Results for 'Patient best interest'

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  1. Free Choice and Patient Best Interests.Emma C. Bullock - 2016 - Health Care Analysis 24 (4):374-392.
    In medical practice, the doctrine of informed consent is generally understood to have priority over the medical practitioner’s duty of care to her patient. A common consequentialist argument for the prioritisation of informed consent above the duty of care involves the claim that respect for a patient’s free choice is the best way of protecting that patient’s best interests; since the patient has a special expertise over her values and preferences regarding non-medical goods she (...)
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  2.  48
    The Best Interest Standard: Both Guide and Limit to Medical Decision Making on Behalf of Incapacitated Patients.Thaddeus Mason Pope - 2011 - Journal of Clinical Ethics 22 (2):134-138.
    In this issue of JCE, Douglas Diekema argues that the best interest standard (BIS) has been misemployed to serve two materially different functions. On the one hand, clinicians and parents use the BIS to recommend and to make treatment decisions on behalf of children. On the other hand, clinicians and state authorities use the BIS to determine when the government should interfere with parental decision-making authority. Diekema concedes that the BIS is appropriately used to “guide” parents in making (...)
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  3.  46
    End-of-life decision making in Taiwan: healthcare practice is rooted in local culture and laws that should be adjusted to patients' best interests.Siew Tzuh Tang - 2013 - Journal of Medical Ethics 39 (6):387-388.
    The observed Taiwanese neonatal professionals' more conservative attitudes than their worldwide colleagues towards end-of-life (EOL) decision making may stem from cultural attitudes toward death in children and concerns about medicolegal liability. Healthcare practice is rooted in local culture and laws; however that should be adjusted to patients' best interests. Improving Taiwanese neonatal professionals' knowledge and competence in EOL care may minimize ethical dilemmas, allow appropriate EOL care decision making, avoid infants' suffering, and ease parents' bereavement grief.
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  4.  9
    Marginally Represented Patients, Best Interests, and Ends-in-Themselves.Peter Shiu-Hwa Tsu - 2020 - American Journal of Bioethics 20 (2):57-59.
    Volume 20, Issue 2, February 2020, Page 57-59.
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  5.  54
    The best interests of persistently vegetative patients: to die rather that to live?Tak Kwong Chan & George Lim Tipoe - 2014 - Journal of Medical Ethics 40 (3):202-204.
    Adults without the capacity to make their own medical decisions have their rights protected under the Mental Capacity Act in the UK. The underlying principle of the court's decisions is the best interests test, and the evaluation of best interests is a welfare appraisal. Although the House of Lords in the well-known case of Bland held that the decision to withhold treatment for patients in a persistent vegetative state should not be based on their best interests, judges (...)
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  6.  22
    In the patient’s best interest: appraising social network site information for surrogate decision making.Shahla Siddiqui & Voo Teck Chuan - 2018 - Journal of Medical Ethics 44 (12):851-856.
    This paper will discuss why and how social network sites ought to be used in surrogate decision making (SDM), with focus on a context like Singapore in which substituted judgment is incorporated as part of best interest assessment for SDM, as guided by the Code of Practice for making decisions for those lacking mental capacity under the Mental Capacity Act (2008). Specifically, the paper will argue that the Code of Practice already supports an ethical obligation, as part of (...)
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  7.  6
    Patient’s best interest as viewed by nursing students.Yusrita Zolkefli & Colin Chandler - forthcoming - Nursing Ethics.
    Background In recent years, patient advocacy has emerged as a prominent concept within healthcare. How nursing students decide what is best for their patients is not well understood. Objective The objective is to examine nursing students' views on doing what is best for patients during their clinical experiences and how they seek to establish patient interests when providing care. Research questions guiding the interview were as follows: (1) What are nursing students' perceptions of patient interests? (...)
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  8.  17
    Can ‘Best Interests’ derail the trolley? Examining withdrawal of clinically assisted nutrition and hydration in patients in the permanent vegetative state.Zoe Fritz - 2017 - Journal of Medical Ethics 43 (7):450-454.
