of genuine autonomy. Our philosophical, scientific and legal understanding of autonomy and its implications is immature and as a result progress towards designing, building, managing, exploiting and regulating autonomous systems is retarded. In response we put forward a framework for exploring autonomy as a concept and capability based on a new cognitive architecture. Using this architecture tools and benchmarks can be developed to analyze and study autonomy in its own right as a means to further our understanding of autonomous systems, life and being. This endeavor would lead to important practical benefits for autonomous systems design and help determine the legal status of autonomous systems. It is only with a new enabling understanding of autonomy that the dream of Artificial Intelligence and Artificial Life can be realized. We argue that designing systems with genuine autonomy capabilities can be achieved by focusing on agent experiences of being rather than attempting to encode human experiences as symbolic knowledge and know-how in the artificial agents we build.

THE CHALLENGE OF AUTONOMY: AN EMPIRICAL STUDY OF THE VARIOUS DIMENSIONS OF AUTONOMY

OpenAIRE

Cristi IFTENE

2009-01-01

There are various dimensions of autonomy (policy, financial, structural, personnel, legal, institutional) as different scholars demonstrated (Christensen 2001, Verhoest et. al. 2004). In the present paper we will focus only on political and financial autonomy. As Yesilkagit and van Thiel demonstrated there is a difference between formal and de facto autonomy. They found that formal autonomy does not reinforce de facto autonomy and that organizations with less autonomy report higher levels of ...

Are the benefits of autonomy satisfaction and the costs of autonomy frustration dependent on individuals' autonomy strength?

Science.gov (United States)

Van Assche, Jasper; van der Kaap-Deeder, Jolene; Audenaert, Elien; De Schryver, Maarten; Vansteenkiste, Maarten

2018-01-29

From a self-determination theory perspective, individuals are assumed to benefit and suffer from, respectively, the satisfaction and frustration of the psychological need for autonomy, even if they score low on autonomy strength. Yet, previous studies on need strength are scarce, operationalized need strength differently, and produced inconsistent findings. In two studies among 224 South African adults (M age  = 24.13, SD = 4.25; 54.0% male) and 156 Belgian prisoners (M age  = 38.60, SD = 11.68; 88.5% male), we investigated the moderating role of autonomy valuation and desire in the relations of autonomy satisfaction and frustration with a variety of well-being and ill-being indicators. Study 1 provided some evidence for the moderating role of mostly explicit autonomy desire (rather than explicit autonomy valuation). In Study 2, neither explicit nor implicit autonomy desire played a consistent moderating role. Overall, these findings are congruent with a moderate (albeit not with a strong) interpretation of the universality claim made within self-determination theory, provide initial evidence for a differentiation between deficit-based and growth-oriented interpersonal differences in need strength, and indicate that the potential moderating role of need strength deserves continued attention before any firm conclusions can be drawn. © 2018 Wiley Periodicals, Inc.

A Battle of Words: "Dignity" and "Peace" in the Writings of Elisabeth Kübler-Ross.

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Burnier, Daniel

2017-04-01

This article analyzes the writings of Elisabeth Kübler-Ross through the discursive lens of the phrase "dying with dignity." For her, the phrase meant allowing someone to die comfortably his/her own death. This phrase has to be understood in relationship with the final "stage of acceptance" of her model. Describing this key part of her well-known scientific output, she often used, in the early 1970s, the phrase "dying in peace and dignity." An evaluation of the evidence suggests that because the concept of dignity was co-opted by the pro-euthanasia movement during this decade, the language of dignity was little by little abandoned by her. In later years, only "peace" survived from her favorite expression. Although this concept of peace remains present to the end in all Kübler-Ross writings, the pro-euthanasia movement has also started to speak the language of peace.

Marine Robot Autonomy

CERN Document Server

2013-01-01

Autonomy for Marine Robots provides a timely and insightful overview of intelligent autonomy in marine robots. A brief history of this emerging field is provided, along with a discussion of the challenges unique to the underwater environment and their impact on the level of intelligent autonomy required.  Topics covered at length examine advanced frameworks, path-planning, fault tolerance, machine learning, and cooperation as relevant to marine robots that need intelligent autonomy.  This book also: Discusses and offers solutions for the unique challenges presented by more complex missions and the dynamic underwater environment when operating autonomous marine robots Includes case studies that demonstrate intelligent autonomy in marine robots to perform underwater simultaneous localization and mapping  Autonomy for Marine Robots is an ideal book for researchers and engineers interested in the field of marine robots.      

Nurses' perceptions of spiritual care and attitudes toward the principles of dying with dignity: A sample from Turkey.

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Gurdogan, Eylem Pasli; Kurt, Duygu; Aksoy, Berna; Kınıcı, Ezgi; Şen, Ayla

2017-03-01

Spiritual care is vital for holistic care and dying with dignity. The aim of this study was to determine nurses' perceptions of spiritual care and their attitudes toward dying with dignity. This study was conducted with 289 nurses working at a public hospital. Results showed three things. First, spiritual care perceptions and attitudes toward dying with dignity were more positive in female participants than in male participants. Second, there was a correlation between participants' education levels and their perceptions of spiritual care. Third, there was also a correlation between participants' attitudes toward dying with dignity and their perceptions of spiritual care.

The end-of-life phase of high-grade glioma patients: dying with dignity?

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Sizoo, Eefje M; Taphoorn, Martin J B; Uitdehaag, Bernard; Heimans, Jan J; Deliens, Luc; Reijneveld, Jaap C; Pasman, H Roeline W

2013-01-01

In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as perceived by their relatives and (b) identify disease and care factors correlated with dying with dignity in HGG patients. We approached relatives of a cohort of 155 deceased HGG patients for the study. Participants completed a questionnaire concerning the EOL phase of the patient, covering several subthemes: (a) symptoms and signs, (b) health-related quality of life, (c) decision making, (d) place and quality of EOL care, and (e) dying with dignity. Relatives of 81 patients participated and 75% indicated that the patient died with dignity. These patients had fewer communication deficits, experienced fewer transitions between health care settings in the EOL phase, and more frequently died at their preferred place of death. Relatives were more satisfied with the physician providing EOL care and reported that the physician adequately explained treatment options. Multivariate analysis identified satisfaction with the physician, the ability to communicate, and the absence of transitions between settings as most predictive of a dignified death. Physicians caring for HGG patients in the EOL phase should timely focus on explaining possible treatment options, because patients experience communication deficits toward death. Physicians should strive to allow patients to die at their preferred place and avoid transitions during the last month of life.

Effects of dignity therapy on terminally ill patients: a systematic review.

Science.gov (United States)

Donato, Suzana Cristina Teixeira; Matuoka, Jéssica Yumi; Yamashita, Camila Cristófero; Salvetti, Marina de Goés

2016-01-01

Analyzing the evidence of the effects of dignity therapy onterminally ill patients. A Systematic review of the literature conducted using the search strategy in six databases. Inclusion criteria were primary studies, excluding literature reviews (systematic or not) and conceptual articles. Ten articles were analyzed regarding method, results and evidence level. Dignity therapy improved the sense of meaning andpurpose, will to live, utility, quality of life, dignity and family appreciationin studies with a higher level of evidence. The effects are not well established in relation to depression, anxiety, spirituality and physical symptoms. Studies with a moderate to high level of evidence have shown increased sense of dignity, will to live and sense of purpose. Further studies should be developed to increase knowledge about dignity therapy. Analisar as evidências sobre os efeitos da terapia da dignidade para pacientes em fase terminal de vida. Revisão sistemática da literatura realizada em seis bases de dados na estratégia de busca. Os critérios de inclusão foram estudos primários, excluindo-se revisões da literatura (sistemáticas ou não) e artigos conceituais. Dez artigos foram analisados quanto ao método, aos resultados e nível de evidência. Nos estudos com maior nível de evidência, a terapia da dignidade melhorou o senso de significado, propósito, vontade de viver, utilidade, qualidade de vida, dignidade e apreciação familiar.Os efeitos não estão bem estabelecidos em relação à depressão, ansiedade, espiritualidade e aos sintomas físicos. Os estudos de nível de evidência de moderado a alto demonstraram aumento do senso de dignidade, vontade de viver e senso de propósito. Mais estudos devem ser desenvolvidos para ampliar o conhecimento sobre a terapia da dignidade.

Rural Education and Autonomy: community development and pedagogy of participation in the Settlement of the Landless Movement [MST], Luís Inácio Lula da Silva (Lulão

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Altemar Felberg

2018-05-01

Full Text Available This article seeks to present the role of Rural Education in the process of training autonomous subjects, based on a study carried out in a settlement of the Landless Movement in the South of Bahia, which sought to understand how development indicators reflect the degree Autonomy of its residents. The research was carried out through the qualitative research, with the questionnaire, semi-structured interviews and focus groups as instruments of information collection. Here autonomy is defined as the capacity of the individual to govern himself, according to a law of his own, in a free and rational way, leading him to human dignity; Setting itself up as a powerful resource capable of freeing individuals not only from submission to heteronymous processes that interfere with their freedoms of choice and action, but also from the frameworks of social and economic vulnerability. Having more autonomy and acting with greater freedom of thought and action improves people's potential to take care of themselves and to influence the world - issues central to the development process. To empower autonomy, education plays a fundamental role in the universe and in the population studied, taking place in the praxis of everyday life, in the exercise of citizenship and in social participation, consolidating itself as a practice of freedom.

University autonomy as sensemaking

DEFF Research Database (Denmark)

Lind, Jonas Krog

The formal autonomy of universities in Europe has generally increased over recent decades. However, new forms of accountability measures and more indirect state steering have accompanied this development, making it difficult to assess the actual autonomy. The article addresses this problem...... by applying the sensemaking approach to the study of organizational autonomy. Enacted autonomy is suggested as a new conceptualization that challenges the basic assumption in studies on formal autonomy that autonomy is only about external constraints on action. It does so by insisting on the active subjects...... in the enactment of the environment, thereby questioning the validity of a clear distinction between what is internal and what is external to an organization. By acknowledging the subjective dimension of autonomy, a set of stylized identities is developed as a tool for understanding the enactment of autonomy...

Teaching ethics: when respect for autonomy and cultural sensitivity collide.

Science.gov (United States)

Minkoff, Howard

2014-04-01

Respect for autonomy is a key ethical principle. However, in some cultures other moral domains such as community (emphasizing the importance of family roles) and sanctity (emphasizing the sacred and the spiritual side of human nature) hold equal value. Thus, an American physician may sometimes perceive a conflict between the desire to practice ethically and the wish to be sensitive to the mores of other cultures. For example, a woman may appear to be making what the physician thinks is a bad clinical choice because her spouse is speaking on her behalf. That physician may find it difficult to reconcile the sense that the patient had not exercised freely her autonomy with the desire to be culturally sensitive. In this article, the means by which a physician can reconcile respect for other cultures with respect for autonomy is explored. The question of whether physicians must always defer to patients' requests solely because they are couched in the language of cultural sensitivity is also addressed. Copyright © 2014 Mosby, Inc. All rights reserved.

[Vulnerations of Human Dignity At The End of Life].

Science.gov (United States)

Germán Zurriaráin, Roberto

2017-01-01

Death is constitutive of human nature and therefore it must happen naturally. But there are mainly two ways that falsify it: euthanasia and therapeutic obstinacy. Two wrong choices that do not accept the human reality of death (the first, anticipates death and the second, delays it). From the philosophical and ethical point of view, both options are rejected, because they are against human dignity at the end of life. Aside from these, this article also rejects the different names which are given to refer to euthanasia, that also go against human nature at the end of life. On the other hand, do not confuse euthanasia with sedation. Both have a common goal to prevent the patient from feeling pain and suffering. To achieve this goal, both options administer ″drugs″ to the patient. But in the administration of drugs in euthanasia involves ending patient's life. The administration of drugs in sedation aims for the patient's death to occur naturally. Finally, we briefly discuss the basic care necessary in these situations. The absence of basic care cannot become a covert euthanasia. The patient must die from his/her illness, never from a lack of care. All human actions (euthanasia, sedation, therapeutic obstinacy and basic care) should be an expression and manifestation of what human dignity demands. Such dignity is expressed in the actions performed by human beings.

Respect for rational autonomy.

Science.gov (United States)

Walker, Rebecca L

2009-12-01

The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy.

Live as we choose: The role of autonomy support in facilitating intrinsic motivation.

Science.gov (United States)

Meng, Liang; Ma, Qingguo

2015-12-01

According to Self-determination Theory (SDT), autonomy is a basic psychological need, satisfaction of which may lead to enhanced intrinsic motivation and related beneficial outcomes. By manipulating the opportunity to choose between tasks of equal difficulty, throughout the motivational process, the effect of autonomy support was examined both behaviorally and electrophysiologically. More negative stimulus-preceding negativity (SPN) and an enlarged FRN loss-win difference wave (d-FRN) indicated an enhanced expectation toward the positive outcome (during the anticipation stage) as well as intensified intrinsic motivation toward the task (during the outcome appraisal stage) when choice was available. Taken together, results of the present study suggest d-FRN upon feedback as a real-time electrophysiological indicator of intrinsic/autonomous motivation and illustrate the important role of autonomy-supportive job design in the workplace. Copyright © 2015 Elsevier B.V. All rights reserved.

Professional autonomy.

Science.gov (United States)

Aprile, A E

1998-02-01

Professional autonomy may represent the first step to implementing measures that will allow CRNAs to attain a level of independent practice consistent with their clinical and educational training. Autonomy is regarded as an essential ingredient of professionalism and confers independent function at the individual practitioner level. The principle of autonomy refers to the individual's capacity to make independent decisions based on the assumption that he or she possesses the cognitive, psychological, and emotional faculties to make rational decisions. Nursing practice meets the first two criteria of professionalism--competence and dedication to an important social good. The third criterion of professionalism, autonomy, has been a focal point for controversy since the late nineteenth century, in which obedience to supervisors and physicians remained a central focus of nursing ethics teaching until the advent of feminism in the 1970s. This article presents a thorough analysis of these concepts with some thoughts on how understanding the fundamental precepts and further research may not only help maintain the current level of CRNA professional autonomy but serve to guide us to become more autonomous in the future.

Autonomy as Aesthetic Practice

NARCIS (Netherlands)

Lütticken, S.

2014-01-01

This essay examines various conceptions of autonomy in relation to recent artistic practices. Starting from the apparent opposition between modernist notions of the autonomy of art and theorizations of political autonomy, the text problematizes the notion of the autonomy of art by using Jacques

Regimes of Autonomy

NARCIS (Netherlands)

Anderson, Joel

2014-01-01

Like being able to drive a car, being autonomous is a socially attributed, claimed, and contested status. Normative debates about criteria for autonomy (and what autonomy entitles one to) are best understood, not as debates about what autonomy, at core, really is, but rather as debates about the

The dignity of the child in a psychiatric hospital

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Błażej Kmieciak

2012-12-01

Full Text Available The right to respect the dignity of children using medical services in psychiatric units is regulated among other by the Patients’ Rights act and the Patients’ Rights Ombudsman act, Physician and Dentist Professions Act and the Medical Ethics Code. Although since 1994 the Mental Health Protection Act has existed, some information appears about the violation of the dignity of the child in psychiatric hospitals. Material and methods: Analysis of the information obtained from different sources (the media, the Internet, from patients and/or their legal guardians, peror Psychiatric Hospital Patients’ Ombudsman allowed to draw up a list of repeated situations in psychiatric units for children and adolescents where the dignity of the juvenile/minor patient may be violated. Results: The most frequently reported issues are: reduction of the minor/juvenile patients’ access to “privileges” (such as direct contacts with colleagues, lack of privacy (such as controls in toilets and bathrooms, irregularities during the use of direct coercion, lack of regular access to a mobile phone, the Internet, stereo equipment, lack of juvenile/minor patients’ consent for treatment (including the double permission, engaging the patients to cleaning work, and medical staff’s interventions of educational and corrective character (the patients perceive this as the use of penalties. Discussion: It was found out that the reaction of a minor/juvenile psychiatric unit patient or her/his carers to the detachment from her/his surroundings, favourite activities or things, and educational interventions are related to precise determination of diagnostic and therapeutic procedures and rules prevalent in the group, privileges, consequences, and application of behavioural effects in the form of negative reinforcements (so-called penalties and positive reinforcements (rewards. A strong response to infringement of the rules may be perceived by the patients as a violation of

The meaning of dignity in nursing home care as seen by relatives

DEFF Research Database (Denmark)

Wilhelm Rehnsfeldt, Arne; Lindwall, Lillemor; Høy, Bente

2014-01-01

culture is assumed to be a more ontological or universal concept than, for example, an ethical context or ethical person-to-person acts. Research design: The methodological approach is hermeneutic. The data consist of 28 interviews with relatives of older persons from Norway, Denmark and Sweden. Ethical...... considerations: The principles of voluntariness, confidentiality and anonymity were respected during the whole research process. Findings: Three patterns were revealed: dignity as at-home-ness, dignity as the little extra and non-dignifying ethical context. Discussion: Caring communion, invitation, at...

Multi-Cultural Long Term Care Nurses’ Perceptions of Factors Influencing Patient Dignity at the End of Life

Science.gov (United States)

Periyakoil, Vyjeyanthi S.; Stevens, Marguerite; Kraemer, Helena

2012-01-01

The goal of this mixed-methods study was to characterize the perceptions of multi-cultural long-term care nurses about patient dignity at the end-of-life (EOL). The study was conducted in a large, urban long-term care (LTC) facility. The participants were forty-five long-term care nurses and 26 terminally ill nursing home patients. Nurses completed an open-ended interview about their perceptions of the concept of dying with dignity and the data were analyzed using grounded theory methods. Main themes identified as promoting patient dignity at the EOL included treating them with respect, helping them prepare for their EOL, promoting shared decision making and providing high quality tenor of care. The nurses’ cultural and religious backgrounds influenced their perceptions of what constitutes dignity-conserving care. Foreign-born nurses stressed the need for end-of-life rituals but this was strikingly absent in the statements of US-born nurses. Foreign-born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Both nurses and terminally ill patients completed the Dignity Card-sort Tool (DCT). A comparison of the LTC nurses cohort to the terminally ill patient responses on the DCT revealed that the nurses felt that patient dignity was eroded when her/his wishes were not carried out and when s/he is treated without respect. In contrast, dying LTC patients felt that poor medical care and loss of ability to choose care options to be the most important factors leading to erosion of dignity. PMID:23496266

Conflict negotiation and autonomy processes in adolescent romantic relationships: an observational study of interdependency in boyfriend and girlfriend effects.

Science.gov (United States)

McIsaac, Caroline; Connolly, Jennifer; McKenney, Katherine S; Pepler, Debra; Craig, Wendy

2008-12-01

This study examined the association between conflict negotiation and the expression of autonomy in adolescent romantic partners. Thirty-seven couples participated in a globally coded conflict interaction task. Actor-partner interdependence models (APIM) were used to quantify the extent to which boys' and girls' autonomy was linked solely to their own negotiation of the conflict or whether it was linked conjointly to their own and their partners' negotiation style. Combining agentic autonomy theories and peer socialization models, it was expected that boys' and girls' autonomy would be associated only with their own conflict behaviors when they employed conflict styles reflective of their same gender repertoire, and associated conjointly with self and partner behaviors when they employed gender-atypical conflict styles. Instead of an equal, albeit distinct, positioning in the autonomy dynamic, the results suggested that girls' autonomy is associated solely with their own conflict behaviors, whereas boys' autonomy is jointly associated with their own and their partners' conflict behaviors. We discuss the relative power of boys and girls in emergent dyadic contexts, emphasizing how romantic dynamics shape salient abilities.

Syntactic autonomy

Energy Technology Data Exchange (ETDEWEB)

Rocha, L.M.

1998-12-01

The study of adapting and evolving autonomous agents should be based on a complex systems-theoretic framework which requires both self-organizing and symbolic dimensions. An inclusive framework based on the notions of semiotics and situated action is advanced to build models capable of representing, as well as evolving in their environments.Such undertaking is pursued by discussing the ways in which symbol and self-organization are irreducibly intertwined in evolutionary systems. With this semiotic view of self-organization and symbols, the authors re-think the notion of autonomy of evolving systems, and show that evolutionary systems are characterized by a particular type of syntactic autonomy. Recent developments in emergent computation in cellular automata are discussed as examples of the emergence of syntactic autonomy in computational environments. New experiments emphasizing this syntactic autonomy in cellular automata are presented.

Autonomy and hyperthyroidism

International Nuclear Information System (INIS)

Emrich, D.; Schicha, H.; Baehre, M.

1986-01-01

The significance of autonomy in iodine-deficiency goiter for the development of hyperthyroidism was investigated. (1) In 171 of 426 consecutive patients high-resolution quantitative scintiscans showed signs suggestive of autonomy. With increasing 99mTc uptake by the thyroid their TT3 levels were found to rise progressively during suppression, while their pre-suppression TSH levels dropped progressively. This suggests global sup(99m)Tc uptake by the thyroid during suppression to be a useful indicator of the functional significance of autonomy. (2) Based on 326 patients with hyperthyroidism a system for differentiating between autonomy-related and immunogenic disease was developed and validated prospectively in another 162 patients with hyperthyroidism by assaying for thyroid stimulating antibodies (TSAb). TSAb was found to be present in 82% of the 77 patients diagnosed as having immunogenic hyperthyroidism and in only 8% of the 85 patients with autonomy-related hyperthyroidism. Our results support the assumption that autonomy in iodine-deficiency goiter plays a major role in the development of hyperthyroidism, while autoimmune processes appear to be of secondary importance. (Author)

Tweeting dignity: A practical theological reflection on Twitter's ...

