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Results for “Coercion”

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At least 199 records · Page 11Linked to original sources
PubMed1995

Couple communication, sexual coercion and HIV risk reduction in Kigali, Rwanda.

OBJECTIVE: To describe sexual interaction and HIV-related communication in Rwandan couples and to examine their relationship to HIV testing and condom use. STUDY DESIGN: Cross-sectional survey of a longitudinal cohort. METHODS: In 1988, women recruited for an epidemiological study of HIV, and interested male partners, received confidential HIV testing and counseling. Two years after enrollment, 876 women reporting one steady partner in the past year completed a questionnaire addressing sexual and HIV-related communication, sexual motivation and violence in the partnership. RESULTS: Men control sexual decision making, and coercive sex and violence between partners is not uncommon. HIV-positive women were more likely to report coercive sex and less likely to have discussed their test results with their partner. Women with HIV-positive partners were more likely to report being physically abused. Condom use was more common if the man had been previously tested, and if women reported discussing or negotiating condom use. HIV-negative women with untested or seronegative partners were the least likely to use condoms or to discuss or attempt to negotiate condom use. CONCLUSIONS: Participation of the male partner is crucial for successful HIV risk reduction in couples. HIV testing and counseling of couples has beneficial long term effects on condom use and HIV-related communication. Couple communication is associated with condom use, but only when the discussion is specific (sexually transmitted disease risks and using condoms). Seronegative women with untested partners are at increased risk for HIV as they are the least likely to discuss or attempt to negotiate condom use.

Coercion↗
PubMed1999

A care perspective on coercion and autonomy.

In the Netherlands there is a growing debate over the possibility of introducing 'compassionate interference' as a form of good psychiatric care. Instead of respecting the autonomy of the patient by adopting an attitude of non-interference, professional carers should take a more active and committed role. There was a great deal of hostile reaction to this suggestion, the most commonly voiced criticism being that it smacked of 'modern paternalism.' Still, the current conception of care leaves us with a paradox. On the one hand patients are regarded as individuals who have a strong interest in (and a right to) freedom and non-interference; on the other hand many of them have a desperate need for flourishing, viable relationships. In fact, part of their problem is that they cannot relate very well with other people. This creates a dichotomy, because respecting patients' autonomy often means that they cannot be given the help they so desperately need. In this respect current care practices do not answer the caring needs of these patients. The criticism on care practices is to be considered as important. It invites us to reexamine and reevaluate the current conception of caring relationships and its main values. In line with this reexamination an alternative perspective on care is introduced in this paper, a perspective in which 'compassionate interference' is not so much a threat to autonomy, but a means of attaining autonomy. For this we need a different definition of autonomy than that commonly used in current care practice.

Altruism↗
PubMed2004

Nurses' ethical perceptions about coercion.

PURPOSE OF THE STUDY: The purpose of this study was to describe Finnish psychiatric nurses' ethical perceptions about coercive measures in acute psychiatric setting. METHODS: The data were collected with a questionnaire developed for this study. The sample included 170 Finnish psychiatric nurses on acute wards in five psychiatric hospitals. The data were analysed using frequency and percentage distributions, mean and standard deviations. The internal consistency of the instrument was explored with Cronbach's alpha. The association between the background variables and the sum score of the items of the questionnaire was tested with Mann-Whitney U-test and Kruskal-Wallis test. The open-ended question was analysed with content analysis. RESULTS: Some psychiatric nurses perceived coercive measures as ethically problematic. In particular, the implementation of forced medication (18%), four-point restraints (16%) and patient seclusion (11%) were perceived as ethically problematic. Female nurses and nurses who worked on closed wards perceived the measures to be more problematic than male nurses and nurses who did not work on closed wards. CONCLUSION: In Finland, special attention has been paid to ethical questions related to the care of psychiatric patients and to the enhancement of patients' rights, yet the majority of the nurses participating in the survey did not perceive coercive measures as ethically problematic. More research on this issue as well as further education of the personnel and more extensive teaching of ethics in nursing schools are needed to support the ability of the psychiatric personnel to identify ethically problematic situations. In addition, it is important to consider new measures for generating genuine moral reflection among the personnel on the usage of coercive measures as well as on their effectiveness and legitimacy in the psychiatric care.

Adult↗
PubMed2005

Coercion or collaboration? Nurses doing research with people who have severe mental health problems.

