Pain: Ethics, Culture, and Informed Consent to Relief

1996 ◽  
Vol 24 (4) ◽  
pp. 348-359 ◽  
Author(s):  
Linda Farber Post ◽  
Jeffrey Blustein ◽  
Elysa Gordon ◽  
Nancy Neveloff Dubler
Keyword(s):  
Informed Consent ◽  
Medical Technology ◽  
Personal Values ◽  
Science And Technology ◽  
Duty Of Care ◽  
Complex Phenomenon ◽  
Cultural Traditions ◽  
Cultural Boundaries

As medical technology becomes more sophisticate the ability to manipulate nature and manage disease forces the dilemma of when can becomes ought. Indeed, most bioethical discourse is framed in terms of balancing the values and interests and the benefits and burdens that inform principled decisions about how, when, and whether interventions should occur. Yet, despite advances in science and technology, one caregiver mandate remains as constant and compelling as it was for the earliest shaman—the relief of pain. Even when cure is impossible, the physician's duty of care includes palliation. Moreover, the centrality of this obligation is both unquestioned and universal, transcending time and cultural boundaries.Although universally acknowledged, pain is a complex phenomenon for both the patient and the caregiver, influenced as much by personal values and cultural traditions as by physiological injury and disease.

scholarly journals “Body Work”: Nurses and the Delegation of Medical Technology at the Ottawa Civic Hospital, 1947-1972

2009 ◽  
Vol 29 (2) ◽  
pp. 155-175 ◽  
Author(s):  
Cynthia Toman
Keyword(s):  
Twentieth Century ◽  
Medical Technology ◽  
Science And Technology ◽  
Working Relationships ◽  
Hospital System ◽  
Body Work ◽  
Ottawa Civic Hospital ◽  
The Everyday ◽  
Predominantly Female ◽  
Female Nurses

Abstract The absence of ordinary women from histories of science and technology may be partially explained by what has been excluded as science, as well as who have been excluded as women of science. Although the delegation of medical technology to Ontario nurses increased rapidly during the mid-twentieth century, we know very little regarding how these ordinary women engaged in science and medical technology through the everyday practice of "body work." Gender structured the working relationships between predominantly-male physicians and predominantly-female nurses, shaping the process of delegation and generating significant changes in nurses' work as well as who provided bedside care. Trained nurses parlayed these new technological skills to their advantage, enabling the extension of technological care at the bedside and assuring their roles as essential for the functioning of the hospital system.

Militaries and the duty of care to enhanced veterans

2019 ◽  
Vol 165 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Adam Henschke
Keyword(s):  
Informed Consent ◽  
Military Service ◽  
Military Veterans ◽  
The State ◽  
Duty Of Care ◽  
Chain Of Command ◽  
Moral Responsibilities

This article argues that there is a duty of care held by the State to military veterans who have been technologically enhanced as part of their military service. It suggests that enhancements may be permanent, persistent or protracted and demonstrates how enhancements generate additional moral responsibilities from the chain of command. The paper concludes by demonstrating how this institutional duty of care relates to issues such as informed consent.

Liability for providing a prognosis in surgical practice

2017 ◽  
Vol 85 (3) ◽  
pp. 145-147 ◽  
Author(s):  
Alex de Costa ◽  
Amy Tam
Keyword(s):  
Informed Consent ◽  
Alternative Treatment ◽  
Duty Of Care ◽  
Surgical Practice ◽  
Treatment Choices ◽  
The Common ◽  
Court Of Appeal

The common law's development of the doctrine of informed consent has progressively imposed broader obligations on surgeons to provide patients with information about the surgical and alternative treatment choices available. Prognosis is critical because the patient cannot provide informed consent without information about the likely evolution of the physiological or pathological processes involved in the surgery under consideration. But does the duty of care that a surgeon owes a patient require a precise prognosis to be given in every case? A recent decision of the Court of Appeal considers that question.

scholarly journals The Impact of Medical Technology on the Pregnant Woman’s Right to Privacy

1987 ◽  
Vol 13 (2-3) ◽  
pp. 213-232
Author(s):  
George J. Annas
Keyword(s):  
Medical Technology ◽  
Science And Technology ◽  
The United States ◽  
United States Constitution ◽  
Human Reproduction ◽  
Right To Privacy ◽  
The Government ◽  
The Right ◽  
The Impact ◽  
The Relationship

In the context of the bicentennial of the Constitution and science's relationship to society, it has been argued that “the advance of science and technology in the West has changed not only the relation of man to nature but of man to man.“ This seemingly immodest statement may soon prove an understatement. In the arena of human reproduction, the marriage of science and technology in medicine may change not only the relationship of man to nature and man to man, but more significantly, the very concept of what it means to be human. This, in turn, will directly affect how we define the “rights” this “new human” may properly claim.This article begins to explore developing reproductive medical technology with a view toward examining the way it might change our concept of humanness, and how this change might be accommodated, encouraged, or truncated by the relationship between the government and its pregnant citizens as defined by the United States Constitution and the “right to privacy.”