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  9. Determining best interests in patients who lack capacity to decide for themselves.Anne-Marie Slowther - 2007 - Clinical Ethics 2 (1):19-21.
  10.  43
    Are physicians obligated always to act in the patient's best interests?D. Wendler - 2010 - Journal of Medical Ethics 36 (2):66-70.
    The principle that physicians should always act in the best interests of the present patient is widely endorsed. At the same time, and often within the same document, it is recognised that there are appropriate exceptions to this principle. Unfortunately, little, if any, guidance is provided regarding which exceptions are appropriate and how they should be handled. These circumstances might be tenable if the appropriate exceptions were rare. Yet, evaluation of the literature reveals that there are numerous exceptions, (...)
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  11. In the patient's best interest. Law and professional conduct.A. P. Young - 1994 - In Geoffrey Hunt (ed.), Ethical Issues in Nursing. Routledge. pp. 164--179.
     
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  12.  35
    Best Interests in the MCA 2005—What can Healthcare Law Learn from Family Law?Shazia Choudhry - 2008 - Health Care Analysis 16 (3):240-251.
    The ‘best interests’ standard is a highly seductive standard in English law. Not only does it appear to be fairly uncontroversial but it also presents as the most sensible, objective and ‘fair’ method of dealing with decision making on behalf of those who are perceived to be the most vulnerable within society. This article aims to provide a critical appraisal of how the standard has been applied within family law, to outline how the standard is to be applied within (...)
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  13.  40
    Surrogate decision making for unrepresented patients: Proposing a harm reduction interpretation of the best interest standard.Nada Gligorov & Phoebe Friesen - 2020 - Clinical Ethics 15 (2):57-64.
    Unrepresented patients are individuals who lack decision makingcapacity and have no family or friends to make medical decisions for them. This population is growing in number in the United States, particularly within emergency and intensive care settings. While some bioethical discussion has taken place in response to the question of who ought to make decisions for these patients, the issue of how surrogate medical decisions ought to be made for this population remains unexplored. In this paper, we argue that standard (...)
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  14.  67
    Doctor? Who? Nurses, patient's best interests and treatment withdrawal: when no doctor is available, should nurses withdraw treatment from patients?Giles Birchley - 2013 - Nursing Philosophy 14 (2):96-108.
    Where a decision has been made to stop futile treatment of critically ill patients on an intensive care unit – what is termed withdrawal of treatment in the UK – yet no doctor is available to perform the actions of withdrawal, nurses may be called upon to perform key tasks. In this paper I present two moral justifications for this activity by offering answers to two major questions. One is to ask if it can be in patients' best interests (...)
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  15.  40
    Applying best interests to persistent vegetative state--a principled distortion?A. J. Fenwick - 1998 - Journal of Medical Ethics 24 (2):86-92.
    "Best interests" is widely accepted as the appropriate foundation principle for medico-legal decisions concerning treatment withdrawal from patients in persistent vegetative state (PVS). Its application appears to progress logically from earlier use regarding legally incompetent patients. This author argues, however, that such confidence in the relevance of the principle of best interests to PVS is misplaced, and that current construction in this context is questionable on four specific grounds. Furthermore, it is argued that the resulting legal inconsistency is (...)
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  16.  48
    Authenticity, Best Interest, and Clinical Nudging.Søren Holm - 2017 - Hastings Center Report 47 (2):38-40.
    In this issue of the Hastings Center Report, Moti Gorin, Steven Joffe, Neal Dickert, and Scott Halpern offer a comprehensive defense of the use of nudging techniques in the clinical context, with the aim of promoting the best interests of patients. Their argument is built on three important claims: Nudging is ubiquitous and inescapable in clinical choice situations, and there is no neutral way of informing patients about their treatment choices; many patients do not have authentic preferences concerning their (...)
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  17.  13
    Reframing “The Patient's Best Interest”: The Burden of The Caregiver.Rhashedah Ekeoduru & Rebecca Lunstroth - 2018 - American Journal of Bioethics 18 (1):67-69.
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  18.  9
    Ethical Oversight: Serving the Best Interests of Patients.Joe V. Selby & Harlan M. Krumholz - 2013 - Hastings Center Report 43 (s1):34-36.
