Autonomy, Privacy and the Implementation of the Principle of Informed Consent with regard to the Nursing Interventions from the View of elderly People

Pflege ◽  
2001 ◽  
Vol 14 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Anja Schopp ◽  
Theo Dassen ◽  
Maritta Välimäki ◽  
Helena Leino-Kilpi ◽  
Gerd Bansemir ◽  
...  
Keyword(s):  
Informed Consent ◽  
Elderly People ◽  
Ältere Menschen ◽  
Nursing Interventions ◽  
Patient’S Autonomy

Ziel dieser Untersuchung war die Autonomie, Privatheit und die Umsetzung des Prinzips der «informierten Zustimmung» aus der Perspektive des institutionell zu betreuenden, älteren Menschen zu beschreiben. Die Untersuchung ist ein Teil des durch die EU-Kommission unterstützten BIOMED 2 Projektes «Patient’s autonomy and privacy in nursing interventions»1. Interviewdaten (n = 95) wurden in deutschen Kliniken der Geriatrie und Pflegeheimen gesammelt. Ergebnisse zeigten, dass die Teilnehmer in geringem Maß selbstbestimmte Entscheidungen treffen konnten. Das Prinzip der «informierten Zustimmung» wurde wenig umgesetzt. Ihre Privatheit sahen die Teilnehmer in Mehrbettzimmern sowie in Situationen des Ankleidens und bei der Verrichtung der Ausscheidungen nicht respektiert. Es ist anzunehmen, dass ältere Menschen wegen Informationsdefiziten, durch ihren Hilfsbedarf und durch die festgelegten Organisationsstrukturen der Pflegeeinrichtungen eine passive Krankenrolle übernehmen. Es wäre denkbar, dass die Autonomie der älteren Menschen gefördert werden könnte, wenn die Pflegekräfte sie in der Rolle des Fürsprechers bei selbstbestimmten Entscheidungen unterstützen würden. Bei den pflegerischen Interventionen würde die Umsetzung des Prinzips der «informierten Zustimmung» sowohl die Autonomie als auch die Respektierung der Privatheit fördern. Es ist außerdem anzunehmen, dass durch Flexibilisierung der Organisationsstrukturen der Pflegeeinrichtungen die Autonomie und Lebensqualität der älteren Menschen gefördert werden könnte.

Perceptions of Informed Consent in the Care of Elderly People in Five European Countries

2003 ◽  
Vol 10 (1) ◽  
pp. 48-57 ◽  
Author(s):  
Anja Schopp ◽  
Maritta Välimäki ◽  
Helena Leino-Kilpi ◽  
Theo Dassen ◽  
Maria Gasull ◽  
...  
Keyword(s):  
Informed Consent ◽  
Elderly Patients ◽  
Comparative Research ◽  
European Countries ◽  
Nursing Interventions ◽  
Nursing Ethics ◽  
Staff Perceptions ◽  
Nurses Perceptions ◽  
Care Of Elderly ◽  
The Uk

The focus of this article is on elderly patients’ and nursing staff perceptions of informed consent in the care of elderly patients/residents in five European countries. The results suggest that patients and nurses differ in their views on how informed consent is implemented. Among elderly patients the highest frequency for securing informed consent was reported in Finland; the lowest was in Germany. In contrast, among nurses, the highest frequency was reported in the UK (Scotland) and the lowest in Finland. In a comparison of patients’ and nurses’ perceptions, nurses had more positive views than patients in all countries except Finland. Patients with less need for nursing interventions in Greece and Spain gave their consent less often. The German and Greek patients were older, and the results also point to an association between this and their lower frequency of giving consent. In Spain, patients who were married or who had a family member or friend to look after their personal affairs were more likely to be included in the group whose consent was sought less often. This is the fourth of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented.