African Journals Online (AJOL)

2017-08-10

Aug 10, 2017 ... content in which a dynamic interpretation of dignity functions strongly. In the acknowledgement ... Koch, tweeting under the user-name of his puppet @ .... example Twitter and Instagram, have seen the light over the past ... and analyze one per cent of the public generated Tweets every 'streaming second' ...

Alexander Meiklejohn in Search of Freedom and Dignity.

Science.gov (United States)

Johnson, Tony W.

1982-01-01

Assesses the contributions of the philosopher/educator Alexander Meiklejohn. Discusses the influences of Jean-Jacques Rousseau, Immanuel Kant, and the U.S. Constitution on Meiklejohn's educational theories, which stressed that human freedom and dignity can be enhanced by rigorous examination of U.S. Supreme Court decisions and the meaning of…

Resolving the dilemma between equality and liberty: the Swedish political system

Directory of Open Access Journals (Sweden)

Nathalie BLANC-NOEL

2013-06-01

Full Text Available Swedish democracy ranks very high in international democracy indexes. It fascinates political scientists from all over the world because it seems to have resolved a fundamental political dilemma: the choice between equality and liberty, without the historical inconvenient of regimes which favoured too much equality - but killed liberty, or regimes which favoured liberty - but failed to make citizens equal... The "'egalitarian pluralism" practiced in Swedish political system is rooted in a specific political culture. This culture has opted for popular sovereignty and comes from the ancient peasant society. Lutheran values and the absence of feudalism paved the way to the search for equality and the edification of a strong State. In the 20th century, the Social-democrats endorsed the traditional Swedish values and prolonged them in the so-called Swedish model, with social policies allowing more equality along with more individual autonomy. Nowadays, the model is evolving, coping with globalization, and the definition of equality is under discussion.

Beyond Pain: Nurses' Assessment of Patient Suffering, Dignity, and Dying in the Intensive Care Unit.

Science.gov (United States)

Su, Amanda; Lief, Lindsay; Berlin, David; Cooper, Zara; Ouyang, Daniel; Holmes, John; Maciejewski, Renee; Maciejewski, Paul K; Prigerson, Holly G

2018-06-01

Deaths in the intensive care unit (ICU) are increasingly common in the U.S., yet little is known about patients' experiences at the end of life in the ICU. The objective of this study was to determine nurse assessment of symptoms experienced, and care received by ICU patients in their final week, and their associations with nurse-perceived suffering and dignity. From September 2015 to March 2017, nurses who cared for 200 ICU patients who died were interviewed about physical and psychosocial dimensions of patients' experiences. Medical chart abstraction was used to document baseline patient characteristics and care. The patient sample was 61% males, 70.2% whites, and on average 66.9 (SD 15.1) years old. Nurses reported that 40.9% of patients suffered severely and 33.1% experienced severe loss of dignity. The most common symptoms perceived to contribute to suffering and loss of dignity included trouble breathing (44.0%), edema (41.9%), and loss of control of limbs (36.1%). Most (n = 9) remained significantly (P dignity (AOR 3.15). Use of feeding tube was associated with severe loss of dignity (AOR 3.12). Dying ICU patients are perceived by nurses to experience extreme indignities and suffer beyond physical pain. Attention to symptoms such as dyspnea and edema may improve the quality of death in the ICU. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

THE FUNDAMENTALITY OF SOCIAL AND LABOR RIGHTS FROM THE PERSPECTIVE OF HUMAN DIGNITY

OpenAIRE

Pinto, Marcio Morena

2016-01-01

Dignity is the common point of unity and existence of all human beings and, therefore, its preservation must legitimize and justify the State action, which must ensure the effectiveness of certain rights considered essential for people to reach a necessary life standard in order to participate as full members of society. In this list of fundamental rights, social and labor rights are included. The purpose of this research is to analyze the scope of human dignity as the main principle of natio...

Mathematics education and the dignity of being

DEFF Research Database (Denmark)

Valero, Paola; García, Gloria; Camelo, Francisco

2012-01-01

On the grounds of our work as researchers, teacher educators and teachers engaging with a socio-political approach in mathematics education in Colombia, we propose to understand democracy in terms of the possibility of constructing a social subjectivity for the dignity of being. We address the di...... of territorialisation, and Latin American epistemology with the notion of intimate space as an important element of social subjectivity....

Autonomy and Reproductive Rights of Married Ikwerre Women in Rivers State, Nigeria.

Science.gov (United States)

Princewill, Chitu Womehoma; Jegede, Ayodele Samuel; Wangmo, Tenzin; Riecher-Rössler, Anita; Elger, Bernice Simone

2017-06-01

A woman's lack of or limited reproductive autonomy could lead to adverse health effects, feeling of being inferior, and above all being unable to adequately care for her children. Little is known about the reproductive autonomy of married Ikwerre women of Rivers State, Nigeria. This study demonstrates how Ikwerre women understand the terms autonomy and reproductive rights and what affects the exercise of these rights. An exploratory research design was employed for this study. A semi-structured interview schedule was used to conduct thirty-four in-depth interviews and six focus group discussions with purposively sampled educated, semi-educated, and uneducated Ikwerre women in monogamous or polygynous marriages. The collected data was analysed qualitatively with MAXQDA 11 using open and axial coding. The interviews and focus group responses reveal a low level of awareness of autonomy and reproductive rights amongst the Ikwerre women in Nigeria. While some educated women were aware of their reproductive rights, cultural practices were reported to limit the exercise of these rights. Participants reported that Ikwerre culture is a patriarchal one where married women are expected to submit and obey their husbands in all matters; and a good married woman according to Ikwerre standard is one who complies with this culture. Women's refusal of sexual advances from their husbands is described as not being acceptable in this culture; and hence rape in marriage is not recognized in Ikwerre culture. Education and awareness creation on the importance of women's reproductive autonomy could improve their reproductive rights and autonomy in marital settings. Overcoming the patriarchal aspects of Ikwerre culture-for example, the greater value placed on male children than female children and treating women as incompetent individuals-is necessary to promote gender equality as well as help improve women's reproductive autonomy.

University Reform and Institutional Autonomy: A Framework for Analysing the Living Autonomy

Science.gov (United States)

Maassen, Peter; Gornitzka, Åse; Fumasoli, Tatiana

2017-01-01

In this article we discuss recent university reforms aimed at enhancing university autonomy, highlighting various tensions in the underlying reform ideologies. We examine how the traditional interpretation of university autonomy has been expanded in the reform rationales. An analytical framework for studying how autonomy is interpreted and used…

Death with dignity from the perspective of the surviving family: a survey study among family caregivers of deceased older adults.

Science.gov (United States)

van Gennip, Isis E; Pasman, H Roeline W; Kaspers, Pam J; Oosterveld-Vlug, Mariska G; Willems, Dick L; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D

2013-07-01

Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. (1) To assess the prevalence of death with dignity in older adults from the perspective of family caregivers, (2) to determine factors that diminish dignity during the dying phase according to family caregivers, and (3) to identify physical, psychosocial, and care factors associated with death with dignity. A survey study with a self-administered questionnaire. Family caregivers of 163 deceased older (>55 years of age) adults ("patients") who had participated in the Longitudinal Aging Study Amsterdam. Of the family caregivers, 69% reported that their relative had died with dignity. Factors associated with a dignified death in a multivariate regression model were patients feeling peaceful and ready to die, absence of anxiety and depressive mood, presence of fatigue, and a clear explanation by the physician of treatment options during the final months of life. The physical and psychosocial condition of the patient in combination with care factors contributed to death with dignity from the perspective of the family caregiver. The patient's state of mind during the last phase of life and clear communication on the part of the physician both seem to be of particular importance.

Dignity and existential concerns among nursing homes residents from the perspective of their relatives

DEFF Research Database (Denmark)

Caspari., Synnøve; Høy, Bente; Lohne, Vibeke

2014-01-01

Aims and objectives: The aim of this cross-country Scandinavian study was to explore how residents in nursing homes experience that their dignity is promoted and attended to. This is one part of the Scandinavian project in which we interviewed residents, relatives and staff members. Background......: The main subject concerns the dignity of residents of nursing homes for older people. This article brings forward results from interviews of relatives on how they experience that the dignity is met, promoted and attended to for their next of kin. Design: The study was qualitative with a hermeneutic...... approach. Methods: Qualitative research interviews of 28 relatives of residents at six participating nursing homes in Scandinavia. The results derive from analysis of the interviews using Kvale’s three levels of interpretation; self-understanding, common sense and a theoretical understanding. Results...

(Re)Discovering University Autonomy

DEFF Research Database (Denmark)

Reilly, John; Turcan, Romeo V.; Bugaian, Larisa

2016-01-01

discussion of challenges. The other outcome is the extent to which academic colleagues in a wide-range of disciplines and not directly engaged with research on university autonomy may not perceive or engage with the wider autonomy outcomes of their work and as a result their own case studies may not fully...... identify the autonomy impact real or potential. Many academic staff take for granted university autonomy without questioning its sometimes contradictory assumptions and impacts....

Law, autonomy and advance directives.

Science.gov (United States)

Willmott, Lindy; White, Ben; Mathews, Ben

2010-12-01

The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

Entrepreneurial autonomy and its dynamics

NARCIS (Netherlands)

van Gelderen, M.W.

2016-01-01

Founding and owning an independent business does not automatically provide the owner/founder with autonomy. Autonomy-motivated entrepreneurs must often make an effort to achieve and maintain autonomy. The aim of this research is to investigate the experience of autonomy, its variations over time,

[Autonomy and dementia Part II: autonomy and representation: a possible combination?].

Science.gov (United States)

Rigaux, Natalie

2011-06-01

This paper, based on a critical review of the medico-social literature, questions the representation of patients with dementia in relation to the autonomy perspectives presented in a previous article. In the canonical perspective of autonomy (defined as a rational decision-making by a stand alone self), the surrogate is the spokeperson of the subject's wills when he was competent because he knows these wills through advance directives or assuming them via substituted judgment. Best patient's interest is then depreciated because it is focused on the present incompetent self. In the relational perspective, where autonomy is constructed through a dialogue with others, the surrogate is the present interlocutor, making the decisions with the patient and care-givers in a way varying with the disease process. He represents the subject with dementia as he was before the disease but also as he has become. Therefore, there is a continuum between autonomy and representation. Autonomy and well being are both the surrogate aims. The relational perspective allows care continuity of patients with dementia even when considered as incompetent. It offers a more balanced perspective on the patient autonomy since it is embedded in all others, and opens a richer view on what good life is, untill the end of dementia.

Human dignity and sexual behavious � A theological perspective

Directory of Open Access Journals (Sweden)

N Vorster

2005-10-01

Full Text Available This article compares the sex ethic of Scripture with the anthropological values that underlie modern sexual morality and gives guidelines for a responsible� sex ethics that can safeguard human dignity. As point of departure it states that the biblical view of sexuality must be understood from the perspective of creation and re-creation and not the fall. The creation narratives teach that humanity possesses qualities of sameness and difference that constitutes our being. Sexuality forms the dynamic which bonds the dialectic of sameness and difference into a unity of persons. The� article concludes that the� African concept of gender , the radical freedom concept of secular society, the utilitarian view of sex, and the postmodern view that sexual behaviour and marriage are social constructs, aggravate sexual promiscuity. In order to fight HIV/AIDS and preserve human dignity the exclusiveness of the sex act, the importance of faithfulness and the sanctity of marriage must be proclaimed.

From solidarity to autonomy: towards a redefinition of the parameters of the notion of autonomy.

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Fainzang, Sylvie

2016-12-01

Starting from examples of concrete situations in France, I show that autonomy and solidarity can coexist only if the parameters of autonomy are redefined. I show on the one hand that in situations where autonomy is encouraged, solidarity nevertheless remains at the foundation of their practices. On the other hand, in situations largely infused with family solidarity, the individual autonomy may be put in danger. Yet, based on my ethnographic observations regarding clinical encounters and medical secrecy, I show that while solidarity may endanger individual autonomy, it does not necessarily endanger autonomy itself. The social practices observable in France reflect the reality of an autonomy that goes beyond the individual, a reality that involves a collective subject and includes solidarity. The opposition between these two values can then be resolved if the content of the notion of autonomy is understood to be dependent on its cultural context of application and on its social use.

Ethical downsizing. Managers must focus on justice and human dignity.

Science.gov (United States)

Weber, L J

1994-01-01

It is vital that leaders and managers focus on justice and human dignity in the workplace when faced with the possible need to downsize. First, administrators should clearly identify the goals of work force reduction, evaluate their importance, and consider whether they could be achieved through other means. Once they have made the decision to downsize, top managers must clearly communicate the reasons and the goals to those responsible for identifying the employees affected. Employees selected for layoff should be identified on the basis of the articulated goals for work force reduction, whenever possible. When this is not clear, the tough decisions can be based on a variety of factors: "across-the-board" reductions; employee abilities, qualifications, and performance; diversity goals; seniority; or multiple criteria. It is also important to respect human dignity in the layoff process. Affected employees should be informed in advance and given an honest explanation for the layoff. Ordinarily, they should be encouraged to work until the effective date. All employees need a clear and honest explanation of the reasons for and the expected effects of the layoff. There should be a stress on the free flow of information, without an effort to control it. How downsizing is handled says a lot about the nature of an organization and its leadership. Ethical downsizing is, first of all, a refusal to deny the complexity of the issues and evidence of the organization's commitment to justice and human dignity.

Death and dignity through fresh eyes.

Science.gov (United States)

Phillips, Matthew; Pilkington, Ruth; Patterson, Aileen; Hennessy, Martina

2011-12-01

Trinity College Dublin remains one of the Medical Schools that uses traditional dissection to teach anatomy, exposing students from the first week of entry to cadavers. This early exposure makes it imperative that issues surrounding death and donor remains are explored early on within the main structure of the curriculum. The School of Medicine began a programme of Medical Humanities student-selected modules (SSMs) in 2010, and the opportunity to offer a module on medical ethics regarding death and dignity was taken. A course was devised that touched only lightly on subjects such as palliative care and the concept of a good death. The course focused much more strongly on the reality of death as part of cultural and societal identity and placement. This was facilitated by field trips to settings where discussions regarding death, dying and dignity were commonplace and authentic experiences, rather than classroom discussions based on theoretical circumstances that may not yet have been experienced by the student. The module ran very well, with students feeling that they had had a chance to think critically about the role of death as an event with significance within society and culture, rather than purely in a medico-legal framework. Options to extend the module to the compulsory element of the course, to be built upon in later years looking at more technical aspects surrounding death, are being explored. © Blackwell Publishing Ltd 2011.

Compulsory Autonomy-Promoting Education

Science.gov (United States)

Schinkel, Anders

2010-01-01

Today, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the development of autonomy in children, but also that this aim should…

Spirituality and Dignity of Thai Adolescents Living with HIV

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Karnsunaphat Balthip

2017-11-01

Full Text Available (1 Background: Adolescents are a key asset and resource for the social and economic development of any country, with the potential to make a significant contribution to their families, communities and countries. Healthy and educated adolescents are important. However, there are still significant rates of death, illness and disease among adolescents in some countries, where HIV is one of the most prevalent causes of death in this group. Adolescents living with HIV may experience and encounter social restrictions and physiological limitations. Therefore, this investigation explored whether the concepts of spirituality and dignity had any relevance to participants sense of meaning and purpose and whether these had any impact upon their health and well-being (2 Methods: A qualitative descriptive design was used involving twenty-two adolescents living with HIV attending one regional hospital in Southern Thailand. One to one interviews and descriptive diaries were used to collect the data and thematic analysis enabled the identification of attributes of spirituality and dignity. (3 Results: The findings revealed that spirituality and dignity were present in the lives of Thai adolescents living with HIV expressed in the main category of living life responsibly. This comprised of six themes: (a Understanding the disease and accepting the truth about life, (b Maintaining hope for a cure, (c Focusing on life’s purposes, (d Making life choices, (e Caring for oneself and (f Responsibility towards other. (4 Conclusions: The findings provide helpful insights for parents, nurses, and other health professionals supporting adolescents living with HIV to obtain a holistic, dignified approach to care that includes attention to the spiritual dimension.

Autonomy-Supportive Parenting and Autonomy-Supportive Sibling Interactions: The Role of Mothers' and Siblings' Psychological Need Satisfaction.

Science.gov (United States)

van der Kaap-Deeder, Jolene; Vansteenkiste, Maarten; Soenens, Bart; Loeys, Tom; Mabbe, Elien; Gargurevich, Rafael

2015-11-01

Autonomy-supportive parenting yields manifold benefits. To gain more insight into the family-level dynamics involved in autonomy-supportive parenting, the present study addressed three issues. First, on the basis of self-determination theory, we examined whether mothers' satisfaction of the psychological needs for autonomy, competence, and relatedness related to autonomy-supportive parenting. Second, we investigated maternal autonomy support as an intervening variable in the mother-child similarity in psychological need satisfaction. Third, we examined associations between autonomy-supportive parenting and autonomy-supportive sibling interactions. Participants were 154 mothers (M age = 39.45, SD = 3.96) and their two elementary school-age children (M age = 8.54, SD = 0.89 and M age = 10.38, SD = 0.87). Although mothers' psychological need satisfaction related only to maternal autonomy support in the younger siblings, autonomy-supportive parenting related to psychological need satisfaction in both siblings and to an autonomy-supportive interaction style between siblings. We discuss the importance of maternal autonomy support for family-level dynamics. © 2015 by the Society for Personality and Social Psychology, Inc.

Reproductive autonomy of women and girls under the Convention on the Rights of Persons with Disabilities.

Science.gov (United States)

Ngwena, Charles G

2018-01-01

Women and girls with disabilities have historically been denied the freedom to make their own choices in matters relating to their reproduction. In the healthcare sector they experience multiple discriminatory practices. Women and girls with intellectual disabilities are particularly vulnerable to coerced or forced medical interventions. The present article considers the contribution the Convention on the Rights of Persons with Disabilities makes towards affirming the rights of women and girls with disabilities to enjoy reproductive autonomy, including autonomy related to reproductive health, on an equal basis with individuals without disabilities. The Convention is paradigm-setting in its maximal approach to affirming the rights of individuals with disabilities to make autonomous choices under conditions of equality and non-discrimination. The Convention is the first human rights treaty to clearly affirm that impairment of decision-making skills is not a justification for depriving a person with cognitive or intellectual disability of legal capacity. © 2017 International Federation of Gynecology and Obstetrics.

Autonomy of State Agencies

DEFF Research Database (Denmark)

Hansen, Morten Balle; Niklasson, Birgitta; Roness, Paul

agencies in four Nordic countries: Denmark, Finland, Norway and Sweden. By using survey data from more than 500 state agencies in the four countries, the article analyses whether there is indeed a Scandinavian style of autonomy and result control and assesses which structural, cultural, and environmental......NPM-doctrines states that ideal-type agencies should have a high level of managerial autonomy, while being controlled through result-based control instruments, like performance contracts. In this article, the authors present a first preliminary attempt to comparatively analyze the autonomy of state...... variables might explain similarities and differences in the autonomy of agencies....

Raising the question of dignity through knowledge about tacit practices and politics: sharing learning from the Norwegian welfare state

Directory of Open Access Journals (Sweden)

Oddgeir Synnes

2017-09-01

Full Text Available The focus of this special issue is some of the main tacit policies and practices in the Norwegian welfare state. By looking at what is tacit, mute, unarticulated and neglected we will contribute to raising and presenting knowledge about the social and ethical question of dignity in welfare. This introductory article will first give a short overview of the historical background of the Norwegian welfare state and some of its current features. This will be followed by our positioning of the Norwegian welfare state as situated within complex practices, political discourses and dimensions that might be characterised as tacit, implicit or unarticulated. The article aims to discuss the concept of dignity in welfare services, at the individual and structural level, by asking ‘what kind of practices and structural conditions preserve dignity and where might dignity be violated, ignored or left out?’ The various articles in this special issue of the International Practice Development Journal illuminate what can be said and what is mute and tacit in different ways, and consider a range of practice-based responses. By revealing tacit dimensions in the Norwegian welfare this issue offers important insight into practices and discourses where dignity is at stake. It is a requirement of us all that we revisit dignity and its location and representation in our health systems to ensure it is not left behind as the state and other systems within it evolve.

The Concept of Human Dignity in German and Kenyan ...

African Journals Online (AJOL)

... of the concept of human dignity in German and Kenyan constitutional law. We base our analysis on decisions of the Federal Constitutional Court of Germany, in particular its take on life imprisonment and its 2006 decision concerning the shooting of hijacked airplanes, and on a close reading of the Constitution of Kenya.