Nurses should address the concerns of service users in research and engage in collaborative work with them. Doing this presents ethical dilemmas, not least around the issues of assessing capacity and informed consent to participation in research. The view that judgement regarding the capacity to consent is solely the responsibility of a consultant psychiatrist is challenged as inadequate. The concept of 'moral discourse' (Pike 1991) is used to understand the process by which the assessment of capacity may be carried out. This is illustrated by the application of the concept in a qualitative research study carried out to explore what makes mental health services accessible to women with children. The role of the mental health nurse entails surveillance and the development of expertise in negotiating compliance with treatment programmes. The paper outlines the measures taken to ensure that service users felt empowered, rather than coerced, to participate in this study. While Community Mental Health Team workers were engaged in 'moral discourse' in respect of participation by service users in the study, there were difficulties in engaging General Practitioners. However, there was evidence that women themselves felt empowered both to express interest in participating and to withdraw if they so wished.

Coercion↗
PubMed2006

Heterosocial perceptual organization: application of the choice model to sexual coercion.

Luce's (1959, 1963) choice model was used to characterize individual differences in men's perception of women's affect as friendly, sexually interested, sad, or rejecting. Women's clothing styles were associated with differences in the model's parameters. Sensitivity to sadness, rejection, and friendliness declined when women were dressed provocatively, whereas sensitivity to sexual interest increased. Provocative clothing was also associated with an increased bias to assume that positive affect was sexual interest rather than friendliness. Men at risk for perpetrating sexual aggression were less sensitive to women's affect than low-risk men were. They were also more likely than low-risk men to associate provocative clothing with sexual interest, and conservative clothing with friendliness. Results indicate that heterosocial perception may help to predict sexually coercive behavior and may be an important target for intervention.

Adolescent↗
PubMed2001

Just coercion? Detention of nonadherent tuberculosis patients.

The need to balance the rights of individuals and to protect the public health will bring with it demands for the restriction of individuals' liberty. Three points should always be considered when these measures are adopted: (1) the lack of evidence that detention benefits the public health; (2) the risk that fundamental human rights may be overridden unnecessarily; and (3) that coercive practices may act as a smokescreen for improved, but more complex or more costly, public health responses to the causes of TB control failures. The policies of New York City and England are presented, and the argument is made that neither is just.

Coercion↗
PubMed2001

Missed opportunities? Coercion or commitment: policies of prevention.

The DOTS strategy (directly observed therapy, short course) has been the cornerstone of international TB control policy since the early 1990s. This strategy has provided the international community with an advocacy tool to harness funds for TB as well as a method for helping country programs to achieve high cure rates for TB. But as much as the strategy is seen as successful by some, it is perceived as unsuccessful by others. This paper looks at the results of the introduction of DOTS into control programs and discusses research relating to direct observation of treatment. It asks how policies like DOTS are created, and how they are administered and transferred from the international to the national and finally to the local level. The discipline of public health policy is used to interrogate the creation and history of the DOTS strategy in order to find ways of aiding the transfer of the policy to national and local levels. Finally, the paper asks whether the concepts of "control" and "elimination" continue to be useful in the management of infectious diseases. We ask whether it is time to change the perspective to policies that focus more on the context of implementation and the importance of the development of care, integration, and flexibility rather than cure, targets, and short-term solutions.

Coercion↗
PubMed2003

A 15-year retrospective on sexual coercion: advances and projections.

This paper surveys the clinical and legal literature in the area of sexual offender law, policy, and research from 1987 through 2001. Eleven clinical journals, yielding approximately 12,858 articles were screened, as well as 1196 articles in law journals. Content trends over fifteen years are reported. In addition, five major areas within the sexual offender field (etiology, risk assessment, legislative management, remediation, and public policy) are examined for noteworthy changes over the past fifteen years. Advances and projections for future developments are discussed.

Child↗
PubMed2000

The morality of coercion.

The author congratulates Dr Brian Hurwitz, who recently reported the successful "intimidation" of an elderly competent widow into accepting badly needed therapy for a huge ulcerated carcinoma. He reports approvingly of the Israeli Patients' Rights Law, enacted in 1996, which demands detailed informed consent from competent patients before permitting treatment. But the law also provides an escape clause which permits coercing a competent patient into accepting life-saving therapy if an ethics committee feels that if treatment is imposed the patient will give his/her consent retroactively. He suggests this approach as an appropriate middle road between overbearing paternalism and untrammelled autonomy.

Aged↗
PubMed2006

The spectre of coercion: is public health genetics the route to policies of enforced disease prevention?

The paper discusses options for disease prevention in Public Health Genetics and attempts to assess the probability that coercive strategies might be chosen in public health policies that impose duties to undergo genetic testing. Given the social values, legal and political cultures and professional orientations in Western Europe and the United States, which provide the terms of reference for this assessment, it is unlikely that the preventive options which might emerge from human genetics in the future will trigger policies that force preventive behavior upon people, except in the cases where such enforcement is designed to protect third parties.

Abortion, Eugenic↗