Prescribing: the ethical dimension

2004 ◽  
Vol 1 (7) ◽  
pp. 1-3 ◽  
Author(s):  
John Adams
Keyword(s):  
Clinical Practice ◽  
Ethical Dilemmas ◽  
Biomedical Ethics ◽  
Everyday Practice ◽  
Ethical Dimension ◽  
Ethical Reflection ◽  
Respect For Autonomy

SummaryPrescribers face a range of ethical dilemmas in their everyday practice. In this article, the principles-based approach to biomedical ethics developed by Beauchamp and Childress is outlined, with a particular focus on ‘respect for autonomy’. It is argued that the purpose of ethical reflection is to deepen and enrich more general reflection about clinical practice, rather than to provide definitive answers to dilemmas in prescribing.

scholarly journals Nursing students’ experience of learning ethical competence and person-centred care through simulation

2021 ◽  
Vol 11 (2) ◽  
pp. 1-13
Author(s):  
Tone K. Knudsen Oddvang ◽  
◽  
Anne-Lise G. Loftfjell ◽  
Liv Mari Brandt ◽  
Kristin Sørensen ◽  
...  
Keyword(s):  
Nursing Education ◽  
Clinical Practice ◽  
Nursing Students ◽  
Learning Strategy ◽  
Ethical Dilemmas ◽  
Research Question ◽  
Ethical Reflection ◽  
Ethical Competence ◽  
Clinical Scenarios ◽  
Starting Point

Background: Ethics is a difficult subject for nursing students to grasp and learn but, like person-centredness, it has an important role in the relationship between nurses and patients. Simulation has been found to be a suitable method for learning nursing procedures and actions, and the researchers wanted to explore whether it could be a suitable learning strategy for acquiring ethical skills, which are a prerequisite for delivering person-centred care. Aim: In response to the research question How can nursing students develop ethical competence through simulation? the study sought to consider how students could learn ethical reflection and decision making through simulated ethical dilemmas, and whether this could enhance their ability to deliver person-centred care. Design: The study was qualitative and exploratory, and based on students acting in scenarios representing general ethical dilemmas in nursing. There were four focus group interviews with nine nursing students in their second year, during their clinical practice. Students were recruited by self-selection. Data were transcribed and analysed using Graneheim and Lundman’s content analysis. Findings: The students gained experience through participation and acting in simulation exercises. The shared experience was a good starting point for guided reflection on ethical and tacit knowledge, and the acquired experience led to knowledge that is transferable to similar situations in clinical practice. Conclusion: This study shows that simulation is a valuable method for learning ethical reflection in nursing education. It found simulation to be suitable for developing ethical awareness that helps prepare nursing students to deliver person-centred practice. It has become a permanent learning strategy within nursing training at Nord University. Implications for practice: • Nursing students benefit from learning to practise critical ethical thinking as early as possible in order to become ethically aware and reflective during their training and later as nurses • Simulation is a valuable way to practise personal relationships with patients and colleagues • Simulated clinical scenarios improve competence in critical thinking and ethical conduct, and help prepare nurses to deliver person-centred practice. They can be used in all healthcare settings.

Ethical dilemmas in clinical practice

1993 ◽  
Author(s):  
William A. Rae ◽  
Frances Worchel
Keyword(s):  
Clinical Practice ◽  
Ethical Dilemmas

scholarly journals Kardia Mobile and ISTEL HR applicability in clinical practice: A comparison of Kardia Mobile, ISTEL HR and standard 12-lead electrocardiogram records in 98 consecutive patients of a tertiary cardiovascular care centre

2021 ◽  
Author(s):  
Bartosz Krzowski ◽  
Kamila Skoczylas ◽  
Gabriela Osak ◽  
Natalia Żurawska ◽  
Michał Peller ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Sinus Rhythm ◽  
Sensitivity And Specificity ◽  
Heart Rhythm ◽  
Everyday Practice ◽  
Portable Devices ◽  
Care Centre ◽  
Cardiovascular Care

