Biomedical subjects
A Dines
Publications and source records attributed to A Dines.
The risks of poisoning in later life.
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Does the distinction between killing and letting die justify some forms of euthanasia?
Nurses will often be at the forefront in a health care team which decides that it is ethically acceptable to allow a particular patient to die but the possibility of actually killing another patient who requests his own death is met with heartfelt resistance. This paper explores the distinction between killing and letting die and the connection these arguments have with justifications for euthanasia. Two practical examples of killing and letting die are analysed. Various issues are examined including the active-passive distinction, the difference between causing and preventing a death and the probability of outcome. Justifications for euthanasia are then revisited and some concluding remarks made.
What changes in health behaviour might nurses logically expect from their health education work?
This paper examines nurses' health education work from a philosophical perspective. Two key concepts, choice and autonomy, are explored by analysing examples of the health education work of the practice nurse and the health visitor. As a result, the question, 'what changes in health behaviour might nurses logically expect from their health education work?' is considered. The individualistic assumption within nurses' health education work, that individual patients and clients face certain choices and are able to exert some control over their health status, is reviewed. Choices related to healthy eating, for example, are recognized to be constrained by issues such as finance, time and social circumstances. The choice not to smoke is similarly constrained, for example, by social deprivation, cultural patterns and advertising. The paper both rejects an overly determined conception of patients and clients where they are viewed as unable to make any choices, but also cautions against the danger of victim-blaming. Constraints on patients' and clients' autonomy in health education by nurses are also considered. These limitations on health education work include, for example, a lack of scientific knowledge related to an individual's propensity to develop disease. In contrast, health education work within nursing may also be seen as enabling people to be more autonomous in relation to their health by imparting knowledge about health risks. Health education work by nurses thus emerges from the analysis as a constrained but valuable activity.
The health care needs of ethnic minority groups: are nurses and individuals playing their part?
The UKCC Code of Professional Conduct for nurses, midwives and health visitors stresses the need to have an understanding of the social and cultural determinants of health and illness. There is as yet little evidence of what might constitute good practice in this area and it is difficult to ascertain why this basic philosophy is not translated into action. Indeed, the nursing and midwifery professions' ability to deliver adequate and appropriate health care more generally to Britain's multiracial, multicultural population has been questioned. This literature review presents evidence which strongly suggests that although we are living in a multicultural society patients from minority ethnic groups are additionally disadvantaged because the initiatives by nurses, and others working in the National Health Service, to meet their health care needs are inadequate and often inappropriate.
A review of lay health beliefs research: insights for nursing practice in health promotion.
Recent sociological research in the field of lay health and illness beliefs is reviewed and discussed in the light of nursing practice in health promotion. How the findings might deepen nurses' understanding of difficulties in adhering to desired health behaviours is outlined. The distinctions between 'public' and 'private' accounts of health, the 'taken-for-grantedness' of health, the emotive nature of health and the difficulty of accessing 'unpolluted' lay views of health is considered. The implications for nurses working in health promotion are discussed. There is a need for further research into the relationship between health beliefs and behaviour, the health beliefs of various groups within society and a need to examine how health beliefs arise and change.