scholarly journals Decisional authority of gamete donors over embryos created with their gametes

2020 ◽  
Vol 37 (2) ◽  
pp. 281-286
Author(s):  
Guido Pennings
Keyword(s):  
Decisional Authority

Governing Information Security

2013 ◽  
pp. 29-45
Author(s):  
Yu “Andy” Wu ◽  
Carol Stoak Saunders
Keyword(s):  
Information Technology ◽  
Information Security ◽  
Decision Rights ◽  
Security Governance ◽  
Level Information ◽  
Information Security Governance ◽  
Allocation Patterns ◽  
High Level ◽  
Decisional Authority ◽  
Selection Of

Governance of the information security function is critical to effective security. In this paper, the authors present a conceptual model for security governance from the perspective of decision rights allocation. Based on Da Veiga and Eloff’s (2007) framework for security governance and two high-level information security documents published by the National Institute of Standards and Technology (NIST), the authors present seven domains of information security governance. For each of the governance domains, they propose a main decision type, using the taxonomy of information technology decisions defined by Weill and Ross (2004). This framework recommends the selection of decision rights allocation patterns that are proper to those decision types to ensure good security decisions. As a result, a balance can be achieved between decisional authority and responsibility for information security.

scholarly journals Effects of Maternal Decisional Authority and Media Use on Vaccination for Children in Asian Countries

Medicina ◽  
2018 ◽  
Vol 54 (6) ◽  
pp. 105 ◽  
Author(s):  
Minsung Sohn ◽  
Leesa Lin ◽  
Minsoo Jung
Keyword(s):  
Media Use ◽  
The Philippines ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Vaccination Rates ◽  
Child Morbidity ◽  
Health Strategy ◽  
Health Need ◽  
Critical Public Health ◽  
Decisional Authority

Background and objectives: It is now accepted that vaccination is a critical public health strategy in preventing child morbidity and mortality. Understanding factors that promote vaccination is a critical first step. The objective of this study was to investigated associations of maternal decisional authority and media use on vaccination for children in six South and Southeast Asian countries. Materials and Methods: Data come from demographic and health surveys conducted in Bangladesh, Cambodia, Indonesia, Nepal, Pakistan, and the Philippines between 2011 and 2014 (N = 45,168 women). Main outcome variables were four types of basic vaccination for children. Independent variables were maternal decisional authority and media use. Hierarchical multivariable regression analyses were performed to examine associations. Results: Children of mothers who had more decisional authority were more likely to be vaccinated compared to those participants who did not have such authority. The likelihood to have their children vaccinated was higher among women who frequently used media than those who did not use media. Conclusions: Maternal decisional authority and media use are related to improved vaccination for children. To increase vaccination rates in developing countries in South and Southeast Asia, programs and policies that promote maternal decisional authority and the use of media for health need to be implemented to help families and local communities.

Minding the State — or a State of Mind?

1990 ◽  
Vol 23 (1) ◽  
pp. 25-55 ◽  
Author(s):  
BERT A. ROCKMAN
Keyword(s):  
Political Theory ◽  
The State ◽  
The Public ◽  
The Third ◽  
State Of Mind ◽  
Unique Definition ◽  
Public Cultures ◽  
State Organization ◽  
Decisional Authority

In political theory the state has been enjoying a conceptual rebirth even while some of its activities have been receding. The state, however, remains conceptually ambiguous and is thus molded into many different conceptual forms. Three of those forms are discussed in this article: the decision-making state, the production state, and the intermediary state. The first relates to the organization and architecture of decisional authority; the second to the public and distributive goods supplied by the state; and the third to the interconnections between state organization and the organizations of civil society. Although the state lacks unique definition as a concept, its value lies in bringing together the most important macro-level connections of the polity, the society, and the economy that cannot otherwise be adequately analyzed in isolation from one another. In particular, the state provides a focus for the study of statecraft within a given constellation of institutional and interest formations and public cultures. And yet statecraft itself cannot be detached from an analytic focus on the role of incentives, which must be effectively manipulated in order to preserve the fundamental functions of the state.