Autonomy and interdependence: beliefs of Brazilian mothers from state capitals and small towns.

Science.gov (United States)

Vieira, Mauro Luis; Seidl-de-Moura, Maria Lucia; Macarini, Samira Mafioletti; Martins, Gabriela Dal Forno; Lordelo, Eulina da Rocha; Tokumaru, Rosana Suemi; Oliva, Angela Donate

2010-11-01

This study aimed to investigate characteristics of Brazilian mothers' beliefs system, in the dimensions of autonomy and interdependence. A group of 600 women, half from state capitals and half from small towns, participated in the study. They were individually interviewed with Scales of Allocentrism, Beliefs about Parental Practices and Socialization Goals. Paired and Independent samples t tests and Multivariate GLM were performed. The results indicate that although mothers from both contexts value autonomy, mothers inhabiting small towns considered the relational dimension as the most important; whereas mothers inhabiting capitals valued equally both dimensions, either in their beliefs about practices or in the socialization goals for their children. Mothers from small towns have a higher mean score for allocentrism than mothers living in capitals. Thus, place of residence proved to be a relevant variable in the modulation of maternal beliefs. Educational level was not a significant factor in the variables considered and with this group of mothers. The study results are discussed in terms of their contribution to the understanding of the complex relationship between dimensions of autonomy and interdependence in mothers' beliefs system.

[The dignity of the patient: a legal problem?].

Science.gov (United States)

Schultz, H

1980-11-01

Rules of medical ethic bid since the times of antiquity to respect the patients dignity. Today to respect the dignity of any man is a general legal rule. In the same way other rules of the traditional medical ethic became legal norms as for instance the command forbidding to do harm to someone. The law intends to limit the possibilities to exercise power. Therefore it does not compete to the doctor alone to decide that a medical treatment has to be applied. The legal base of a medical treatment lies in the consent of the patient who has been duly cleared up on his state, the necessary treatment and its risks. If it has to be decided if a doctor has given the right treatment in a special case it does not suffice to consult the general rules of the law; the circumstances of the case have to be considered as well. The doctor has to decide, according to the actual medical knowledge and the rules of his professional art what the appropriate proceeding is. Legal and medical considerations are closely connected if one judges a doctor handling a special case. If the patient consents, the doctor is not obliged to treat him, but he is entitled to do it, cases of emergency excepted. If and in what way he treats the patient has to be decided by the doctor according to medical criterias. If a patient, sound of mind, who is suffering heavily by an incurable illness asks the doctor to restrain treatment to alleviating the pains and to the absolute cares to preserve life, the doctor is bound by his patient's wish. In analogy the legal construct of "conducting business without mandate" allows the doctor to proceed in the same way if the patient who lost consciousness is not able to decide upon the treatment and whose death is inevitable and imminent if this is the only wise to respect the dignity of the patient.

The failure of formal rights and equality in the clinic: a critique of bioethics.

Science.gov (United States)

Atkins, Chloe G K

2005-01-01

For communities which espouse egalitarian principles, the hierarchical nature of care-giving relationships poses an extraordinary challenge. Patients' accounts of their illnesses and of their medical care capture the latent tension which exists between notional, political equality and the need for dependency on care from others. I believe that the power imbalance in doctor-patient relationships has broad implications for liberal democracies. Professional and care-giving relationships almost always consist of an imbalance of knowledge and expertise which no template of egalitarian moralism can suppress. When we seek help or guidance from authority figures, we are at a disadvantage politically even though we may be equal citizens theoretically and legally. Hierarchic relationships persist within democracies. Moreover, they tend to exist within a realm of privacy which is only partially visible from the social realm. In the end, traditional notions of liberal autonomy and egalitarianism do not properly describe or monitor these interactions. Liberal rhetoric (i.e., terms such as equality, rights, consent, etc.) pervades much of bioethical literature and interventions but, this very language tends to mask the persistence of structural hierarchies in the clinic. The doctor-patient relationship forces democratic communities to confront the problem of continuing hierarchic power relations and challenges liberalism to revise its understanding of individual autonomies.

Public Health Autonomy: A Critical Reappraisal.

Science.gov (United States)

Zimmerman, Frederick J

2017-11-01

The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

Patterns of dignity-related distress at the end of life: a cross-sectional study of patients with advanced cancer and care home residents.

Science.gov (United States)

Hall, Sue; Davies, Joanna M; Gao, Wei; Higginson, Irene J

2014-10-01

To provide effective palliative care in different settings, it is important to understand and identify the sources of dignity-related distress experienced by people nearing the end of life. To describe and compare the sources of dignity-related distress reported by cancer patients and care home residents. Secondary analysis of merged data. Participants completed the Patient Dignity Inventory (assessing 25 sources of dignity-related distress) and measures of quality of life and depression. A total of 45 adult patients with advanced cancer referred to hospital-based palliative care teams in London, United Kingdom, and 60 residents living in one of 15 care homes in London. Care home residents were older and had poorer functioning. Both groups reported a wide range of dignity-related problems. Although the number or problems reported on the Patient Dignity Inventory was similar for the two groups (mean (standard deviation): 5.9 (5.5) for cancer patients and 4.1 (4.3) for care home residents, p = 0.07), there was a tendency for more cancer patients to report some existential problems. Experiencing physically distressing symptoms and functional limitations were prevalent problems for both groups. Patient Dignity Inventory problems were associated with poorer performance status and functioning for residents, with age and cognitive impairment for cancer patients and with poorer quality of life and depression for both groups. Although characteristics of the samples differed, similarities in the dignity-related problems reported by cancer patients and care home residents support research suggesting a common pathway towards death for malignant and non-malignant disease. A wider understanding of the sources of dignity-related distress would help clinicians provide more effective end-of-life care. © The Author(s) 2014.

Human Dignity in the Surrogacy%代孕与人的尊严辨析

Institute of Scientific and Technical Information of China (English)

罗维萍; 韩跃红

2015-01-01

Commercial surrogacy is a deviation from the moral principle of“Man is the goal”,which dama-ges the dignity of life,human dignity and the dignity of human being of surrogate mother and the born babies. Aided surrogacy between relatives and volunteer surrogacy for some special unfortunate family are in accordance with the principle of life ethics and humanitarian spirit.Seeing that there are an enormous number of China's women loss fertility,the underground illegal surrogacy is rampant,and the dignity and human rights of surrogate women and the babies are seriously threatened,and thereby while the combat against commercial surrogacy is intensely carried out,the aided surrogacy between relatives could be cautiously initiated.%商业性代孕背离了“人是目的”的道德原则，损害了代孕妇女、代孕婴儿的生命尊严、人格尊严以及人类尊严。亲属间的援助性代孕和针对某些特殊不幸家庭的志愿者代孕符合生命伦理原则和人道主义精神。鉴于中国女性丧失生育能力者众多、地下非法代孕猖獗、代孕妇女和婴儿的尊严和人权受到严重威胁的现状，在加大打击商业性代孕的同时，可先行谨慎开放亲属间的援助性代孕。

University Internationalization and University Autonomy

DEFF Research Database (Denmark)

Turcan, Romeo V.; Gulieva, Valeria

2016-01-01

Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability are d......, dissimilar, and sometimes conflicting dimensions of the financial, legal, organisational, staffing, and academic autonomy of the host country, are compromising key aspects of their own autonomy and core mission?......Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability...... are determined by the structure and exercise of university autonomy settings at home and in the host countries, and that the process itself cannot be successfully achieved and maintained without changes in the autonomy settings. The key question the authors ask is to what degree universities, in embracing new...

Intention, autonomy, and brain events.

Science.gov (United States)

Gillett, Grant

2009-07-01

Informed consent is the practical expression of the doctrine of autonomy. But the very idea of autonomy and conscious free choice is undercut by the view that human beings react as their unconscious brain centres dictate, depending on factors that may or may not be under rational control and reflection. This worry is, however, based on a faulty model of human autonomy and consciousness and needs close neurophilosophical scrutiny. A critique of the ethics implied by the model takes us towards a 'care of the self' view of autonomy and the subject's attunement to the truth as the crux of reasoning rather than the inner mental/neural state views of autonomy and human choice on offer at present.

Revisiting Privacy and Dignity: Online Shaming in the Global E-Village

Directory of Open Access Journals (Sweden)

Anne S.Y. Cheung

2014-06-01

Full Text Available Since the introduction of new Web-based technology in the early 21st century, online shaming against those who have violated social norms has been proliferating fast in cyberspace. We have witnessed personal information of targeted individuals being disclosed and displayed for the purpose of humiliation and social condemnation by the anonymous Internet crowd, followed often by harassment and abusive behavior online and offline, resulting in serious disruption of personal life. While public shaming as a form of criminal sanction has been widely discussed in present literature, social policing by shaming transgressions via the Internet is largely a new terrain yet to be explored and studied. Drawing on socio-legal literature on shaming and punishment, and jurisprudence from the English Courts on defamation, harassment and misuse of personal information and the European Court of Human Rights on the relationship between the right to private life and dignity, the discussion will explain how the role of dignity has informed the development of the right to privacy where its value has played a distinctive role. This refers especially to the context in which the plaintiffs could be said to be partly at fault as transgressor-victims. It argues that the recognition and protection of the dignity and privacy of an individual is necessary in order to arrive at norms and values inherent in decent participation in the e-village. In this article, the term “dignity” refers to one’s innate personhood, integrity and self-respect.

An intercultural nursing perspective on autonomy.

Science.gov (United States)

Hanssen, Ingrid

2004-01-01

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients' possibly harmful choices is discussed, the focus is on 'forced' autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively participate neither in the treatment offered nor in making choices regarding that treatment. Nurses' demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person's autonomy is also respect for the person, one's respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second-order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why.

Individual autonomy in work teams : the role of team autonomy, self-efficacy, and social support

NARCIS (Netherlands)

Mierlo, van H.; Rutte, C.G.; Vermunt, J.K.; Kompier, M.A.J.; Doorewaard, J.A.C.M.

2006-01-01

Task autonomy is long recognized as a means to improve functioning of individuals and teams. Taking a multilevel approach, we unravelled the constructs of team and individual autonomy and studied the interplay between team autonomy, self-efficacy, and social support in determining individual

[The dignity of older persons in view of postconciliar church teaching].

Science.gov (United States)

Necek, Ks Robert

2014-01-01

Dignity is innate value of human. In perspective of human dignity the health protection of patients is the essence of medical deontology, duty of love, which is taking by doctor and nurse is express by practice of profession, which does not lose human features. It is important, that is impossible to enjoin love, because love is not an order, it is open for other's needs. By virtue of this elderly cannot be treated like things in economic system of hospital, but through love "we should enable the elderly to grow in the conventional wisdom gathered by the entire life". Pope Benedict XVI notices that, every work, competence is the most important thing. Due to it, medicine extend respect for body human and the law, which rules it, furthermore recognize human life as sign of unexplored secret.

[The concept of dignity and life science law: a symbolic, dynamic value at the heart of the social construction of man].

Science.gov (United States)

Byk, Christian

2010-12-01

Included in human rights law just after the Second World War, dignity is the quality common to all people in that it symbolises their human condition. Inherent to each person, it is therefore independent of any other personal and random condition (physical state, origin, colour, religion...) just as it is independent of social conditions (a person's dignity cannot be questioned by society). However, the very context of this recognition--in the aftermath of the defeat of Nazism--emphasises the fact that it was not something evident in human history. So there is in this manifestation of the international community a strong political sign which makes dignity as much a construction of man as a quality consubstantial with his nature. A symbol of the human condition, dignity is therefore also a dynamic value, a combat value. As such, it forces us to wonder about what belongs to the human sphere and also about the particular responsibility which springs for every man and for mankind, from the dignity with which he is invested.

Life Written in Bytes . The Superinformacional and New Technologies Company : Will the End of Privacy and Human Dignity ?

Directory of Open Access Journals (Sweden)

Cleide Aparecida Gomes Rodrigues Fermentão

2015-12-01

Full Text Available Recent technologies have changed the way media of the human being, which shall establish direct contact with many people anywhere in the world. Allied to this fact, there is a virtualization increasing the human person, culminating in an immersion in the virtual world, which ultimately creates an increasing dependence on technology in order to exist socially. This transformation in the world of concepts makes the virtual pass to have direct impact in the real world. Attracted by the glitter and glamor of virtual network, the person finds no limits to their self-promotion. The private life is increasingly exposed to an undetermined number of people. So the person who is exposed in the virtual media in search of acceptance, forgets that it is not only stripping of his clothes or his privacy, but mainly is stripped of his dignity. The frantic search for some "tanned" finds no limit on common sense, coisificando the person and transforming it into mere virtual profile. The human person is in this state, the total lack of dignity, without realizing it, it becomes an object on display. The internet is a stage conducive to the spectacle of the self virtual, making it fertile ground for the indignity. The history of civilization dating back to fighting and winning the dignity of the human person, however, the time in which we live watch a reverse movement. Contemporaneously it is no longer the state or private to be constant threat to human dignity. Those who, seduced by the possibility of becoming the personality of the time, voluntarily abdicate their dignity in a process whose reversibility is questionable. The legislation can not keep up the speed of the transformations occurred in the virtual world and this mismatch can leave unprotected person especially in relation to their rights to intimacy, privacy and human dignity itself.

Safety, Dignity and the Quest for a Democratic Campus Culture

Science.gov (United States)

Ben-Porath, Sigal

2016-01-01

In his excellent paper, Callan (2016) differentiates intellectual safety, which fosters smugness, indifference and lack of effort, from dignity safety, which is needed for participation, learning and engagement. He suggests that college classrooms that reject the first and espouse the second would be ones that focus on "cultivating…

Understanding the Different Dimensions of Human Dignity: Analysis of the Decision of the Constitutional Courth of the Republic of Slovenia on the »Tito Street« Case

Directory of Open Access Journals (Sweden)

Kleindienst Petra

2017-09-01

Full Text Available In 2011, the Constitutional Court of the Republic of Slovenia made a historical decision on the ‘Tito street’ case, thereby placing human dignity at the centre of the constitutional order. A few years later, some related doubts not resolved by the Constitutional Court remain. For instance, the Court argues that an exhaustive a priori definition of human dignity is impossible since the notion depends on the development of its historical and ethical substance over time. The question thus arises of why legislation states that human dignity is universal even though it can be perceived as being a product of time and place. In this paper, we strive to answer this question by arguing that human dignity has two dimensions, initial dignity and realised dignity, and interpret the Court’s decision from a new angle. Thereby, the aim of this paper is to build a conceptual framework of human dignity and discuss it from a fresh perspective as well as to prove its applicability by presenting Slovenian constitutional case law. The paper offers significant insights into the discussion and may therefore help to improve future interpretations of human dignity in the field of constitutional case law.

The economic value of autonomy

NARCIS (Netherlands)

Boot, A.W.A.; Thakor, A.V.

2003-01-01

We develop an economic theory of "autonomy", which we interpret as the discretion or ability to make a decision that others disagree with. We show that autonomy is essentially an option for the decisionmaker, and can be valued as such. The value of the autonomy option is decreasing in the extent to

Controlled Autonomy: Novice Principals' Schema for District Control and School Autonomy

Science.gov (United States)

Weiner, Jennie M.; Woulfin, Sarah L.

2017-01-01

Purpose: The purpose of this paper is to gain insights into how a group of novice principals, all in schools that deployed principles of autonomy as mechanisms for improvement, conceptualized what the authors label "controlled autonomy"--a condition in which school leaders are expected to both make site-based decisions and be accountable…

Autonomy and Acceptance of Long-Term Care

Science.gov (United States)

Hsu, Hui-Chuan; Ting, Yu-Shan; Jiang, Ting-Wen; Chien, Ming-Chih; Chien, Chih-Hsin

2009-01-01

This study explored the relationship between four types of autonomy (health autonomy, informational autonomy, living autonomy, and financial autonomy) and the acceptance of five types of long-term care (adult day care, respite care, assisted living, unit care, and group home) for the elderly in Taiwan. Data were collected from 167 middle-aged and…

Shared decision-making and patient autonomy.

Science.gov (United States)

Sandman, Lars; Munthe, Christian

2009-01-01

In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.

Motivating Proteges' Personal Learning in Teams: A Multilevel Investigation of Autonomy Support and Autonomy Orientation

Science.gov (United States)

Liu, Dong; Fu, Ping-ping

2011-01-01

This study examined the roles of 3 multilevel motivational predictors in proteges' personal learning in teams: an autonomy-supportive team climate, mentors' autonomy support, and proteges' autonomy orientation. The authors followed 305 proteges in 58 teams for 12 weeks and found that all 3 predictors were positively related to the proteges'…

Hospice-assisted death? A study of Oregon hospices on death with dignity.

Science.gov (United States)

Campbell, Courtney S; Cox, Jessica C

2012-05-01

Nearly 90% of terminally ill patients who have used Oregon's distinctive death with dignity law to receive a medication to end their lives are enrolled in hospice care programs. In 2009-2010, we conducted a study of the policies developed by Oregon hospices to address patient inquiries and requests for death with dignity. The study examined the stated hospice values and positions and identified the boundaries to participation drawn by the hospice programs to protect personal and programmatic integrity. The boundaries were drawn around 6 key caregiving considerations: (1) language regarding physician-assisted death (PAD); (2) informed decision making by patients; (3) collaboration with physicians; (4) provision of lethal medication; (5) assistance in the patient's act of taking the medication; and (6) staff presence at the time of medication ingestion.

Senegal : School Autonomy and Accountability

OpenAIRE

World Bank

2012-01-01

Senegal has accelerated the decentralization of education since 1996. Budgetary autonomy is latent. Autonomy over the management of operational budgets has been delegated to the communes, but salaries for teachers are managed at the central level. Autonomy in personnel management is latent. Both school directors and teachers are appointed at the central level. The role of the school counci...

The Right to Dignity and Restorative Justice in Schools | Reyneke ...

African Journals Online (AJOL)

A retributive and punitive approach is normally adopted in dealing with misbehaviour in South African schools. Despite the legal abolition of corporal punishment, more than 50 percent of schools still administer it. Other forms of punishment generally applied are also punitive in nature. The right to dignity of all of the parties ...

Physicians' perceptions of autonomy across practice types: Is autonomy in solo practice a myth?

Science.gov (United States)

Lin, Katherine Y

2014-01-01

Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians' autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked "spell" data constructed from the Community Tracking Study (CTS) Physician Survey (1996-2005) (n = 16,519) I examine how physicians' perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. Copyright © 2013

Physicians’ Perceptions of Autonomy across Practice Types: Is Autonomy in Solo Practice a Myth?

Science.gov (United States)

Lin, Katherine Y.

2013-01-01

Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians’ autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked “spell” data constructed from the Community Tracking Study (CTS) Physician Survey (1996–2005) (n=16,519) I examine how physicians’ perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. PMID:24444835

The Relation between Law and Fraternity as a Promotional Instrument for Human Dignity in Labor Law

OpenAIRE

Guilherme Domingos de Luca; Lafayette Pozzoli

2015-01-01

Examine in this study as a problem, the relationship of law and Fraternity as a promotional instrument of Human Dignity in Labour Law, pointing out the means by which positive law has constitutionalized the fundamental guarantees of man labor law. Understand the relationship of human labor versus the dignity of the human person, and the idea of fraternity as a promotional function. The research was based on bibliographic compared. The main object is to understand the role of the fraternity an...

Understanding nurse practitioner autonomy.

Science.gov (United States)

Weiland, Sandra A

2015-02-01

This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.

Death with dignity from the perspective of the surviving family: A survey study among family caregivers of deceased older adults

NARCIS (Netherlands)

van Gennip, I.E.; Pasman, H.R.W.; Kaspers, P.J.; Oosterveld-Vlug, M.G.; Willems, D.L.; Deeg, D.J.H.; Onwuteaka-Philipsen, B.D.

2013-01-01

Background: Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified

Death with dignity from the perspective of the surviving family: a survey study among family caregivers of deceased older adults

NARCIS (Netherlands)

van Gennip, Isis E.; Pasman, H. Roeline W.; Kaspers, Pam J.; Oosterveld-Vlug, Mariska G.; Willems, Dick L.; Deeg, Dorly J. H.; Onwuteaka-Philipsen, Bregje D.