Abstract Aims Mobile, portable ECG-recorders allow the assessment of heart rhythm in out-of-hospital conditions and may prove useful for monitoring patients with cardiovascular diseases. However, the effectiveness of these portable devices has not been tested in everyday practice. Methods and results A group of 98 consecutive cardiology patients (62 males [63%], mean age 69 ± 12.9 years) were included in an academic care centre. For each patient, a standard 12-lead electrocardiogram (SE), as well as a Kardia Mobile 6L (KM) and Istel (IS) HR-2000 ECG were performed. Two groups of experienced physycians analyzed obtained recordings. After analyzing ECG tracings from SE, KM, and IS, quality was marked as good in 82%, 80%, and 72% of patients, respectively (p < 0.001). There were no significant differences between devices in terms of detecting sinus rhythm (SE [60%, n = 59], KM [58%, n = 56], and IS [61%, n = 60]; SE vs KM p = 0.53; SE vs IS p = 0.76) and atrial fibrillation (SE [22%, n = 22], KM [22%, n = 21], and IS [18%, n = 18]; (SE vs KM p = 0.65; SE vs IS = 0.1). KM had a sensitivity of 88.1% and a specificity of 89.7% for diagnosing sinus rhythm. IS showed 91.5% and 84.6% sensitivity and specificity, respectively. The sensitivity of KM in detecting atrial fibrillation was higher than IS (86.4% vs. 77.3%), but their specificity was comparable (97.4% vs. 98.7%). Conclusion Novel, portable devices are useful in showing sinus rhythm and detecting atrial fibrillation in clinical practice. However, ECG measurements concerning conduction and repolarisation should be clarified with a standard 12-lead electrocardiogram.

scholarly journals Ethics of Vaccination in Childhood—A Framework Based on the Four Principles of Biomedical Ethics

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 113
Author(s):  
Meta Rus ◽  
Urh Groselj
Keyword(s):  
Public Health ◽  
Moral Obligation ◽  
Common Good ◽  
Herd Immunity ◽  
Ethical Analysis ◽  
Biomedical Ethics ◽  
Responsibility To Protect ◽  
Ethical Aspects ◽  
Respect For Autonomy ◽  
Mandatory Vaccination

Although vaccination is recognised as the top public health achievement of the twentieth century, unequivocal consensus about its beneficence does not exist among the general population. In countries with well-established immunisation programmes, vaccines are “victims of their own success”, because low incidences of diseases now prevented with vaccines diminished the experience of their historical burdens. Increasing number of vaccine-hesitant people in recent years threatens, or even effectively disables, herd immunity levels of the population and results in outbreaks of previously already controlled diseases. We aimed to apply a framework for ethical analysis of vaccination in childhood based on the four principles of biomedical ethics (respect for autonomy, nonmaleficence, beneficence and justice) to provide a comprehensive and applicable model on how to address the ethical aspects of vaccination at both individual and societal levels. We suggest finding an “ethical equilibrium”, which means that the degree of respect for parents’ autonomy is not constant, but variable; it shall depend on the level of established herd immunity and it is specific for every society. When the moral obligation of individuals to contribute to herd immunity is not fulfilled, mandatory vaccination policies are ethically justified, because states bear responsibility to protect herd immunity as a common good.

scholarly journals A principled Australian text

2005 ◽  
Vol 29 (3) ◽  
pp. 369
Author(s):  
William J Uren
Keyword(s):  
Ethical Dilemmas ◽  
Biomedical Ethics ◽  
Theory And Practice ◽  
Central Values ◽  
Moral Principles ◽  
American Authors

In 1979, the American authors Tom L Beauchamp and James F Childress published the first edition of Principles of biomedical ethics. They espoused the theory of what has come to be known as ?principlism? as a bridge between the deontological and ut i l i tarian approaches to bioethics. They identified four central values ? autonomy, beneficence, non-maleficence and justice ? as the fundamental moral principles in terms of which to address ethical dilemmas in biomedical theory and practice.

