Ethical Issues in Healthcare for Women in the Context of Violence

2019 ◽  
pp. 129-148
Author(s):  
Rochelle Einboden ◽  
Colleen Varcoe
Keyword(s):  
Violence Against Women ◽  
Ethical Issues ◽  
Ethical Reasoning ◽  
Case Finding ◽  
Relational Ethics ◽  
Health Issue ◽  
Women's Lives ◽  
Forms Of Violence ◽  
Policies And Practices

Violence against women is a complex social and health issue. Addressing it meaningfully requires careful ethical reasoning. This chapter offers an overview of the issue of violence against women, beginning with its definition and the link between structural and interpersonal forms of violence. The implications of using traditional bioethical reasoning in this context are analyzed, followed by the use of relational ethics, which is shown to be superior. The chapter ends by focusing on healthcare policies and practices that respond ethically to violence against women. Considered are managing disclosures of violence, establishing trauma- and violence-informed policies, using case finding as an alternative to screening, and ensuring that responses are culturally safe and supportive, do not stigmatize the woman, and consider the context of women’s lives and relationships, especially their caregiving relationships.

scholarly journals Inter-physician variability in strategies linked to treatment limitations after severe traumatic brain injury; proactivity or wait-and-see

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Annette Robertsen ◽  
Eirik Helseth ◽  
Reidun Førde
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Ethical Issues ◽  
Ethical Reasoning ◽  
Depth Information ◽  
Worst Case ◽  
Life Sustaining Treatment ◽  
Wait And See ◽  
Prognostic Uncertainty

Abstract Background Prognostic uncertainty is a challenge for physicians in the neuro intensive care field. Questions about whether continued life-sustaining treatment is in a patient’s best interests arise in different phases after a severe traumatic brain injury. In-depth information about how physicians deal with ethical issues in different contexts is lacking. The purpose of this study was to seek insight into clinicians’ strategies concerning unresolved prognostic uncertainty and their ethical reasoning on the issue of limitation of life-sustaining treatment in patients with minimal or no signs of neurological improvement after severe traumatic brain injury in the later trauma hospital phase. Methods Interviews with 18 physicians working in a neurointensive care unit in a large Norwegian trauma hospital, followed by a qualitative thematic analysis focused on physicians’ strategies related to treatment-limiting decision-making. Results A divide between proactive and wait-and-see strategies emerged. Notwithstanding the hospital’s strong team culture, inter-physician variability with regard to ethical reasoning and preferred strategies was exposed. All the physicians emphasized the importance of team—family interactions. Nevertheless, their strategies differed: (1) The proactive physicians were open to consider limitations of life-sustaining treatment when the prognosis was grim. They initiated ethical discussions, took leadership in clarification and deliberation processes regarding goals and options, saw themselves as guides for the families and believed in the necessity to prepare families for both best-case and worst-case scenarios. (2) The “wait-and-see” physicians preferred open-ended treatment (no limitations). Neurologically injured patients need time to uncover their true recovery potential, they argued. They often avoided talking to the family about dying or other worst-case scenarios during this phase. Conclusions Depending on the individual physician in charge, ethical issues may rest unresolved or not addressed in the later trauma hospital phase. Nevertheless, team collaboration serves to mitigate inter-physician variability. There are problems and pitfalls to be aware of related to both proactive and wait-and-see approaches. The timing of best-interest discussions and treatment-limiting decisions remain challenging after severe traumatic brain injury. Routines for timely and open discussions with families about the range of ethically reasonable options need to be strengthened.

Violence before pregnancy and the risk of violence during pregnancy

2018 ◽  
Vol 46 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Vislava Globevnik Velikonja ◽  
Miha Lučovnik ◽  
Tanja Premru Sršen ◽  
Vesna Leskošek ◽  
Megie Krajnc ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Response Rate ◽  
Intimate Partner ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Anonymous Questionnaire ◽  
Violence During Pregnancy ◽  
Forms Of Violence ◽  
In Pregnancy ◽  
Consequences Of Violence

AbstractObjective:To investigate the relationships among different forms of violence before and during pregnancy.Material and methods:An anonymous questionnaire (adapted NorAQ) was given to 1269 women after childbirth.Results:The response rate was 80% (n=1018). Different forms of violence were experienced by 46.9% of the women; 9.2% reported violence in pregnancy. Suffering from the consequences of violence was reported by 43.8% of the women; sexual (76.6%) and psychological (54.1%) ranked the highest. Past experience of any form of violence increased the risk of violence in pregnancy, violences experienced in adulthood even more than that in childhood [odds ratio (OR) 4.2, 95% confidence interval (CI) 2.7–6.5 vs. OR 1.9, 95% CI 1.2–2.9]. The onset of violence during pregnancy is rare. Violence was most frequently exerted by the intimate partner.Conclusion:Healthcare systems have access to most women of reproductive age, thus they have the unique opportunity to identify and adequately manage violence against women and its consequences.