Response to “Reassessing the Reliability of Advance Directives” by Thomas May (CQ Vol. 6, No. 5)

1998 ◽  
Vol 7 (4) ◽  
pp. 405-413 ◽  
Author(s):  
Christopher Tollefsen
Keyword(s):  
Informed Consent ◽  
Advance Directives ◽  
Patient Autonomy ◽  
Recent Article ◽  
Prima Facie ◽  
Modern Medicine ◽  
Moral Principles ◽  
Patient’S Autonomy

In a recent article Thomas May has argued that the use of advance directives (ADs) to respect a no longer competent patient's autonomy is a failed strategy. Respect for patient autonomy is clearly one of the guiding moral principles of modern medicine, and its importance is reflected in medical emphasis on informed consent. Prima facie, at least, ADs seem likewise to respect patient autonomy by allowing patients to make decisions about treatment in advance of situations in which the patient may no longer be able to specify the form of treatment desired. So a claim that ADs do not extend patient autonomy to these situations of diminished competence represents a serious criticism of our understanding not only of advance directives, but of autonomy as well.

scholarly journals 知情同意臨床實踐實證研究——第一人稱視角的考察

2017 ◽  
Vol 15 (2) ◽  
pp. 9-20
Author(s):  
Hua CHEN ◽  
Yonghui MA
Keyword(s):  
Informed Consent ◽  
Individual Autonomy ◽  
Medical Treatments ◽  
Legal Implications ◽  
Patient’S Autonomy ◽  
Digital Commons ◽  
Consent Document ◽  
Informed Consent Document ◽  
China Today ◽  
Medical Policy

LANGUAGE NOTE | Document text in Chinese; abstract also in English.知情同意作為一項權利，患者成為闡述其體驗的首要主體。實證調查表明，患者對於其權利認知還存在不足，多數偏好於患者與家庭共用模式；在實踐中，知情與同意在主體層面存在分離現象。對於病情的告知傾向於任選模式，但家庭是不可或缺的告知物件，對於診療、護理等相關資訊，傾向於患者模式；在同意方面，家屬成為獲取同意的主體。經濟因素成為患方“不同意”的首要原因。對於不同維度的調查表明，基於女性相對脆弱性特點，他們對於家庭的依賴性更強，其維權意識更強；在年齡層面，青少年對於權利的認知更理性，具有現代契約精神。在地域層面，縣級以上城市居民對於權利認知度更高；職業往往與教育程度相關，表明農民的個體依賴性更強；政府機關以及事業單位人員個體主體性更強。為此，需要加強患者權利教育，提升主體意識；對醫務人員加強職業道德教育，履行告知義務，強化醫患信任；深化醫療衛生體制改革，為知情同意的踐行提供空間與時間。An informed consent document is vital for all surgical procedures and medical treatments. Proper documentation and counseling of patients is important for informed consent. Opinion polls conducted in this essay show that the majority of people in China today have accepted informed consent as a legally binding medical policy, yet they do not fully understand the ethical and legal connotations involved, particularly the idea of the patient’s autonomy. As a result, the patient’s own experience as a first-person narrative is often ignored and his/her subjectivity is blurred when his/her family’s subjectivity intervenes. According to the essay, the problem appears when liberalism—which emphasizes individual autonomy and rights—does not square with the Confucian tradition that emphasizes family as a coherent unit. The essay also points out that there is a huge difference in patients’ perceptions of “individual rights,” due to their different levels of education. The author argues that informed consent could be better practiced if both doctors and patients were “well informed” and understood the moral and legal implications of informed consent.DOWNLOAD HISTORY | This article has been downloaded 97 times in Digital Commons before migrating into this platform.

scholarly journals 病人自主性與家庭本位主義之間的張力

2002 ◽  
Vol 4 (2) ◽  
pp. 70-84
Author(s):  
Jin-cheng LEI ◽  
Zhi-qing XIE
Keyword(s):  
Informed Consent ◽  
Basic Unit ◽  
Individual Autonomy ◽  
Cultural Tradition ◽  
The West ◽  
Cultural Contexts ◽  
Patient’S Autonomy ◽  
The Family ◽  
The Difference ◽  
The Individual