2013-01-01

Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. (1)

A Phase II randomised controlled trial assessing the feasibility, acceptability and potential effectiveness of Dignity Therapy for older people in care homes: Study protocol

Directory of Open Access Journals (Sweden)

Richardson Alison

2009-03-01

Full Text Available Abstract Background Although most older people living in nursing homes die there, there is a dearth of robust evaluations of interventions to improve their end-of-life care. Residents usually have multiple health problems making them heavily reliant on staff for their care, which can erode their sense of dignity. Dignity Therapy has been developed to help promote dignity and reduce distress. It comprises a recorded interview, which is transcribed, edited then returned to the patient, who can bequeath it to people of their choosing. Piloting has suggested that Dignity Therapy is beneficial to people dying of cancer and their families. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in older people reaching the end of life in care homes, and to pilot the methods for a Phase III RCT. Methods/design A randomised controlled open-label trial. Sixty-four residents of care homes for older people are randomly allocated to one of two groups: (i Intervention (Dignity Therapy offered in addition to any standard care, and (ii Control group (standard care. Recipients of the "generativity" documents are asked their views on taking part in the study and the therapy. Both quantitative and qualitative outcomes are assessed in face-to-face interviews at baseline and at approximately one and eight weeks after the intervention (equivalent in the control group. The primary outcome is residents' sense of dignity (potential effectiveness assessed by the Patient Dignity Inventory. Secondary outcomes for residents include depression, hopefulness and quality of life. In view of the relatively small sample size, quantitative analysis is mainly descriptive. The qualitative analysis uses the Framework method. Discussion Dignity Therapy is brief, can be done at the bedside and could help both patients and their families. This detailed exploratory research shows if

A Phase II randomised controlled trial assessing the feasibility, acceptability and potential effectiveness of dignity therapy for older people in care homes: study protocol.

Science.gov (United States)

Hall, Sue; Chochinov, Harvey; Harding, Richard; Murray, Scott; Richardson, Alison; Higginson, Irene J

2009-03-24

Although most older people living in nursing homes die there, there is a dearth of robust evaluations of interventions to improve their end-of-life care. Residents usually have multiple health problems making them heavily reliant on staff for their care, which can erode their sense of dignity. Dignity Therapy has been developed to help promote dignity and reduce distress. It comprises a recorded interview, which is transcribed, edited then returned to the patient, who can bequeath it to people of their choosing. Piloting has suggested that Dignity Therapy is beneficial to people dying of cancer and their families. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in older people reaching the end of life in care homes, and to pilot the methods for a Phase III RCT. A randomised controlled open-label trial. Sixty-four residents of care homes for older people are randomly allocated to one of two groups: (i) Intervention (Dignity Therapy offered in addition to any standard care), and (ii) Control group (standard care). Recipients of the "generativity" documents are asked their views on taking part in the study and the therapy. Both quantitative and qualitative outcomes are assessed in face-to-face interviews at baseline and at approximately one and eight weeks after the intervention (equivalent in the control group). The primary outcome is residents' sense of dignity (potential effectiveness) assessed by the Patient Dignity Inventory. Secondary outcomes for residents include depression, hopefulness and quality of life. In view of the relatively small sample size, quantitative analysis is mainly descriptive. The qualitative analysis uses the Framework method. Dignity Therapy is brief, can be done at the bedside and could help both patients and their families. This detailed exploratory research shows if it is feasible to offer Dignity Therapy to residents of

[Applying the human dignity ideals of Confucianism and Kant to psychiatric nursing: from theory to practice].

Science.gov (United States)

Lee, Mei-Hsiu; Lee, Shui-Chuen; Lee, Shu-Chen

2012-04-01

Literature articles and clinical observation suggest disease and environmental factors as primary causes of the low self-esteem and stigmatization that typify most psychiatric patients. These patients are at risk of injury when subjected to inappropriate physical restraint. Hospital staffs, including nurses, are in immediate and close contact with psychiatric patients. Mencius's and Kant's thoughts on human dignity can enhance reflections on clinical nursing practices. Mencius's belief that preserving life is not the most desirable thing and death is not the most hated thing can help nurses realize the human dignity of psychiatric patients by understanding that, as an unrighteous act is more detestable than death, the meaning and value of righteousness are greater than life itself. In light of Kant's views on human dignity, nurses should treat patients as goals rather than means. Exploring such ideas can raise nursing quality, restore a positive sense of humanity to psychiatric patients, and develop nursing values and meaning to a higher plane.

Dignity, religion and freedom of expression in South Africa | van ...

African Journals Online (AJOL)

The issue that this article dealt with is whether, in South African law, speech that infringes upon the religious feelings of an individual is protected by the dignity clause in the Constitution of the Republic of South Africa. The Constitution, as well as the Broadcasting Code, prohibits language that advocates hatred, inter alia, ...

Compulsory autonomy-promoting education

NARCIS (Netherlands)

A. Schinkel (Anders)

2010-01-01

textabstractToday, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the

The effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial

Science.gov (United States)

Chochinov, Harvey Max; Kristjanson, Linda J.; Breitbart, William; McClement, Susan; Hack, Thomas F; Hassard, Tom; Harlos, Mike

2011-01-01

Objectives Dignity Therapy is a unique, individualized, brief psychotherapy, developed for patients (and their families) living with life threatening or life limiting illness. The purpose of this study was to determine if Dignity Therapy could mitigate distress and/or bolster end-of-life experience for patients nearing death. Trial Design Multi-site randomized controlled trial, with patients assigned to Dignity Therapy, Client Centred Care or Standard Palliative Care. Study arm assignment was based on a computer-generated table of random numbers. Blinding was achieved using opaque sealed envelopes, containing allocations that were only opened once consent had been obtained. Participants Patients receiving hospital or community (hospice or home) based palliative care, in Winnipeg, New York, or Perth, randomly assigned to, Dignity Therapy [n=108], Client Centered Care [n=107] and Standard Palliative Care (n=111). Main Outcome Measures The primary outcome measures included the FACIT Spiritual Well-Being Scale, the Patient Dignity Inventory, the Hospital Anxiety and Depression Scale; items from the Structured Interview for Symptoms and Concerns, the Quality of Life Scale and a modified Edmonton Symptom Assessment Scale. Mean changes between baseline and end of intervention ratings were determined. Secondary outcomes, examining self-report end-of-life experience, consisted of a post-study survey administered across all study arms. Intervention Dignity Therapy, a novel, brief psychotherapy, provides patients with life threatening and life limiting illnesses an opportunity to speak about things that matter most to them. These recorded conversations form the basis of a generativity document, which patients can bequeath to individuals of their choosing. Client Centred Care is a supportive psychotherapeutic approach, in which research nurse/therapists guide patients through discussions focusing on here and now issues. Findings No significant differences across study arms

Psychometric properties of the Patient Dignity Inventory in an acute psychiatric ward: an extension study of the preliminary validation

Directory of Open Access Journals (Sweden)

Di Lorenzo R

2018-03-01

Full Text Available Rosaria Di Lorenzo,1 Paola Ferri,2 Carlotta Biffarella,2 Giulio Cabri,3 Eleonora Carretti,4 Gabriella Pollutri,5 Ludovica Spattini,5 Cinzia Del Giovane,6 Harvey Max Chochinov7 1Psychiatric Intensive Treatment Facility, Mental Health Department, Azienda USL, Modena, Italy; 2Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy; 3Service of Psychiatric Diagnosis and Treatment, Mental Health Department, Azienda USL, Modena, Italy; 4School of Nursing, University of Modena and Reggio Emilia, Italy; 5School of Specialization in Pscyhiatry, Faculty of Medicine, University of Modena and Reggio Emilia, Italy; 6Faculty of Medicine, Institute of Primary Care (BIHAM, University of Bern, Bern, Switzerland; 7Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada Background: During the last decades, dignity has been an emerging issue in mental health since its ethical and therapeutic implications became known. This study is an extension of the preliminary validation of the Patient Dignity Inventory (PDI in a psychiatric setting, originally designed for assessing perceived dignity in terminal cancer patients. Methods: From October 21, 2015 to December 31, 2016, we administered the Italian PDI to all patients hospitalized in an acute psychiatric ward, who provided their consent and completed it at discharge (n=165. We performed Cronbach’s alpha coefficient and principal factor analysis. We administered other scales concomitantly to analyze the concurrent validity of PDI. We applied stepwise multiple linear regression to identify the patients’ demographic and clinical variables related to the PDI score. Results: Our response rate was 93%, with excellent internal consistency (Cronbach’s alpha coefficient=0.94. The factorial analysis showed three factors with eigenvalue >1, which explained >80% of total variance: 1 “loss of self-identity and anxiety for the future”, 2 �

"Ultimately, mom has the call": Viewing clinical trial decision making among patients with ovarian cancer through the lens of relational autonomy.

Science.gov (United States)

Asiedu, Gladys B; Ridgeway, Jennifer L; Carroll, Katherine; Jatoi, Aminah; Radecki Breitkopf, Carmen

2018-04-14

This study employs the concept of relational autonomy to understand how relational encounters with family members (FMs) and care providers may shape decisions around ovarian cancer patients' clinical trial (CT) participation. The study also offers unique insights into how FMs view patients' decision making. In-depth interviews were conducted with 33 patients with ovarian cancer who had been offered a CT and 39 FMs. Data were inductively analysed using a thematic approach and deductively informed by constructs derived from the theory of relational autonomy (RA). Patients' relationships, experiences and social status were significant resources that shaped their decisions. Patients did not give equal weight to all relationships and created boundaries around whom to include in decision making. Doctors' recommendations and perceived enthusiasm were described as influential in CT decisions. Both patients with ovarian cancer and their FMs maintained that patients have the "final say," indicating an individualistic autonomy. However, maintaining the "final say" in the decision-making process is constitutive of patients' relationships, emphasizing a relational approach to autonomy. FMs support patients' autonomy and they do so particularly when they believe the patient is capable of making the right choices. Although ethical principles underlying informed consent for CT participation emphasize individual autonomy, greater attention to relational autonomy is warranted for a more comprehensive understanding of CT decision making. © 2018 Mayo Clinic. Health Expectations published by John Wiley & Sons Ltd.

Respect for autonomy and technological risks

NARCIS (Netherlands)

Asveld, L.

2008-01-01

Technological developments can undermine the autonomy of the individual. Autonomy is one's ability to make and act upon decisions according to one's own moral framework. Respect for autonomy dictates that risks should not be imposed on the individual without her consent. Technological developments

(Re)Discovering University Autonomy

DEFF Research Database (Denmark)

This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter-re...

The Fundamental Principle of Human Dignity and the Right to Life : Collision Any of These Fundamental Principles The Perspective of Abortion

Directory of Open Access Journals (Sweden)

Érika do Amaral Véras

2016-12-01

Full Text Available This legal article works the theme of the collision of the fundamental principles, especially the principle of human dignity and the right to life, abortion perspective. First, we discuss of fundamental rights, bringing its definition, observed the distinction between human rights and fundamental rights. Then the super principle of human dignity is covered and, soon after, the right to life is highlighted through its relevant elements. Finally, talks on a possible collision beween the fundamental right to life and the principle of human dignity, with a special focus on the issue of abortion.

Models, controls, and levels of semiotic autonomy

Energy Technology Data Exchange (ETDEWEB)

Joslyn, C.

1998-12-01

In this paper the authors consider forms of autonomy, forms of semiotic systems, and any necessary relations among them. Levels of autonomy are identified as levels of system identity, from adiabatic closure to disintegration. Forms of autonomy or closure in systems are also recognized, including physical, dynamical, functional, and semiotic. Models and controls are canonical linear and circular (closed) semiotic relations respectively. They conclude that only at higher levels of autonomy do semiotic properties become necessary. In particular, all control systems display at least a minimal degree of semiotic autonomy; and all systems with sufficiently interesting functional autonomy are semiotically related to their environments.

Ethical fundamentals in human subjects research : On equipoise and human dignity

NARCIS (Netherlands)

van der Graaf - Verhave, R.

2010-01-01

In her PhD thesis Rieke van der Graaf has studied how we can ethically justify human subjects research. In particular she has studied two ethical fundamentals that play a key role in the justification process, that of equipoise and human dignity. Equipoise is often taken to mean that

Changing professional autonomy?

DEFF Research Database (Denmark)

Jespersen, Peter Kragh

The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway......The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway...

Subsidiary Autonomy and Knowledge Transfer

DEFF Research Database (Denmark)

Søberg, Peder Veng; Wæhrens, Brian Vejrum

2015-01-01

Purpose: This paper explores the effect of subsidiary autonomy on knowledge transfers during captive R&D offshoring to emerging markets. Design/methodology/approach: A framework to this end is developed and illustrated in relation to four cases of captive R&D offshoring to emerging markets....... Findings: Subsidiary autonomy has a mainly negative effect on primary knowledge transfer and a mainly positive effect on reverse knowledge transfer. Newly established R&D subsidiaries in emerging markets need primary knowledge transfer in order to build up their competence before they can add...... to the knowledge level of the MNE. Originality: A dual role of subsidiary autonomy is identified. Gradual increase in R&D subsidiary autonomy is beneficial for subsidiary innovation performance....

Characteristics of Law-Autonomy Foreign Subsidiaries

DEFF Research Database (Denmark)

Gammelgaard, Jens; McDonald, Frank; Stephan, Andreas

2012-01-01

This paper examines several characteristics of foreign subsidiaries with low autonomy. Data derived from a survey of 381 MNC subsidiaries located in Denmark, Germany and the UK demonstrate that low-autonomy subsidiaries are highly embedded in their respective MNC networks and that they establish ...... relationship between lower autonomy and the production activities carried out by the subsidiary. In fact, low-autonomy subsidiaries appear to be specialized in that they focus on a few value-chain activities and they typically serve as marketing outlets....

The gender gap in student engagement: The role of teachers' autonomy support, structure, and involvement.

Science.gov (United States)

Lietaert, Sofie; Roorda, Debora; Laevers, Ferre; Verschueren, Karine; De Fraine, Bieke

2015-12-01

The gender gap in education in favour of girls is a widely known phenomenon. Boys generally have higher dropout rates, obtain lower grades, and show lower engagement. Insight into factors related to these academic outcomes could help to address the gender gap. This study investigated, for Dutch language classes, (1) how boys and girls differ in behavioural engagement, (2) which teacher support dimensions (autonomy support, structure, involvement) may explain gender differences in engagement (mediation hypothesis), and (3) whether and which of these teacher support dimensions matter more for boys' as opposed to girls' engagement (moderation or differential effects hypothesis). A total of 385 Grade 7 students and their 15 language teachers participated in this study. Teacher support was assessed through student reports. Student engagement was measured using student, teacher, and observer reports. By means of structural equation modelling, the mediating role of the teacher support dimensions for gender differences in behavioural engagement was tested. The potential differential role of the teacher support dimensions for boys' and girls' engagement was investigated through multigroup analysis. Boys were less engaged than girls and reported lower support from their teacher. Autonomy support and involvement partially mediated the relationship between gender and behavioural engagement. Autonomy support was demonstrated to be a protective factor for boys' engagement but not for girls'. Structure and involvement contributed equally to engagement for both sexes. Although involvement and autonomy support partly explained the gender gap in engagement (mediation hypothesis), more support was found for differential effects of autonomy support on boys' versus girls' engagement (differential effects hypothesis). © 2015 The British Psychological Society.

The tension between self governance and absolute inner worth in Kant's moral philosophy.

Science.gov (United States)

Häyry, M

2005-11-01

The concepts of autonomy as the self governance of individuals and dignity as the inner worth of human beings play an important role in contemporary bioethics. Since both notions are crucial to Immanuel Kant's moral theory, it would be tempting to think that Kantian ethics could ease the friction between the two concepts. It is argued in this paper, however, that this line of thought cannot be supported by Kant's original ideas. While he did make a conscious effort to bring autonomy and dignity together, his emphasis on the absolute inner worth of our collective humanity made it impossible for him to embrace fully the personal self determination of individuals, as it is usually understood in today's liberal thinking.

Autonomy and minority rights

DEFF Research Database (Denmark)

Barten, Ulrike

2008-01-01

on the content of the syllabus. When autonomy is understood in the literal sense, of giving oneself one's own laws, then there is a clear connection. Autonomy is usually connected to politics and a geographically limited territory. Special political rights of minorities - e.g. is the Danish minority party SSW...

Autonomy, Social Interactions and Culture

OpenAIRE

Marini, Annalisa; Navarra, Pietro

2016-01-01

The present paper, using a social interactions model, studies the impact of culture on autonomy of immigrants. The results suggest that: (i) immigrants' autonomy is largely influenced by the autonomy of individuals living in a host country; (ii) some immigrants are better off in countries and regions with better institutional environments. The results are robust to sensitivity checks. The contributions of the paper are as follows. First, we estimate a social interactions model that models bot...

School Autonomy and District Support: How Principals Respond to a Tiered Autonomy Initiative in Philadelphia Public Schools

Science.gov (United States)

Steinberg, Matthew P.; Cox, Amanda Barrett

2017-01-01

A tiered autonomy policy was recently implemented in Philadelphia, where select principals were granted autonomy to manage school operations while others were promised greater district support to improve school functioning. This article provides evidence on how principals used their autonomy and the extent of district support for non-autonomous…

Authenticity and autonomy in deep-brain stimulation.

Science.gov (United States)

Wardrope, Alistair

2014-08-01

Felicitas Kraemer draws on the experiences of patients undergoing deep-brain stimulation (DBS) to propose two distinct and potentially conflicting principles of respect: for an individual's autonomy (interpreted as mental competence), and for their authenticity. I argue instead that, according to commonly-invoked justifications of respect for autonomy, authenticity is itself in part constitutive of an analysis of autonomy worthy of respect; Kraemer's argument thus highlights the shortcomings of practical applications of respect for autonomy that emphasise competence while neglecting other important dimensions of autonomy such as authenticity, since it shows that competence alone cannot be interpreted as a reliable indicator of an individual's capacity for exercising autonomy. I draw from relational accounts to suggest how respect for a more expansive conception of autonomy might be interpreted for individuals undergoing DBS and in general. 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.

The link between perceived maternal and paternal autonomy support and adolescent well-being across three major educational transitions.

Science.gov (United States)

Duineveld, Jasper J; Parker, Philip D; Ryan, Richard M; Ciarrochi, Joseph; Salmela-Aro, Katariina

2017-10-01

To what extent does maternal and paternal autonomy support enhance well-being across the major transitions of high school? We tested the degree to which perceived autonomy supportive parenting facilitated positive changes in self-esteem and life satisfaction and buffered against negative changes in depressive symptoms and school related burnout in 3 Finnish longitudinal studies, each with a measurement point before and after a major transition (middle school, N1 = 760, 55.7% girls; high school, N2 = 214, 51.9% girls; post high school, N3 = 858, 47.8% girls). Results showed that perceived parental autonomy support was negatively related to depressive symptoms and positively related to self-esteem. The findings for the effects on depressive symptoms were replicated across all 3 transitions, while effects on self-esteem were only found for the high school and post high school transitions. Moreover, evidence of coregulation was found for depressive symptoms. Depressive symptoms before the transition were found to decrease autonomy support after the transition for both the high school and post high school transitions. Maternal and paternal autonomy support was of equal importance. Importantly, the effects on depressive symptoms increased as children developed, suggesting the continual importance of parents throughout high school and into emerging adulthood. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Autonomy in chimpanzees.

Science.gov (United States)

Beauchamp, Tom L; Wobber, Victoria

2014-04-01

Literature on the mental capacities and cognitive mechanisms of the great apes has been silent about whether they can act autonomously. This paper provides a philosophical theory of autonomy supported by psychological studies of the cognitive mechanisms that underlie chimpanzee behavior to argue that chimpanzees can act autonomously even though their psychological mechanisms differ from those of humans. Chimpanzees satisfy the two basic conditions of autonomy: (1) liberty (the absence of controlling influences) and (2) agency (self-initiated intentional action), each of which is specified here in terms of conditions of understanding, intention, and self-control. In this account, chimpanzees make knowledge-based choices reflecting a richly information-based and socially sophisticated understanding of the world. Finally, two major theories of autonomy (Kantian theory and two-level theory) are rejected as too narrow to adequately address these issues, necessitating the modifications made in the present approach.

Institutional Financial Autonomy in Practice

DEFF Research Database (Denmark)

Szwebs, Witold

2016-01-01

The article reveals how university autonomy may in practice prove to be restrictive for units within the university. The need to implement and interpret external regulations and protect the institution may, argued in the paper, lead to a risk averse, conservative approach which is experienced...... by departments as bureaucratic and hampering effective research. Thus autonomy has produced new internal tensions between the central management/administration and the departments which it is argued is counter-productive and not beneficial for research and could be seen as a perverse aspect of greater autonomy....... Indeed because university policy and ‘interference’ is much closer to the researcher than in former less autonomous times and the university may now exercise other direct incentives through resource allocation, promotion and salary enhancement, the department and the individual may view autonomy...

The Connotations of Language Teacher Autonomy

Science.gov (United States)

Han, Ligang

2017-01-01

With the research on the development of learner autonomy in foreign language education, teacher autonomy has become a hot topic in the research of foreign language teacher education. However, it is the most difficult question to define language teacher autonomy and any answer to it is likely to be subjective. On the basis of expounding upon the…

Autonomy and Firefighting: Perceived Competence and Stress.

Science.gov (United States)

Chiang, Evelyn S; Baley, John; Ponder, Joy; Padilla, Miguel A

2016-12-01

In workplace settings, autonomy is implicated in employee motivation as well as supervisor autonomy support. As a profession of risk, firefighters may experience greater levels of stress. A self-determination paradigm was applied to the firefighter workplace. Of particular interest were perceived competence (to perform job duties) and the experience of stress. Firefighters' levels of autonomous and controlled regulation were surveyed, along with their perceptions of the autonomy support of their immediate supervisor. Autonomous regulation was positively related to perceived competence, whereas controlled regulation was negatively related. Higher levels of controlled regulation were also connected with greater stress. In contrast, greater perceived autonomy support was associated with decreased stress. Both perceived competence and stress are related to firefighter motivation and autonomy support. Recommendations are offered to increase autonomy support by chief officers.