scholarly journals The placebo effect

2006 ◽  
Vol 30 (5) ◽  
pp. 185-188 ◽  
Author(s):  
Sundararajan Rajagopal
Keyword(s):  
Clinical Practice ◽  
Psychiatric Disorders ◽  
Placebo Effect ◽  
Ethical Dilemmas ◽  
Medical Conditions ◽  
Wide Range ◽  
The Common

The placebo effect is a fascinating phenomenon in clinical practice. Studies have shown that there is a significant placebo effect in a wide range of medical conditions including psychiatric disorders. This article looks at the background of the placebo effect, defines the common terms used, describes the various hypotheses that have been put forward to explain this seemingly inexplicable phenomenon and also covers the issue of using placebos in research trials, highlighting the important ethical dilemmas involved. Throughout, specific emphasis is given to psychiatry.

Respect for Autonomy: Seeking the Roles of Healthcare Design From the Principle of Biomedical Ethics

2020 ◽  
Vol 13 (3) ◽  
pp. 230-244
Author(s):  
Liwei Zhu ◽  
Shanshan Zhang ◽  
Zhipeng Lu
Keyword(s):  
Patient Autonomy ◽  
Modern Society ◽  
Biomedical Ethics ◽  
Environment Design ◽  
Design Strategies ◽  
Respect For Autonomy ◽  
Healthcare Environment ◽  
Patient’S Autonomy ◽  
Definition Of

Objective: This article aims to discuss the role of the healthcare environment on patient’s autonomy. Referring to biomedical ethics will provide a research logic and form a theoretical framework for healthcare designers to define patient autonomy, to master the conditions for promoting it, and to discover the potential of the environment. Background: In modern society, it becomes the responsibility of healthcare architects to realize the design of “benefit for patients.” The goal of healthcare environment design and research is also gradually from a basic level of ensuring the physiological safety of patients to achieving a higher level of respecting patients and helping realize their self-realization. However, how to express respect to patients in the healthcare environment is ambiguous. In order to break through the limitation of architectural specialty, we propose to introduce biomedical ethics. Under this major premise, this article will discuss from the perspective of respect for autonomy (RA). Method: This article combines the definition of autonomy and the discussion of the medical and nursing practice to summarize and propose the themes about RA. It draws on the top-down deductive logic of biomedical ethics from theory to application and applies the three-condition theory of Beauchamp and Childress to deduce the role of the healthcare environment on patient autonomy in each theme. Conclusion: Introducing biomedical ethics into the study of environmental design provides a more theoretical and systematic way of thinking about the role of the healthcare environment. Some autonomy-supportive design strategies are collected and proposed.

CO-ACTIVE COACHING SUPPORTING THE DEVELOPMENT OF SKILLS IN SOLVING ETHICAL DILEMMAS IN ACCOUNTING AND FINANCE-RELATED PROFESSIONS

2019 ◽  
Vol 20 (4) ◽  
pp. 23-44
Author(s):  
Janina Stankiewicz ◽  
Hanna Bortnowska ◽  
Patrycja Łychmus
Keyword(s):  
Decision Making ◽  
Market Economy ◽  
Ethical Dilemma ◽  
Professional Ethics ◽  
Ethical Dilemmas ◽  
Ethical Dimension ◽  
Coaching Session ◽  
Key Competencies ◽  
The Subject

In contemporary market economy, an increasing importance is attributed to the observance of ethics. The subject of considerations of researchers dealing with this issue is also the ethical dimension of professions, including those ones, which are related to accounting and finances. It is recognized the need to develop substantive and interpersonal competences, but also in the field of professional ethics. The aim of the article is: 1) to demonstrate that co-active coaching is a particularly useful tool for developing skills to solve ethical dilemmas among employees working in accounting and finance; 2) to present the key competencies of a co-active coach, with particular emphasis on the ability to ask questions facilitating analysis and decision-making for the coachee when facing an ethical dilemma; 3) to present the stages of a coaching session supporting the development of skills to solve ethical dilemma common among professionals whose job relates to accounting and finance using the GROW model, plus to indicate selected questions recommended in each of these stages. It was achieved on the basis of the results of the analysis of the literature of the subject.

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