LANGUAGE NOTE | Document text in Chinese; abstract also in English.在中國幾千年小農經濟和傳統文化背景下，個人利益、個人權利一直被置於家庭之下，個人自主性被包含在家庭自主性之內，表現為一種家庭本位主義。源自西方歷史、文化的知情同意移植到中國後，受傳統文化概念的影響，中國人對知情同意的認知、理解以及實踐方式均不同於西方人。這種不同集中表現在人們對家屬同意權的認可。以個人本位主義為背景的病人自主性與中國文化中的家庭本位主義之間存在張力。對知情同意在不同文化環境中不同踐行方式，應以文化寬容主義的態度對待之。不同文化背景下的倫理觀念，不僅存在差異性，而且也存在可通約性和相容性。由於種種原因，家庭同意並不能等同於病人本人的意願。隨著全球化進程的加速和人們相互交往的密切，類似知情同意這樣一些原本屬於個人的自然權利，將會愈來愈多地為各國人民接受。我們應當在某些條件具備時，盡可能地將家屬同意限制在合理的範圍，讓病人更好地表達自己的意願。Family has a long history. With China's small-scale peasant economy and traditional cultural background for centuries, family has been the most basic unit of polity, economy, and socio-cultural life. Interests and rights of the individual are always placed below those of family; individual autonomy is often included in family autonomy. All this can be called familism. There are deeper and determining economic reasons for familism. The economy of the family is controlled by the head of the family or clan so that the individual usually has no independent economic measures to support his or her autonomous rights.Informed consent originated in the Western culture. The theoretical premise of informed consent is respect for the patient's autonomy. The patient's autonomy is closely related with individualism in the West. After informed consent is spread from the West to China, due to the influence of traditional Chinese culture, the Chinese perception, understanding, and practice of are different from those of the West. The difference mainly lies in Chinese familism. To focus on the autonomy of the family reflects the influence of traditional familism upon informed consent. As a result, there exits a tension between the patient's autonomy based on individualism and familism in Chinese culture.Informed consent is not a culture issue, but it is closely related with cultural tradition. It is impossible to get away with cultural norms in the practice of informed consent. To different practicing methods of informed consent in different cultural contexts, the spirit of cultural tolerance is needed. In China, with the principle of cultural tolerance as a practical guidance, we should establish a set of procedure and ways of practicing informed consent with Chinese characteristics. Fundamentally, informed consent is to balance the unbalanced power between doctors and patients. According to the principle of cultural tolerance, the difference in the practice of informed consent at different cultural contexts should be tolerated so long as the basic purpose of informed consent is not violated. There exists a variety of cultural ideas among contemporary Chinese. The individual patient and his or her family are essential part of informed consent, with both having their rationality. Thus, we shouldn't reject absolutely some methods. From the angle of historical development, it is worthwhile noticing the transformation from family determination to individual autonomy. National and cultural differences are integrating in the age of globalization. Since laws, ethics, and customs in different countries and cultures are mutually exchanging, we should promote to make the practice of informed consent to become similar.DOWNLOAD HISTORY | This article has been downloaded 35 times in Digital Commons before migrating into this platform.

scholarly journals Nursing intervention assessment tool fall prevention in elderly people with systemic arterial hypertension

2020 ◽  
Vol 10 (7) ◽  
pp. 60 ◽  
Author(s):  
Paula Cristina Morais Pinheiro ◽  
Glauciano de Oliveira Ferreira ◽  
Francisca Valúzia Guedes Guerra ◽  
Tahissa Frota Cavalcante ◽  
Nirla Gomes Guedes ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Elderly People ◽  
Fall Prevention ◽  
Assessment Tool ◽  
Nursing Intervention ◽  
Nursing Interventions ◽  
Final Assessment ◽  
Nursing Diagnosis ◽  
Effective Interventions ◽  
Risk Of Falls

Background and objective: Elderly people are at greater risk for falls and, therefore, need effective interventions to prevent them. The aim of the study was to develop an assessment tool for nursing intervention fall prevention to elderly with arterial hypertension and with nursing diagnosis Risk of falls.Methods: A methodological study, accomplished in four stages: activities selection of the fall Prevention intervention from Nursing Interventions Classification (NIC); 2) construction of constructive definitions and operational for selected activities; 3) expert validation of constructed definitions; 4) pretest of the final assessment tool.Results: The experts selected 50 activities out of 65 presented by NIC. The constitutive and operational definitions of the 50 activities were elaborated. From the focus group, some activities were grouped and the content of others changed. The pretest showed that, although the application of the assessment tool with the definitions take longer, it was more complete and targeted. The final assessment tool contains 28 activities with constitutive definitions and operational.Conclusions: The produced assessment tool has nursing activities with constitutive and operational definitions suitable for clinical nursing practice. It is believed that it can lead the intervention of the nurses in preventing falls in elderly people with SAH and with the nursing diagnosis Risk of falls.