Palliative care in amyotrophic lateral sclerosis: a review of current international guidelines and initiatives.

LENUS (Irish Health Repository)

Bede, Peter

2011-04-01

Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive neurodegenerative condition. Optimal management requires a palliative approach from diagnosis with emphasis on patient autonomy, dignity and quality of life.

The Fundamental Right To Grow Old With Dignity

Directory of Open Access Journals (Sweden)

Camila Rabelo de Matos Silva Arruda

2016-12-01

Full Text Available Over the years the role the growing old in society has been changing considerably, the population is aging and increasing life expectancy. Law No. 10741/03, which established the Statute of the Elderly, where the legislator sought to ensure the right to grow old with dignity. The increase in the number of retirees and unemployment generated changing the demand in the social security system, which is being processed at the national congress. This article examines how society has been treating the elderly and preparing to deal with the aging population.

The concept of «honor», «dignity» in the context of the professionalization of public service

Directory of Open Access Journals (Sweden)

S. M. Serjogin

2016-09-01

Full Text Available The article analyzes ethical aspects of the personality of a public servant. Such  concepts as, «professional honor», «professional dignity», «professional justice», «professional responsibility» are disclosed. The role of these concepts in public servants’ professional activities is defermined. It is stated that professional dignity of the public servant is closely connected with his position in the team, his personal merit and honor public servant. The matter is that a public servant is a representative a particular team, and the entire public service. The attention is focused on the fact that the higher developed feeling of personal and official dignity of public servants, the more he values his professional honor, the more significant social value he has to society. As a result, professional honor and professional dignity, complement each other, help to maintain a certain, fairly high level of a public servant’s morality. It was found that such concepts as «professional honor», «professional dignity», «professional justice», «professional responsibility» were brought up before and are brought up now in a large stable structures and organizations of the world. In developed countries, such as France, Germany, Japan, England – the honor and responsibility of public servant are essential professional qualities, which largely determine style of activities and influence decision-making process. In our country, nowadays, the education of a public servant is missed, therefore we will not be able in the future to count on the loyalty of civil servants to their job. We will have to deal with the satisfaction of public servants’ personal needs, as it often happens now. Based on the analysis concluded that the professional ethics of a public servant is a rather complicated and weighty task of harmonizing professional and personal moral responsibility, principles, values and interests.

Indications for treatment of thyroid autonomy

International Nuclear Information System (INIS)

Emrich, D.

1989-01-01

Based on pathophysiological findings and considerations it is attempted to review critically the present state of indications and therapeutic modalities in cases of thyroid autonomy. If hyperthyroidism occurs or has occurred in autonomy, definitive treatment with radioiodine or surgery is indicated. In cases of autonomy with euthyroidism, treatment planning and indication of definite therapy are difficult still today, because the risk to develop hyperthyroidism cannot as yet be sufficiently estimated. A useful indicator in such cases seems to be the percentage of global thyreoidal uptake of 99m-technetium under supression. If autonomy is severe surgical treatment today is superior to radio-iodine therapy, but is associated with a higher rate of manifest hypothyroidism. Further research into both the risk of hyperthyroidism in thyroid autonomy and the optimization of radio-iodine therapy are needed. (orig./MG) [de

Cancer cachexia and its impact on patient dignity: What nurses need to know

Directory of Open Access Journals (Sweden)

Susan McClement

2016-01-01

Full Text Available Noted physician, Sr. William Osler, is credited with saying, “Care more particularly for the individual patient than for the special features of the disease”. Osler understood that each patient for whom we care is first and foremost a person, who also happens to be living with a particular illness. In addition to understanding the nature of the patient's illness, therefore, it is also critically important that we come to understand the patient's unique story and set of circumstances. Doing so allows us to engage with patients in a way that affirms their sense of dignity and personhood. Drawing on the exemplar of cancer cachexia, this editorial reminds clinicians of the importance of Osler's sage advice to attend to patient dignity and personhood, and provides nurses with direction about how they can do that in practice.

Autonomy and dependence--experiences of home abortion, contraception and prevention.

Science.gov (United States)

Makenzius, Marlene; Tydén, Tanja; Darj, Elisabeth; Larsson, Margareta

2013-09-01

Few studies have explored experiences and needs in relation to an induced medical abortion with the final treatment at home. To explore women's and men's experiences and needs related to care in the context of a home abortion as well as to elicit their views on contraception and prevention of unwanted pregnancies. Qualitative interviews were carried out with 24 women and 13 men who had experienced a home abortion; they took place in Sweden during 2009/10. Two overarching themes were identified: Autonomy--the decision to undergo an abortion and the choice of method were well considered by the woman, supported by the partner. The home environment increased their privacy and control, which helped them freely express and share their emotions. They were motivated to avoid a subsequent abortion and considered it an individual responsibility; however, contraceptive follow-up visits were rare. Dependence--a desire to be treated with empathy and respect by care providers and to receive adequate information. In the prevention of unwanted pregnancies, financial resources, improved communication/education and subsidized contraceptives were considered important. Home abortion increases autonomy, and women and partners demonstrate self-care ability. This autonomy, however, is related to dependence: a desire to be treated with empathy and respect on equal terms and to receive adequate information tailored to their self-care needs. Routines in abortion care should be continuously evaluated to ensure care satisfaction, safety and security as well as contraceptive adherence. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Autonomy and the Sources of Political Normativity

DEFF Research Database (Denmark)

Rostbøll, Christian F.

Contemporary political liberals argue for extending the scope of reasonable disagreement to include also the principle of autonomy that was central in classical liberal theory. I take outset in Charles Larmore, The Autonomy of Morality (2008), which argues that liberal theory can dispense...... with the commitment to autonomy that one finds in Locke, Kant, and Mill, because "the essential convictions of liberal thought lie at a more fundamental level," namely in the principle of respect for persons. The main question I address is whether we can see the commitment to respect for persons as separable from...... the commitment to autonomy. My focus is the Kantian conception of autonomy, and I argue for understanding this conception practically and politically, rather than metaphysically and theoretically. In this way we can separate the principle of respect for persons from the metaphysical idea of autonomy as self...

Adolescents, Graduated Autonomy, and Genetic Testing

Directory of Open Access Journals (Sweden)

Susan Fox

2012-01-01

Full Text Available Autonomy takes many shapes. The concept of “graduated autonomy” is conceived as comprising several unique features: (1 it is incremental, (2 it is proportional, and (3 it is related to the telos of the life stage during which it occurs. This paper focuses on graduated autonomy in the context of genetic testing during adolescence. Questions can be raised about other life stages as well, and some of these questions will be addressed by discussing a possible fourth characteristic of graduated autonomy, that is, its elasticity. Further scholarship and analysis is needed to refine the concept of graduated autonomy and examine its applications.

Autonomy support for autonomous motivation in medical education.

Science.gov (United States)

Kusurkar, Rashmi A; Croiset, Gerda

2015-01-01

Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

Standby-battery autonomy versus power quality

Science.gov (United States)

Bitterlin, Ian F.

Batteries are used in a wide variety of applications as an energy store to bridge gaps in the primary source of supplied power for a given period of time. In some cases this bridging time, the battery's "autonomy", is fixed by local legislation but it is also often set by historically common practices. However, even if common practice dictates a long autonomy time, we are entering a new era of "cost and benefit realism" underpinned by environmentally friendly policies and we should challenge these historical practices at every opportunity if it can lead to resource and cost savings. In some cases the application engineer has no choice in the design autonomy; either follow a piece of local legislation (e.g. 4 h autonomy for a "life safety" application), or actually work out what is needed! An example of the latter would be for a remote site, off-grid, using integrated wind/solar power (without emergency generator back-up) where you may have to design-in several days' battery autonomy. This short paper proposes that a battery's autonomy should be related to the time expected for the system to be without the primary power source, balanced by the capital costs and commercial risk of power failure. To discuss this we shall consider the factors in selecting the autonomy time and other related aspects for high voltage battery systems used in facility-wide uninterruptible power supply (UPS) systems.

Integrated System Health Management (ISHM) and Autonomy

Science.gov (United States)

Figueroa, Fernando; Walker, Mark G.

2018-01-01

Systems capabilities on ISHM (Integrated System Health Management) and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.

Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial.

Science.gov (United States)

Chochinov, Harvey Max; Kristjanson, Linda J; Breitbart, William; McClement, Susan; Hack, Thomas F; Hassard, Tom; Harlos, Mike

2011-08-01

Dignity therapy is a unique, individualised, short-term psychotherapy that was developed for patients (and their families) living with life-threatening or life-limiting illness. We investigated whether dignity therapy could mitigate distress or bolster the experience in patients nearing the end of their lives. Patients (aged ≥18 years) with a terminal prognosis (life expectancy ≤6 months) who were receiving palliative care in a hospital or community setting (hospice or home) in Canada, USA, and Australia were randomly assigned to dignity therapy, client-centred care, or standard palliative care in a 1:1:1 ratio. Randomisation was by use of a computer-generated table of random numbers in blocks of 30. Allocation concealment was by use of opaque sealed envelopes. The primary outcomes--reductions in various dimensions of distress before and after completion of the study--were measured with the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale, Patient Dignity Inventory, Hospital Anxiety and Depression Scale, items from the Structured Interview for Symptoms and Concerns, Quality of Life Scale, and modified Edmonton Symptom Assessment Scale. Secondary outcomes of self-reported end-of-life experiences were assessed in a survey that was undertaken after the completion of the study. Outcomes were assessed by research staff with whom the participant had no previous contact to avoid any possible response bias or contamination. Analyses were done on all patients with available data at baseline and at the end of the study intervention. This study is registered with ClinicalTrials.gov, number NCT00133965. 165 of 441 patients were assigned to dignity therapy, 140 standard palliative care, and 136 client-centred care. 108, 111, and 107 patients, respectively, were analysed. No significant differences were noted in the distress levels before and after completion of the study in the three groups. For the secondary outcomes, patients reported that

Autonomy and independence in language learning

CERN Document Server

Benson, Phil

2014-01-01

The topics of autonomy and independence play an increasingly important role in language education. They raise issues such as learners' responsibility for their own learning, and their right to determine the direction of their own learning, the skills which can be learned and applied in self-directed learning and capacity for independent learning and the extents to which this can be suppressed by institutional education. This volume offers new insights into the principles of autonomy and independence and the practices associated with them focusing on the area of EFL teaching. The editors' introduction provides the context and outlines the main issues involved in autonomy and independence. Later chapters discuss the social and political implications of autonomy and independence and their effects on educational structures. The consequences for the design of learner-centred materials and methods is discussed, together with an exploration of the practical ways of implementing autonomy and independence in language ...

Stakeholder Capability Enhancement as a Path to Promote Human Dignity and Cooperative Advantage

NARCIS (Netherlands)

Westermann-Behaylo, M.K.; Van Buren III, H.J.; Berman, S.L.

2016-01-01

Promoting dignity is at the heart of the human capability approach to development. We introduce the concept of stakeholder capability enhancement, beginning with a discussion of the capability approach to development proposed by Sen (1985) and further advanced by Nussbaum (1990) to incorporate

Autonomy support for autonomous motivation in medical education

Directory of Open Access Journals (Sweden)

Rashmi A. Kusurkar

2015-05-01

Full Text Available Background: Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Discussion: Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Conclusion: Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

The Principalship, Autonomy, and After

Science.gov (United States)

Eacott, Scott

2015-01-01

Contemporary discourses in educational administration have exponentially grown the number of adjectival leaderships, challenged traditional organisational structures, and offered autonomy as a solution to performance issues. In this theoretical paper, I ask "what does the principalship look like after autonomy?" Despite the range of…

Testing the feasibility of the Dignity Therapy interview: adaptation for the Danish culture

DEFF Research Database (Denmark)

Houmann, Lise J; Rydahl-Hansen, Susan; Chochinov, Harvey M

2010-01-01

ABSTRACT: BACKGROUND: 'Dignity Therapy' (DT) is a brief, flexible intervention, which allows patients to complete an interview and create a document regarding their life, identity and what they want to leave in writing for their loved ones. DT is based on the DT Question Protocol. Developed...... patients, and to obtain preliminary estimates of patient uptake for DT. These results will be used to inform a larger evaluation study. METHOD: Ten professionals were interviewed about their perception of DT and the Question Protocol. It was then tested with 20 patients at two palliative care sites and one...... and tested in English speaking settings, DT has proven to be a feasible and effective way to enhance patient dignity, while diminishing suffering and depression. The aim of this study was to test the acceptability and feasibility of the DT Question Protocol among Danish health professionals and cancer...

Protecting autonomy as authenticity using Ulysses contracts.

Science.gov (United States)

van Willigenburg, Theo; Delaere, Patrick

2005-08-01

Pre-commitment directives or Ulysses contracts are often defended as instruments that may strengthen the autonomous self-control of episodically disordered psychiatric patients. Autonomy is understood in this context in terms of sovereignty ("governing" or "managing" oneself). After critically analyzing this idea of autonomy in the context of various forms of self-commitment and pre-commitment, we argue that what is at stake in using Ulysses contracts in psychiatry is not autonomy as sovereignty, but autonomy as authenticity. Pre-commitment directives do not function to protect autonomous self-control. They serve in upholding the guidance that is provided by one's deepest identity conferring concerns. We elucidate this concept of autonomy as authenticity, by showing how Ulysses contracts protect the possibility of being "a self."

Autonomy, Vulnerability, Recognition, and Justice

NARCIS (Netherlands)

Anderson, J.H.; Honneth, A.

2005-01-01

One of liberalism’s core commitments is to safeguarding individuals’ autonomy. And a central aspect of liberal social justice is the commitment to protecting the vulnerable. Taken together, and combined with an understanding of autonomy as an acquired set of capacities to lead one’s own life,

Radioiodine therapy of thyroid autonomy

Energy Technology Data Exchange (ETDEWEB)

Reiners, Christoph; Schneider, Peter [Clinic and Policlinic for Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)

2002-08-01

Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. {sup 131}I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

Radioiodine therapy of thyroid autonomy

International Nuclear Information System (INIS)

Reiners, Christoph; Schneider, Peter

2002-01-01

Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. 131 I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

The ADEPT Framework for Intelligent Autonomy

National Research Council Canada - National Science Library

Ricard, Michael; Kolitz, Stephan

2003-01-01

...) architecture for intelligent autonomy. Intelligent autonomy is the ability to plan and execute complex activities in a manner that provides rapid, effective response to stochastic and dynamic mission events...

A Critical Analysis of Criticisms of the Oregon Death with Dignity Act

Science.gov (United States)

Werth, James L., Jr.; Wineberg, Howard

2005-01-01

This article critically examines the validity of common criticisms of the Oregon Death with Dignity Act, primarily through reviewing published research and analyses. After summarizing the law and recent developments, 11 areas of concerns are examined: (a) the amount of data collected, (b) the availability of the data, (c) the reporting process,…

Student Perceptions of Their Autonomy at University

Science.gov (United States)

Henri, D. C.; Morrell, L. J.; Scott, G. W.

2018-01-01

Learner autonomy is a primary learning outcome of Higher Education in many countries. However, empirical evaluation of how student autonomy progresses during undergraduate degrees is limited. We surveyed a total of 636 students' self-perceived autonomy during a period of two academic years using the Autonomous Learning Scale. Our analysis suggests…

Progress in medicine: autonomy, oughtonomy and nudging.

Science.gov (United States)

Devisch, Ignaas

2011-10-01

In this article, I argue that we need a new perspective in the debate on autonomy in medicine, to understand many of the problems we face today - dilemmas that are situated at the intersection of autonomy and heteronomy, such as why well informed and autonomous people make unhealthy lifestyle choices. If people do not choose what they want, this is not simply caused by their lack of character or capability, but also by the fact that absolute autonomy is impossible; autonomous individuals are 'contaminated' by heteronymous aspects, by influences from 'outside'. Consequently, there are many good reasons to question the widely accepted hierarchical opposition of autonomy (progress) versus heteronomy (paternalism) in medicine. In an earlier article an analysis is made of the neologism 'oughtonomy' to support the thesis that when it comes down to human existence, autonomy and heteronomy are intertwined, rather than being merely opposites. In this article, I reflect upon how social conditions might improve our 'choice architecture', what Thaler & Sunstein have called 'nudging': how to change individual health choices without being paternalistic? I explore the extent to which both oughtonomy and nudging are able to challenge the question of autonomy in today's medicine. Autonomy may and should be a shared target in today's medicine, but we should never forget that it is always intertwined with heteronomy. Starting from this perspective, progress in medicine demands far more than the increase of autonomy. © 2011 Blackwell Publishing Ltd.

Autonomy, nudging and post-truth politics.

Science.gov (United States)

Keeling, Geoff

2017-11-16

In his excellent essay, 'Nudges in a post-truth world', Neil Levy argues that 'nudges to reason', or nudges which aim to make us more receptive to evidence, are morally permissible. A strong argument against the moral permissibility of nudging is that nudges fail to respect the autonomy of the individuals affected by them. Levy argues that nudges to reason do respect individual autonomy, such that the standard autonomy objection fails against nudges to reason. In this paper, I argue that Levy fails to show that nudges to reason respect individual autonomy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Decision-Making Autonomy and Subsidiary Innovation

DEFF Research Database (Denmark)

Van Vo, Dut; Beugelsdijk, Sjoerd; de Jong, Gjalt

2013-01-01

This paper investigates how decision-making autonomy affects the possibility and intensity of innovation in subsidiaries of multinational enterprises (MNEs). Subsidiaries are increasingly identified as sources of innovation and as vehicles for cross-border transfer of new competences. The question...... of how much decision-making autonomy subsidiaries should have is a core issue in the management of headquarters-subsidiary relationships. Using two complementary theoretical perspectives, we hypothesize a non-linear relationship between subsidiary’s decision-making autonomy and innovation. We test our...... hypothesis in a multi-country and multiindustry database based on survey evidence of 134 subsidiaries located in five Central and Eastern European countries from 23 home countries. The empirical results provide support for a non-linear U shaped relationship between subsidiary decision-making autonomy...

School Autonomy, Leadership and Learning: A Reconceptualisation

Science.gov (United States)

Cheng, Yin Cheong; Ko, James; Lee, Theodore Tai Hoi

2016-01-01

Purpose: The purpose of this paper is to develop a framework for reconceptualising research on school autonomy to redress the limitations of traditional research, strengthen the conceptual links between school autonomy and learning outcomes and offer a range of new strategies for studying the interplay of school autonomy, leadership and learning.…

Issues of promoting learner autonomy in EFL context

Directory of Open Access Journals (Sweden)

Pichugova Inna L.

2016-01-01

Full Text Available The paper is focuded on investigating the phenomenon of learner autonomy, which has mostly been explored in Europe and the USA and is now attracting attention of researchers and academics in many other countries including Russia. Learner autonomy through a focus on learner reflection and taking responsibility for one’s own learning processes has become a central concern in the recent history of language teaching. However, many language teachers, who are committed to concepts of learnercentredness and autonomy, struggle with the ways to foster learner autonomy or at least to encourage the idea of learner autonomy in language classroom. The study aims at investigating what the most important issues which have a great impact on developing learner autonomy are. Having given special attention to conditions which can insure development of learner autonomy, a model covering seven issues relating to the subject matter has been designed. The authors state that such aspects as choice, goals and needs, support, emotional climate, learning strategies, learner attitude and motivation, and self-esteem should be considered as the goal to promote learner autonomy in EFL context.

Freedom of Expression, Deliberation, Autonomy, and Respect

DEFF Research Database (Denmark)

Rostbøll, Christian Fogh

for freedom of expression in terms of its relationship to different dimensions of autonomy. In response to the objection that Enlightenment theories pose a threat to cultures that reject autonomy, it is argued that autonomy-based democracy is not only compatible with but necessary for respect for cultural......The strongest versions of the democracy argument for freedom of expression rely on the deliberative conception of democracy. Deliberative democracy entails both an ideal of political autonomy and of autonomous preference formation. This paper elaborates the deliberative democracy argument...... diversity. On the basis of an intersubjective epistemology, I argue that citizens cannot know how to live on mutually respectful terms without engaging in public deliberation. Moreover, to be successful deliberation must foster some degree of personal autonomy, at least the ability to distinguish what...

Buddhism and Autonomy-Facilitating Education

Science.gov (United States)

Morgan, Jeffrey

2013-01-01

This article argues that Buddhists can consistently support autonomy as an educational ideal. The article defines autonomy as a matter of thinking and acting according to principles that one has oneself endorsed, showing the relationship between this ideal and the possession of an enduring self. Three central Buddhist doctrines of conditioned…

Autonomy and Complexity at Sandia Executive Summary of Academic Alliance Workshop on Autonomy and Complex Systems.