    The papers by Nancy Kass, Ruth Faden, and colleagues describe an ethical imperative to study clinical care as it is being delivered. The goal of learning from each patient is attractive, but integrating research and clinical practice is not easy. The authors suggest that the bioethical framework in use for the past forty years to oversee clinical research may be as much an impediment to the development of a learning health care system as a means of protecting the interests (...)
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  19. In the Patient's Best Interest-A Call to Action, A Call to Balance.Norma J. Hirsch - 2002 - Bioethics Forum 18:24-29.
     
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  20.  11
    Ethical oversight: serving the best interests of patients. Commentary.J. V. Selby & H. M. Krumholz - forthcoming - Hastings Center Report.
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  21.  40
    Best interests versus resource allocation: could COVID-19 cloud decision-making for the cognitively impaired?Jordan A. Parsons & Harleen Kaur Johal - 2020 - Journal of Medical Ethics 46 (7):447-450.
    The COVID-19 pandemic is putting the NHS under unprecedented pressure, requiring clinicians to make uncomfortable decisions they would not ordinarily face. These decisions revolve primarily around intensive care and whether a patient should undergo invasive ventilation. Certain vulnerable populations have featured in the media as falling victim to an increasingly utilitarian response to the pandemic—primarily those of advanced years or with serious existing health conditions. Another vulnerable population potentially at risk is those who lack the capacity to make their (...)
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  22.  10
    Ethical oversight : serving the best interests of patients.Joe V. Selby & Harlan M. Krumholz - 2013 - In Mildred Z. Solomon & Ann Bonham (eds.), Ethical Oversight of Learning Health Care Systems. Wiley-Blackwell. pp. 34-36.
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  23.  23
    Using best interests meetings for people in a prolonged disorder of consciousness to improve clinical and ethical management.Derick T. Wade - 2018 - Journal of Medical Ethics 44 (5):336-342.
    Current management of people with prolonged disorders of consciousness is failing patients, families and society. The causes include a general lack of concern, knowledge and expertise; a legal and professional framework which impedes timely and appropriate decision-making and/or enactment of the decision; and the exclusive focus on the patient, with no legitimate means to consider the broader consequences of healthcare decisions. This article argues that a clinical pathway based on the principles of the English Mental Capacity Act 2005 and (...)
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  24.  61
    Deciding Together? Best Interests and Shared Decision-Making in Paediatric Intensive Care.Giles Birchley - 2014 - Health Care Analysis 22 (3):203-222.
    In the western healthcare, shared decision making has become the orthodox approach to making healthcare choices as a way of promoting patient autonomy. Despite the fact that the autonomy paradigm is poorly suited to paediatric decision making, such an approach is enshrined in English common law. When reaching moral decisions, for instance when it is unclear whether treatment or non-treatment will serve a child’s best interests, shared decision making is particularly questionable because agreement does not ensure moral validity. (...)
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  25.  67
    Best Interest: A Philosophical Critique. [REVIEW]Søren Holm & Andrew Robert Edgar - 2008 - Health Care Analysis 16 (3):197-207.
    On one conception of “best interest” there can only be one course of action in a given situation that is in a person’s best interest. In this paper we will first consider what theories of “best interest” and rational decision-making that can lead to this conclusion and explore some of the less commonly appreciated implications of these theories. We will then move on to consider what ethical theories that are compatible with such a view (...)
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  26.  27
    Best interests, dementia, and end of life decision-making: the case of Mrs S.Rosalind McDougall - 2005 - Monash Bioethics Review 24 (3):36-46.
    In this paper, I present an ethical analysis of the case of an elderly woman with dementia, Mrs S. The hospital treating Mrs S sought to cease her dialysis treatment despite Mrs S’s family’s protestations that continuing the treatment was in her best interests. Assuming Brock’s framework as a theoretical background, I consider the case in terms of three questions. Firstly, was ‘best interests ’ the appropriate basis for deciding on a course of action in this situation? Secondly, (...)