Conceptions of Family-Centered Medical Decisionmaking and Their Difficulties

2003 ◽  
Vol 12 (2) ◽  
pp. 196-200 ◽  
Author(s):  
INSOO HYUN
Keyword(s):  
Patient Autonomy ◽  
Family Members ◽  
Patient Centered ◽  
Medical Decisions ◽  
Competent Patient ◽  
Legitimate Interest ◽  
The Family ◽  
Related Line ◽  
Family Centered ◽  
Decisional Authority

Over the past decade or so, the predominant patient-centered ethos in American bioethics has come under attack by critics who claim that it is morally deficient in certain respects, particularly when viewed in the context of acute-care decisionmaking. One line of criticism has been that the current ethic of patient autonomy gives an individual competent patient far too much decisional authority over the terms of his own treatment so that the patient is at complete liberty to neglect the ways in which his medical decisions can drastically and negatively affect the lives of other family members. Given that family members must help shoulder the financial, emotional, and rehabilitative burdens involved in the patient's care, it has been argued that they too have a legitimate interest in choosing what sort of medical treatment the patient eventually receives. Another closely related line of criticism is that the prevailing focus on patient autonomy gives short shrift to the moral significance of the family as a genuine community. Echoing a view of the person advanced by most communitarian political theorists, some commentators have argued that the patient comes to the clinic so thoroughly embedded in a complex web of familial relationships and obligations that it does not make sense to identify him as the only person in the family to make decisions about treatment.

scholarly journals A Preliminary Survey Examining Predictors of Burnout in Pain Medicine Physicians in the United States

2016 ◽  
Vol 5;19 (5;19) ◽  
pp. E689-E696 ◽  
Author(s):  
Henry Kroll
Keyword(s):  
United States ◽  
Emotional Exhaustion ◽  
Job Insecurity ◽  
Job Demands ◽  
The United States ◽  
Personal Accomplishment ◽  
Job Dissatisfaction ◽  
Pain Medicine ◽  
Coworker Support ◽  
Decisional Authority

Background: Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, defined by 3 dimensions: exhaustion, depersonalization, and reduced personal accomplishment. While there is a growing body of research on burnout in physicians, there is a dearth of literature on burnout in pain medicine physicians. Objective: This study aimed to determine the incidence of burnout amongst pain medicine physicians and whether there are sociodemographic or psychological demand characteristics of the job setting that predict burnout in pain medicine physicians. Study Design and Setting: Cross-section survey of pain medicine physicians across the United States. Methods: Pain medicine physicians were asked questions on sociodemographics and professional characteristics and measures of decisional authority, psychological job demands, job insecurity, perceived coworker support, and job dissatisfaction. Results: Two hundred seven pain medicine physicians’ responses were analyzed, 60.4% reported high emotional exhaustion, 35.7% reported high depersonalization, and 19.3% reported low personal accomplishment. Greater psychological job demands and greater job dissatisfaction predicted greater emotional exhaustion. Younger age and greater job dissatisfaction predicted higher depersonalization. Lastly, lower coworker support and greater job dissatisfaction predicted lower personal accomplishment. There were no statistical violations of assumptions or collinearity. Limitations: Low response rate and potential for response bias limit generalizability of the study. Conclusion(s): Pain medicine physicians in the United States reported high levels of emotional exhaustion, often considered the most taxing aspect of burnout. Job dissatisfaction appeared to be the leading agent in the development of all 3 components of burnout in pain medicine physicians in the United States. Key words: Burnout, pain medicine physicians, job dissatisfaction, decisional authority, psychological job demands

Fiduciary Principles in Health Care

2019 ◽  
pp. 285-302
Author(s):  
Mark A. Hall
Keyword(s):  
Health Care ◽  
Fiduciary Duty ◽  
Duty Of Care ◽  
Private Hospitals ◽  
Full Disclosure ◽  
Legal Decisions ◽  
Health Care Law ◽  
Physician Patient ◽  
Decisional Authority ◽  
Unanimous Agreement

This chapter examines fiduciary principles in health care law. There is no unanimous agreement when it comes to the precise doctrinal consequences of labeling health care actors as fiduciaries in various contexts, such as personal injury, decisional authority, financial influence, and procedural rules. In the case of patients and physicians, certain attributes are said to constitute an archetypal fiduciary relationship, including agency, dependency, trust, and information asymmetry. Thus, many legal decisions and commentators argue that physicians have fiduciary responsibilities to patients. For courts, however, hospitals are not fiduciaries. They regard private hospitals as ordinary commercial enterprises. This chapter first provides an overview of arguments over whether physicians and non-physicians (for example, hospitals and health insurers) are “fiduciaries” before discussing health care fiduciaries’ duty of loyalty and duty of care, along with their other obligations such as duties of confidentiality and full disclosure. It also explores the ability of health care fiduciaries and patients to waive fiduciary duties, as well as how courts have addressed distinct causes of action for physicians’ breach of fiduciary duty. It shows that courts often invoke fiduciary concepts and terminology in discussing physicians’ obligations to patients, and that physician-patient (and other medical treatment) relationships have classic attributes of fiduciary status.