Energy Technology Data Exchange (ETDEWEB)

Hayden, Nancy Kay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kleban, Stephen D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-05-01

Sandia has identified autonomy as a strategic initiative and an important area for providing national leadership. A key question is, “How might autonomy change how we think about the national security challenges we address and the kinds of solutions we deliver?” Three workshops at Sandia early in 2017 brought together internal stakeholders and potential academic partners in autonomy to address this question. The first focused on programmatic applications and needs. The second explored existing internal capabilities and research and development needs. This report summarizes the outcome of the third workshop, held March 3, 2017 in Albuquerque, NM, which engaged Academic Alliance partners in autonomy efforts at Sandia by discussing research needs and synergistic areas of interest within the complex systems and system modeling domains, and identifying opportunities for partnering on laboratory directed and other joint research opportunities.

The End-of-Life Phase of High-Grade Glioma Patients: Dying With Dignity?

NARCIS (Netherlands)

Sizoo, E.M.; Taphoorn, M.J.B.; Uitdehaag, B.M.J.; Heimans, J.J.; Deliens, L.; Reijneveld, J.C.; Pasman, H.R.W.

2013-01-01

Background. In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with

Perceived autonomy in the first semester of mathematics studies

OpenAIRE

Liebendörfer, Michael; Hochmuth, Reinhard

2015-01-01

International audience; We focus on the perceived autonomy of mathematics students in their first semester at university. According to self-determination theory by Deci and Ryan (1985), students have to satisfy their need for autonomy in order to develop intrinsic motivation. Using two facets of autonomy, we analyse interview data to explore which situations foster or hinder the students' perceived autonomy. The main factors affecting students' autonomy are briefly discussed.

Psychometric Properties of the Greek Version of the Patient Dignity Inventory in Advanced Cancer Patients.

Science.gov (United States)

Parpa, Efi; Kostopoulou, Sotiria; Tsilika, Eleni; Galanos, Antonis; Katsaragakis, Stylianos; Mystakidou, Kyriaki

2017-09-01

The patient dignity inventory (PDI) is an instrument to measure dignity distressing aspects at the end of life. The aims of the present study were the translation of the PDI in Greek language as well as to measure its psychometric aspects in a palliative care unit. A back-translation method was obtained at the Greek version. One hundred twenty advanced cancer patients completed the Greek version of the PDI, the Greek hospital anxiety and depression scale, the Greek schedule of attitudes toward hastened death (SAHD-Gr), and the Greek 12-item short form health survey. Confirmatory factor analysis failed to fit to the original instrument's structure and exploratory factor analysis was conducted revealing five factors ("Psychological Distress," "Body Image and Role Identity," "Self-Esteem," "Physical Distress and Dependency," and "Social Support"). The psychometric analysis of the PDI-Gr demonstrated a good concurrent validity, and the instrument discriminated well between subgroups of patients regarding age differences. Cronbach α were between 0.71 and 0.9 showing a good internal consistency. The Greek version of the PDI showed good psychometric properties in advanced cancer patients, supported the usefulness of the instrument assessing the sense of dignity distressing aspects of the terminally ill cancer patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Euthyroid goitre with and without functional autonomy: A comparison; Jodmangelstruma mit und ohne funktionelle Autonomie in der euthyreoten Phase: Ein Vergleich

Energy Technology Data Exchange (ETDEWEB)

Hillenhinrichs, H.; Emrich, D. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

1998-05-01

Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global {sup 99m}Tc thyroid uptake of {>=}3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [Deutsch] Analyse der funktionellen Autonomie in der euthyreoten Phase. Methoden: Es wurden 163 klinisch euthyreote Patienten mit Jodmangelstruma ohne und 179 mit funktioneller Autonomie anhand von Geschlechtsverhaeltnis, Lebensalter, Beschwerden, Symptomen, sonographischem Befund, qualitativer und quantitativer Szintigraphie ohne und mit Suppression, TRH-Test, Hormonkonzentrationen und Jodausscheidung im Urin verglichen. Ergebnisse: Lebensalter, Beschwerden und Symptome, Schilddruesenvolumen und Echomuster lieferten keinen ausreichend sicheren Beitrag zur Diagnose. Die quantitative Szintigraphie war dem TRH-Test ueberlegen. Erhoehte Hormonkonzentrationen ergaben sich bei 15% der Patienten mit funktioneller Autonomie. Als Grenzwert fuer ein erhoehtes spontanes Hyperthyreoserisiko wurde eine globale thyreoidale {sup 99m}Tc-Aufnahme unter Suppression von {>=}3% ermittelt, die in 20% der Patienten mit funktioneller

Freedom of Expression, Deliberation, Autonomy and Respect

DEFF Research Database (Denmark)

Rostbøll, Christian F.

2011-01-01

This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy...... is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms without engaging in public deliberation and develop some degree of personal autonomy. While freedom...... of expression is indispensable for deliberation and autonomy, this does not mean that people have no obligations regarding how they speak to each other. The moral insights provided by deliberation depend on the participants in the process treating one another with respect. The argument is related to the Danish...

Male nurses and the protection of female patient dignity.

Science.gov (United States)

Prideaux, Antony

Nurses need to be aware of their professional, legal and ethical responsibilities towards patients. Male nurses in particular face problems in their practice as a result of their gender and the stereotypes associated with male nurses. Such stereotypes can act as a barrier to their duty of care. This article examines the challenges associated with male nurses carrying out intimate, physical care. It discusses the ethical, legal and professional issues that male nurses should consider in relation to maintenance of patient dignity during nursing care provision, particularly in relation to female patients.

Concept analysis: patient autonomy in a caring context.

Science.gov (United States)

Lindberg, Catharina; Fagerström, Cecilia; Sivberg, Bengt; Willman, Ania

2014-10-01

This paper is a report of an analysis of the concept of patient autonomy Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Concept analysis. Medline, CINAHL, The Cochrane Library and PsycINFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved. The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context. © 2014 John Wiley & Sons Ltd.

Euthanasia and death with dignity: still poised on the fulcrum of homicide.

Science.gov (United States)

Biggs, H

1996-12-01

This article questions whether the law of homicide is an appropriate mechanism to adjudicate the humanitarian issues involved in voluntary euthanasia; particularly where painful protracted dying appears inherently more harmful than euthanasia. The author suggests that even if euthanasia can provide death with dignity this will not be achieved while the law requires the undignified criminalisation of the practitioner.

Human dignity after ten years of the constitutional state in South Africa

African Journals Online (AJOL)

The Constitution not only elevates human dignity to a specially entrenched value, but also affords it special protection in the context of fundamental rights. It is furthermore a specific consideration in the limitation of rights and in the development of the common law. It applies not only to the state/subject relationship, but also to ...

Personal Autonomy and Rational Suicide.

Science.gov (United States)

Webber, May A.; Shulman, Ernest

That certain suicides (which can be designated as rational) ought not to be interfered with is closely tied to the notion of the "right to autonomy." Specifically it is because the individual in question has this right that interference is prohibited. A proper understanding of the right to autonomy, while essential to understanding why…

Teacher Autonomy: Power or Control?

Science.gov (United States)

Lawson, Tony

2004-01-01

The article explores the issue of teacher autonomy in relation to its potential for freedom or control. It examines the concept of empowerment as applied to education, arguing that, although it is traditionally cast as a means of achieving autonomy, an alternative approach sees empowerment as part of the disciplinary apparatus of late modern…

Equality, autonomy, and efficiency: what health care system should we have?

Science.gov (United States)

Menzel, P T

1992-02-01

The U.S. has a wide range of options in choosing a health care system. Rational choice of a system depends on analysis and prioritization of the basis moral goals of equitable access to all citizens, the just sharing of financial costs between well and ill, respect for the values and choices of subscribers and patients, and efficiency in the delivery of costworthy care. These moral goals themselves, however, tell us little about what health care system the United States should have. Equitable access does not demand a level and scope of care for the poor equal to that rationally chosen by the middle class, and there are ways within mixed systems, though not easy ways, to achieve a fair distribution of costs between well and ill. Despite pluralistic systems' apparent advantage in allowing subscribers to choose their own forms of rationing, problems in translating serious long-term subscriber choices into actual medical practice may be greater in pluralistic than in unitary systems. Final choice of a system hinges primarily on peculiar historical facts about U.S. political culture, not on moral principle.

Dignity and Distress towards the End of Life across Four Non-Cancer Populations

Science.gov (United States)

Chochinov, Harvey Max

2016-01-01

Objective The purpose of this study was to identify four non-cancer populations that might benefit from a palliative approach; and describe and compare the prevalence and patterns of dignity related distress across these diverse clinical populations. Design A prospective, multi-site approach was used. Setting Outpatient clinics, inpatient facilities or personal care homes, located in Winnipeg, Manitoba and Edmonton, Alberta, Canada. Participants Patients with advanced Amyotrophic Lateral Sclerosis (ALS), Chronic Obstructive Pulmonary Disease (COPD), End Stage Renal Disease (ESRD); and the institutionalized alert frail elderly. Main Outcome Measure In addition to standardized measures of physical, psychological and spiritual aspects of patient experience, the Patient Dignity Inventory (PDI). Results Between February 2009 and December 2012, 404 participants were recruited (ALS, 101; COPD, 100; ESRD, 101; and frail elderly, 102). Depending on group designation, 35% to 58% died within one year of taking part in the study. While moderate to severe loss of sense of dignity did not differ significantly across the four study populations (4–11%), the number of PDI items reported as problematic was significantly different i.e. ALS 6.2 (5.2), COPD 5.6 (5.9), frail elderly 3.0 (4.4) and ESRD 2.3 (3.9) [p < .0001]. Each of the study populations also revealed unique and distinct patterns of physical, psychological and existential distress. Conclusion People with ALS, COPD, ESRD and the frail elderly face unique challenges as they move towards the end of life. Knowing the intricacies of distress and how they differ across these groups broadens our understanding of end-of-life experience within non-cancer populations and how best to meet their palliative care needs. PMID:26808530

Private law and the European constitutionalisation of values

NARCIS (Netherlands)

Hesselink, M.W.

2016-01-01

According to the CFREU, the EU is founded on the general values such as values of human dignity, freedom, equality and solidarity. In addition, the TEU refers to a more political set of foundational values, ie respect for human dignity, freedom, democracy, equality, the rule of law and respect for

Oppression, Autonomy and the Impossibility of the Inner Citadel

Science.gov (United States)

Nelsen, Peter

2010-01-01

This paper argues for a conception of autonomy that takes social oppression seriously without sapping autonomy of its valuable focus on individual self-direction. Building on recent work in relational accounts of autonomy, the paper argues that current conceptions of autonomy from liberal, feminist and critical theorists do not adequately account…

[A reflection on love, medicine and euthanasia: I know what I like and I like what I know, but is that true?].

Science.gov (United States)

Lossignol, D

2010-01-01

This paper presents the medical practice according to the occidental philosophy (Platon, Spinoza, Kant). Relationships with the concept of "love" (eros, philia, agape) will be described, and the concept of dignity and autonomy as well. The reflection will focus on the end of life aspects. Although medicine cannot avoid morality, ethic, and deontology, it is also part of philosophy and must warrant the respect of human dignity, especially when a physician helps a patient to die.

The Chains on All My People Are the Chains on Me: Restrictions to Collective Autonomy Undermine the Personal Autonomy and Psychological Well-Being of Group Members.

Science.gov (United States)

Kachanoff, Frank J; Taylor, Donald M; Caouette, Julie; Khullar, Thomas H; Wohl, Michael J A

2018-01-11

Four studies assessed the potentially detrimental effects that restrictions to collective autonomy (i.e., a group's freedom to determine and practice its own identity) may have for the personal autonomy and psychological well-being of group members. In Study 1, using 3 distinct samples (NSample1a = 123, NSample1b = 129, NSample1c = 370), correlational and cross-cultural evidence indicates that perceived restrictions to the collective autonomy of one's group is directly associated with reduced personal autonomy, and indirectly associated with diminished well-being through personal autonomy. In Study 2 (N = 411), a longitudinal assessment of group members over 3 time-points during a 4-month period found that group members who perceived greater collective autonomy restriction also experienced reduced personal autonomy, and in turn, reduced psychological well-being over time. In Study 3 (N = 255), group members described a time during which their ingroup had (or did not have) its collective autonomy unduly restricted by other groups. Participants who were primed to think that their group lacked collective autonomy reported reduced feelings of personal autonomy, and reduced psychological well-being (compared with those primed to think their group had collective autonomy). In Study 4 (N = 389), collective autonomy was manipulated within the context of an intensive laboratory simulation. Collective autonomy-restricted group members experienced less personal autonomy than those who did not have their collective autonomy restricted. Together these findings suggest that restrictions to a group's collective autonomy may have detrimental consequences for the personal autonomy and psychological well-being of group members. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Autonomy @ Ames

Science.gov (United States)

Van Dalsem, William; Krishnakumar, Kalmanje Srinivas

2016-01-01

This is a powerpoint presentation that highlights autonomy across the 15 NASA technology roadmaps, including specific examples of projects (past and present) at NASA Ames Research Center. The NASA technology roadmaps are located here: http:www.nasa.govofficesocthomeroadmapsindex.html

Heteronomous Citizenship: Civic Virtue and the Chains of Autonomy

Science.gov (United States)

Swaine, Lucas

2010-01-01

In this article, I distinguish personal autonomy from heteronomy, and consider whether autonomy provides a suitable basis for liberalism. I argue that liberal government should not promote autonomy in all its citizens, on the grounds that not all members of liberal democracies require autonomy for a good life. I then outline an alternative option…

Artist Craftsman or Artist Equal Mason: from Mozart to "Macaco Bong", a history of struggles for autonomy

Directory of Open Access Journals (Sweden)

RAFAEL LAGE

2013-01-01

Full Text Available In the book "Mozart – Sociology of a Genius", Norbert Elias describes clashes around craftsmen artists (attached to the musical tastes of the court aristocracy and independent artists (with more freedom and musical autonomy, only less socially structured, presenting Mozart as an agent of transition. On the other hand, in the XXI century, comes up with the Brazilian band "Macaco Bong" the concept artist like mason, i. e., the idea of Musician’s involvement in the production process, not just in time to take the stage, pointing out the new digital technologies as a way for democratizing music. In this article, I will discuss reappropriations of ancient strategies of the music industry, and how they return reconfigured with these young people from the new music industry of the XXI century.

Autonomy, recognition and education

Directory of Open Access Journals (Sweden)

Angelo Vitório Cenci

2015-01-01

Full Text Available This paper addresses Honneth’s concept of autonomy from two dimensions of his work, distinct, though inseparable. The first one is suggested through the subject’s positive practical self-relation linked to the patterns of reciprocal recognition of love, right and social esteem; the second is formulated as non-centered autonomy opposed to the present-day criticism of the modern autonomous subject encompassing three levels, namely: the capacity of linguistic articulation, the narrative coherence of life and the complementation of being guided by principles with some criteria of moral sensitivity to the context. We defend the position that, by metaphysically anchoring the concept of autonomy onto the intersubjective assumptions of his/her theory of the subject, and exploring it linked to the subject’s positive practical self-relation and to a non-centered meaning, Honneth has managed to renew it, which allows drawing important consequences of such effort to the field of education.

Volitional Trust, Autonomy Satisfaction, and Engagement at Work.

Science.gov (United States)

Heyns, Marita; Rothmann, Sebastiaan

2018-02-01

This study tested a structural model that identifies the nature of relationships between trust, autonomy satisfaction, and personal engagement at work. A cross-sectional survey design with a convenience sample ( n = 252) was used. The Behavioral Trust Inventory, Work-Related Basic Need Satisfaction Scale, and Work Engagement Scale were administered. While reliance-based trust did not have a significant influence on engagement, disclosure-based trust in a focal leader was found to predict satisfaction of autonomy needs and employee engagement. Mediation analyses revealed that satisfaction of the need for autonomy facilitates the influence of trust on work outcomes. More specifically, disclosure (a dimension of trust) impacted engagement via autonomy satisfaction. Overall, the model explained 44% of total variance in engagement, to which the variables proportionately contributed as follows: autonomy satisfaction = 79.58%, disclosure = 18.22%, and reliance = 2.20%. The findings provide possible directions for how leaders can leverage trust to facilitate autonomy support and higher levels of engagement.

Teacher Autonomy Perceptions of Iranian and Turkish EFL Teachers

Directory of Open Access Journals (Sweden)

Ebrahim KHEZERLOU

2013-07-01

Full Text Available The study aimed at examining Iranian (N= 218 and Turkish (N=142 high school EFL teachers’ opinions about teacher autonomy over (a the choice of appropriate teaching methods, strategies and techniques and implementation of the established curriculum (b teacher involvement in decision making processes and (c teachers’ use of personal initiative in solving their work problems. An 11-item questionnaire (α= .758 was used to measure autonomy perceptions of the participants. The results revealed that Turkish teachers’ autonomy perceptions were greater than that of Iranian teachers in the three teacher autonomy dimensions. Moreover, it was observed that male and master- holder teachers perceive less autonomy than female and bachelor-holder ones; whereas, no significant relationship were observed for the age and marital status variables with any teacher autonomy dimensions. Lastly, decision making dimension was the strongest predictor of teacher autonomy among both Iranian and Turkish teachers.

[What is patient autonomy?

Science.gov (United States)

Durand, Guillaume

What does patient autonomy mean? If an autonomous choice is defined as an objective and rational choice, is the doctor's prescription not always the best route? Our contemporary democracies are marked by moral and religious pluralism which obliges society to respect a multiplicity of choices of existence. Three levels are important in terms of autonomy: a range of intellectual capacities, freedom with regard to constraints (external and internal), the capacity to be in control of one's existence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Emotional autonomy and depression among Chinese adolescents.

Science.gov (United States)

Chou, K L

2000-06-01

Depression is quite common among young people in Hong Kong Chinese society. This study examined the association between emotional autonomy and depressive symptomatology among Chinese young people in Hong Kong. The respondents were 512 young people between 16 and 18 years of age from a cross-sectional study in Hong Kong. Significant bivariate relationships were found between depressive symptomatology and three dimensions of emotional autonomy (individuation, nondependency on parents, and deidealization of parents). Using multiple regression models, the author found that depressive symptomatology was associated with two aspects of emotional autonomy: individuation and deidealization of parents. Results indicate that the relationships between depressive symptomatology and these three aspects of emotional autonomy are similar in both individualistic and collectivistic societies.

Resident Autonomy in the Operating Room: Expectations Versus Reality.

Science.gov (United States)

Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M

2017-09-01

There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application. A separate "expected autonomy" survey elicited faculty and resident perceptions of how much autonomy a resident should have for six common operations: decortication, wedge resection, thoracoscopic lobectomy, coronary artery bypass grafting, aortic valve replacement, and mitral valve repair. Thirty-three trainees from 7 institutions submitted evaluations of 596 cases over 18 months (March 2015 to September 2016). Thirty attendings subsequently provided their evaluation of 476 of those cases (79.9% response rate). Expected autonomy surveys were completed by 21 attendings and 19 trainees from 5 institutions. The six operations included in the survey constituted 47% (226 of 476) of the cases evaluated. Trainee and attending expectations did not differ significantly for senior trainees. Both groups expected significantly higher levels of autonomy than observed in the operating room for all six types of cases. Although faculty and trainees both expect similar levels of autonomy in the operating room, real-time measurements of autonomy show a gap between expectations and reality. Decreasing this gap will require a concerted effort by both faculty and residents to focus on the development of independent operative skills. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

[Difficulties of the negotiation process of the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the application of biology and medicine (and a call for its adhesion)].

Science.gov (United States)

de Alba Ulloa, Jessica

2012-01-01

Making an attempt to frame the controversial topic of bioethics within international law and with the aim of watching over the society, the Council of Europe elaborated the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the application of biology and medicine. The instrument, which came into force 12 years ago, is opened to all countries but only 29 states have ratified it. This legal document represents the base of a universal legislation on the subject. The present article examines the origin of the Convention, its process and evolution. It analyses the intense debates with regard to the human dignity, the freedom of science, the beginning of life, among others; equally it explores the interests at stake within the convention, whether political, moral, scientific, and economic, at the moment of its draft and in the present. Finally, the article analyses the possibility of the adoption of the Convention by the Mexican government. It concludes on the effectiveness of the international law of bioethics, and calls for the need that the Convention be used as a base for universal legislation.

Radioiodine-treatment (RIT) of functional thyroidal autonomy

International Nuclear Information System (INIS)

Meller, J.; Sahlmann, C.O.; Becker, W.

2002-01-01

Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

Netherlands: Steady decline in job autonomy

NARCIS (Netherlands)

Muller, J.; Hooftmann, W.; Houtman, I.L.D.

2015-01-01

Research shows that job autonomy has predominantly positive effects, such as the prevention of stress, burnout and cardiovascular disease. Employees with a good deal of autonomy generally report better well-being, are more productive, more creative, have more self-esteem and have higher work

Housing Options for Older Adults: A Guide for Making Housing Decisions

Science.gov (United States)

... to strengthening and securing the legal rights, dignity, autonomy, quality of life and quality of care of ... ensures that the older adult’s health, social and financial needs are met, and that the older adult’s ...

Some Equalities Are More Equal Than Others: Quality Equality Emerges Later Than Numerical Equality.

