This edited volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organised around the main stages of the clinical encounter from the patient's perspective. This introductory chapter opens up crucial issues of methodology and of practical application in this highly innovative approach to the role of ethics in healthcare.
In this article, the question is discussed if and how HealthcareEthics Committees (HECs) should be regulated. The paper consists of two parts. First, authors from eight EC member countries describe the status quo in their respective countries, and give reasons as to the form of regulation they consider most adequate. In the second part, the country reports are analysed. It is suggested that regulation of HECs should be central and weak. Central regulation is argued to be apt (...) to improve HECs’ accountability, relevance and comparability. To facilitate biomedical citizenship and ethical reflection, regulation should at the same time be weak rather than strict. Independence of HECs to deliberate about ethical questions, and to give solicited and unsolicited advice, should be supported and only interfered with by way of exception. One exception is when circumstances become temporary adversarial to ethical deliberation in healthcare institutions. In view of European unification, steps should be taken to develop consistent policies for both Eastern and Western European countries. (shrink)
This article is intended to serve as a roadmap to help new healthcareethics leaders establish or renew an ethics program in a healthcare organization. The authors share a systemic step-by-step process for navigating this early career passage. In this paper, we describe five critical success strategies and provide explanations and concrete tools to help get you on the road to success as quickly and painlessly as possible. We will discuss how to define your role; diagnose (...) your organization’s needs; build important relationships; and develop a strategic plan for starting or revitalizing an ethics program. We also review some of the more personal challenges that may be encountered along the way, and identify social supports and self-care strategies. The advice we provide grows out of reflections on our collective experience as new ethics leaders in three Ontario healthcare organizations. (shrink)
The contribution of healthcareethics committee (HEC) members to HECs is fundamental. However, little is known about how HEC members view clinical ethics. We report results from a qualitative study of the moral psychology of HEC members. We found that contrary to the existing Kohlberg-based studies, HEC members hold a pragmatic non-expert view of clinical ethics based mainly on respect for persons and a commitment to the patient’s good. In general, HEC members hold deflationary views regarding (...) moral theory. Ethical principles are not abstract foundations but the expression of moral commitments to patients that pre-exist awareness of moral theory. Emotions and proximity to patient sufferance fundamentally shape the views of HEC members on clinical ethics. Further work at the intersection of clinical ethics and qualitative research could bring to the foreground lay perspectives on moral problems that may differ from bioethics expert views. (shrink)
One of the challenges of modern healthcareethics practice is the navigation of boundaries. Practicing healthcare ethicists in the performance of their role must navigate meanings, choices, decisions and actions embedded in complex cultural and social relationships amongst diverse individuals. In light of the evolving state of modern healthcareethics practice and the recent move toward professionalization via certification, understanding boundary navigation in healthcareethics practice is critical. Because healthcareethics is (...) endowed with many boundaries which often delineate concerns about professional expertise and authority, epistemological reflection on the relationship between theory and practice points toward the social context as relevant to the conceptualization of boundaries. The skills of social scientists may prove helpful to provide data and insights into the conceptualization and navigation of clinical ethics qua profession. Empirical ethics research, which combines empirical description (usually social scientific) with normative-ethical analysis and reflection, is a way forward as we engage and reflect upon issues which have implications for practice standards and professionalization of the role. This requires cooperative engagement of the descriptive and normative disciplines to explore our understandings of boundaries in healthcareethics practice. This will contribute to the ongoing reflection not only as we envision the professional role but to ensure that it is enacted in practice. (shrink)
This paper considers the utility of Ethnomethodology (EM) for the study of healthcareethics as part of the empirical turn in Bioethics. I give a brief introduction to EM through its respecification of sociology, the specific view on the social world this generates and EM's posture of ‘indifference’. I then take a number of EM concepts and articulate each in the context of an EM study of healthcareethics in professional practice. Having given an overview of (...) the relationship and perspective EM might bring to the professional practice of healthcareethics I consider whether and how such an approach could be deployed. Whilst an ethnographic study might be problematic I suggest a number of alternative methods through which such EM research could be accomplished. I conclude with the suggestion that, as a particular approach to sociological research, EM offers good deal of potential for the empirical study of healthcareethics in practice which could result in an improved reflexive understanding of professional ethical practices in bioethics. (shrink)
