Results for 'patient autonomy'

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  1. Patient Autonomy and the Ethics of Responsibility.Alfred I. Tauber - 2005 - MIT Press.
    The principle of patient autonomy dominates the contemporary debate over medical ethics. In this examination of the doctor-patient relationship, physician and philosopher Alfred Tauber argues that the idea of patient autonomy -- which was inspired by other rights-based movements of the 1960s -- was an extrapolation from political and social philosophy that fails to ground medicine's moral philosophy. He proposes instead a reconfiguration of personal autonomy and a renewed commitment to an ethics of care. (...)
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  2.  52
    Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-Conceptualization.Aanand D. Naik, Carmel B. Dyer, Mark E. Kunik & Laurence B. McCullough - 2009 - American Journal of Bioethics 9 (2):23 – 30.
    The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out (...)
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  3.  52
    Patient Autonomy and Choice in Healthcare: Self-Testing Devices as a Case in Point.Anna-Marie Greaney, Dónal P. O’Mathúna & P. Anne Scott - 2012 - Medicine, Health Care and Philosophy 15 (4):383-395.
    This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue (...)
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  4.  31
    Patient Autonomy: A View From the Kitchen.Rita M. Struhkamp - 2004 - Medicine, Health Care and Philosophy 8 (1):105-114.
    In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the (...)
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  5. Shared Decision-Making and Patient Autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to (...)
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  6. Patient Autonomy and the Family Veto Problem in Organ Procurement.Alexander Zambrano - 2017 - Social Theory and Practice 43 (1):180-200.
    A number of bioethicists have been critical of the power of the family to “veto” a patient’s decision to posthumously donate her organs within opt-in systems of organ procurement. One major objection directed at the family veto is that when families veto the decision of their deceased family member, they do something wrong by violating or failing to respect the autonomy of that deceased family member. The goal of this paper is to make progress on answering this objection. (...)
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  7.  10
    Presuming Patient Autonomy in the Face of Therapeutic Misconception.Pat McConville - 2017 - Bioethics 31 (9):711-715.
    Therapeutic misconception involves the failure of subjects either to understand or to incorporate into their own expectations the distinctions in nature and purpose of personally responsive therapeutic care, and the generic relationship between subject and investigator which is constrained by research protocols. Researchers cannot disregard this phenomenon if they are to ensure that subjects engage in research on the basis of genuine informed consent. However, our presumption of patient autonomy must be sustained unless we have compelling evidence of (...)
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  8.  10
    Patient Autonomy and Quality of Care in Telehealthcare.Giovanni Rubeis, Maximilian Schochow & Florian Steger - 2018 - Science and Engineering Ethics 24 (1):93-107.
    Telemedicine is a complex field including various applications and target groups. Especially telehealthcare is seen by many as a means to revolutionize medicine. It gives patients the opportunity to take charge of their own health by using self-tracking devices and allows health professionals to treat patients from a distance. To some, this means an empowerment of patient autonomy as well as an improvement in the quality of care. Others state the dangers of depersonalization of medicine and the pathologization (...)
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  9. Patient Autonomy, Assessment of Competence and Surrogate Decision‐Making: A Call for Reasonableness in Deciding for Others.Kristine Bærøe - 2010 - Bioethics 24 (2):87-95.
    ABSTRACTIn this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline decision‐making competence and 2) the practice of surrogate decision‐making in general. I argue that none of these practices are currently aligned with respectful treatment of vulnerable individuals. Because of (...)
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  10.  12
    Patient Autonomy in Home Care: Nurses’ Relational Practices of Responsibility.Gaby Jacobs - 2019 - Nursing Ethics 26 (6):1638-1653.
    Background: Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. Aim: To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A (...)
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  11.  75
    Patient Autonomy in Emergency Medicine.Anne-Cathrine Naess, Reidun Foerde & Petter Andreas Steen - 2001 - Medicine, Health Care and Philosophy 4 (1):71-77.
