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Results for “Ethical Analysis”

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At least 127 records · Page 7Linked to original sources
PubMed2003

Ethical analysis of withdrawal of pacemaker or implantable cardioverter-defibrillator support at the end of life.

OBJECTIVE: To describe a series of terminally ill patients who requested (or whose surrogates requested) withdrawal of pacemaker or implantable cardioverter-defibrillator (ICD) support and the ethical issues pertaining to these requests. PATIENTS AND METHODS: We performed a retrospective review of the medical records of patients seen at the Mayo Clinic in Rochester, Minn, between January 1996 and June 2002 and identified 6 terminally ill patients who requested (or whose family members requested) withdrawal of pacemaker or ICD support. Potential interventions were an ethics consultation and subsequent withdrawal of pacemaker or ICD support. The study's main outcome measures were death and the context in which it occurred. RESULTS: The mean age of the 6 patients (3 men, 3 women) was 75.5 years. Five had pacemakers, and 1 had an ICD. Five patients had advance directives that indicated a desire to withdraw medical interventions if death was inevitable. Two patients and 4 surrogates requested withdrawal of pacemaker or ICD support. One patient died without withdrawal of support despite an ethics consultation that endorsed its permissibility. Another died while an ethics consultation was in progress. The request to withdraw support was granted in 4 patients, all of whom died within 5 days of withdrawal of support. CONCLUSIONS: Granting terminally ill patients' requests to withdraw unwanted medical support is legal and ethical. Death after withdrawal of support is attributable to the patient's underlying pathology and is not the same as physician-assisted suicide or euthanasia. Clinician familiarity with these concepts may lead to more expeditious withdrawal of unwanted medical support from terminally ill patients.

Aged↗
PubMed2001

The Manchester Siamese twins case--a French ethical analysis.

Conjoined twins were born on 8th August 2000 in Manchester. After a 2-month period of legal fighting between their parents and the medical team, which was widely reported in the media, the twins were surgically separated on 7th November 2000. This case-report scrutinises the ethical dilemma from a fresh perspective.

England↗
PubMed2003

Involuntary sterilization of persons with mental retardation: an ethical analysis.

Legitimate concerns on the part of parents and guardians may lead to requests for sterilization of a mentally retarded person in their care. At the same time, mentally retarded persons must be protected from actions that do not serve their best interests. This paper will review the history of involuntary sterilization in the United States and evaluate the ethical arguments that are relevant to decisions about involuntary sterilization. While other, less permanent forms of contraception might be acceptable, involuntary sterilization ought not be performed on mentally retarded persons who retain the capacity for reproductive decision-making, the ability to raise a child, or the capacity to provide valid consent to marriage. Mentally retarded persons who lack capacity in those three areas should be considered for involuntary sterilization only when the procedure is necessary, sterilization would serve the best interests of the mentally retarded person, less intrusive and temporary methods of contraception or control of menstruation are not acceptable alternatives, and procedural safeguards have been implemented to assure a fair decision-making process.

Humans↗
PubMed1992

HIV testing: an ethical analysis.

As the epidemic of the human immunodeficiency virus continues to grow, the relationship between patients and health care workers is being tainted with fear and mistrust. The demand for mandatory testing of health care providers has caused many of us to assess our basic values of autonomy, beneficence, nonmaleficence, and justice. Is our "right to privacy" more important than our "right to know"? This article will analyze some of the legal, moral, and ethical issues to be considered in identifying possible alternatives and a justified solution to this dilemma.

AIDS Serodiagnosis↗
PubMed1985

An ethical analysis of double bind conflicts as experienced by care workers feeding severely demented patients.

When patients with incurable dementia diseases no longer take food or fluid voluntarily, the care workers experience distress and anxiety. Thirty-nine care workers were interviewed about their thoughts, feelings and attitudes towards feeding severely demented patients. A phenomenological approach was used and the interviews were developed, attention paid to Bateson's double bind theory, Kohlberg's theory of moral development and ethical theories. Ethical theories, principles and rules, containing messages at different logical levels and the lack of empirical knowledge of the demented patients' inner world, led to the care worker's difficult double bind situations. To solve the conflicts the care workers need insight in all aspects of the problem. In order to understand all the components in a double bind situation it is important to redefine it from outside.

Beneficence↗
PubMedDate not supplied

Referencing in transcultural nursing: an ethical analysis.