Viewing difficulty as an opportunity for learning runs counter to the common view of difficulty as a source of frustration and confusion. The aim of this article is to focus on the idea of difficulty as a stepping-off point for learning. The literature on difficulty in reading texts, and its impact on thinking and the interpretive process, serve as a foundation for the use of poetry in healthcareethics education. Because of its complexity and strangeness compared to the (...) usual scientific and clinical texts health science students encounter, poetry is an excellent means to achieve the aim of thinking through difficulties in ethics. Specific examples of teaching and learning strategies for turning difficulty into opportunities for learning are presented, including the difficulty paper and the triple mark-up method. Both methods require students to examine their process of working through difficulties, reflect on how they make sense of difficult texts and then share their process and interpretations in a collaborative manner with peers. The importance of framing difficulties as a public, visible, collaborative process rather than a personal process is emphasized. Working together to hypothesize reasons for difficulty and map out plans to come to terms with difficulty are equally relevant for reading text as they are for reading complex ethical situations. Finally, I argue that transference of this kind of personal and collaborative learning about difficulties benefits interprofessional clinical practice, particularly when dealing with ethical issues. (shrink)
In recent years, the theoretical work of Gilligan in women's psychological development has led to the development of the concept of moral orientation or moral voice in contrast to the concept of moral reasoning or moral judgment developed by Kohlberg. These concepts have been of particular interest in gender studies, especially as applied to adolescence. These concepts of moral orientation and moral reasoning are being increasingly employed in healthcareethics studies in a wide variety of settings. The recent (...) work has included studies of physicians, nurses, dentists, veterinarians, social workers, teachers of medical ethics, and hospital ethics committees. However, the study of moral development in healthcare providers has been hampered because collecting the necessary data from healthcare workers has been labor intensive and extremely time consuming. More efficient methods are needed. (shrink)
The heart-rending story of Mrs. J raises many complex ethical issues. Key elements include suffering, disagreement, culture, religion, perspective, and facts. Overarching concerns include whose voices and stories should count, the connection of pain with suffering, and how healthcareethics committees should respond.
Over the past two decades ethics committees have proliferated in healthcare institutions across the country. Catalysts for this growth include the endorsement of ethics committees by the New Jersey Supreme Court in the Quinlan case, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research in its report entitled Deciding to Forgo Life Sustaining Medical Treatment, by the U.S. Department of Health and Human Services in its 1985 “Baby Doe” regulations, by numerous (...) other courts in treatment decisionmaking opinions issued after Quinlan, and more recently by the Joint Commission on Accreditation of Healthcare Organizations. (shrink)
“Chiaroscuro” is a art technique that makes use of light and shade to suggest depth and solidity on a flat surface. I argue that the standards regarding accountability in the second edition of the Core Competencies for HealthcareEthics Consultation , are chiaroscuro, because, despite the offered lists of competencies, it is very difficult to imagine how consultants might be held accountable to such standards. It is not clear to which of the many suggested standards a consultant should (...) be held accountable, and even if one stipulates that only the tabulated competencies are meant as standards, the vague wording makes it hard to know how a consultant might fail to meet the standards or perform excellently. In addition, because terms such as “ethics” and “ethical” are not defined in the document, we are left with no way to determine whether consultants have made appropriate recommendations. The document is useful as a point of discussion, but not yet ready to serve as a tool for holding practitioners accountable. (shrink)
Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, (...) the aim of this study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved. (shrink)
Introduction to healthcareethics committees / D. Micah Hester and Toby Schonfeld -- Brief introduction to ethics and ethical theory / D. Micah Hester and Toby Schonfeld -- Ethics committees and the law / Stephen Latham -- Cultural and ...