    Theoretical models for patient-physician communication in clinical practice are frequently described in the literature. Respecting patient autonomy is an ethical problem the physician faces in a medical emergency situation. No theoretical physician-patient model seems to be ideal for solving the communication problem in clinical practice. Theoretical models can at best give guidance to behavior and judgement in emergency situations. In this article the premises of autonomous treatment decisions are discussed. Based on a case-report we discuss different (...)
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  12.  50
    Patient Autonomy and the Challenge of Clinical Uncertainty.Mark Parascandola, Jennifer Hawkins & Marion Danis - 2002 - Kennedy Institute of Ethics Journal 12 (3):245-264.
    : Bioethicists have articulated an ideal of shared decision making between physician and patient, but in doing so the role of clinical uncertainty has not been adequately confronted. In the face of uncertainty about the patient's prognosis and the best course of treatment, many physicians revert to a model of nondisclosure and nondiscussion, thus closing off opportunities for shared decision making. Empirical studies suggest that physicians find it more difficult to adhere to norms of disclosure in situations where (...)
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  13.  32
    Putting Patient Autonomy in its Proper Place; Professional Norm-Guided Medical Decision-Making.Thomas Huddle - 2016 - Kennedy Institute of Ethics Journal 26 (4):457-482.
    Since patient autonomy became a prominent theme in medical ethics in the 1970s and 1980s, it has had a troubled reputation among many physicians, to whom claims for its importance in medical decision making seem unrealistic and even undesirable. Of course the discussion has moved on since the early days in which informative or interpretive models of medical decision-making—in which physicians provided information and helped patients clarify and express preferences that then determined decisions—were contrasted with usual medical practice (...)
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  14.  28
    A Fine Balance: Reconsidering Patient Autonomy in Light of the UN Convention on the Rights of Persons with Disabilities.Jillian Craigie - 2015 - Bioethics 29 (6):398-405.
    The Convention on the Rights of Persons with Disabilities is increasingly seen as driving a paradigm shift in mental health law, particularly in relation to the understanding that it requires a shift from substituted to supported decisions. This article identifies two competing moral commitments implied by this shift, both of which appeal to the notion of autonomy. It is argued that because of these commitments the Convention is in tension with more general calls in the medical ethics literature for (...)
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  15.  32
    Patient Autonomy, Assessment of Competence and Surrogate Decision-Making: A Call for Reasonableness in Deciding for Others.Kristine Baerøe - 2010 - Bioethics 24 (2):87-95.
    In this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline decision-making competence and 2) the practice of surrogate decision-making in general. I argue that none of these practices are currently aligned with respectful treatment of vulnerable individuals. Because of (...)
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  16. Patient Autonomy in Talmudic Context: The Patient’s ‘‘I Must Eat’’ on Yom Kippur in the Light of Contemporary Bioethics.Zackary Berger & Joshua Cahan - 2016 - Journal of Religion and Health 5 (5):5.
    In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which (...)
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  17.  39
    Patient Autonomy and Medical Paternity: Can Nurses Help Doctors to Listen to Patients?Sarah Breier-Mackie - 2001 - Nursing Ethics 8 (6):510-521.
    Nurses are increasingly faced with situations in practice regarding the prolongation of life and withdrawal of treatment. They play a central role in the care of dying people, yet they may find themselves disempowered by medical paternalism or ill-equipped in the decision-making process in end-of-life situations. This article is concerned with the ethical relationships between patient autonomy and medical paternalism in end-of-life care for an advanced cancer patient. The nurse’s role as the patient’s advocate is explored, (...)
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  18.  18
    Patient Autonomy Is a Right, But Exercising That Right May Not Be an Obligation for Patients and Kin.Thor Willy Ruud Hansen - 2018 - American Journal of Bioethics 18 (1):32-33.
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  19.  16
    Patient Autonomy and Provider Beneficence Are Compatible.Howard Brody & Luana Colloca - 2013 - Hastings Center Report 43 (6):6-6.
