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Biomedical subjects

D DeGrazia

Publications and source records attributed to D DeGrazia.

10 recordsLinked to original sources
PubMed2001

Ethical issues in early-intervention clinical trials involving minors at risk for schizophrenia.

Early-intervention clinical trials involving persons at risk for schizophrenia raise a variety of ethical issues. These issues range from some of the most general questions of ethical theory and research ethics to some very specific pragmatic questions about optimal procedures for protecting subjects. Giving special attention to minor subjects (and adult subjects lacking decision-making capacity), this paper aims to provide an overview of some leading ethical issues and concerns as well as a rights-based framework and several concrete suggestions for addressing these issues and concerns.

Adolescent↗
PubMed1996

Why the United States should adopt a single-payer system of health care finance.

Although nothing could be less fashionable today than talk of comprehensive health care reform, the major problems of American health care have not gone away. Only a radical change in the way the U.S. finances health care--specifically, a single-payer system--will permit the achievement of universal coverage while keeping costs reasonably under control. Evidence from other countries, especially Canada, suggests the promise of this approach. In defending the single-payer approach, the author identifies several political and cultural factors that make it difficult for Americans to obtain a clear view of this option. Finally, the author argues that much discussion of rationing is vitiated by bracketing more systemic questions to which the issue of rationing is inextricably linked.

Canada↗
PubMed1994

Autonomous action and autonomy-subverting psychiatric conditions.

The following theses are defended in this paper: (1) The concept of autonomous action is centrally relevant to understanding numerous psychiatric conditions, namely, conditions that subvert autonomy; (2) The details of an analysis of autonomous action matter; a vague or rough characterization is less illuminating; (3) A promising analysis for this purpose (and generally) is a version of the "multi-tier model". After opening with five vignettes, I begin the discussion by highlighting strengths and weaknesses of contributions by other authors who examine the relationship between autonomy and autonomy-subverting psychiatric conditions. I then present an analysis of the concept of autonomous action, before employing this analysis in a suggestive exploration of the conditions illustrated in the vignettes.

Attitude↗
PubMed1991

Pain, suffering, and anxiety in animals and humans.

We attempt to bring the concepts of pain, suffering, and anxiety into sufficient focus to make them serviceable for empirical investigation. The common-sense view that many animals experience these phenomena is supported by empirical and philosophical arguments. We conclude, first, that pain, suffering, and anxiety are different conceptually and as phenomena, and should not be conflated. Second, suffering can be the result--or perhaps take the form--of a variety of states including pain, anxiety, fear, and boredom. Third, pain and nociception are not equivalent and should be carefully distinguished. Fourth, nociception can explain the behavior of insects and perhaps other invertebrates (except possibly the cephalopods). Fifth, a behavioral inhibition system associated with anxiety in humans seems to be present in mammals and most or all other vertebrates. Based on neurochemical and behavioral evidence, it seems parsimonious to claim that these animals are capable of experiencing anxious states.

Animal Welfare↗
PubMed1991

An outcomes model of medical decision making.

In the traditional 'fix-it' model of medical decision making, the identified problem is typically characterized by a diagnosis that indicates a deviation from normalcy. When a medical problem is multifaceted and the available interventions are only partially effective, a broader vision of the health care endeavor is needed. What matters to the patient, and what should matter to the practitioner, is the patient's future possibilities. More specifically, what is important is the character of the alternative futures that the patient could have and choosing among them so as to achieve the best future possible, with the ranking of outcomes determined by the patient's preferences. This paper describes the fix-it model, presents and defends the outcomes-based model, and demonstrates that the latter is useful in developing normative conceptions of informed consent and decision making and in establishing a basis for societal involvement in the decision making process. Finally, several shortcomings of the model will be acknowledged.

Attitude of Health Personnel↗
PubMedDate not supplied

Momento mori.

Explore the source record for details and available documents.

Brain Death↗