scholarly journals The Capabilities Approach and the Concepts of Self-Determination, Legal Competence and Human Dignity in Social Services for Older People

2022 ◽  
pp. 175-189
Author(s):  
Eva-Maria Svensson ◽  
Therese Bäckman ◽  
Torbjörn Odlöw
Keyword(s):  
Older People ◽  
Social Services ◽  
Human Dignity ◽  
Capabilities Approach ◽  
Self Determination ◽  
Individual Autonomy ◽  
Political Obligations ◽  
Nation States ◽  
Legal Competence ◽  
The Individual

AbstractIn this chapter, the tension between self-determination and human dignity in the Swedish legal system of social care for older people is analysed with help of the capabilities approach. The core focus of this approach is the individual person’s capability to make decisions. Also important is a supportive societal system that enables the realisation of self-determination, specifically for individuals who are not fully capable of making arrangements for themselves. The capabilities approach emphasises the responsibility of the State and can be used to analyse the impact of legal and political obligations for nation-states, and to balance the increased focus on self-determination and the quest for increased capabilities among older people. In the context of a dismantled welfare state, a one-sided focus on individual autonomy might turn out to be a double-edged sword, leaving the individual with self-determination but no (or insufficient) available care to decide about. In this chapter, the underlying principles of practical decisions are theoretically explored and reflected upon. Of specific relevance is human dignity (in addition to enhancing individual freedom), normativity (a set of fundamental capabilities is identified) and the central role of the nation-state (as the responsible political subject for the achievement of minimum thresholds for all capabilities).

Die heilige Ordnung der Menschenwürde

2020 ◽  
Author(s):  
Malte Möbius
Keyword(s):  
Human Dignity ◽  
Self Determination ◽  
Human Beings ◽  
Central Question ◽  
Basic Law ◽  
The Stability ◽  
The Individual

As human beings we are exposed to our mortality. Though we are unable to find the reason for our existence, we exist—with others. Being with others is both necessary for our survival and a source of joy and pain. The central question remains: How do we want to live together? Human beings need to be empowered to participate in this fundamental discourse. The concept of the ‘sacrality of the individual’ explains why inviolable values, such as human dignity, do not only need to be implemented in our Basic Law, but need to be filled with life—they need to be believed in. Rational concepts of order will always have arational foundations. The ‘Sacred Order of Human Dignity’ shows why an awareness of this fact is crucial for the stability of democratic self-determination.

scholarly journals Institutul Național de Cercetări Economice, Chișinău, Republica Moldova

2021 ◽  
Vol 32 (2) ◽  
Author(s):  
Mariana Buciuceanu-Vrabie ◽  
Tatiana Tabac
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
Social Services ◽  
Social Impact ◽  
The Elderly ◽  
Community Level ◽  
Social Risks ◽  
Increased Risk ◽  
The Social ◽  
The Individual

Articolul se focusează pe evaluarea situației persoanelor în vârstă din Republica Moldova în contextul pandemiei COVID-19. Prin diagnosticarea socială a deschiderii structurale, instituționale, comunitare și inter-generaționale la nevoile acestei categorii de populație, se evidențiază provocările pandemice cu care aceasta se confruntă. Metodologia cercetării are la bază rezultatele studiului calitativ, realizat în lunile august−septembrie 2020 și aprilie−mai 2021 cu persoanele vârstnice, reprezentanții administrației publice locale și asistenții sociali. Prin constatări argumentate empiric, în articol sunt actualizate principalele dificultăți parvenite în contextul pandemiei și profunzimea impactului social asupra persoanelor în vârstă la nivel comunitar. Pe lângă riscul direct asupra stării de sănătate fizică, excluderea și discriminarea persoanelor în vârstă s-a accentuat în timpul pandemiei COVID-19, s-a evidențiat riscul sporit de violență și neglijare, și cazurile de stigmatizare la nivel comunitar. Resursele individuale/ familiale ale persoanelor vârstnice, în special în cazul infectării cu COVID-19 și a tratamentului, au jucat un rol important în depășirea crizei. Consecințele COVID-19 se asociază cu agravarea stării de sănătate a persoanelor vârstnice și creșterea necesarului de în servicii medicale. Atitudinile „age-iste” au loc și în perioada după carantină, subminând drepturile persoanelor vârstnice la servicii de calitate. Astfel, se accentuează necesitatea monitorizării continue a situației și combaterii atitudinilor „age-iste” în perioada post pandemie. Cuvinte-cheie: COVID-19; populația în vârstă; studiul calitativ; riscuri sociale; accesul la serviciile sociale; izolare, violență. ●●●●● The paper focuses on assessing the situation of older persons in the Republic of Moldova, in the context of the COVID-19 pandemic. The social diagnosis of the structural, institutional, community and intergenerational openness to the needs of this category of population highlights the pandemic challenges it faces. The methodology of the study is based on the results of the qualitative study conducted in August−September 2020 and April−May 2021 with the older people, local public administration and social workers. Through empirically reasoned findings, the paper updates the main difficulties encountered in the context of the pandemic and the depth of the social impact on the older people at community level. In addition to the direct risk to physical health, the exclusion and discrimination of the older people increased during the COVID-19 pandemic, there has been an increased risk of violence and neglect, and cases of stigma at community level. The individual/family resources of the older people, especially in the case of COVID-19 infection and treatment, have played an important role in overcoming the crisis. The consequences of COVID-19 are associated with a worsening of the health of the elderly and an increase in the need for medical services. “Ageist” attitudes also occurred in the post-quarantine period, undermining the rights of older people to quality services. Thus, the need for continuous monitoring of the situation and combating "ageist" attitudes in the post-pandemic period is emphasized. Keywords: COVID-19, older adults, qualitative study, social risks, access to social services, isolation, violence.