scholarly journals 知情同意臨床實踐中倫理學技術研究

2002 ◽  
Vol 4 (2) ◽  
pp. 38-48
Author(s):  
Guobin CHENG
Keyword(s):  
Clinical Practice ◽  
Informed Consent ◽  
Logical Consequence ◽  
Field Research ◽  
Fundamental Rights ◽  
Self Determination ◽  
Cultural Traditions ◽  
Digital Commons ◽  
The Right ◽  
Theoretical Issues

LANGUAGE NOTE | Document text in Chinese; abstract also in English.具體實踐中的知情同意是一種倫理學技術，注重利用現有的文化傳統、理論資源和法律工具，合理有效地分析問題、解決問題，強調它作為體現對病人基本權利的尊重和調節醫患關係手段的作用。在民主社會，知情同意乃是建立醫患權責餘的必要條件。知情同意來自於醫療活動的自發秩序：醫患雙方通過知情同意活動，明確醫療活動中雙方的權利和責任界限，進行有成效的醫療實踐。知情同意既是對基本人權的尊重，又是確保雙方責任的工具。具體實踐中的知情同意，提供一種促進多種價值觀和平共存、通過學習和對話實現平衡的運行機制，在社會整體利益優先與個人最基本權利不可侵犯的框架下滿足雙方不同的價值需求。臨床“知情同意”活動的目的在於：促進患者自主權的行使；明晰醫療活動中的權責關係，在合法限度內為醫療活動的正常進行提供保護。實踐中追求資訊的“充分”取決於患方要求的“主觀的充分”。臨床醫療活動中，醫方要不斷提高患方知情的充分程度。隨著知情程度的增加，患方自主程度隨之自動上升。目前關於“知情向意”的理論研究中，缺少對知情同意的狀況、分佈及相關因素的實地調查和量化分析，研究多集中在道德、文化理論上，實踐策略的指導意義不強。應當把知情同意視作貫穿於整個臨床醫療活動的一個連續的整體。要關注本社區成員的文化和心理結構的特殊性，從本社區歷史特點出發，建立本社區知情同意情況的常規模式和量化標準。還應當設計臨床知情同意調查制度，作為醫方制定知情同意策略的依據，同時又可作為說明醫療活動發生的真實過程的法律檔。Informed consent is an ethical technique which emphasizes using the existing cultural traditions, theoretical resources and legal instruments to analyze and solve the problems reasonably and effectively. Informed consent can thus play a significant role in adjusting the relationship between patients and physicians. As an ethical technique, it focuses on the method of applying various ethical resources and not simply on the combination of the logical consequence and criteria. In a democratic society, informed consent is a necessary requirement for the right-duty relationship between patients and physicians. Informed consent is seen as a prerequisite obligation to physicians and implies certain rights for patients. Patients and physicians are bound by informed consent so that they are able to "trade" equally. Informed consent is not only a means to confirming the property rights but also a tool of reducing the costs of "trade". In practice, informed consent helps to promote and achieve the peaceful co-existence of pluralistic values. It can do so by learning and having conversations with the other sides so that different parties can satisfy under the framework which gives priority to the total interests of society and guarantees the fundamental rights of individuals.The aims of informed consent in clinical practice are to promote the self-determination of patients and to clarify rights and duties in medical activities. In practice, the sufficiency of information depends on the subjective sufficiency of patients. Physicians should ensure that the patient comprehend the information and follow the appropriate procedure to manage and supervise. The most active method for physician to take is to increase the degree of informational sufficiency. The degree of the patient's self-determination increases accordingly with the increase of informational sufficiency. Their relationship can be described by a curve like "S".The current studies on informed consent in China lack the empirical data from field research. Most studies focus on the theoretical issues of morality and culture. As a result, research results are hardly applicable in clinical practice. Informed consent should a holistic entity in clinical practice. We should pay more attention to the specificity of the cultural and psychological structure of members of every community. We should establish the ordinary model and criteria of informed consent in the particular community. We should also design an applicable and legally-bond system of informed consent to regulate clinical practice.DOWNLOAD HISTORY | This article has been downloaded 13 times in Digital Commons before migrating into this platform.

Conclusion

2019 ◽  
pp. 251-264
Author(s):  
Sabita Singh
Keyword(s):  
Property Rights ◽  
Social Order ◽  
Active Role ◽  
Theoretical Concept ◽  
The State ◽  
Complex Phenomenon ◽  
Ruling Elite ◽  
Cultural Traditions ◽  
Marriage Customs ◽  
Caste Structure

Political changes impacted the marriage customs and practices. The caste structure and the emergence of Rajputs indicate deviations from the theoretical concept of caste and as the clan structure of the Rajputs remained significant throughout. For the ruling elite, marriage was a channel for diplomacy. The rituals of marriage were a mixture of local customs and the Sastras, a syncretic fusion of Brahmanism with several disparate vibrant cultural traditions. Sati was a complex phenomenon. The number of women committing Sati declined in the Mughal period, precisely the period of hardening of attitude towards women and widow remarriage. Widows of non-elite families were fully aware of their property rights and petitioned the state whenever their rights were violated. Infidelity was prevalent across all sections of society, and the state played an active role as a regulating body. For the state marriage was an edifice through which social order could be maintained.