  20. Patient Autonomy Investigation Under the Technology-Based Health Care System.Yi Yang - 2012 - Bulletin of Science, Technology and Society 32 (2):163-170.
    With widespread advances in the diffusion and application of medical technologies, the phenomena of misuse and overuse have become pervasive. These phenomena not only increase the cost of health care systems and deplete the accessibility and availability of health care services, they also jeopardize patient autonomy. From a literature review on this aspect of medical technology, an impact on patient autonomy is found in almost all cases, with the exception of philosophical or ethical writings, in which (...)
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  21.  97
    Informed Consent: Patient Autonomy and Physician Beneficence Within Clinical Medicine. [REVIEW]Stephen Wear & Jonathan D. Moreno - 1994 - HEC Forum 6 (5):323-325.
    Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received (...)
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  22.  15
    Patient Autonomy Writ Large.Barbara Russell - 2009 - American Journal of Bioethics 9 (2):32 – 34.
  23.  40
    Patient Autonomy and the Freedom to Act Against One's Self-Interest.Jennifer Wilson Mulnix - 2008 - Clinical Laboratory Science 21 (2):114-115.
    A 16 year old Hodgkin lymphoma patient refuses to have his blood specimen drawn, thus canceling his scheduled oncologic treatment. As a 16 year old, he has no legal standing as an adult. His parents are split over his decision. One supports his right to choose; the other wishes the specimen to be drawn and the chemotherapy reinstated. The physicians at the hospital are seeking legal redress to have the court order the blood specimens to be taken.
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  24. Patients' Autonomy: Three Models of the Professional-Lay Relationship in Medicine.David T. Ozar - 1984 - Theoretical Medicine and Bioethics 5 (1).
    Health care is not merely a matter of individual encounters between patients and physicians or other health care personnel. For patients and those who provide health care come to these encounters already possessed of learned habits of perception and judgment, valuation and action, which define their roles in relation to one another and affect every aspect of their encounter. So the presuppositions of these encounters must be examined if our understanding of patients' autonomy is to be complete. In this (...)
     
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  25. Communication Behaviors and Patient Autonomy in Hospital Care: A Qualitative Study.Zackary Berger - 2017 - Patient Education and Counseling 2017.
    BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were (...)
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  26.  10
    Overriding Patient Autonomy to Enhance It: Not the Role of a Consultation Team.John J. Paris, Robert L. Fogerty, Brian M. Cummings & M. Patrick Moore Jr - 2016 - American Journal of Bioethics 16 (8):11-13.
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  27. Promoting Patient Autonomy: Looking Back.Gene H. Stollerman - 1984 - Theoretical Medicine and Bioethics 5 (1).
    The pinnacle of the physician's clinical skills is his ability to develop the autonomy of his patients in the management of their health affairs. To do this requires the forging of a relationship in which patients' attitudes toward their health and illness are products of the doctor-patient relationship rather than unilateral behavior by either one. Modern medicine is beset with problems that make it difficult for physicians to develop and exercise the skills that lead to patient (...). An erosion of public confidence in physicians is being caused by several mojar forces that include: (1) the power of science over life; (2) medical technology's dehumanizing effect; (3) legalization of medical ethics; and (4) industrialization and commercialization of medical care. To restore the kind of confidence that makes the physician an effective proponent of his patient's autonomy will require a major emphasis upon all aspects of medical ethics in the medical curriculum and in medical practice. Clinical investigation of this subject is highly appropriate. Clinical faculties should be developed in greater numbers who are authorities in the humanities as well as in science. Our medical schools need also to develop and to utilize models of health care in which relations with patients are personalized, continuous, and comprehensive so that ethical ideals such as patient autonomy can be demonstrated by precept and example, and can also be researched. (shrink)
     
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  28.  18
    Advocating Mandatory Patient 'Autonomy' in Healthcare: Adverse Reactions and Side Effects. [REVIEW]Myfanwy Davies & Glyn Elwyn - 2008 - Health Care Analysis 16 (4):315-328.