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  27.  61
    The theorisation of ‘best interests’ in bioethical accounts of decision-making.Giles Birchley - 2021 - BMC Medical Ethics 22 (1):1-18.
    Background Best interests is a ubiquitous principle in medical policy and practice, informing the treatment of both children and adults. Yet theory underlying the concept of best interests is unclear and rarely articulated. This paper examines bioethical literature for theoretical accounts of best interests to gain a better sense of the meanings and underlying philosophy that structure understandings. Methods A scoping review of was undertaken. Following a literature search, 57 sources were selected and analysed using the thematic (...)
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  28.  48
    Best Interests and Treatment for Mental Disorder.Phil Fennell - 2008 - Health Care Analysis 16 (3):255-267.
    This paper considers the role of the concept of best interests in the treatment of mental disorder. It considers the Mental Capacity Act 2005 where treatment of an incapacitated person’s mental disorder is authorized if treatment is in the patient’s own best interests. It also examines the Mental Health Act 1983 as amended by the Mental Health Act 2007 where treatment without consent of a detained patient is allowed where necessary for the patient’s health or (...)
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  29.  5
    In the Patient's Best Interest, by Sue Fisher, Rutgers University Press, New Brunswick, NJ, 1986.Ellen Dorsch - 1989 - Hypatia 4 (2):188-191.
  30.  11
    In the Patient's Best Interest: Women and the Politics of Medical DecisionsSue Fisher.Elizabeth Fee - 1987 - Isis 78 (2):288-288.
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  31.  8
    A physician’s identity can never be reconfigured to put climate protection on par with an individual patient’s best interests.Narcyz Ghinea - 2024 - Journal of Medical Ethics 50 (6):375-375.
    In their article, van Gils Schmidt and Salloch defend the claim that physicians have a duty to protect the climate. The logic of the argument in broad terms is that (i) there is a relationship between climate change and the burden of disease, (ii) the healthcare sector is a significant emitter of global greenhouse gasses, thereby enhancing the burden of disease and (iii) since doctors are advocates of health and stakeholders in the healthcare sector, they have a duty to respond (...)
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  32.  20
    Best Interests: a Concept Analysis and Its Implications for Ethical Decision-Making in Nursing.Pat Rose - 1995 - Nursing Ethics 2 (2):149-160.
    The purpose of this paper is to analyse the concept of 'best interest' in order to give nurses, who use it to justify their actions, a clear picture of what this means, and to identify the skills needed for doing so. The process for concept analysis developed by Walker and Avant was used in the analysis of data generated from the literature. Themes were identified from which the defining attributes, antecedents and consequences emerged. The congruence of the findings (...)
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  33.  25
    The weight attributed to patient values in determining best interests.Carolyn Johnston - 2013 - Journal of Medical Ethics 39 (9):562-564.
    In W v M and Others (Re M) the Court of Protection considered whether withdrawal of artificial nutrition and hydration was in the best interests of a person in minimally conscious state. The Mental Capacity Act 2005 states that in determining best interests the decision-maker must consider, so far as is reasonably ascertainable, the patient's wishes, feelings, beliefs and values. Baker J. indicated that a high level of specificity is required in order to attribute significant weight to (...)
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  34.  32
    Best Interests: Puzzles and Plausible Solutions at the End of Life. [REVIEW]Simon Woods - 2008 - Health Care Analysis 16 (3):279-287.
    This paper argues that the concept of best interests in the context of clinical decisions draws on concepts rooted in the philosophical discipline of axiology. Reflection on the philosophical origins enables a distinction to be drawn between those interests related to clinical goals and those global interests that are axiological in nature. The implication of this distinction is most clearly seen in the context of end of life decisions and it is argued here that greater weight ought to be (...)
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  35. An Unblinkered View of Best Interests.Wayne Martin, Fabian Freyenhagen, Elizabeth Hall, Tom O’Shea, Antal Szerletics & Vivienne Ashley - 2012 - British Medical Journal 1 (345):1-3.
