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PubMed2005

Intellectual property and pharmaceutical drugs: an ethical analysis.

The pharmaceutical industry has in recent years come under attack from an ethical point of view concerning its patents and the non-accessibility of life-saving drugs for many of the poor in both less developed countries and in the United States. The industry has replied with economic and legal justifications for its actions. The result has been a communication gap between the industry on the one hand and poor nations and American critics on the other. This paper attempts to present and evaluate the arguments on all sides and suggests a possible way out of the current impasse. It attempts to determine the ethical responsibility of the drug industry in making drugs available to the needy, while at the same time developing the parallel responsibilities of individuals, governments, and NGOs. It concludes with the suggestion that the industry develop an international code for its self-regulation.

Developed Countries↗
PubMed1998

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau.

Nursing typically has been viewed as a moral practice, for instance by new developments in the ethics of care. Nevertheless, many philosophical-ethical presuppositions of nursing theories remain to be clarified. This paper presents a philosophical-ethical analysis of the work of Hildegard E. Peplau. Analysis of the philosophical-ethical background of Peplau's works illuminates a view on nursing practice that is relevant today. Three main components are analysed more deeply, i.e. the professionalization of nursing, the philosophical underpinnings of Peplau's view on nursing science, and the nurse-patient relationship as the central event in nursing.

Ethics, Nursing↗
PubMedDate not supplied

Ethical analysis.

Critical care nurses care for patients at the end of their lives on a daily basis. Ethical dilemmas are often encountered while caring for these patients and their families. This article reviews a case scenario along with a framework for ethical analysis.

Advance Directives↗
PubMed1988

The standard of care: a case report and ethical analysis.

Physicians increasingly allow their perceived legal responsibilities to displace their clinical judgment. Misunderstandings that surround the term "standard of care" have encouraged fears of liability and have led to the practice of defensive medicine. Physicians may consider the standard of care to be a technical or legal obligation, but an optimal standard would be one based on detailed knowledge of a patient's medical history and personal condition. It would include the physician's clinical judgment, which integrates specific technical and legal information with clinical experience in caring for patients. Occasionally, such judgment may conflict with the rulings of a court, which considers technical and legal information without the benefit of clinical judgment. Physicians must be prepared to be advocates for their patients, especially when legal proceedings are flawed or injurious. Systematic processes of examination and analysis, such as those used by ethics consultants, can help resolve questions about the standard of care.

Aged↗
PubMed2003

Actor-network theory: a tool to support ethical analysis of commercial genetic testing.

Social, ethical and policy analysis of the issues arising from gene patenting and commercial genetic testing is enhanced by the application of science and technology studies, and Actor-Network Theory (ANT) in particular. We suggest the potential for transferring ANT's flexible nature to an applied heuristic methodology for gathering empirical information and for analysing the complex networks involved in the development of genetic technologies. Three concepts are explored in this paper--actor-networks, translation, and drift--and applied to the case of Myriad Genetics and their commercial BRACAnalysis genetic susceptibility test for hereditary breast cancer. Treating this test as an active participant in socio-technical networks clarifies the extent to which it interacts with, shapes and is shaped by people, other technologies, and institutions. Such an understanding enables more sophisticated and nuanced technology assessment, academic analysis, as well as public debate about the social, ethical and policy implications of the commercialization of new genetic technologies.

Breast Neoplasms↗
PubMed2002

The goals of psychiatric rehabilitation: an ethical analysis.

This study addressed the question under what conditions ought client-centered psychiatric rehabilitation work towards goals set by its clients. This was done by means of an ethical analysis of goal setting in psychiatric rehabilitation, using standard ethical principles of health care and a case study for illustration. The analysis demonstrated that client-centered psychiatric rehabilitation ought to work towards goals set by its clients under the conditions that they not involve serious danger and are not induced by severe mental impairment. When these conditions are not fulfilled, it may be most helpful to engage the clients in critical dialogue so as to reach an agreement regarding the setting of goals for their psychiatric rehabilitation. Special ways of engaging clients with severe mental impairments in such dialogue may have to be explored.

Adult↗
PubMed1986

An ethical analysis of the policies of British community and hospital care for mentally ill people.

Scant consideration has been given to the ethical implications of the policy of closing down psychiatric hospitals in favour of community care. The recent adherents of this policy in government have been enthusiastic in encouraging its implementation. This paper has three sections: a brief resumé of the history and principles of community care for the mentally ill; a discussion on the merits and de-merits of psychiatric care in the hospital and in the community; and an outline of some preliminary categories for ethical analysis.

