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PubMedDate not supplied

An international role model for training staff in health care facilities.

This paper describes a unique experience in training the staff in the Borders Health District in Scotland in techniques to improve the quality of life of elderly people inside and out of the institution. The reader is given a concise description of the curriculum; the philosophic approach; and the methodology. The latter is of particular interest since it appeals to emotional as well as cognitive learning. These techniques are spelled out as are some of the simple exercises used to demonstrate how elderly people may feel re: specific physical and emotional handicaps. The need for and a plan for administrative support and follow up are described as well as the close relationship of education and improved services.

Aged↗
PubMed1992

Designing animals: ethical issues for genetic engineers.

Two general philosophical approaches to ethical issues in property rights are described. Instrumental approaches take property rights to be means for achieving goals such as social efficiency or economic growth. Labor approaches take property rights to be fundamental human rights that protect liberty or that assign ownership of goods based on criteria of desert. A thought experiment is used to illustrate the relevance of these theories to intellectual property. Alternative strategies for application of ethical theory to animal biotechnology are surveyed. The choice of an approach determines a burden of proof that must be met before property claims can be ethically sanctioned, but the question of which approach should be applied to animal biotechnology remains open. Ethical issues raised by unwanted consequences of biotechnology and religious objections to gene transfer are briefly summarized with emphasis on how these issues have influenced public debate on animal patents.

Animals↗
PubMed2001

"The art is long and the life short": the letters of Wilder Penfield and Harvey Cushing.

Wilder Penfield and Harvey Cushing created legacies to neurosurgery, both in terms of those they trained and in their philosophical approach to the field. Their biographies provide only brief comments on their relationship without any thorough examination of their personal correspondence. In this article the Penfield-Cushing relationship is examined through an analysis of their unpublished personal letters. The Penfield-Cushing correspondence is a treasure for neurosurgery: it provides remarkable insight into the embryonic period of the discipline and into the relationship of two of the most influential figures in modern neurosurgery.

Correspondence as Topic↗
PubMed1983

Beyond medical paternalism and patient autonomy: a model of physician conscience for the physician-patient relationship.

Medical paternalism lies at the heart of traditional medicine. In an effort to counteract the effects of this paternalism, medical ethicists and physicians have proposed a model of patient autonomy for the physician-patient relationship. However, neither paternalism or autonomy are adequate characterizations of the physician-patient relationship. Paternalism does not respect the rights of adults to self-determination, and autonomy does not respect the principle of beneficence that leads physicians to argue that acting on behalf of others is essential to their craft. A model of physician conscience is proposed that summarizes the best features of both models--paternalism and autonomy.

Beneficence↗
PubMed1994

Quality management: implementing incentive plans.

Many prominent health care organizations that have embraced the concepts of total quality management have not altered their traditional philosophical approaches of managing compensation through base pay administration. How exactly does one incent individuals to participate in the total quality management process through their paycheck? This article offers some specific models that human resource managers may use to accomplish this goal.

Employee Incentive Plans↗
PubMed2000

[The continuity of biological models in psychiatry: melancholy as brain disease in scholastic psychology].

This paper emphasizes the long lines of tradition biological concepts have in the explanation of mental disorders in classical antiquity and the middle ages; yet it also portrays rivalling theories. I describe both medical and philosophical approaches, as they merged into a quite coherent model during scholasticism. The work of Albert the Great serves as an example for this model. A last paragraph shows its plausibility for authors even of the 17th century and discusses the epistomological basis of dualistic systems.

Biological Psychiatry↗
PubMed2000

A multivariate model of determinants of motor change for children with cerebral palsy.

The purpose of this article is to describe the development of a theory- and data-based model of determinants of motor change for children with cerebral palsy. The dimensions of human functioning proposed by the World Health Organization, general systems theory, theories of human ecology, and a philosophical approach incorporating family-centered care provide the conceptual framework for the model. The model focuses on relationships among child characteristics (eg, primary and secondary impairments, personality), family ecology (eg, dynamics of family function), and health care services (eg, availability, access, intervention options). Clarification of the complex multivariate and interactive relationships among the multiple child and family determinants, using statistical methods such as structural equation modeling, is necessary before determining how physical therapy intervention can optimize motor outcomes of children with cerebral palsy. We propose that the development and testing of multivariate models is also useful in physical therapy research and in the management of complex chronic conditions other than cerebral palsy. Testing of similar models could provide physical therapists with support for: (1) prognostic discussions with clients and their families, (2) establishment of realistic and attainable goals, and (3) interventions to enhance outcomes for individual clients with a variety of prognostic attributes.

Activities of Daily Living↗
PubMed2001

Bioethics for clinicians: 27. Catholic bioethics.

There is a long tradition of bioethical reasoning within the Roman Catholic faith, a tradition expressed in scripture, the writings of the Doctors of the Church, papal encyclical documents and reflections by contemporary Catholic theologians. Catholic bioethics is concerned with a broad range of issues, including social justice and the right to health care, the duty to preserve life and the limits of that duty, the ethics of human reproduction and end-of-life decisions. Fundamental to Catholic bioethics is a belief in the sanctity of life and a metaphysical conception of the person as a composite of body and soul. Although there is considerable consensus among Catholic thinkers, differences in philosophical approach have given rise to some diversity of opinion with respect to specific issues. Given the influential history of Catholic reflection on ethical matters, the number of people in Canada who profess to be Catholic, and the continuing presence of Catholic health care institutions, it is helpful for clinicians to be familiar with the central tenets of this tradition while respecting the differing perspectives of patients who identify themselves as Catholic.

Adult↗
PubMed2001

William Osler's influence on the career of Tinsley Randolph Harrison.

In 1957, I was graduated from what was then the Medical College of Alabama, a division of the University of Alabama. It was a privilege and honor to be on Dr. Harrison's service on two occasions during my last 2 years of medical school. He was the most influential role model during my student years and has remained so throughout my professional life. I have always benefitted from his writings, his profound philosophical approach to medicine, and his numerous aphorisms. Only in later years have I come to know of the tremendous influence of William Osler on Tinsley Harrison through his father, William Groce Harrison. Unfortunately, Tinsley Harrison never knew Sir William Osler because he died the year Tinsley Harrison began his second year of medical school at Johns Hopkins. This connection is interesting from many standpoints. For instance, Osler advised Groce Harrison to make Tinsley a "teacher of medicine" when Tinsley was only 3 years old. Through the advice of his father, Tinsley followed the Oslerian tradition throughout his life. This paper presents several similarities between Osler and Harrison.

History, 20th Century↗