scholarly journals Forms of subjectification: Rights and freedom as neoliberal politics in healthcare system. The Italian law on Living Will

2020 ◽  
Vol 10 (6) ◽  
pp. 1133-1165
Author(s):  
Matteo Finco ◽  
Keyword(s):  
Living Will ◽  
Self Determination ◽  
Social Solidarity ◽  
Individual Autonomy ◽  
Social Forces ◽  
Italian Law ◽  
Social System Theory ◽  
The Individual ◽  
The Relationship ◽  
Theoretical Reflection

Health represents a context where it is possible to observe the relationship between individuals and society, namely which spaces of autonomy are left for the individuals and which social forces are exercised on them. If Critical Theory points out the mechanisms of a neoliberal matrix that makes individuals “subjugate subjects”, Social System Theory allows to investigate how they are “included” in various spheres of society. Integrating these theories, we investigate mechanisms of subjectification on health. Moreover, through the analysis of the recent Italian law on advance directives and living will, we question if the claims of self-determination expressed by individuals could represent a form of “resistance” against neoliberal policies. Through a theoretical reflection and an analysis of the background and the juridical consequences of the law n. 219/2017, we conclude that the individual autonomy could be exercised together with responsibility towards others, balancing individual needs and claims with social solidarity. La salud representa un contexto en el cual se puede observar la relación entre los individuos y la sociedad. Si la Teoría Crítica apunta a los mecanismos de una matriz neoliberal que convierte a los individuos en “sujetos subyugados”, la Teoría de Sistemas Sociales permite investigar cómo éstos son “incluidos” en diversas esferas de la sociedad. Al integrar esas teorías, investigamos los mecanismos de subjetivización en el área de la salud. Además, a través del análisis de una ley italiana reciente, nos preguntamos si las proclamas de autodeterminación expresadas por los individuos podrían representar una forma de “resistencia” contra las políticas neoliberales. A través de la reflexión teórica y el análisis del contexto y de las consecuencias jurídicas de la Ley 219/2017, concluimos que la autonomía personal se podría ejercitar junto con la responsabilidad hacia el prójimo, equilibrando las necesidades y las reivindicaciones personales con la solidaridad social.

scholarly journals Social work with older people from culturally and linguistically diverse backgrounds: Using research to inform practice

2016 ◽  
Vol 23 (3) ◽  
pp. 3-15
Author(s):  
Jane Maidment ◽  
Ronnie Egan ◽  
Jane Wexler
Keyword(s):  
Social Work ◽  
Older People ◽  
Social Services ◽  
Group Discussion ◽  
Work Practice ◽  
Linguistically Diverse ◽  
Research Process ◽  
Social Work Practice ◽  
Culturally And Linguistically Diverse ◽  
The Individual

This research investigated the views of older culturally and linguistically diverse (CALD) people, their families and paid workers about experiences of giving and receiving care services in the Barwon region of Victoria, Australia. The project was conducted in collaboration with Diversitat, Geelong. While the research process incorporated a range of qualitative techniques this article is confined to reporting selected findings from the individual interviews and a focus group discussion. These findings demonstrated that particular caregiver personal attributes strengthened the relationship between older people and caregivers; differing interpretations were offered up about the use of time; multiple barriers for older CALD people using health and social services were identified; and that experiences of ageism within the health services were reported along with infrequent use of interpreter services. The article concludes with a discussion about the implications for social work practice and education with older CALD people. 