Moral Theory and Theorizing in HealthcareEthics Content Type Journal Article Category Editorial Pages 365-368 DOI 10.1007/s10677-011-9291-x Authors Mike McNamee, College of Human and Health Sciences, Swansea, SA28PP UK Thomas Schramme, Universität Hamburg, Philosophisches Seminar, Von-Melle-Park 6, 20146 Hamburg, Germany Journal Ethical Theory and Moral Practice Online ISSN 1572-8447 Print ISSN 1386-2820 Journal Volume Volume 14 Journal Issue Volume 14, Number 4.
It is nearly two decades now since the publication of Godfrey Tangwa's article, ‘Bioethics: African Perspective’, without a critical review. His article is important because sequel to its publication in Bioethics, the idea of ‘African bioethics’ started gaining some attention in the international bioethics literature. This paper breaks this relative silence by critically examining Tangwa's claim on the existence of African bioethics. Employing conceptual and critical methods, this paper argues that Tangwa's account of African bioethics has some conceptual, methodic and (...) substantive difficulties, which altogether do not justify the idea of African bioethics, at least for now. Contra Tangwa, this article establishes that while African bioethics remains a future possibility, it is more cogent that current efforts in the name of ‘African bioethics’ be primarily re-intensified towards ‘Healthcareethics in Africa’. (shrink)
The concept of âhumane healthcareâ cannot and may not be limited to a personal virtue. For elucidating its meaning and making it functional as a critical ethical criterion for healthcare as a social institution, it is necessary to reflect on the social, cultural, and historical conditions in which modern healthcare finds its offspring and its further development. Doing this is the object and aim of social ethics. Social ethics in itself covers a broad area of different (...) approaches. A main division can be made between a liberal and a communitarian approach. This article focuses on the latter and concentrates on one of its representatives, Charles Taylor. The paper starts with two clarifying paragraphs: one about the terms humane and human, a second about the scope of social ethics. Next, because the term humane presupposes a certain view of man, attention will be paid to the lack of consensus in this respect within modernity, using some reflections of Taylor. In his view, resigning in this lack is a threat for one of the main motives behind modernity: the pursuit of a good and meaningful life. In the following section Taylor's analysis is applied to contemporary healthcare, by means of two examples. At the end the question is raised how to promote humane healthcare? In a short and conclusive sketch, three suggestions are offered for further research: scrutiny of goals and meanings within healthcare and culture, the broadening of the concept of autonomy and the upholding of human dignity as an intrinsic and imperative value. (shrink)
Background The aim of the study is to assess the knowledge, attitudes and practices among healthcare professionals in Barbados in relation to healthcareethics and law in an attempt to assist in guiding their professional conduct and aid in curriculum development. Methods A self-administered structured questionnaire about knowledge of healthcareethics, law and the role of an Ethics Committee in the healthcare system was devised, tested and distributed to all levels of staff at (...) the Queen Elizabeth Hospital in Barbados (a tertiary care teaching hospital) during April and May 2003. Results The paper analyses 159 responses from doctors and nurses comprising junior doctors, consultants, staff nurses and sisters-in-charge. The frequency with which the respondents encountered ethical or legal problems varied widely from 'daily' to 'yearly'. 52% of senior medical staff and 20% of senior nursing staff knew little of the law pertinent to their work. 11% of the doctors did not know the contents of the Hippocratic Oath whilst a quarter of nurses did not know the Nurses Code. Nuremberg Code and Helsinki Code were known only to a few individuals. 29% of doctors and 37% of nurses had no knowledge of an existing hospital ethics committee. Physicians had a stronger opinion than nurses regarding practice of ethics such as adherence to patients' wishes, confidentiality, paternalism, consent for procedures and treating violent/non-compliant patients (p = 0.01) Conclusion The study highlights the need to identify professionals in the workforce who appear to be indifferent to ethical and legal issues, to devise means to sensitize them to these issues and appropriately training them. (shrink)