scholarly journals Intersectional Violence against Women in Politics

2018 ◽  
Vol 14 (4) ◽  
pp. 685-690 ◽  
Author(s):  
Rebecca Kuperberg
Keyword(s):  
Violence Against Women ◽  
Women In Politics ◽  
Forms Of Violence ◽  
Theoretical Conceptualization

The field of violence against women in politics (VAWIP) is so new, it seems unfair to discuss its “gaps”; rather, the study of VAWIP is defined by its uncharted territory. The bulk of existing literature, compiled by scholars as well as practitioners, emphasizes theoretical conceptualization, empirical forms of violence, and the tracking of incidents across regions (Krook 2017; Krook and Restrepo Sanín 2016). Researchers have stressed the gendered motivations and implications of VAWIP. In short, women are targets of violence because they are women and because they are in politics.

scholarly journals Physical, sexual and psychological intimate partner violence and non-partner sexual violence against women and girls: a systematic review protocol for producing global, regional and country estimates

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045574
Author(s):  
Heidi Stöckl ◽  
Lynnmarie Sardinha ◽  
Mathieu Maheu-Giroux ◽  
Sarah R Meyer ◽  
Claudia García-Moreno
Keyword(s):  
Systematic Review ◽  
Sexual Violence ◽  
Violence Against Women ◽  
Partner Violence ◽  
Population Based ◽  
Intimate Partner ◽  
Sustainable Development Goal ◽  
Development Goal ◽  
Women And Girls ◽  
Forms Of Violence

IntroductionIn 2013, the WHO published the first global and regional estimates on physical and sexual intimate partner violence (IPV) and non-partner sexual violence (NPSV) based on a systematic review of population-based prevalence studies. In this protocol, we describe a new systematic review for the production of updated estimates for IPV and NPSV for global monitoring of violence against women, including providing the baseline for measuring Sustainable Development Goal to eliminate all forms of violence against women and girls.Methods and analysisThe systematic review will update and extend the previous search for population-based surveys (either nationally or subnationally representative) conducted among women aged 15+ years that measured the prevalence of physical, sexual, psychological and physical and/or sexual IPV, NPSV or sexual violence by any perpetrator up to December 2019. Data will be extracted separately for all age groups, setting (urban/rural), partnership status (currently partnered/ever partnered/all women) and recall period (lifetime prevalence/past 12 months). Studies will be identified from electronic searches of online databases of EMBASE, MEDLINE, Global Health and PsycInfo. A search of national statistics office homepages will be conducted for each country to identify reports on population-based, national or subnational studies that include data on IPV or NPSV published outside academic journals. Two reviewers will be involved in quality assessment and data extraction of the review. The review is planned to be updated on a continuous basis. All findings will undergo a country consultation process.Ethics and disseminationFormal ethical approval is not required, as primary data will not be collected. This systematic review will provide a basis and a follow-up tool for global monitoring of the Sustainable Development Goal Target 5.2 on the elimination of all forms of violence against women and girls.PROSPERO registration numberCRD42017054100.

What Is Violence against Women and Girls (VAWG)?

2020 ◽  
Author(s):  
Jacqui True
Keyword(s):  
Domestic Violence ◽  
Intimate Partner Violence ◽  
Violence Against Women ◽  
Partner Violence ◽  
Intimate Partner ◽  
Wide Range ◽  
Women And Girls ◽  
Forms Of Violence

What do we mean by VAWG? “Violence against women and girls” (VAWG) is a catch-all phrase. It includes a wide range of forms of violence. Often when people talk about VAWG in Western societies, they are referring to intimate partner violence or domestic violence...

Violence against Women as a Health Care Issue

2018 ◽  
pp. 286-302
Author(s):  
Sangeeta Rege ◽  
Padma Bhate-Deosthali
Keyword(s):  
Health Care ◽  
Violence Against Women ◽  
Health Professionals ◽  
Health Facilities ◽  
International Treaties ◽  
Health Consequences ◽  
Care Issue ◽  
The Government ◽  
Forms Of Violence ◽  
Care Response

Women often approach health facilities to seek treatment for health consequences emerging out of violence. Health facilities are also mandated by several laws in India to play a therapeutic and forensic role in responding to women facing violence. Despite India being a signatory to international treaties, health professionals are unable to respond to violence owing to their own biases and misconceptions related to the issue. The chapter discusses the prevalence of violence against women, the resultant health consequences, and perceptions of health professionals towards this violence. While doing so the chapter raises concerns about the lack of institutionalised health care response and draws attention to the policy gaps that keeps the government from committing itself to ending all forms of violence against women.