scholarly journals 儒家視角下的死亡的尊嚴

2016 ◽  
Vol 14 (1) ◽  
pp. 35-53
Author(s):  
Jianhui LI ◽  
Yaming LI
Keyword(s):  
Human Dignity ◽  
Assisted Suicide ◽  
New Technology ◽  
Death And Dying ◽  
Confucian Ethics ◽  
Individual Autonomy ◽  
Current Debate ◽  
Freedom Of Choice ◽  
The Individual ◽  
The Right

LANGUAGE NOTE | Document text in Chinese; abstract also in English.在當代的醫療實踐中，各種新的醫療技術在臨終階段的應用引發了關於如何維護死亡的尊嚴的激烈爭論。爭論的焦點集中在對什麼是人的尊嚴和什麼是死亡的尊嚴的概念的不同理解上。人的尊嚴概念在當代西方的倫理學中尚沒有得到清晰的闡釋，死亡的尊嚴概念更是存在混亂。儒家倫理學則可以在這種討論中為問題的解決提供新的思路。本文試圖重建儒家的人的尊嚴和死亡的尊嚴的基本含義，並對死亡的尊嚴與人的生物學生命的關係，死亡的尊嚴與人的痛苦的關係，死亡的尊嚴同人的自主性的關係，以及死亡的尊嚴同社會公平正義之間的關係做出分析說明。儒家關於人的尊嚴的觀點有助於化解西方死亡倫理研究中出現的概念混亂和理論矛盾。What does a death have dignity? In modern healthcare, the wide use of new technology has generated confusion around how to define and protect human dignity, especially in the case of death and dying. Those who advocate the legalization of assisted suicide often appeal to the right to “die with dignity” and the right to individual autonomy. The problem is that it is very difficult to justify one particular understanding of human dignity in the contemporary pluralistic world through a rational formulation without defining dignity.In this paper, the authors attempt to respond to the current debate on euthanasia and assisted suicide from a Confucian perspective. The paper first defines the Confucian concept of human dignity and shows how the concept could be used in the case of dignity in death and dying. The authors argue that in Confucianism, there are two kinds of dignity: One is intrinsic dignity, which is endowed by Heaven on everyone, and the other is extrinsic dignity, which arises from the cultivation of virtues. This extrinsic dignity is also called “personal dignity.” Unlike the individual-oriented human dignity model, Confucian ethics argue for a family-oriented model of human dignity. That is to say, the Confucian ideal of human dignity is not satisfied by a concept of human dignity that is centered on individual rights and freedom of choice; instead, it focuses on relations in a concrete community in which a person’s human dignity is actualized through morals and virtues. In the case of euthanasia and assisted suicide, therefore, the decision should not be solely based on freedom of choice, but on what kinds of values and obligations the person has. In addition, the paper shows that the Confucian view of human dignity does not support the idea of prolonging life through technological means without restraints.DOWNLOAD HISTORY | This article has been downloaded 1292 times in Digital Commons before migrating into this platform.

Married Life in the Middle Ages, 900-1300

2019 ◽  
Author(s):  
Elisabeth van Houts
Keyword(s):  
Middle Ages ◽  
Married Couple ◽  
Self Determination ◽  
Emotional Life ◽  
Social And Emotional ◽  
Individual Agency ◽  
Married Life ◽  
The Face ◽  
History Of ◽  
The Individual

This book contains an analysis of the experience of married life by men and women in Christian medieval Europe c. 900–1300. The focus will be on the social and emotional life of the married couple rather than on the institutional history of marriage. The book consists of three parts: the first part (Getting Married) is devoted to the process of getting married and wedding celebrations, the second part (Married Life) discusses the married life of lay couples and clergy, their sexuality, and any remarriage, while the third part (Alternative Living) explores concubinage and polygyny as well as the single life in contrast to monogamous sexual unions. Four main themes are central to the book. First, the tension between patriarchal family strategies and the individual family member’s freedom of choice to marry and, if so, to what partner; second, the role played by the married priesthood in their quest to have individual agency and self-determination accepted in their own lives in the face of the growing imposition of clerical celibacy; third, the role played by women in helping society accept some degree of gender equality and self-determination to marry and in shaping the norms for married life incorporating these principles; fourth, the role played by emotion in the establishment of marriage and in married life at a time when sexual and spiritual love feature prominently in medieval literature.