BackgroundHealthcare ethics is neglected in clinical practice in LMICs such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcareethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal.MethodsThis was a cross sectional study conducted among resident doctors and ward nurses in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer’s V value (...) was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05.ResultsOur study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcareethics: Hippocratic Oath, Nuremberg code and Helsinki Declaration. A high percentage of respondents said that their major source of information on healthcareethics were lectures, books, and journals. Attitude of doctors and nurses were significantly different in 9 out of 22 questions pertaining to different aspects of healthcareethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcareethics except for need of integration of medical ethics in ungraduate curricula,paternalistic attitude of doctor was disagreed more by doctors. Notably, only few doctors stood in support of physician-assisted dying.ConclusionsSignificant proportion of doctors and nurses were unaware of three major documents on healthcareethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics. (shrink)
The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional–patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional–patient relationship and allocation of resources. To date, there (...) exists a limited focus on rural healthcareethics shown by the scarcity of rural healthcareethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcareethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcareethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcareethics through the development of evidence—informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population. (shrink)
From the beginning, a code of ethics for bioethicists has been conceived of as part of a movement to professionalise the field. In advocating for such a code, Baker repeatedly identifies 'having a code of ethics' with 'professionalization'. The American Society of Bioethics and Humanities echoes this view in their code of ethics for healthcareethics consultants 1 and the subsequent publication in the American Journal of Bioethics.2 Taking for granted that a code of (...) class='Hi'>ethics could be a valuable asset for HCECs, this essay has two aims. First, there are good reasons to doubt that the label 'profession' has significant meaning for HCECs. Attempts to accurately conceive of a profession fall into two broad camps: substantive and formal. Substantive conceptions should be rejected. Specifically, substantive conceptions beg the question about what it means to be a profession, which produces devastating problems for practical application. Formal conceptions of profession avoid begging the question, but do so at the cost of identifying the responsibilities of a profession. Using the term 'professional responsibilities', then, requires additional explication and classifying HCECs as professionals requires the identification of their role-specific responsibilities.i Second, this essay will critique the ASBH code of ethics for HCECs as a first articulation of these responsibilities. As written, this code of ethics has limited value for HCECs because most of the responsibilities identified in this code do not identify HCEC-specific responsibilities. In closing, some important strategies to improve upon this initial attempt to define the responsibilities of HCECs are identified. (shrink)
There is currently a dearth of bioethical literature presenting what might be called a more traditional approach to medicine and health care. Life and Death in HealthcareEthics promises a reasoned and clear alternative. It considers ethical concerns raised by reproduction and death and dying. The issues considered include euthanasia and withdrawal of treatment, the persistent vegetative state, abortion, cloning and in vitro fertilization. Given its clarity and simplicity the book is likely to be read eagerly by students (...) from a range of different disciplines. For those who want a basic text to introduce them to life and death issues in bioethics, this is a most welcome contribution. (shrink)
Finland is a country in Northern Europe with a population of approximately 5.1 million people. It lies between Sweden and Russia and has a border with Norway too. It is part of the European Union and also belongs to the European Monetary Union. It is a welfare state in the sense that healthcare services, schools, universities, and social services are for the most part paid for by tax-based funding. In terms of basic healthcare, the state, through local municipalities, (...) provides comprehensive coverage to all residents, and this is utilized by both the wealthy and the poor. (shrink)
Last year we reported that there are no professorships in medical ethics in Finland. This year we are happy to report that a chair in medical ethics has now been advertised at the University of Turku. We also gave details about the attempts to come up with a law on assisted reproduction. As predicted, there were problems, and eventually the proposal was withdrawn, leaving Finland still without a law on assisted reproduction. The talk on large-scale genetic databases has (...) been surprisingly quiet, and even the report published by the Parliament's working group on this matter, implying that a population database should be created, went virtually unnoticed. In this year's contribution, we address the issues of male circumcision, stem cell research, and, within the field of research ethics, the problem of defining medical research. (shrink)
Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcareethics consultation.
