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Biomedical subjects

J Liaschenko

Publications and source records attributed to J Liaschenko.

At least 19 recordsLinked to original sources
PubMed2006

Critique of the "tragic case" method in ethics education.

It is time for the noon conference. Your job is to impart a career-changing experience in ethics to a group of students and interns gathered from four different schools with varying curriculums in ethics. They have just finished 1 1/2 h of didactic sessions and lunch. One third of them were on call last night. Your first job is to keep them awake. The authors argue that this "tragic case" approach to ethics education is of limited value because it limits understanding of moral problems to dilemmas; negates the moral agency of the student; encourages solutions that are merely intellectual; and suggests that ethical encounters are a matter for experts. The authors propose an alternative that focuses on three issues: the provider-patient relationship, the relationships between providers in the everyday world of health work and, the social position of healthcare providers in society. In this approach, teachers are not experts but more like guides on a journey who help students to learn that much of ethical practice comprises living through difficult situations of caring for vulnerable others and who help students to navigate some of these difficulties.

Bioethics↗
PubMed1999

Ethical issues in infection control in home care.

The history of infection control is ancient and inextricably bound to the histories of disease, medicine, and nursing. This history reveals the beliefs about the cause of infectious disease through time and the remedies enacted in response. Implicit in this history is an ethical history reflecting the relationship of the infected individual to the group and the power of the state to institute protective measures. In the Middle Ages, for example, a requiem mass or mass for the dead was held for lepers in which the church was draped in black and dirt thrown on the lepers' head. Afterward, they were lead to the leprosaria and given a rattle they were required to use to warn others of their approach.

Attitude of Health Personnel↗
PubMed1999

Ethical issues in management.

Home care takes place in a complex landscape in which multiple interests and responsibilities intersect in many ways and at many levels. These responsibilities include the agency to the public, management to care providers and vice versa, workers to each other, patients to workers, and workers to caregivers, to name but a few relationships. In such complicated situations, not surprisingly, some of these interests and responsibilities are at odds.

Community Health Nursing↗
PubMed1999

Balancing an ethics of conviction and an ethics of responsibility.

Ethics is one means that societies use to deal with certain kinds of problems, specifically those that can cause harm. One approach to these problems is the creation of laws designed to prevent or limit harm in specified situations. Thus ethics and politics, although not equivalent, are closely related. Because both arenas are concerned with a multiplicity of relationships defining complex situations, it is not surprising that, in our desire to address a social harm, some relationships are emphasized but others are de-emphasized or overlooked completely. When this oversight occurs, harm may be the likely result for some group or groups even if others benefit. Nurturing our ability to see and appreciate the full range of situations and relationships can contribute to better ethical responses and better laws.

Community Health Nursing↗
PubMed1999

Can justice coexist with the supremacy of personal values in nursing practice?

This article explores a relationship between justice and personal values, typically understood as illustrative of universalist and particularist accounts of morality, and therefore, as oppositional. The possibility of the coexistence of personal values and justice depends on the conceptualization of justice and the nature of the personal values. In contrast to traditional conceptions, the author presents an alternative and feminist view of justice in which the universalist and particularist accounts of morality need not conflict. The author argues that personal values that work in such a way so as to include previously marginalized others in the group of those who have access to the goods of social life are the personal values that are compatible with justice. In conclusion, the author focuses on the implications for the care/justice debate, the necessity of political participation, and the importance of educating for justice.

Attitude of Health Personnel↗
PubMed1999

Theorizing the knowledge that nurses use in the conduct of their work.

The authors propose a classification of knowledge that they call case, patient, and person and that reflects the content of the knowledge necessary to the conduct of nursing work. This classification represents an attempt to theorize from their respective empirical research data. Case knowledge is general knowledge of pathophysiology, disease processes, pharmacology, and other therapeutic protocols. Patient knowledge is that knowledge that defines the individual within the health care system, the knowledge expressed in the individual's response to therapeutics, and the knowledge that enables nurses to move the recipient of care through the health care system and along the illness trajectory. Person knowledge is knowledge of the individual as a subject with a personal biography who occupies a certain social space and who acts with his or her own desires and intentions for reasons that make sense to him or her. Two types of social knowledge serve as relational knowledge, or a bridge that links case knowledge to patient knowledge and patient knowledge to person knowledge. Each type of knowledge is accessed differently and the extent to which each is attained and used is determined by the circumstances of the patient's illness and his or her location in the health care system. The authors make a case for why this classification might be useful to the discipline.

Clinical Competence↗
PubMed1998

The inadequacy of a duty-based approach to the moral problems of health care.

Moral beliefs commonly are thought to be eternal and not subject to change, a perspective frequently reinforced by religious authority and secular traditions. Yet an examination of morality shows that moral beliefs and actions have changed over time in response to various factors. Indeed, the point could be argued that one of the challenges to morality is responding to change--no less so in the domain of bioethics and health care than in society at large.

Community Health Nursing↗
PubMed1998

What if...? Language, health care, and moral imagination.

Language is important to human life. It shapes the way we see our world, is the symbolic means by which we express our knowledge of the world and each other, and guides and justifies our actions. In addition to these roles, language conveys what moral ideas and values are significant to a group. These functions are related and not mutually exclusive.

Attitude to Health↗
PubMed1998

Moral evaluation and concepts of health and health promotion.

This article considers the moral implications of some of the ways in which society, including nursing, thinks about health and health promotion. How we think about health shapes what we describe as healthy or unhealthy, as well as those factors that promote or hinder the attainment and maintenance of health. In turn, these concepts lead to actions that have moral significance. These issues are of particular import to nursing because health is central to what we understand our aims to be. To this end, the article addresses definitions of health, the relationship between morality and health, health promotion and the moral harms following from some of those practices, and the challenges to nursing.

Attitude to Health↗
PubMed1997

Trust and physician-assisted suicide.

In the first week of January, the U.S. Supreme Court began hearing arguments in the matter of assisted suicide. The prohibition against physician-assisted suicide (PAS) in Oregon, New York, and Washington is being challenged.

Ethics, Medical↗
PubMed1995

Ethics in the work of acting for patients.

A nursing therapeutics requires that nurses literally act for patients, and they do so in three domains: the physical the psychological, and what the author calls the "integrity of the self." Acting for the patient is a matter of inherent ethical significance. Acting for another carries the risk of instrumentality; that is, one person becomes the means to another's end. This can result in a variety of moral problems depending on who determines what the ends will be; the degree to which the ends are agreed on among nurse, patient, significant others, and physicians; and whether nurses are acting for their patients, for themselves, or for institutionalized medicine. A therapeutics exists to do something to and for another, and therefore several knowledges are relevant. While the knowledge of physiology, disease, and interventions is necessary, it is not sufficient, nor perhaps even the most important. Also required for an ethical therapeutics is the knowledge of the social and political place occupied by nurses, self-knowledge, knowledge of the person, and the knowledge of the worthiness of ends to be ends of human life.

Aged↗