Informed Consent: For Whose Benefit?

1981 ◽  
Vol 62 (9) ◽  
pp. 537-542 ◽  
Author(s):  
Joan K. Parry
Keyword(s):  
Social Work ◽  
Informed Consent ◽  
Medical Technology ◽  
Patient Rights ◽  
Self Determination ◽  
Case Illustration ◽  
Ideological Conflict ◽  
Relationship Of ◽  
The Relationship

The relationship of social work ideology to the ideological conflict between informed consent and medical technology relates directly to patient rights and self-determination. The struggle between modern medical technology and informed consent is discussed by examining its history, legal involvement, and a case illustration.

scholarly journals Connected Medical Technology and Cybersecurity Informed Consent: A New Paradigm

10.2196/17612 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17612
Author(s):  
Jeffrey Tully ◽  
Andrea Coravos ◽  
Megan Doerr ◽  
Christian Dameff
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
Medical Technology ◽  
Current Practice ◽  
New Paradigm ◽  
Health Care Environment ◽  
Care Environment

Background Connected medical technology is increasingly prevalent and offers both a host of new therapeutic potentials and cybersecurity-related considerations. Current practice largely does not include discussions of cybersecurity issues when clinicians obtain informed consent. Objective This paper aims to raise awareness about cybersecurity considerations for connected medical technology as they relate to informed consent discussions between patients and clinicians. Methods Clinicians, health care cybersecurity researchers, and informed consent experts propose the concept of a cybersecurity informed consent for connected medical technology. Results This viewpoint discusses concepts designed to facilitate further discussion on the need, development, and execution of cybersecurity informed consent. Conclusions Cybersecurity informed consent may be a necessary component of informed consent practices, as connected medical technology proliferates in the health care environment.

scholarly journals Between two dangers: technology and virus

2020 ◽  
Vol 3 ◽  
pp. 56-64
Author(s):  
Elena Pogorelskaya ◽  
◽  
Leonid Chernov ◽  
Keyword(s):  
Analytical Approach ◽  
Science And Technology ◽  
Phenomenological Approach ◽  
Human Experience ◽  
Modern World ◽  
Scientific Theories ◽  
Cultural Boundaries ◽  
Engineering And Technology ◽  
Symbolic World ◽  
Different Levels

Introduction. The 2020 viral pandemic put humanity in a forced isolation environment. This crisis situation provoked the total inclusion of technology in the modern dialogue at different levels of connections and relationships. This phenomenon does not only demonstrate the enormous importance of technology in the modern world, but also raises the question of the essence of such a “mandatory” dialogue partner. The aim of the study is to raise a question about ontological essence of technology, formulating a hypothesis about the involvement of the “technical” in the symbolic world. The authors use the phenomenological approach that makes it possible to see behind an array of diverse human experience interacting with the “technical” — the anonymity of the essence of technology. The usual attitude to engineering and technology as a tool that performs certain initially laid down tasks is unsatisfactory, since the importance of technology in modern civilization is much wider. In addition, the authors use the analytical approach that makes it possible to see behind scientific theories and facts a certain “logic of behavior” of science and technology aimed at overcoming the nature of things. Symbolic technology passes all natural and cultural boundaries.

scholarly journals Public Interest in New Medical Discoveries Analyses of US and European Citizens` Interest in and Knowledge of Medical Discoveries and New Science and Technology Issues

2004 ◽  
Vol 19 (1) ◽  
pp. 71-85
Author(s):  
Minah Kang Kim
Keyword(s):  
Medical Technology ◽  
Technology Development ◽  
Science And Technology ◽  
Medical Science ◽  
The United States ◽  
Public Expenditures ◽  
New Science ◽  
Medical Technologies ◽  
Conceptual Structures ◽  
The Us

The rapidly rising cost of health care has been an important policy concern in the United States, and the continuing explosion of medical research and increased utilization of medical technology are believed to be important factors driving up the costs. Several studies have implied that the US's continuous expansion of medical technology development and utilization might derive from Americans' strong commitment to medical innovation and a willingness to pay for expensive medical technologies. Using the data on the US and European citizens' attitudes toward other sciences and technologies and new medical discoveries, this study explores why Americans have such strong devotion to medical technologies. Specifically, this study examines whether the high level of interest that Americans have in new medical discoveries comes from their interest in new inventions or in new scientific discoveries and new science and technology issues show that the conceptual structures and determinants of the American public's interest in medical issues are different from those in science and technology issues. This pattern does not occur among European citizens. The US Government's decisions on public expenditures for medical science compared to those for science and technology issues seem to reflect the public's attitudes toward thses issues.

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