Efforts to professionalize the field of bioethics have led to the development of the HealthcareEthics Consultant-Certified Program intended to credential practicing healthcareethics consultants. Our team of professional ethicists participated in the inaugural process to support the professionalization efforts and inform our views on the value of this credential from the perspective of ethics consultants. In this paper, we explore the history that has led to this certification process, and evaluate the ability of the (...) HEC-C Program to meet the goals it has set forth for HCECs. We describe the benefits and weaknesses of the program and offer constructive feedback on how the process might be strengthened, as well as share our team’s experience in preparing for the exam. (shrink)
Ethics committees are the most important practical instrument of clinical ethics in Belgium and fulfil three tasks: the ethical review of experimental protocols, advising on the ethical aspects of healthcare practice, and ethics consultation. In this article the authors examine the current situation of ethics committees in Belgium from the perspective of clinical ethics. Firstly, the most important steps which thus far have been taken in Belgium are examined. Secondly, recent opinion by the Belgian (...) Advisory Committee on Bioethics with regard to ethics committees is presented and the activities of Belgian ethics committees are discussed. Finally, the option to bring research ethics and clinical ethics under the roof of just one committee is criticised using a pragmatic and a methodological argument. Concomitantly, the authors build an argument in favour of the further development of ethics consultation. (shrink)
The rural health context in the United States presents unique ethical challenges to its approximately 60 million residents, who represent about one quarter of the overall population and are distributed over three-quarters of the country’s land mass. The rural context is not only identified by the small population density and distance to an urban setting but also by a combination of social, religious, geographical, and cultural factors. Living in a rural setting fosters a sense of shared values and beliefs, a (...) strong work ethic, self-reliance, and a tendency for close-knit extended social structures where overlapping relationships are commonplace. (shrink)
One element of the American Society for Bioethics and Humanities’ recently-piloted quality attestation portfolio for clinical ethics consultants is a “philosophy of clinical ethics consultation statement” describing the candidate’s approach to clinical ethics consultation. To date, these statements have been under-explored in the literature, in contrast to philosophy statements in other fields such as academic teaching. In this article, I argue there is merit in expanding the content of these statements beyond clinical ethics consultation alone to (...) describe the author’s approach to other important “domains” of healthcareethics practice. I also claim such statements have at least three additional uses outside quality attestation: as a reflective practice learning tool to increase role clarity among practicing healthcare ethicists and bioethics fellows; assisting practicing healthcare ethicists in clarifying role expectations with those they work with; and helping inform developing professional practice standards. (shrink)
Healthcareethics committees, physicians, surgeons, nurses, families, and patients themselves are constantly under pressure to make appropriate medically ethical decisions concerning patient care. Various models for healthcareethics decisions have been proposed throughout the years, but by and large they are focused on making the initial ethical decision. What follows is a proposed model for healthcareethics that considers the most appropriate decisions before, during, and after any intervention. The Just War Tradition is a (...) model that is thorough in its exploration of the ethics guiding a nation to either engage in or refuse to engage in combatant actions. In recent years, the Just War Tradition has expanded beyond the simple consideration of going to war or not to include how the war is conducted and what the post-war phase would look like ethically. This paper is an exploration of a healthcareethics decision making model using the tenets of the Just War Tradition as a framework. It discusses the initial consult level of decision making prior to any medical intervention, then goes further in considering the ongoing ethical paradigm during medical intervention and post intervention. Thus, this proposal is a more holistic approach to healthcareethics decision making that encourages healthcareethics committees to consider alternate models and ways of processing so that ultimately what is best for patient, family, staff, and the environment is all taken into consideration. (shrink)
Until recently, business issues in healthcare organizations were relatively insulated from clinical issues, for several reasons. The hospital at earlier stages of its development operated on a combination of charitable and equitable premises, allowing for providing care to be separated from financial support. Physicians, who were primarily responsible for clinical care, constituted an independent power nexus within the hospital and were governed by their own professional codes of ethics. In exchange for a great deal of control over their (...) conditions of practice, they took almost complete responsibility for patient care. Thus clinical and professional ethics could to some extent be compartmentalized from the business issues—a much easier feat when, as in much of the last few decades, virtually all care was reimbursed from some source or other. In addition, many HCOs were not categorized or treated as businesses, although of course they were presumed to be governed by the same expectation for good management as any other organization. (shrink)