Science.gov (United States)

Sheskin, Mark; Nadal, Amber; Croom, Adam; Mayer, Tanya; Nissel, Jenny; Bloom, Paul

2016-09-01

By age 6, children typically share an equal number of resources between themselves and others. However, fairness involves not merely that each person receive an equal number of resources ("numerical equality") but also that each person receive equal quality resources ("quality equality"). In Study 1, children (N = 87, 3-10 years) typically split four resources "two each" by age 6, but typically monopolized the better two resources until age 10. In Study 2, a new group of 6- to 8-year-olds (N = 32) allocated resources to third parties according to quality equality, indicating that children in this age group understand that fairness requires both types of equality. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Advancing Learner Autonomy in TEFL via Collaborative Learning

Science.gov (United States)

Jacobs, George M.; Shan, Tan Hui

2015-01-01

The present paper begins by situating learner autonomy and collaborative learning as part of a larger paradigm shift towards student-centred learning. Next are brief discussions of learner autonomy and how learner autonomy links with collaborative learning. In the main part of the paper, four central principles of collaborative learning are…

A Reconfigurable Testbed Environment for Spacecraft Autonomy

Science.gov (United States)

Biesiadecki, Jeffrey; Jain, Abhinandan

1996-01-01

A key goal of NASA's New Millennium Program is the development of technology for increased spacecraft on-board autonomy. Achievement of this objective requires the development of a new class of ground-based automony testbeds that can enable the low-cost and rapid design, test, and integration of the spacecraft autonomy software. This paper describes the development of an Autonomy Testbed Environment (ATBE) for the NMP Deep Space I comet/asteroid rendezvous mission.

Finding Autonomy in Birth*

Science.gov (United States)

Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret; Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M.; Harris, Lisa

2009-01-01

Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside of this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women’s agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be ‘for’ or ‘against’ women’s access to cesarean delivery in the absence of traditional medical indications - and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach, but rather, taking the value of women’s autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women’s full inclusion in a safe and positive birth process. PMID:19076937

Death AND DIGNITY. WHY VOLUNTARY EUTHANASIA IS A QUESTION OF CHOICE.

Science.gov (United States)

Denton, Andrew

2016-12-01

The prospect of voluntary euthanasia has created strong debate for decades and provoked passionate opinions from both sides of the fence. While not legal in Australia, a recent revived push for national voluntary euthanasia legislation has once again opened up the conversation and nurses have been encouraged to join the debate. Robert Fedele investigates the latest thinking and why more people are supporting voluntary euthanasia and the right to die with dignity.

Two Rounds of Postwar Restitution and Dignity Restoration in the Netherlands and in France

NARCIS (Netherlands)

Veraart, Wouter

2016-01-01

The looting and systematic deprivation of the property rights of the Jewish population in the Netherlands and France during the years of occupation brought about a deprivation of dignity, since these measures were intended to hit these people in their capacities as legal subjects, destroying their

Means-ends decoupling and academic identities in Ukrainian university after the Revolution of Dignity

NARCIS (Netherlands)

Hladchenko, Myroslava; Westerheijden, Don F.

2018-01-01

This article aims to explore the academic identities under the conditions of means-ends decoupling at the nation-state level. For empirical evidence we choose Ukraine. In 2014, after the Revolution of Dignity despite the adoption of the policies aimed to construct academic identities like in the

KANT ON HUMAN DIGNITY: A CRITICAL APPROACH -- KANT E A DIGNIDADE HUMANA: UMA INTERPRETAÇÃO CRÍTICA

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Antonio Pele

2016-08-01

Full Text Available In this article, I intend to reframe and qualify Kant’s moral philosophy for the understanding human dignity. Some Kant’s formulas seem to grant to the human being an inherent and absolute worthiness, when they are read (often in a very decontextualized way. To achieve this objective, I identify the basic characteristics we commonly attribute to the contemporary model of human dignity. This model has some expressions in the axiological field (inherent and absolute worth, and, at the same time, in the legal-political field (cornerstone of human rights and guiding principle of the Rule of law. I intend to see if we can find some of these latter characteristics in the mentioned usages that Kant gives to the term “dignity” and of formulas supposedly connected (“end in itself”, “autonomy”, “humanity”. When contextualizing these expressions, either in the motivations or in the results of Kant’s philosophy, I arrived to the conclusion that Kant was less concerned with the intrinsic worthiness of the human beings, than with establishing the authority of morality. Keywords: Categorical imperative. Human dignity. Humanity. Kant. Rights.

The Notions of the Human Person and Human Dignity in Aquinas and Wojtyla

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Jove Jim S. Aguas

2009-06-01

Full Text Available At the center of the various transformations and advancements inmodern society is man. It is man by whom and for whom these transformations and advancements are made. But one negative factoraccompanying these transformations is the violence or the degradation of the human person and his dignity, more alarming is the violence committed by man against his fellow man. Today, there is so much violence in the world, everyday we hear about killings, kidnappings, rapes, abortion, terrorist attacks, hunger, wars and many other acts of violence. It is ironic that, while the human person is the very victim of this violence, it is also the human person who is the perpetrator of such violence, man is simultaneously the victim and the culprit. Man indeed is a paradox, for while he is bestowed with dignity and good nature, he is also capable of doing evil and inflicting harm against others. This violent tendency happens because man fails to acknowledge the very dignity of his nature which is rooted in his fundamental relation with God and extended to his fellow human beings. Man is by nature good, but he is also capable of doing evil things. The Catholic Church through its teachings and writings have always emphasized the value of the person, while at the same time acknowledging the fact that he is as much capable of degrading himself. The Pastoral Constitution of the Church in the Modern World, “Gaudium et Spes” acknowledges the many divergent and contradicting opinions of man about himself, one of which “exalts man as the absolute measure of all things and debases himself to the point of despair. The result is doubt and anxiety.”

The Ideal of Moral Autonomy

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Ricardo Marquisio Aguirre

2017-10-01

Full Text Available Some elements of the ideal of moral autonomy are discussed in this paper. Such ideal is a key assumption in social practices focused on normative imputation, particularly morality and law. First, a constructivist conception of normativity is introduced, taking reasons as an essential and non-reducible element, and focused on the conceptual features of moral reasons within the normative domain. Then, an idea of moral autonomy based on the self-constitution is developed including three key features: the possibility of responding to reasons based on shared social expectations; the responsibility for certain scope of actions, according to a set of reasons available to the individual and to their maximum extent of expansion; and the need to preserve autonomy as a purpose unifying the set of autonomous actions of moral agents.

Effect of dignity therapy on end-of-life psychological distress in terminally ill Portuguese patients: A randomized controlled trial.

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Julião, Miguel; Oliveira, Fátima; Nunes, Baltazar; Carneiro, António Vaz; Barbosa, António

2017-12-01

Dignity therapy (DT) is a brief form of psychotherapy developed for patients living with a life-limiting illness that has demonstrated efficacy in treating several dimensions of end-of-life psychological distress. Our aim was to determine the influence of DT on demoralization syndrome (DS), the desire for death (DfD), and a sense of dignity (SoD) in terminally ill inpatients experiencing a high level of distress in a palliative care unit. A nonblinded phase II randomized controlled trial was conducted with 80 patients who were randomly assigned to one of two groups: the intervention group (DT + standard palliative care [SPC]) or the control group (SPC alone). The main outcomes were DS, DfD, and SoD, as measured according to DS criteria, the Desire for Death Rating Scale, and the Patient Dignity Inventory (PDI), respectively. All scales were assessed at baseline (day 1) and at day 4 of follow-up. This study is registered with http://www.controlled-trials.com/ISRCTN34354086. Of the 80 participants, 41 were randomized to DT and 39 to SPC. Baseline characteristics were similar between the two groups. DT was associated with a significant decrease in DS compared with SPC (DT DS prevalence = 12.1%; SPC DS prevalence = 60.0%; p Dignity therapy had a beneficial effect on the psychological distress encountered by patients near the end of life. Our research suggests that DT is an important psychotherapeutic approach that should be included in clinical care programs, and it could help more patients to cope with their end-of-life experiences.

How important is Autonomy to Professional Workers?

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Arne Mastekaasa

2011-11-01

Full Text Available A common assumption is that autonomy is crucial to professional workers. I examine this using survey data on a sample of public sector welfare professionals, viz. medical doctors, nurses, teachers, social workers. Comparisons are made with general population data from the International Social Survey Programme. Two methods of assessing the importance of work autonomy are employed; respondents’ direct ratings and statistical associations between work autonomy (and other job characteristics on the one hand and job satisfaction and organizational commitment on the other. Findings: Autonomy is not rated as more important among the professionals than in the general population, and neither is it more strongly related to job satisfaction. Interesting work and workplace social support appear to be more central.

The Oregon Death with Dignity Act: The Right to Live or the Right to Die?

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Westefeld, John S.; Doobay, Alissa; Hill, Jennifer; Humphreys, Clare; Sandil, Riddhi; Tallman, Benjamin

2009-01-01

Two hundred six individuals were surveyed concerning their views about the Oregon Death with Dignity Act, which allows for physician-assisted suicide under certain conditions. Results indicated extensive heterogeneity and strong opinions concerning the act. Implications are discussed. (Contains 2 tables.)

Freedom of Expression, Deliberation, Autonomy and Respect

OpenAIRE

Rostbøll, Christian F.

2011-01-01

This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms w...

The Japan HOspice and Palliative Care Evaluation Study (J-HOPE Study): views about legalization of death with dignity and euthanasia among the bereaved whose family member died at palliative care units.

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Okishiro, Nao; Miyashita, Mitsunori; Tsuneto, Satoru; Sato, Kazuki; Shima, Yasuo

2009-01-01

There has been a debate in appropriateness of legalization of death with dignity and euthanasia in Japan. To clarify views about these issues, we conducted a large nationwide study of the bereaved whose family member died at palliative care units. The percentages of 429 bereaved family members (response rate 65%) who affirmed legal authorization were 52 for death with dignity and 45 for euthanasia and who affirmed assignment at the discretion of the physician involved were 37 for death with dignity and 38 for euthanasia. In conclusion, views about legalization of death with dignity and euthanasia among the bereaved are inconsistent. No consensus is reached as to legislation of these issues.

Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy

OpenAIRE

Rostbøll, Christian F.

2009-01-01

Udgivelsesdato: 2009 Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disre...

End-of-Life Care Education for Psychiatric Residents: Attitudes, Preparedness, and Conceptualizations of Dignity

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Tait, Glendon R.; Hodges, Brian D.

2009-01-01

Objective: The authors examined psychiatric residents' attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity. Methods: The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey…

Autonomy and informed consent: a mistaken association?

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Kristinsson, Sigurdur

2007-09-01

For decades, the greater part of efforts to improve regulatory frameworks for research ethics has focused on informed consent procedures; their design, codification and regulation. Why is informed consent thought to be so important? Since the publication of the Belmont Report in 1979, the standard response has been that obtaining informed consent is a way of treating individuals as autonomous agents. Despite its political success, the philosophical validity of this Belmont view cannot be taken for granted. If the Belmont view is to be based on a conception of autonomy that generates moral justification, it will either have to be reinterpreted along Kantian lines or coupled with a something like Mill's conception of individuality. The Kantian interpretation would be a radical reinterpretation of the Belmont view, while the Millian justification is incompatible with the liberal requirement that justification for public policy should be neutral between controversial conceptions of the good. This consequence might be avoided by replacing Mill's conception of individuality with a procedural conception of autonomy, but I argue that the resulting view would in fact fail to support a non-Kantian, autonomy-based justification of informed consent. These difficulties suggest that insofar as informed consent is justified by respect for persons and considerations of autonomy, as the Belmont report maintained, the justification should be along the lines of Kantian autonomy and not individual autonomy.

Epistemic Autonomy: A Criterion for Virtue?

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Mudd, Sasha

2013-01-01

Catherine Elgin proposes a novel principle for identifying epistemic virtue. Based loosely on Kant's Categorical Imperative, it identifies autonomy as our fundamental epistemic responsibility, and defines the epistemic virtues as those traits of character needed to exercise epistemic autonomy. I argue that Elgin's principle fails as a…

Are there limits to respect for autonomy in bioethics?

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de Roubaix, Malcolm

2008-06-01

I discuss the significance of respect for personal autonomy in bioethics with reference to its practical expression: rational informed patient choice. The question is whether, given the apparent practical limitations to this notion, bioethical autonomy should be seen as an absolute. After a historical review of informed consent and its development, I discuss the requirements for informed consent. Some inherent tensions are evaluated, as is the applicability of the notion that in order to be legitimate, autonomy should do some ethical work. Limits to the notion of informed consent are explored with reference to six examples: the right of women to reproductive autonomy; the autonomy of legally minor Jehovah's Witnesses; autonomy in cosmetic surgery; inappropriate treatment; autonomy and human medical research, and euthanasia and other end-of-life options. The discussion is within a South African framework with reference to other jurisdictions and decisions where appropriate. I conclude that whilst some unusual instances of limitation of bioethical informed consent might be ethically justifiable, the arguments presented point to the opposite: the unfounded limitation of informed consent.

A balanced intervention ladder: promoting autonomy through public health action.

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Griffiths, P E; West, C

2015-08-01

The widely cited Nuffield Council on Bioethics 'Intervention Ladder' structurally embodies the assumption that personal autonomy is maximized by non-intervention. Consequently, the Intervention Ladder encourages an extreme 'negative liberty' view of autonomy. Yet there are several alternative accounts of autonomy that are both arguably superior as accounts of autonomy and better suited to the issues facing public health ethics. We propose to replace the one-sided ladder, which has any intervention coming at a cost to autonomy, with a two-sided 'Balanced Intervention Ladder,' where intervention can either enhance or diminish autonomy. We show that not only the alternative, richer accounts of autonomy but even Mill's classic version of negative liberty puts some interventions on the positive side of the ladder. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

The Autonomy of Deportation

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Nicholas de Genova

2017-06-01

Full Text Available As ostensibly unwanted or undesirable non-citizens, the utter disposability of deportees appears to be finally and conclusively verified by deportation as a sovereign state power’s perfunctory and mundane act of 'taking out the trash.' Hence, it is no accident that, etymologically, the origins of the very word 'deportation' would indicate a carrying away, a removal, a disposal. The eradication of deportees’ individual lives — their personal identities and life trajectories — emerges as a frightfully routine and prosaic fact of deportation. In spite of the sheer violence of the ruptures inflicted though deportation, however, those who have been rendered the objects of this power persistently reassert their own subjectivity. Ethnographic insights into the lived struggles of the deported (as well as their loved ones and communities elucidates the enduring subjectivity of those who have been made the objects of such sovereign acts of state power and subjected to deportation's techniques of eradication, and illustrates the stubborn incorrigibility of human life against the myriad forces that would seek to enforce its precarity and disposability. In the post-deportation condition, we confront anew the elementary and elemental human freedom of movement, and the incorrigibility of the autonomy and subjectivity of migration. Much as the autonomy of migration instigates a contest in which state power never has the first word, what we may now conceive as the autonomy of deportation — an autonomy and subjectivity of the deported within and against their predicaments of deportation — similarly ensures that state power never has the last word, either.

La trama filosofica della Dichiarazione universale sulla Bioetica e i diritti umani: autonomia, dignità, vulnerabilità

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Emilia D’Antuono

2017-12-01

Full Text Available The philosophical frame of the Universal Declaration on Bioethics and Human Rights: autonomy, dignity, vulnerability. Among the many different aspects of the Declaration (Unesco, 2005, some conceptual perspectives are now crucial in the international bioethical and biolegal debate. Particularly relevant is the link between notions like dignity, autonomy, vulnerability and responsibility. Even though they have different historical-philosophical origins, in the Unesco text they show reciprocal implications, which refer to the construction of a renewed semantics of personhood. Just as much relevant is the necessity of giving new meaning to the notion of universality. The Declaration suggests a perspective of inclusive universality, capable of embracing plurality. It also points out the practice of dialogue as the instrument for recognising diversities and for promoting the democratic participation in public debate, also through the dissemination of bioethics education programs.

Autonomy and Interests: The Social Life of a Curriculum.

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Reddiford, Gordon

1993-01-01

Examines the arguments that students should determine their own curriculum. Reviews the case for student autonomy based on philosophical anarchism and Immanuel Kant's views on autonomy. Argues that curriculum should be a result of the shared autonomy of students and teachers. (CFR)

Euthyroid goitre with and without functional autonomy: A comparison

International Nuclear Information System (INIS)

Hillenhinrichs, H.; Emrich, D.

1998-01-01

Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global 99m Tc thyroid uptake of ≥3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [de

Autonomy and Housing Accessibility Among Powered Mobility Device Users

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Brandt, Åse; Lexell, Eva Månsson; Iwarsson, Susanne

2015-01-01

OBJECTIVE. To describe environmental barriers, accessibility problems, and powered mobility device (PMD) users’ autonomy indoors and outdoors; to determine the home environmental barriers that generated the most housing accessibility problems indoors, at entrances, and in the close exterior surroundings; and to examine personal factors and environmental components and their association with indoor and outdoor autonomy. METHOD. This cross-sectional study was based on data collected from a sample of 48 PMD users with a spinal cord injury (SCI) using the Impact of Participation and Autonomy and the Housing Enabler instruments. Descriptive statistics and logistic regression were used. RESULTS. More years living with SCI predicted less restriction in autonomy indoors, whereas more functional limitations and accessibility problems related to entrance doors predicted more restriction in autonomy outdoors. CONCLUSION. To enable optimized PMD use, practitioners must pay attention to the relationship between client autonomy and housing accessibility problems. PMID:26356666

Effective means of planning for and implementing autonomy

DEFF Research Database (Denmark)

Rehof, Lars Adam

1991-01-01

Autonomy, self-government, indigenous people, human rights, minority protection, minority rights......Autonomy, self-government, indigenous people, human rights, minority protection, minority rights...

Dignity and cost-effectiveness: a rejection of the utilitarian approach to death.

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Brooks, S A

1984-01-01

Utilitarianism is commonly assumed to be the most appropriate sub-structure for medical ethics. This view is challenged. It is suggested that the utilitarian approach to euthanasia works against the patient's individual advantage and is a corrupting influence in the relationship between the physician and society. Dignity for the individual patient is not easily achieved by assessing that person's worth against the yardstick of others' needs and wishes. PMID:6502643

Understanding critical care nurses' autonomy in Jordan.

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Maharmeh, Mahmoud

2017-10-02

Purpose The aim of this study was to describe Jordanian critical care nurses' experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse's autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses' job satisfaction. Therefore, improving nurses' clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

Experienced job autonomy among maternity care professionals in The Netherlands.

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Perdok, Hilde; Cronie, Doug; van der Speld, Cecile; van Dillen, Jeroen; de Jonge, Ank; Rijnders, Marlies; de Graaf, Irene; Schellevis, François G; Verhoeven, Corine J

2017-11-01

High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care system and whether they expect a new system of integrated maternity care to affect their experienced job autonomy. A cross-sectional survey. The Leiden Quality of Work Life Questionnaire was used to assess experienced job autonomy among maternity care professionals. Data were collected in the Netherlands in 2015. 799 professionals participated of whom 362 were primary care midwives, 240 obstetricians, 93 clinical midwives and 104 obstetric nurses. The mean score for experienced job autonomy was highest for primary care midwives, followed by obstetricians, clinical midwives and obstetric nurses. Primary care midwives scored highest in expecting to lose their job autonomy in an integrated care system. There are significant differences in experienced job autonomy between maternity care professionals. When changing the maternity care system it will be a challenge to maintain a high level of experienced job autonomy for professionals. A decrease in job autonomy could lead to a reduction in job related wellbeing and in satisfaction with care among pregnant women. Copyright © 2017. Published by Elsevier Ltd.

Autonomy, Competence and Non-interference

OpenAIRE

Roberts, Joseph T.F.

2017-01-01

In light of the variety of uses of the term autonomy in recent bioethics literature, in this paper, I suggest that competence, not being as contested, is better placed to play the anti-paternalistic role currently assigned to autonomy. The demonstration of competence, I will argue, can provide individuals with robust spheres of non-interference in which they can pursue their lives in accordance with their own values. This protection from paternalism is achieved by granting individuals rights ...

The Changing Scope of Professional Autonomy

DEFF Research Database (Denmark)

Jespersen, Peter Kragh; Wrede, Sirpa

2009-01-01

Kapitlet undersøger hvordan lægeprofessionens autonomi ændres i relation til ledelse i sygehuse i Danmark, Norge, Sverige og Finland i tiden fra 1970 og fremefter.......Kapitlet undersøger hvordan lægeprofessionens autonomi ændres i relation til ledelse i sygehuse i Danmark, Norge, Sverige og Finland i tiden fra 1970 og fremefter....

Autonomy and Automation

Science.gov (United States)

Shively, Jay

2017-01-01

A significant level of debate and confusion has surrounded the meaning of the terms autonomy and automation. Automation is a multi-dimensional concept, and we propose that Remotely Piloted Aircraft Systems (RPAS) automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present definitions of automation, pilot in the loop, pilot on the loop and pilot out of the loop. We further propose that in future, the International Civil Aviation Organization (ICAO) RPAS Panel avoids the use of the terms autonomy and autonomous when referring to automated systems on board RPA. Work Group 7 proposes to develop, in consultation with other workgroups, a taxonomy of Levels of Automation for RPAS.