Economic Violence

2020 ◽  
pp. 177-186
Author(s):  
Mona Lena Krook
Keyword(s):  
Civil Society ◽  
Violence Against Women ◽  
Financial Support ◽  
Economic Hardship ◽  
Women In Politics ◽  
Negative Effects ◽  
Economic Violence ◽  
Property Destruction ◽  
Forms Of Violence

Chapter 15 provides an overview of economic forms of violence against women in politics. Economic violence employs economic hardship and deprivation as a means of control, most often by destroying a person’s property or harming their financial livelihood as a form of intimidation. Forms of economic violence include vandalism, property destruction, theft, extortion, raids to remove property, withholding of funds and resources, threats to terminate employment, withdrawal of financial support, and restrictions on access to funding. Despite direct links between economic violence and the ability of women to perform political functions, it remains a largely invisible phenomenon. Few women, indeed, appear willing to speak on the record about their experiences for fear of negative effects on their personal and professional livelihoods. Relative silence on these dynamics, in turn, means that few measures exist to address economic violence, with civil society largely filling the gap to provide emergency grants and accounting oversight.

Psychological Violence

2020 ◽  
pp. 139-153
Author(s):  
Mona Lena Krook
Keyword(s):  
Social Media ◽  
Coping Strategies ◽  
Violence Against Women ◽  
Mental State ◽  
Well Being ◽  
Women In Politics ◽  
Psychological Violence ◽  
Forms Of Violence

Chapter 13 provides an overview of psychological forms of violence against women in politics. Psychological violence inflicts trauma on individuals’ mental state or emotional well-being. It seeks to disempower targets by degrading, demoralizing, or shaming them—often through efforts to instill fear, cause stress, or harm their credibility. These acts may occur inside and outside official political settings and be carried out in person, by telephone, or via digital means like email and social media. Experiencing it firsthand, targets (and their allies) have taken the lead in devising and sharing coping strategies, empowering individuals and mobilizing groups to call out psychological violence and counteract its pernicious effects.

Physical Violence

2020 ◽  
pp. 127-138
Author(s):  
Mona Lena Krook
Keyword(s):  
Violence Against Women ◽  
Physical Violence ◽  
Women In Politics ◽  
Wide Range ◽  
State Actors ◽  
Forms Of Violence ◽  
Politically Active

Chapter 12 provides an overview of physical forms of violence against women in politics. Physical violence encompasses a wide range of bodily harms involving unwanted contact and confinement resulting in death or injury. The tangible nature of these acts makes them the most widely recognized and least contested forms of violence against women. They tend to be relatively rare, however, with offenders opting for “less costly” means of violence before escalating to physical attacks. While legal redress may be a solution for at least some forms of physical violence, politically active women have developed a number of grassroots strategies to respond to and anticipate physical violence. At the same time, individual women and state actors have devised new preventive security arrangements, seeking to avert or mitigate the effects of physical attacks.

scholarly journals Draw(Me) and Tell: Use of Children’s Drawings as Elicitation Tools to Explore Embodiment in the Very Young

2019 ◽  
Vol 18 ◽  
pp. 160940691881623 ◽  
Author(s):  
Gillian M. Martin
Keyword(s):  
Qualitative Research ◽  
Childhood Obesity ◽  
Qualitative Data ◽  
Ethical Issues ◽  
Relational Ethics ◽  
Ethnographic Study ◽  
Generation Process ◽  
Data Generation ◽  
Research With Children ◽  
Body Shapes

Qualitative research with children as participants is challenging on many levels—ethical, methodological, and relational. When researching the experience of children with particular bodily vulnerabilities, these issues are further amplified. This article describes a data generating tool designed to address these challenges. It was used within the context of an ethnographic study exploring relational societal processes associated with childhood obesity in Malta. This creative child-centric method uses “me” drawings as elicitation foci during informal conversations in the field where the agentic status of the child was prioritized and their role as active collaborators emphasized. Optimizing ethical symmetry was a key concern, as was emphasis on relational ethics and assent. Using the “Draw(Me) and Tell” activity positioned the child in a realistic position of power by giving them control over the data generation process, and helped address ethical issues related to agency, privacy, and sensitivity. It allowed ethical generation of qualitative data based on the children’s reflexive commentary on their own body shapes, with the aim of exploring their embodied habitus, identity, and selfhood.

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