Healthcareethics has become part of the standard curriculum of students in the health professions. The goals of healthcareethics education are to give students the skills they need to identify, assess, and address ethical issues in clinical practice and to develop virtuous practitioners. Incorporating the medical humanities into medical school, for example, is intended to foster empathy and professionalism among students and to provide mechanisms for enhanced physician well-being. Yet, despite the long-standing inclusion of the (...) humanities in nursing curricula, increases in the amount and kinds of scientific knowledge essential for clinical practice has resulted in the erosion of the “humanistic arts” from nursing education. One potential solution to this challenge comes with the increase in interprofessional education, where students in a variety of healthcare professions programs come together to learn about issues common to all healthcare fields. (shrink)
Bioethics, clinical ethics, and professional ethics are mature, well-developed fields of applied ethics that focus on medical research, patient autonomy and patient care, patient–healthcare professional relationships, and issues that arise in clinical and other medical settings. However, despite these developments, little attention has been paid to the organizational aspects of healthcare in these fields. This is surprising, because in the last 30 years healthcare has become more and more institutionalized in provider, management, and insurer (...) organizations. Despite JCAHO's preoccupation with organizational ethics during the last decade, the philosophical underpinnings of their requirements have been less explored in the literature. Clinical ethics remains preoccupied with clinical patient care and professional ethics with individual professional guidelines; even the American College of Healthcare Executives focuses primarily on healthcare managers, not on healthcare organizations. (shrink)
As the structure of healthcare delivery undergoes a breathtaking transformation, many ethics committees are wondering how and if they will be affected. Although the impact has not yet been widely felt, hospital-based ethics committees cannot avoid the pressures and upheaval caused by the reorganization of healthcare. This article will briefly review some of the factors contributing to the transformation of medicine, and suggest a number of ways in which ethics committees can respond proactively.
A common financial model used in business decisions is the cost/benefit comparison. The costs of a proposed project are compared with the benefits, and if the benefits outweigh the costs, the project is accepted; if the costs exceed the benefits, the project is rejected. This model is applicable when tangible costs and benefits can be reasonably measured in monetary units. However, it is difficult to consider intangible factors in this model because intangible factors cannot be readily quantified in money.While some (...) might argue that the financial model should not apply to healthcare decisions, the fact is that costs do enter into the picture. People may decide to forego needed healthcare because they cannot afford it. Healthcare providers may make choices based in part on the costs of diagnosis and treatment, rather than solely on medical information and what is best for the patient. Should financial issues enter into healthcare decisions – decisions about human health and well being? If so, how should the costs and benefits be measured and evaluated? What are some ethical issues and dilemmas involved in such decisions? (shrink)
What is health policy for? In Health and the Good Society, Alan Cribb addresses this question in a way that cuts across disciplinary boundaries. His core argument is that biomedical ethics should draw upon public health values and ethics; specifically, he argues that everybody has some share of responsibility for health, including a responsibility for promoting greater health equality. In the process, Cribb argues for a major rethink of the whole project of health education.
This volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organized around the main stages of the clinical encounter from the patient's perspective. They run from staying well and 'first contact' through to either recovery or to long-term illness, death and dying.
As national and state health care policy -making becomes contentious and complex, there is a need for a forum to debate and explore public concerns and values in health care, give voice to local citizens, to facilitate consensus among various stakeholders, and provide feedback and direction to health care institutions and policy makers. This paper explores the role that regional health care ethics committees can play and provides two contrasting examples of Networks involved in facilitation of public input into (...) and the development of health care policies and adoption of state-wide practices. (shrink)
Role conflict occurs when a job possesses inconsistent expectations incongruent with individual beliefs, a situation that precipitates considerable frustration and other negative work outcomes. Increasing interest in processes that reduce role conflict is, therefore, witnessed. With the help of information collected from a large sample of individuals employed at an education-based healthcare institution, this study identified several factors that might decrease role conflict, namely mindfulness and organizational ethics. In particular, the results indicated that mindfulness was associated with decreased (...) role conflict, and that perceived ethical values and a shared ethics code were associated with decreased role conflict and increased mindfulness. Despite the study's limitations, these findings imply that companies might better manage role conflict through the development of mindfulness and organizational ethics. (shrink)