    Promoting patient autonomy has become a key imperative in health service encounters. We will examine the potential negative effects of over-promoting patient autonomy and consider the impact on patient access, their experience and the provision of equitable services by focusing on an extreme manifestation of this trend, i.e. calls for patient involvement in health care decision making to be mandatory. Advocates of mandatory autonomy hold that patients have a duty to themselves, to society (...)
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  29.  41
    Patient Autonomy and Social Fairness.Joshua Cohen - 2000 - Cambridge Quarterly of Healthcare Ethics 9 (3):391-399.
    In this paper, an attempt is made to give patient autonomy added conceptual clarity. A concept of patient autonomy grounded in both negative and positive freedoms is defended. Amartya Sen's capabilities approach is used as a conceptual framework in which patient autonomy and fairness are defined compatibly. It is argued that in a socially fair healthcare system, everyone should have at least the degree of patient autonomy that affords access to those healthcare (...)
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  30. Patient Autonomy, Paternalism, and the Conscientious Physician.Stephen Wear - 1983 - Theoretical Medicine and Bioethics 4 (3).
    This paper concerns itself with the concept of diminished competence with particular regard to the problems and options that mentally compromised patients raise for medical management. It proceeds through three general stages: (1) a restatement of the sense and grounds of the new patients' rights ethos which the existence of such patients calls into question; (2) a consideration of what expanded responsibilities and tactics physicians should embrace to protect and enhance such patients' autonomy; and (3) the standards, criteria, and (...)
     
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  31.  17
    Ideals of Patient Autonomy in Clinical Decision Making: A Study on the Development of a Scale to Assess Patients' and Physicians' Views.A. M. Stiggelbout - 2004 - Journal of Medical Ethics 30 (3):268-274.
    Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the (...)
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  32.  31
    Physicians' Silent Decisions: Because Patient Autonomy Does Not Always Come First.Simon N. Whitney & Laurence B. McCullough - 2007 - American Journal of Bioethics 7 (7):33 – 38.
    Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions - not all - are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, (...)
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  33.  17
    Chronic Patients’ Autonomy in Iranian Hospitals: A Qualitative Study.Hossein Ebrahimi, Efat Sadeghian, Naeimeh Seyedfatemi & Eesa Mohammadi - 2017 - Ethics and Behavior 27 (1):74-87.
    The autonomy of chronic patients in Iranian hospitals is challenged by impaired functioning resulting from chronic illness, a negative image in society, and effects related to hospitalization. Comprehensive interviews and observations of 34 patients, nurses, and physicians were performed to assess the autonomy of chronic patients in Iran. Conceptualization, constant comparison, and the combination of data resulted in the identification of 5 main categories related to autonomy: welcoming paternalism, self-expression, self-proof, shared decision making, and self-determination. Authority scrambling (...)
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  34.  23
    Patient Autonomy and the Twenty-First Century Physician.Jeremy R. Garrett & John D. Lantos - 2011 - Hastings Center Report 41 (5):3-3.
    In this issue of the Report, Daniel Groll suggests new ways to understand old tensions between autonomy and paternalism. He categorizes disagreements between doctors and patients in four ways. Some are about the ends or goals of medical treatment. For these, he claims, patient choices are based upon patient values, and physicians should neither challenge nor assess them. More common are disagreements about the appropriate means to achieve an agreed-upon goal. These subdivide into two distinct categories—those in (...)
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  35.  22
    Respecting Patient Autonomy Versus Protecting the Patient's Health.James M. Badger, Rosalind Ekman Ladd & Paul Adler - 2009 - Jona's Healthcare Law, Ethics, and Regulation 11 (4):120-124.
  36.  16
    Patient Autonomy and the Unfortunate Choice Between Repatriation and Suboptimal Treatment.Kevin Wack & Toby Schonfeld - 2012 - American Journal of Bioethics 12 (9):6-7.