Surgical nurses’ knowledge and practices about informed consent

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2172-2184 ◽  
Author(s):  
Elif Akyüz ◽  
Hülya Bulut ◽  
Mevlüde Karadağ
Keyword(s):  
Informed Consent ◽  
Research Question ◽  
Healthcare Providers ◽  
Nursing Interventions ◽  
Roles And Responsibilities ◽  
Policies And Procedures ◽  
Surgical Nurses ◽  
Patient Consent ◽  
Collection Form ◽  
The University

Background: Informed consent involves patients being informed, in detail, of information relating to diagnosis, treatment, care and prognosis that relates to him or her. It also involves the patient explicitly demonstrating an understanding of the information and a decision to accept or decline the intervention. Nurses in particular experience problems regarding informed consent. Research question and design: This descriptive study was designed to determine nurse knowledge and practices regarding their roles and responsibilities for informed consent in Turkey. The research was performed using 92 nurses who work at the surgical clinics. Data collection form was prepared by the researchers with assistance from the literature, and the data were evaluated by the SPSS 12.0 data analysis program. Ethical consideration: This study was approved by the Medicine and Health Sciences Research and Ethics Committee of the university. Written consent was received from the nurses. Findings: Among the nurses who participated in this study, 39.1% indicated that they were responsible for obtaining informed consent. It was also found that 90.2% of the nurses informed patients before providing nursing interventions and 32.6% of the nurses obtained consent from patients, and 90.0% of the nurses who indicated that they obtain patient consent only obtain verbal consent. Among all of the nurses, 21.7% agreed that informed consent needs to be obtained in order to protect the medical staff legally. Discussion: It is argued that a lack of official procedures at hospitals regarding informed consent and insufficient information being provided to healthcare providers has caused problems regarding informed consent. Conclusion: The nurses in this study lacked information regarding their role in obtaining informed consent from patients and they often performed incomplete and/or incorrect practices within the framework of their required role. It is believed that an increased level of education along with the creation of official policies and procedures would contribute towards solving these problems.

Confrontation of Human Rights in Daily Clinical Situations

2016 ◽  
pp. 255-281
Author(s):  
Anna Konieczna ◽  
Przemysław Słomkowski
Keyword(s):  
Human Rights ◽  
Informed Consent ◽  
Terminal Care ◽  
Moral Distress ◽  
Real Life ◽  
Self Determination ◽  
Icu Patients ◽  
Care Treatment ◽  
Patient’S Autonomy ◽  
Values And Beliefs

The chapter concerns human rights as they are enacted in daily clinical situations. It invokes basic documents describing human rights as well as legislative acts dealing more specifically with the rights of doctors and patients. Basing on the theoretical legislative background, the text presents cases of conflict and misunderstanding between various participants of clinical situations. The authors are mainly concerned with the clash of values and beliefs concerning terminal care treatment of ICU patients and with the issue of patient's autonomy and self-determination. The concepts of informed consent and moral distress are explained and visualized with real life examples.

Confrontation of Human Rights in Daily Clinical Situations

2017 ◽  
pp. 1220-1245
Author(s):  
Anna Konieczna ◽  
Przemysław Słomkowski
Keyword(s):  
Human Rights ◽  
Informed Consent ◽  
Terminal Care ◽  
Moral Distress ◽  
Real Life ◽  
Self Determination ◽  
Icu Patients ◽  
Care Treatment ◽  
Patient’S Autonomy ◽  
Values And Beliefs

The chapter concerns human rights as they are enacted in daily clinical situations. It invokes basic documents describing human rights as well as legislative acts dealing more specifically with the rights of doctors and patients. Basing on the theoretical legislative background, the text presents cases of conflict and misunderstanding between various participants of clinical situations. The authors are mainly concerned with the clash of values and beliefs concerning terminal care treatment of ICU patients and with the issue of patient's autonomy and self-determination. The concepts of informed consent and moral distress are explained and visualized with real life examples.

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