A Revised Theory of Regional Integration

1970 ◽  
Vol 24 (4) ◽  
pp. 836-868 ◽  
Author(s):  
Philippe C. Schmitter
Keyword(s):  
Regional Integration ◽  
International Organization ◽  
Past Work ◽  
Research Tradition ◽  
New Concepts ◽  
Political Inquiry ◽  
Decisional Authority

The study of regional integration, of how national units come to share part or all of their decisional authority with an emerging international organization, is one of the areas of political inquiry in which a cumulative research tradition has developed. Previous paradigms are scrutinized critically in new settings; replications are made and even encouraged; new concepts, hypotheses, and measures are suggested and incorporated without obliterating past work. Under these conditions theoretical formalization may play a particularly fruitful role.

Governing Information Security

2011 ◽  
Vol 24 (1) ◽  
pp. 28-45 ◽  
Author(s):  
Yu ’Andy’ Wu ◽  
Carol Stoak Saunders
Keyword(s):  
Information Security ◽  
Decision Rights ◽  
Security Governance ◽  
Level Information ◽  
Information Security Governance ◽  
Allocation Patterns ◽  
Decision Type ◽  
High Level ◽  
Decisional Authority ◽  
Selection Of

Governance of the information security function is critical to effective security. In this paper, the authors present a conceptual model for security governance from the perspective of decision rights allocation. Based on Da Veiga and Eloff’s (2007) framework for security governance and two high-level information security documents published by the National Institute of Standards and Technology (NIST), the authors present seven domains of information security governance. For each of the governance domains, they propose a main decision type, using the taxonomy of information technology decisions defined by Weill and Ross (2004). This framework recommends the selection of decision rights allocation patterns that are proper to those decision types to ensure good security decisions. As a result, a balance can be achieved between decisional authority and responsibility for information security.

Decision Making in Pediatric Oncology: Who Should Take the Lead? The Decisional Priority in Pediatric Oncology Model

2006 ◽  
Vol 24 (1) ◽  
pp. 160-165 ◽  
Author(s):  
Simon N. Whitney ◽  
Angela M. Ethier ◽  
Ernest Frugé ◽  
Stacey Berg ◽  
Laurence B. McCullough ◽  
...  
Keyword(s):  
Decision Making ◽  
Pediatric Oncology ◽  
Parental Authority ◽  
Ethical Theories ◽  
Clinical Reality ◽  
Parents And Children ◽  
The Family ◽  
Dominant Characteristic ◽  
Medical Choice ◽  
Decisional Authority

Decision making in pediatric oncology can look different to the ethicist and the clinician. Popular ethical theories argue that clinicians should not make decisions for patients, but rather provide information so that patients can make their own decisions. However, this theory does not always reflect clinical reality. We present a new model of decision making that reconciles this apparent discrepancy. We first distinguish decisional priority from decisional authority. The person (parent, child, or clinician) who first identifies a preferred choice exercises decisional priority. In contrast, decisional authority is a nondelegable parental right and duty, in which a mature child may join. This distinction enables us to analyze decisional priority without diminishing parental authority. This model analyzes decisions according to two continuous underlying characteristics. One dominant characteristic is the likelihood of cure. Because cure, when possible, is the ultimate goal, the clinician is in a better position to assume decisional priority when a child probably can be cured. The second characteristic is whether there is more than one reasonable treatment option. The interaction of these two complex continual results in distinctive types of decisional situations. This model explains why clinicians sometimes justifiably assume decisional priority when there is one best medical choice. It also suggests that clinicians should particularly encourage parents (and children, when appropriate) to assume decisional priority when there are two or more clinically reasonable choices. In this circumstance, the family, with its deeper understanding of the child's nature and preferences, is better positioned to take the lead.

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