    The American Journal of Bioethics, Volume 12, Issue 9, Page 6-7, September 2012.
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  37. Patient Autonomy: A Turn in the Tide.R. Bailey-Harris - 2000 - In Michael D. A. Freeman & A. D. E. Lewis (eds.), Law and Medicine. Oxford University Press.
     
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  38.  13
    Reluctant Patients: Autonomy and Delegating Medical Decisions.Jodi Halpern - 2002 - Journal of Clinical Ethics 13 (1):78.
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  39.  18
    Patient Autonomy as the Prerequisite for Care: Opioids for Chronic Pain of Non-Malignant Origin. [REVIEW]Sylvie C. Tourigny - 1995 - Health Care Analysis 3 (4):345-350.
  40.  79
    Adherence, Shared Decision-Making and Patient Autonomy.Lars Sandman, Bradi B. Granger, Inger Ekman & Christian Munthe - 2012 - Medicine, Health Care and Philosophy 15 (2):115-127.
    In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding (...)
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  41.  11
    Patients' Autonomy and Privacy in Nursing Interventions.H. Leino-Kilpi, M. Välimäki, T. Dassen, M. Gasull, C. Lemonidou, A. P. Scott & M. Arndt - 1999 - Nursing Ethics 6 (4):337.
  42. Forced to Be Free? Increasing Patient Autonomy by Constraining It.Neil Levy - 2014 - Journal of Medical Ethics 40 (5):293-300.
    It is universally accepted in bioethics that doctors and other medical professionals have an obligation to procure the informed consent of their patients. Informed consent is required because patients have the moral right to autonomy in furthering the pursuit of their most important goals. In the present work, it is argued that evidence from psychology shows that human beings are subject to a number of biases and limitations as reasoners, which can be expected to lower the quality of their (...)
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  43.  8
    Patient Autonomy Between Right and Duty. Patient Health Education Programmes: A Cost Containment Measure - Way of Controlling the Demand.Patricia Majdak - 2002 - Disputatio Philosophica 4 (1):181-185.
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  44.  18
    Patient Autonomy Naturalized.Bruce N. Waller - 2001 - Perspectives in Biology and Medicine 44 (4):584-593.
  45.  61
    Cultural Competence: Reflections on Patient Autonomy and Patient Good.Martin G. Leever - 2011 - Nursing Ethics 18 (4):560-570.
    Terms such as ‘cultural competence’ and ‘transcultural nursing’ have comfortably taken their place in the lexicon of health care. Their high profile is a reflection of the diversity of western societies and health care’s commitment to provide care that is responsive to the values and beliefs of all who require treatment. However, the relationship between cultural competence and familiar ethical concepts such as patient autonomy has been an uneasy one. This article explores the moral foundations of cultural competence, (...)
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  46.  6
    Prescription Requirements and Patient Autonomy: Considering an Over‐the‐Counter Default.Madison Kilbride, Steven Joffe & Holly Fernandez Lynch - 2020 - Hastings Center Report 50 (6):15-26.
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  47.  5
    Patient Autonomy and Professional Expertise in Decisions Near the End of Life: Commentary on Francis Kamm.Robert D. Truog - 2017 - Journal of Medical Ethics 43 (9):587-588.
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  48. Informed Consent: Patient Autonomy and Physician Beneficience Within Clinical Medicine.Stephen Wear & Andrew Crowden - 1996 - Bioethics 10 (1):83-86.
     
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  49.  13
    Evidence-Based Medicine and Patient Autonomy.Robyn Bluhm - 2009 - International Journal of Feminist Approaches to Bioethics 2 (2):134-151.
  50.  3
    Patient Autonomy: Imperfect, Insufficient, but Still Quite Necessary.Lainie Friedman Ross - 2002 - Journal of Clinical Ethics 13 (1):57.
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