Community Mental Health Services↗
PubMed1994

Transcultural nursing ethics: a framework and model for transcultural ethical analysis.

Increased awareness of cultural diversity in contemporary society and nursing mandates the need for transcultural nursing ethics. The core of this ethics assumes that all discourse and interaction is transcultural because of strengths and differences in values and beliefs of individuals and groups within global society. Transcultural ethics addresses how people ought to live when subjectively sharing a common world. This article presents a framework and model with four parts: Transcultural Caring Dynamics, Principles, Transcultural Context, and Universal Source. These incorporate the ethics of virtue, principle, values, and belief, respectively. Interactive parts of the holistic process provide the foundation for assessing and analyzing transactions to facilitate understanding and direction toward culturally based ethical decision making.

Beneficence↗
PubMed1983

A model for organizing an ethical analysis of the discharge planning process.

This paper presents a model for identifying, clarifying and analyzing the ethical dilemmas inherent in the discharge planning process of the chronically impaired older person from an acute care hospital to the community or an institution. From the myriad of moral quandaries that patients, families and service providers face in the process, this paper will address two categories of questions. The first concerns the conflict between provider paternalism and client autonomy. The second question involves distributive justice and the allocation of scarce resources. Two cases at different stages of the identification, assessment and disposition process will be examined in order to identify the morally relevant facts and persons, possible alternatives and competing values and ethical principles.

Aged↗
PubMed2006

Ethical analysis of HPV vaccine policy options.

Vaccines against human papillomavirus (HPV) may soon be licensed. In contrast to most vaccine-preventable diseases, which are transmitted by air or casual contact, HPV is primarily transmitted by sexual contact. An analysis that applies ethical theories, such as utilitarianism, rule of double effect, and principlism, is needed for policy considerations. These analyses reveal that HPV vaccination can be recommended universally, including at ages 11-12 years. However, given concerns for autonomy, justice, as not all persons are at risk, and non-maleficence, HPV vaccine should not be mandated for school entry. Economic justice indicates a need to provide vaccination for the disadvantaged.

Ethical Theory↗
PubMed2005

Ethical analysis of living organ donation.

In 2003, the first 3-way living kidney donor-swap was performed at Johns Hopkins Hospital in Baltimore, Md. Three new donor protocols includingpaired donation now allow unrelated individuals to serve as donors. Some ethicists have suggested that emotionally unrelated individuals not be permitted to donate because they will not experience the same satisfaction that a family member who is a donor experiences. Others who frame living donation as an autonomous choice do not see emotionally unrelated or even nondirected donation as ethically problematic. This article uses an ethical framework of principlism to examine living donation. Principles salient to living donation include autonomy, beneficence, and nonmaleficence. The following criteria are used to evaluate autonomous decision making by living donors, including choices made (1) with understanding, (2) without influence that controls and determines their action, and (3) with intentionality. Empirical work in these areas is encouraged to inform the ethical analysis of the new living donor protocols.

Altruism↗
PubMed2004

Sham surgery: an ethical analysis.

Surgical clinical trials have seldom used a "sham" or placebo surgical procedure as a control, owing to ethical concerns. Recently, several ethical commentators have argued that sham surgery is either inherently or presumptively unethical. In this article I contend that these arguments are mistaken, and that there are no sound ethical reasons for an absolute prohibition of sham surgery in clinical trials. Reflecting on three cases of sham surgery, especially on the recently reported results of a sham-controlled trial of arthroscopic surgery for arthritis of the knee, I present an ethical analysis that focuses on the methodological rationale for use of sham surgery, risk-benefit assessment, and informed consent.

Angina Pectoris↗
PubMed1988

Age as a basis for allocating lifesaving medical resources: an ethical analysis.

In light of the growing prominence of an age criterion in patient selection, it is essential to scrutinize the ethical legitimacy of arguments being offered both for and against using age as a criterion. Accordingly, the present study first explores the primary justifications for an age criterion, then examines the criterion's weaknesses. Weaknesses are grouped into two areas: deficiencies in the justifications of the criterion, and overarching critiques. Finally, a way forward in the midst of the present controversy is suggested. The study's conclusion is that an age criterion per se is unjustified, though age may play a carefully defined role in medical assessments relevant to patient selection.

Age Factors↗
PubMedDate not supplied

An ethical analysis of student-faculty interactions.

Senior nursing students described their interactions with faculty in a journal writing assignment. These interactions were categorized by the ethical perspectives of justice, autonomy, beneficence, and caring. An ethical analysis of faculty-student interactions is a strategy that may help nursing faculty and students understand differing perceptions about their relationships.

Attitude↗