Advance Directives of Will (Living Will: Ethical and Legal Implications Based on the Principle of Dignity of Human Person

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Maria Aparecida Alkimim

2016-12-01

Full Text Available This paper, with methodology of philosophical, bibliographical and documentary research intends to apply the principle of dignity of human person to the vicissitudes around the advance directives of will, to the ethical aspects disciplined by the Code of Medical Ethics, as well as to what regards the legal aspects, involving the Federal Constitution, the Civil Code, the Code of Medical Ethics and the Resolution 1995/2012 (CFM. The principle of dignity of human person along with the consequent application in the principles of bioethics is considered in a personalistic perspective. This kind of approach is indicative of the interdisciplinarity of bioethics.

Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education.

Science.gov (United States)

Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

2016-09-01

Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students' perceived autonomy and intrinsic motivation.

Patient autonomy and informed consent in critically lll

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Todorović Zoran M.

2017-01-01

Full Text Available Patient autonomy has been a cornerstone of contemporary clinical ethics since the Nuremberg trial, especially in American school of bioethics. Topic: Patient autonomy has been defined in the Nuremberg Code, and re-defined in the Declaration of Helsinki, Belmont Report and Barcelona Declaration. Founders and followers of the rights-oriented bioethics (for example, Hellegers, Beauchamp and Childers have established and promoted the patient autonomy as the main principle of bio(medical ethics since 1970s. However, there is a lot of controversy surrounding such a principle, especially in vulnerable patients. We aimed at evaluating the real meaning and value of patient autonomy in critical care settings regarding the communication between health workers and their patients and families. Conclusion: Protection of patients autonomy in critically ill is a complex issue. Careful benefit-risk assessment is needed in order to find the most appropriate way of obtaining the informed consent, proxy consent or to omit or delay it.

[Psychiatric advance directives and the role of autonomy].

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Ambrosini, Daniel L; Crocker, Anne G

2009-01-01

Although psychiatric advance directives (PADs) are grounded in the ethics of autonomy, the relationship between the two is unclear. PADs are legal documents that allow individuals with mental illness to record their treatment preferences should they become incompetent in the future. The relationship between autonomy and PADs has been discussed in ethical, legal, and philosophical terms, but has not been clearly operationalized for clinical purposes. Autonomy is a fundamental ethical value that includes having the independence from outside controlling influences and the mental capacity to direct one's personal actions. Individuals with mental illness sometimes require assistance to understand their ethical and legal rights with respect to autonomous choice, and professional stakeholders need education regarding the importance of autonomy for clinical practice. Competency to consent to treatment is the mental prerequisite that ensures individuals with mental illness are able to complete PADs with insight, whereas autonomy is the value that empowers individuals to work towards their recovery.

Security, Dignity, Caring Relationships, and Meaningful Work: Needs Motivating Participation in a Job-Training Program

Science.gov (United States)

Ayers, David F.; Miller-Dyce, Cherrel; Carlone, David

2008-01-01

Researchers asked 17 participants in a job-training program to describe their personal struggles following an economic restructuring. Examined through a critical theoretical lens, findings indicate that the learners enrolled in the program to reclaim security, dignity, meaningful work, and caring relationships. Program planners at community…

Autonomy, Trust, and Respect.

Science.gov (United States)

Nys, Thomas

2016-02-01

This article seeks to explore and analyze the relationship between autonomy and trust, and to show how these findings could be relevant to medical ethics. First, I will argue that the way in which so-called "relational autonomy theories" tie the notions of autonomy and trust together is not entirely satisfying Then, I will introduce the so-called Encapsulated Interest Account as developed by Russell Hardin. This will bring out the importance of the reasons for trust. What good reasons do we have for trusting someone? I will criticize Hardin's business model as insufficiently robust, especially in the context of health care, and then turn to another source of trust, namely, love. It may seem that trust-through-love is much better suited for the vulnerability that is often involved in health care, but I will also show that it has its own deficiencies. Good health care should therefore pay attention to both models of trust, and I will offer some tentative remarks on how to do this. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Emotional autonomy and problem behavior among Chinese adolescents.

Science.gov (United States)

Chou, Kee-Lee

2003-12-01

The author examined the association between emotional autonomy and problem behavior among Chinese adolescents living in Hong Kong. The respondents were 512 adolescents, 16 to 18 years of age, who were interviewed for a cross-sectional study. Three dimensions of emotional autonomy including individuation, nondependency on parents, and de-idealization of parents were significantly and positively correlated with the amount of problem behavior the participants engaged in during the past 6 months. Using a simple linear multiple regression model, the author found that problem behavior was associated with only one aspect of emotional autonomy-individuation. Results indicated that the relationship between problem behavior and three aspects of emotional autonomy was similar in both individualistic and collectivistic societies.

Demographic and Socio-Economic Determinants of Local Financial Autonomy in Romania

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Dănuţ Vasile JEMNA

2013-06-01

Full Text Available Local autonomy is a rarely explored concept in the literature, still holding an increasing importance in the current context of Romania’s development in the European Union. In this paper we attempt to provide an overall survey on the financial dimension of local autonomy, assuming that local autonomy cannot be implemented, unless local authorities have adequate financial resources. In this study we also analyze the possibility to measure the local revenue autonomy and to identify the variables which represent the determinants of the local revenue autonomy. Using empirical evidence from Romanian counties, we analyze the regional distributions for own revenues and for the significant determinants of local revenue autonomy. By means of econometric modeling we will highlight the variables which are statistically significant and explain the variation of the local revenues of Romanian counties, as well as the order of importance of the determinants of local financial autonomy. The empirical results show us that, although, theoretically, the counties have a great administrative and financial autonomy, practically this autonomy is very reduced (an average of under 40% for local revenue. The modeling results show that the degree of local financial autonomy can be increased by increasing economic development, urbanization, the average living area per person and fertility. Unemployment and a high level of demographic dependency contribute to the decrease of local financial autonomy.

Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education

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Yu-Kai Chang, Senlin Chen, Kun-Wei Tu, Li-Kang Chi

2016-09-01

Full Text Available Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61 or the control group (n = 65 for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation.

Students' autonomy and teacher's interpersonal style in self-determination theory

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Lalić-Vučetić Nataša

2009-01-01

Full Text Available Starting from psychological needs that are considered basic within self-determination theory (autonomy, competence and relatedness, the importance of encouraging students' autonomy in school context is particularly emphasised. Appreciation of students' autonomy has a stimulating effect on school achievement, conceptual understanding, creativity development, strengthening of self-esteem, and students adapt better to school system and demonstrate a larger degree of internalisation of school rules and intrinsic motivation. Teachers' behavioural style largely determines the degree of students' autonomy in school life and work. Self-determination theory implies the necessity of agreement between the developmental need for autonomy in children and the level of adult control and distinguishes between two styles of interpersonal behavior of teachers: (a those who offer support to students' autonomy by their behavior and (b those that are predominantly inclined to control students' behavior. This paper also points out to different strategies that can be applied by teachers in working with students in school, which also contribute to the development of students' autonomy. What is especially encouraging is the fact that it is possible to learn and to develop 'appreciation of students' autonomy' as teacher's interpersonal style.

Italian Adaptation of the "Autonomy and Relatedness Coding System"

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Sonia Ingoglia

2013-08-01

Full Text Available The study examined the applicability of the observational technique developed by Allen and colleagues (Allen, Hauser, Bell, & O’Connor, 1994; Allen, Hauser, et al., 2003 to investigate the issues of autonomy and relatedness in parent-adolescent relationship in the Italian context. Thirty-five mother-adolescent dyads participated to a task in which they discussed a family issue about which they disagree. Adolescents were also administered a self-report measure assessing their relationship with mothers. Mothers reported significantly higher levels of promoting and inhibiting autonomy, and promoting relatedness behaviors than their children. Results also suggested a partial behavioral reciprocity within the dyads, regarding promoting and inhibiting relatedness, and inhibiting autonomy. Finally, mothers’ inhibiting autonomy behaviors positively correlated to teens’ perception of their relationship as conflicting; adolescents’ inhibiting and promoting autonomy and inhibiting relatedness behaviors positively correlated to open confrontation, rejection and coolness, while promoting relatedness behaviors negatively correlated to open confrontation, rejection and coolness. The results suggest that, for Italian mothers, behaviors linked to autonomy seem to be associated with being involved in a more negative relationship with their children, even if not characterized by open hostility, while for Italian adolescents, behaviors linked to autonomy seem to be associated with threatening the closeness of the relationship. Globally, the findings suggest that the application of this observational procedure may help our understanding of youth autonomy and relatedness development in Italy, but they leave unanswered questions regarding its appropriate adaptation and the role played by cultural differences.

Investigation of the Ethical Concepts that Inform the Laws Limiting Genetic Screening in Employment Decisions: Privacy, Human Dignity, Equality, Autonomy, Efficiency

Energy Technology Data Exchange (ETDEWEB)

Pasquerella, Lynn; Rothstein, Lawrence E.

2003-01-16

The broad question addressed in our research is : What is the influence of ethical concepts on legislative outcomes? The research focuses on the important ethical concerns that surround the use of genetic information in employment matters and in American state legislatures. By analyzing the contents of hearings, interviews and advocacy documents involved in the legislative process, the research seeks to answer the question: How might the dominance of a particular ethical concept informing the discussion of a bill influence the legislative outcome?

A longitudinal research on the development of emotional autonomy during adolescence.

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Parra, Agueda; Oliva, Alfredo

2009-05-01

The purpose of the present paper was to study the development of emotional autonomy through adolescence analysing its association with family relationships. The development of emotional autonomy involves an increase in adolescents' subjective sense of his or her independence, especially in relation to parents. From some scholars emotional autonomy is a normative manifestation of the detachment process from parents, however, others point out that detachment from parental ties is not the norm, so high level of adolescent emotional autonomy is the consequence of negative family relationships. In our study a sample of 101 adolescents were followed for 5 years, from early to middle adolescence, and completed questionnaires to measure their emotional autonomy and the quality of their family relationships. Our results showed that over the course of adolescence some dimensions of emotional autonomy increase, meanwhile others decrease, so the global level of emotional autonomy global level remains stable. On the other hand, emotional autonomy is associated with negative family relationships, so emotional autonomy, more than a necessary process to become adult, could be indicating an insecure attachment to parents.

Dying with dignity.

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Madan, T N

1992-08-01

Death is a theme of central importance in all cultures, but the manner in which it is interpreted varies from society to society. Even so, traditional cultures, including Christian, Hindu and Jain religious traditions, exhibited a positive attitude to death and did not look upon it in a dualistic framework of good vs bad, or desirable vs undesirable. Nor was pessimism the dominant mood in their thinking about death itself. A fundamental paradigm shift occurred in the West in the eighteenth century when death was desacralized and transformed into a secular event amenable to human manipulation. From those early beginnings, dying and death have been thoroughly medicalized and brought under the purview of high technology in the twentieth century. Once death is seen as a problem for professional management, the hospital displaces the home, and specialists with different kinds and degrees of expertise take over from the family. Everyday speech and the religious idiom yield place to medical jargon. The subject (an ageing, sick or dying person) becomes the object of this make-believe yet real world. As the object of others' professional control, he or she loses the freedom of self-assessment, expression and choice. Or, he or she may be expected to choose when no longer able to do so. Thus, not only freedom but dignity also is lost, and lawyers join doctors in crisis manipulation and perpetuation. Although the modern medical culture has originated in the West, it has gradually spread to all parts of the world, subjugating other kinds of medical knowledge and other attitudes to dying and death.(ABSTRACT TRUNCATED AT 250 WORDS)

Limits to relational autonomy--the Singaporean experience.

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Krishna, Lalit Kumar Radha; Watkinson, Deborah S; Beng, Ng Lee

2015-05-01

Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered "content neutral" not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and "operationalize" the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. © The Author(s) 2014.

On the Compatibility of Autonomy and Relatedness.

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Hodgins, Holley S.; And Others

1996-01-01

Investigates the relation of autonomy to naturally occurring social interactions in two studies: the first investigated college students' interactions with parents, and the second examined interactions across all relationships. Autonomy was significantly related to more positive and naturally occurring interaction, whereas control related more to…

40 CFR 73.86 - State regulatory autonomy.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false State regulatory autonomy. 73.86 Section 73.86 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... regulatory autonomy. Nothing in this subpart shall preclude a State or State regulatory authority from...

Autonomy, Equality, and Teaching among Aka Foragers and Ngandu Farmers of the Congo Basin.

Science.gov (United States)

Boyette, Adam H; Hewlett, Barry S

2017-09-01

The significance of teaching to the evolution of human culture is under debate. We contribute to the discussion by using a quantitative, cross-cultural comparative approach to investigate the role of teaching in the lives of children in two small-scale societies: Aka foragers and Ngandu farmers of the Central African Republic. Focal follows with behavior coding were used to record social learning experiences of children aged 4 to 16 during daily life. "Teaching" was coded based on a functional definition from evolutionary biology. Frequencies, contexts, and subtypes of teaching as well as the identity of teachers were analyzed. Teaching was rare compared to observational learning, although both forms of social learning were negatively correlated with age. Children received teaching from a variety of individuals, and they also engaged in teaching. Several teaching types were observed, including instruction, negative feedback, and commands. Statistical differences in the distribution of teaching types and the identity of teachers corresponded with contrasting forager vs. farmer foundational cultural schema. For example, Aka children received less instruction, which empirically limits autonomous learning, and were as likely to receive instruction and negative feedback from other children as they were from adults. Commands, however, exhibited a different pattern suggesting a more complex role for this teaching type. Although consistent with claims that teaching is relatively rare in small-scale societies, this evidence supports the conclusion that teaching is a universal, early emerging cognitive ability in humans. However, culture (e.g., values for autonomy and egalitarianism) structures the nature of teaching.

Why job autonomy matters for young companies' performance: company maturity as a moderator between job autonomy and company performance

NARCIS (Netherlands)

Preenen, P.T.Y.; Howaldt, J.; Oeij, P.R.A.; Dhondt, S.; Kraan, K.O.; Jansen, E.

2016-01-01

Although the positive impact of job autonomy has been widely shown for individual-level employee outcomes, research on job autonomy and company-level outcomes has been surprisingly scarce. Therefore, among 3,311 companies in the Netherlands, we investigate the relationship between employees' job

LGBT: equally entitled to human rights and dignity

Directory of Open Access Journals (Sweden)

Anne C Richard

2013-04-01

Full Text Available Recognition that LGBT rights are universal rights is gaining ground.The trend, finally, is positive. But greater respect for LGBT rights andinclusion of LGBT people still is not a worldwide movement.

An introduction to the Ethical Foundations of the Radiation Protection System

International Nuclear Information System (INIS)

Lochard, Jacques

2013-01-01

Jacques Lochard reminded participants about the long tradition of the system of radiological protection to combine science and values. He also reminded the background of the ICRP initiative on ethics, from the establishment of a Working Party in 2009 to the recent creation of Task Group (TG 94) through the workshop in Daejeon, Korea, in August 2013. The objective of ICRP TG 94 is to develop a publication referring to the ethical foundations of the system of radiological protection recommended by the Commission. The presentation went on by presenting the importance of value judgements in the structuration of the scientific basis on the system and how models, default options and expert judgments are necessary to cope with the various uncertainties associated with radiological risk. Among the structuring values, the old ethical virtue of prudence is playing a key role by allowing the system to drive affectively the daily activities in radiation protection in the absence of a full knowledge of the risk associated to radiation. Benevolence, justice and equity were also presented as ethical and social values underlying the system of protection and a special attention was given on the value of dignity, as an attribute of the human condition, with autonomy as a corollary. Autonomy, in turn, implies freedom and the ability to deliberate, decide and act. Even if the word dignity is not present in ICRP Recommendations, the radiological protection system is promoting dignity through a set of requirements like the duty of informing stakeholders, the right to know and informed consent principles or the encouragement of self-help protection actions. These elements of the system are, closely related to the process of stakeholder engagement to promote their empowerment and autonomy, maintain their vigilance and finally contributing to the development of the radiation protection culture within the society. Overall the presentation emphasises the importance of making explicit the

Don’t Always Prefer My Chosen Objects: Low Level of Trait Autonomy and Autonomy Deprivation Decreases Mere Choice Effect

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Shang, Zhe; Tao, Tuoxin; Wang, Lei

2016-01-01

Choice effect is a robust phenomenon in which even “mere choice” that does not include actual choosing actions could result in more preference for the self-chosen objects over other-chosen objects. In the current research, we proposed that autonomy would impact the mere choice effect. We conducted two studies to examine the hypothesis. The results showed that the mere choice effect measured by Implicit Association Test (IAT) significantly decreased for participants with lower levels of trait autonomy (Study 1) and when participants were primed to experience autonomy deprivation (Study 2). The theoretical and practical implications are discussed. PMID:27148132

[The medical autonomy of elderly in Taiwan].

Science.gov (United States)

Chen, Kai-Li; Chen, Ching-Huey

2014-10-01

The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan.

Patient autonomy: a view from the kitchen.

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Struhkamp, Rita M

2005-01-01

In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the concrete activities of day-to-day health care, in the material and technological context of care, in arrangements of health care institutions, in the physical training of people with disabilities, as well as in the concrete activities of care-giving. This move from conversations in the consultation room to other sites and situations in the practice of care takes seriously the empirical reality of medical care and intends to show that patient autonomy is practically realised in a much richer and more creative way than most ethical theory seems to assume.

Do privacy and data protection rules apply to legal persons and should they? A proposal for a two-tiered system

NARCIS (Netherlands)

van der Sloot, B.

2015-01-01

Privacy and data protection rules are usually said to protect the individual against intrusive governments and nosy companies. These rights guarantee the individual's freedom, personal autonomy and human dignity, among others. More and more, however, legal persons are also allowed to invoke the

[Autonomy: to what extent is the concept relevant in psychiatry?].

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de Wit, F A

2012-01-01

Autonomy is an important concept in psychiatry, but because it is a somewhat abstract and ambiguous notion, it is not applicable in its entirety in a psychiatric context. This becomes obvious in situations where patients are receiving long term care and treatment. To modify the concept of autonomy in such a way that it acquires an extra dimension that renders it applicable to daily psychiatric practice. The literature was reviewed in order to find articles that reveal the tensions that arise between autonomy and dependence in psychiatry and that reflect the human characteristics that are concealed behind the modern concepts of autonomy, freedom and respect for autonomy. Concepts such as person, identity, acknowledgement, dialogical ethics and life histories are used as an addition to the concepts of autonomy of Kant and Mill. A phenomenological and a context sensitive conception of autonomy is needed within the perspective of dialogical ethics. A dialogical perspective requires from psychiatric professionals a susceptibility for what the patient as a human being really has to say. On the basis of a dialogue where there is space and attention for life histories, backgrounds and the potentials of patients, a new perspective can be developed that is shared by the persons involved. In psychiatry, statements about real autonomy and genuine respect for autonomy are only truly meaningful within the context of doctors, nurses and patients. A hermeneutic approach to patients which involves dialogue creates new opportunities in the field of staff-patient relations.

"It's My Life": Autonomy and People with Intellectual Disabilities

Science.gov (United States)

Björnsdóttir, Kristín; Stefánsdóttir, Guðrún V; Stefánsdóttir, Ástríður

2015-01-01

This article discusses autonomy in the lives of adults with intellectual disabilities. The article draws on inclusive research in Iceland with 25 women and 16 men and employs ideas of relational autonomy from the perspectives of the Nordic relational approach to disability. In this article, we examine autonomy in relation to private life, that is,…

Charter School Autonomy: The Mismatch between Theory and Practice

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Finnigan, Kara S.

2007-01-01

In theory, the charter school concept is based on a trade-off or exchange: greater autonomy for increased accountability. Although charter schools have been operating for more than 10 years, little is known about charter school autonomy in practice. This mixed-methods study used survey and case study data to examine the degree of autonomy of…

The Need for Authenticity-Based Autonomy in Medical Ethics.

Science.gov (United States)

White, Lucie

2017-08-11

The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of "authenticity", the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical ethics, and too stringent for use in practical contexts. I argue, however, that the very condition of authenticity that forms a focus in theoretical philosophy is also essential to autonomy and competence in medical ethics. After tracing the contours of contemporary authenticity-based theories of autonomy, I consider and respond to objections against the incorporation of a notion of authenticity into accounts of autonomy designed for use in medical contexts. By looking at the typical problems that arise when making judgments concerning autonomy or competence in a medical setting, I reveal the need for a condition of authenticity-as a means of protecting choices, particularly high-stakes choices, from being restricted or overridden on the basis of intersubjective disagreement. I then turn to the treatment of false and contestable beliefs, arguing that it is only through reference to authenticity that we can make important distinctions in this domain. Finally, I consider a potential problem with my proposed approach; its ability to deal with anorexic and depressive desires.

The Counter-Normative Effects of Service-Learning: Fostering Attitudes toward Social Equality through Contact and Autonomy