scholarly journals Cost-Effectiveness of an Exercise Programme that Provided Group or Individual Training to Reduce the Fall Risk in Healthy Community-Dwelling People Aged 65–80: A Secondary Data Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 714
Author(s):  
Isaac Aranda-Reneo ◽  
Laura Albornos-Muñoz ◽  
Manuel Rich-Ruiz ◽  
María Ángeles Cidoncha-Moreno ◽  
Ángeles Pastor-López ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Older People ◽  
Incremental Cost ◽  
Fall Risk ◽  
Community Dwelling ◽  
Effective Measure ◽  
The Individual ◽  
The Cost ◽  
Individual Training

Research has demonstrated that some exercise programs are effective for reducing fall rates in community-dwelling older people; however, the literature is limited in providing clear recommendations of individual or group training as a result of economic evaluation. The objective of this study was to assess the cost-effectiveness of the Otago Exercise Program (OEP) for reducing the fall risk in healthy, non-institutionalized older people. An economic evaluation of a multicenter, blinded, randomized, non-inferiority clinical trial was performed on 498 patients aged over 65 in primary care. Participants were randomly allocated to the treatment or control arms, and group or individual training. The program was delivered in primary healthcare settings and comprised five initial sessions, ongoing encouragement and support to exercise at home, and a reinforcement session after six months. Our hypothesis was that the patients who received the intervention would achieve better health outcomes and therefore need lower healthcare resources during the follow-up, thus, lower healthcare costs. The primary outcome was the incremental cost-effectiveness ratio, which used the timed up and go test results as an effective measure for preventing falls. The secondary outcomes included differently validated tools that assessed the fall risk. The cost per patient was USD 51.28 lower for the group than the individual sessions in the control group, and the fall risk was 10% lower when exercises had a group delivery. The OEP program delivered in a group manner was superior to the individual method. We observed slight differences in the incremental cost estimations when using different tools to assess the risk of fall, but all of them indicated the dominance of the intervention group. The OEP group sessions were more cost-effective than the individual sessions, and the fall risk was 10% lower.

When Is Patient Education Unethical?

2008 ◽  
Vol 15 (6) ◽  
pp. 813-820 ◽  
Author(s):  
Barbara K Redman
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Patient Education ◽  
Capabilities Approach ◽  
Ethical Practice ◽  
Patient Beliefs ◽  
Moral Framework ◽  
Provider Group ◽  
The Individual ◽  
Group Limit

Although patient education is central to the ethical practice of nursing, it can be practiced in an ethically contested or unethical way. It is sometimes used to: forward a societal goal the individual might not have chosen; assume that patients should learn to accommodate unjust treatment; exclude the views of all except the dominant health care provider group; limit the knowledge a patient can receive; make invalid or unreliable judgments about what a patient can learn; or require a patient to change his or her identity to meet a medical ideal. Both health promotion education and manipulating patient beliefs in situations of uncertainty are ethically contested. Nussbaum's capabilities approach is used here as a moral framework through which to view the goals and practice of patient education. This provides better guidance than the current conception of patient education as an instrument to carry out the directives of medical practice.

Two Models of Pluralism and Tolerance

1992 ◽  
Vol 14 (1) ◽  
Author(s):  
Will Kymlicka
Keyword(s):  
Political Theory ◽  
Recent Work ◽  
John Rawls ◽  
Religious Pluralism ◽  
Religious Diversity ◽  
Individual Autonomy ◽  
Individual Rights ◽  
Group Rights ◽  
The Individual ◽  
Social Pluralism

AbstractIn his most recent work, John Rawls argues that political theory must recognize and accomodate the ‘fact of pluralism’, including the fact of religious diversity. He believes that the liberal commitment to individual rights provides the only feasible model for accomodating religious pluralism. In the paper, I discuss a second form of tolerance, based on group rights rather than individual rights. Drawing on historical examples, I argue that this is is also a feasible model for accomodating religious pluralism. While both models ensure tolerance between groups, only the former tolerates individual dissent within groups. To defend the individual rights model, therefore, liberals must appeal not only to the fact of social pluralism, but also to the value of individual autonomy. This may require abandoning Rawls’s belief that liberalism can and should be defended on purely ‘political’, rather than ‘comprehensive’ grounds.

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