    Wayne Martin and colleagues argue that decisions about patients’ best interests must sometimes take into account the interests of others Doctors often find themselves in circumstances where they must make decisions on behalf of an incapacitated patient. As a matter of both ethics and law, such decisions must be taken in the best interests of the patient, but uncertainty remains about what is meant by best interests, especially in relation to the interests of others. Should (...)
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  36.  76
    In the best interests of the deceased: A possible justification for organ removal without consent?Govert Hartogh - 2011 - Theoretical Medicine and Bioethics 32 (4):259-269.
    Opt-out systems of postmortem organ procurement are often supposed to be justifiable by presumed consent, but this justification turns out to depend on a mistaken mental state conception of consent. A promising alternative justification appeals to the analogical situation that occurs when an emergency decision has to be made about medical treatment for a patient who is unable to give or withhold his consent. In such cases, the decision should be made in the best interests of the (...). The analogous suggestion to be considered, then, is, if the potential donor has not registered either his willingness or his refusal to donate, the probabilities that he would or would not have preferred the removal of his organs need to be weighed. And in some actual cases the probability of the first alternative may be greater. This article considers whether the analogy to which this argument appeals is cogent, and concludes that there are important differences between the emergency and the organ removal cases, both as regards the nature of the interests involved and the nature of the right not to be treated without one’s consent. Rather, if opt-out systems are to be justified, the needs of patients with organ failure and/or the possibility of tacit consent should be considered. (shrink)
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  37.  45
    Best Interest of the Child: Surrogate Decision Making and the Economics of Externalities. [REVIEW]Joseph P. DeMarco, Douglas P. Powell & Douglas O. Stewart - 2011 - Journal of Bioethical Inquiry 8 (3):289-298.
    The case of Twin B involves the decision to send a newborn to a less intensive Level 2 special care nursery (SCN) than to the Level 3 neonatal intensive care unit (NICU) that is considered optimal by the physician. The physician’s acceptance of the transfer is against the child’s best interest and is due to parental convenience. In analyzing the case, we reject the best interest standard. Our rejection is partly supported by the views of Douglas (...)
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  38.  50
    Best interests and the sanctity of life after W v M.Alexandra Mullock - 2013 - Journal of Medical Ethics 39 (9):553-554.
    The case of W v M and Others, in which the court rejected an application to withdraw artificial nutrition and hydration from a woman in a minimally conscious state, raises a number of profoundly important medico-legal issues. This article questions whether the requirement to respect the autonomy of incompetent patients, under the Mental Capacity Act 2005, is being unjustifiably disregarded in order to prioritise the sanctity of life. When patients have made informal statements of wishes and views, which clearly—if not (...)
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  39.  17
    The role of anticipated decision regret and the patient's best interest in sterilisation and medically assisted reproduction.Heidi Mertes - 2017 - Journal of Medical Ethics 43 (5):314-318.
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  40.  23
    Best interests determination within the Singapore context.Lalit R. K. Krishna - 2012 - Nursing Ethics 19 (6):787-799.
    Familialism is a significant mindset within Singaporean culture. Its effects through the practice of familial determination and filial piety, which calls for a family centric approach to care determination over and above individual autonomy, affect many elements of local care provision. However, given the complex psychosocial, political and cultural elements involved, the applicability and viability of this model as well as that of a physician-led practice is increasingly open to conjecture. This article will investigate some of these concerns before proffering (...)
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  41.  36
    Persistent vegetative state, withdrawal of artificial nutrition and hydration, and the patient's "best interests".R. Gillon - 1998 - Journal of Medical Ethics 24 (2):75-76.
  42.  96
    Value Theory and the Best Interests Standard1.David Degrazia - 1995 - Bioethics 9 (1):50-61.
    The idea of a patient's best interests raises issues in prudential value theory–the study of what makes up an individual's ultimate (nonmoral) good or well‐being. While this connection may strike a philosopher as obvious, the literature on the best interests standard reveals almost no engagement of recent work in value theory. There seems to be a growing sentiment among bioethicists that their work is independent of philosophical theorizing. Is this sentiment wrong in the present case? Does value (...)
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  43. What’s Good for Them? Best Interests and Severe Disorders of Consciousness.Jennifer Hawkins - 2016 - In Walter Sinnott Armstrong (ed.), Finding Consciousness. Oxford, UK: pp. 180-206.
