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Biomedical subjects

W J Pinch

Publications and source records attributed to W J Pinch.

12 recordsLinked to original sources

The Patient Self-Determination Act: the ethical dimensions.

Advanced, sophisticated technology, rising health care costs, and consumerism all combined to drive the development of the Patient Self-Determination Act. Ethical implications include, but are not limited, to the principles of autonomy and beneficence. Paternalism is also discussed as a compromise to autonomy. Caring is used to focus on the contextual perspective of both patients and nurses for ethical decision making. Implications for future ethical practice conclude the discussion.

Beneficence

The parents' perspective: ethical decision-making in neonatal intensive care.

Ethical debate abounds in the literature relative to treatment decisions for the high risk neonate in the intensive care nursery. A systematic examination of the parents' perspective is missing. To fill this existing gap, the ethical dimension of care was explored with 32 families of high risk newborns from a Level III nursery, using a moral conflict interview guide in order to describe their perspective. A concept of the medicalization of parenting appears to best reflect the parents' view of ethical decision-making responsibility. This concept evolved through the parents' reflection on conflict naming, content of decision-making, context of decision-making, information sharing and perception of infant status. These concerns differ profoundly from those of health professionals, philosophers, theologians and others active in this debate who cite lower limits of viability, iatrogenic effects of treatment, use of multiple invasive procedures, and the role of paternalism as ethical issues.

Comprehension

Parental voices in the sea of neonatal ethical dilemmas.

Ethical debate in neonatal intensive care centers around the lower limits of viability, the use of multiple invasive procedures, and the role of paternalism. The parents' perspective has been addressed infrequently. This report will focus on the parents' statements as obtained through predischarge in-depth interviews with 32 families, each with a high-risk infant(s). Discussion will include a summary of the range of parental perceptions during two major periods of time: preadmission to the NICU and the NICU experience itself. Some possible nursing implications will be drawn that reflect a sensitive response to these parental perceptions.

Adult

Ethical decision making for high-risk infants. The parents' perspective.

The experiences of 32 families with high-risk infants provide the foundation for a discussion of the parents' perception of the ethical dimension of intensive newborn care. The families' focus on the need for support in the NICU crisis rather than a plea for rights, justice, and autonomous decision making leads to a suggested professional response guided by an ethic of care. Through a caring professional, ethical decision making in the NICU can be implemented to encompass a shared moral responsibility for the high-risk infant during this process.

Decision Making

Health needs and concerns of male adolescents.

Lifestyle factors established within the family help determine health-care functioning. Adolescents first may be challenged to meet their own health needs as freshmen in college. A 153-item questionnaire was utilized to examine concerns in the areas of alcohol and other drug use, auto safety, weight and dieting, smoking, sexuality, coping and stress, and selection and utilization of health-care services. One hundred fifty-nine male college students responded. Major problems with alcohol use, auto safety, weight control, stress and sexuality were identified. Positive lifestyle factors that were strongly supported included regular exercise, nonsmoking, regular medical and dental checkups, and the development of some support systems to cope with stress. Health-care services designated by respondents to meet their own needs were significantly different from those services they pointed out as needed for their peers.

Adolescent

Ethical dilemmas in nursing: the role of the nurse and perceptions of autonomy.

This study investigated decision making in ethical dilemmas and attitudes toward professional autonomy. It was based on Murphy's identification of three nurse-patient relationship models. The model identification was the result of Murphy's investigation of the levels of moral reasoning of nurse practitioners, from Kohlberg's theory of moral development. Autonomy is necessary for patient advocacy in Murphy's highest order model of nurse-patient relationship. 109 freshmen, 103 seniors, and 82 graduates (baccalaureate nursing) were examined for model selection, risk-taking, restrictions, and anxiety in the decision-making process in specific situations. Autonomy was measured independently. The most significant results indicated that freshmen were less likely to select the autonomous model of relationship, had lower attitudes toward professional nursing autonomy, and were less willing to take risks. Graduates were lower than either student group in their perceptions of restrictions and anxiety. The responses to each dilemma itself varied by situation in relation to the model preferred.

Adolescent

Integrating research into practice.

Active involvement of students in research projects during implementation of the nursing role emphasizes regular implementation of this component in practice. Several examples of undergraduate research activities are described that developed out of the university based home health care agency and the faculty member's clinical practice. Some of these experiences not only met the educational goals related to research but also became the foundation for quality programs for clients in a variety of areas.

Adolescent