The increasing emphasis placed on transcultural care among clinicians and educators, coupled with the lack of original research in this field, has led to a number of articles in journals and books that are poorly researched and referenced. Authors have a responsibility to critically review primary sources rather than rely on secondary sources that can be erroneous. Having established a unique contribution to the transcultural literature, nurse authors and educators have a responsibility to maintain high professional and ethical standards when disseminating information to readers.

Bibliographies as Topic↗
PubMed1992

Purchasing practices in a hospital environment: an ethical analysis.

The critical state of the hospital industry, as previously described, generates a difficult decision environment for the materiel manager and those in the purchasing function. The unique life- and death circumstances of hospitals impose a further onus on those who manage them. In the name of saving lives, they can find a convenient excuse to disregard all moral principles, forgetting the Socratic dictum "it is not enough that one lives, but that one lives well." Without the moral "right stuff," they can easily give in to the seductions of momentary gains and glory through ethical short-cuts. There is wisdom and consolation in the words that "nice guys may appear to finish last, but usually they're running in a different race." Studies have established a direct relationship between corporate excellence and ethical values. The reality of competition in the hospital industry dictates that the integration of ethics into the life of the organization should happen by design and not by accident. This is what is meant by strategy. If hospitals would strive for excellence to survive and grow, they should have a strategy with a mission statement that also embodies its moral values and moral agenda. Such an approach does not guarantee that an organization will become immune to moral contamination, but it does provide an antidote.

Civil Rights↗
PubMed1992

AIDS, nursing and occupational risk: an ethical analysis.

This paper examines the notion of risk assessment in relation to nursing patients with HIV infection or AIDS. Risk assessment consists in examining three features of a given hazard; its magnitude, its probability, and its acceptability. In relation to the last of these, an 'acceptability threshold' can be identified. If contact with HIV-infected patients is perceived to pass this threshold, nurses may seek to abrogate the usual 'duty to treat'. Rather than endeavour to pinpoint this threshold, the paper explores some of the factors which may either raise or lower it, and their ethical implications. In particular, the consequences of setting a high threshold, and thereby limiting or avoiding contact with patients infected with HIV, are examined. In this debate, the burden of proof is seen as resting firmly on nurses themselves, not on the patients at risk of being deprived of care.

Acquired Immunodeficiency Syndrome↗
PubMed2005

An ethical analysis of exception from informed consent regulations.

Federal regulations enacted in 1996 allow clinical research with an exception from informed consent in select emergency circumstances. Such research is only permitted when the therapy may directly benefit the research participant and it is not possible to conduct the research with informed consent. Among others, protective mechanisms include a process of community consultation and public disclosure and the establishment of a mandatory data safety monitoring board. Although the regulations do not preserve the right of self-determination of the research participant, the author argues that they do provide an ethical means to advance the science of resuscitation.

Beneficence↗
PubMed1997

Smoking cessation programme: an ethical analysis.

Many midwives feel it is their moral duty to advise and help pregnant smokers to stop smoking Do midwives have the right to persuade or coerce pregnant smokers to stop smoking? Giving information is not sufficient to help clients to make informed choice Smokers need help to acquire necessary skills to raise self-esteem and assertiveness to make informed decisions Many women use smoking as a coping strategy to ensure their own mental well-being and that of their families The majority of women smokers are among the lower socio-economic groups It is essential for midwives to develop strategies that are sensitive and pertinent to the smokers' psychological and socio-economic needs Is it ethical or practical to enforce a total non-smoking policy in a maternity unit? As individuals, pregnant smokers have a 'right' to smoke Pregnant smokers smoke more on admission to hospital Illicit smoking will subject non-smokers to passive smoking and increase incidence of fire hazards It is essential to provide a well ventilated smoking-room, thereby respecting the rights of both smokers and non-smokers.

Ethics, Nursing↗
PubMed2002

Termination of pregnancy with a prenatal diagnosis of cleft lip: cultural differences and ethical analysis.

In some societies, an isolated cleft lip may be a defect that is considered more serious and may ultimately warrant more decisive intervention such as abortion. While the individual nurse may have come to appreciate cleft lip as surgically correctable, it is important to provide care with sensitivity to both the culture and societal systems that are the family's foundation for beliefs and support.

Abortion, Induced↗