    I consider the current best interests of patients who were once thought to be either completely unaware (to be in PVS) or only minimally aware (MCS), but who, because of advanced fMRI studies, we now suspect have much more “going on” inside their minds, despite no ability to communicate with the world. My goal in this chapter is twofold: (1) to set out and defend a framework that I think should always guide thinking about the best interests of (...)
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  44. Der best-interest standard in der Pädiatrie–theoretische Konzeption und klinische Anwendung.Andrea Dörries - 2003 - In C. Wiesemann, A. Dörries, G. Wolfslast & A. Simon (eds.), Das Kind Als Patient. Campus.
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  45.  33
    Beyond Autonomy and Best Interests.Daniel Brudney - 2012 - Hastings Center Report 39 (2):31-37.
    According to bioethics orthodoxy, the question, “What would the patient choose?” is a question about the patient's autonomy. is at stake. In fact, what underpins the moral force of that question is a value different from either autonomy or best interests. This is the value of doing things in a way that is authentic to the person.
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  46.  16
    Making a Fetish of “CPR” Is Not in the Patient's Best Interest.John J. Paris & M. Patrick Moore Jr - 2017 - American Journal of Bioethics 17 (2):37-39.
    Rosoff and Schneiderman's essay “Irrational Exuberance: Cardiopulmonary Resuscitation as Fetish” (2017) raises an issue first posed by the then Chairman of the Federal Reserve Board, Alan Greenspan...
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  47.  86
    In the best interests of the deceased: A possible justification for organ removal without consent?Govert den Hartogh - 2011 - Theoretical Medicine and Bioethics 32 (4):259-269.
    Opt-out systems of postmortem organ procurement are often supposed to be justifiable by presumed consent, but this justification turns out to depend on a mistaken mental state conception of consent. A promising alternative justification appeals to the analogical situation that occurs when an emergency decision has to be made about medical treatment for a patient who is unable to give or withhold his consent. In such cases, the decision should be made in the best interests of the (...). The analogous suggestion to be considered, then, is, if the potential donor has not registered either his willingness or his refusal to donate, the probabilities that he would or would not have preferred the removal of his organs need to be weighed. And in some actual cases the probability of the first alternative may be greater. This article considers whether the analogy to which this argument appeals is cogent, and concludes that there are important differences between the emergency and the organ removal cases, both as regards the nature of the interests involved and the nature of the right not to be treated without one’s consent. Rather, if opt-out systems are to be justified, the needs of patients with organ failure and/or the possibility of tacit consent should be considered. (shrink)
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  48.  22
    Antemortem Donor Bilateral Nephrectomy: A Violation of the Patient's Best Interests Standard.Thomas M. Wertin, Mohamed Y. Rady & Joseph L. Verheijde - 2012 - American Journal of Bioethics 12 (6):17-20.
    The American Journal of Bioethics, Volume 12, Issue 6, Page 17-20, June 2012.
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  49.  20
    Commentary on Derick Wade's ‘Back to the bedside? Making clinical decisions in patients with prolonged unconsciousness’ and Zoe Fritz’ ‘Can ‘Best Interests’ derail the trolley?’ Examining withdrawal of clinically assisted nutrition and hydration in patients in the permanent vegetative state.Stephen Holland - 2017 - Journal of Medical Ethics 43 (7):455-456.
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  50.  59
    A Broader Notion of Competent Decision Making in Respect to What Is in the Best Interests of Patients Affected by Anorexia.Floris Tomasini - 2010 - Philosophy, Psychiatry, and Psychology 17 (2):155-157.
    Simona Giordano (2010) claims that whether or not anorexics should be allowed to die should not primarily depend on their competence, but on the extent of whether the condition can be alleviated. This implies two outcomes. First, that if an anorexic has a reasonable chance of recovery, competent refusal of treatment can be overridden. Second, that if an anorexic has no realistic chance of recovery, patient refusal needs to be upheld—not, exclusively, on the basis of patient’s decision-making competence, (...)
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