The best interest standard and children: clarifying a concept and responding to its critics

2018 ◽  
Vol 45 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Johan Christiaan Bester
Keyword(s):  
Medical Ethics ◽  
Medical Practice ◽  
General Principle ◽  
Prima Facie ◽  
Ethical Principle ◽  
Ethical Framework ◽  
Best Interest ◽  
Best Interest Standard ◽  
The Family

This work clarifies the role of the best interest standard (BIS) as ethical principle in the medical care of children. It relates the BIS to the ethical framework of medical practice. The BIS is shown to be a general principle in medical ethics, providing grounding to prima facie obligations. The foundational BIS of Kopelman and Buchanan and Brock are reviewed and shown to be in agreement with the BIS here defended. Critics describe the BIS as being too demanding, narrow, opaque, not taking the family into account and not suitable as limiting principle. This work responds to these criticisms, showing that they do not stand up to scrutiny. They either do not apply to the BIS, only apply to misuses of the BIS or criticise a BIS that is not seriously defended in the literature.

Autonomy, Benevolence, and Alzheimer's Disease

2001 ◽  
Vol 10 (2) ◽  
pp. 184-193 ◽  
Author(s):  
PAM R. SAILORS
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Medical Ethics ◽  
Advance Directive ◽  
Best Interest ◽  
Substituted Judgment ◽  
Best Interest Standard ◽  
Central Concern ◽  
Current Standards ◽  
Substituted Judgment Standard

Medical ethics has traditionally been governed by two guiding, but sometimes conflicting, principles—autonomy and benevolence. These principles provide the rationale for the two most commonly used standards for medical decisionmaking—the Substituted Judgment Standard shows our concern for autonomy, whereas the Best Interest Standard shows our commitment to benevolence. Both standards are vulnerable to criticisms. Further, the principles can seem to offer conflicting prescriptions for action. The criticisms and conflict figure prominently in discussion of advance directive decisionmaking and Alzheimer's disease. After laying out each of the current standards and its problems, with Alzheimer's issues as my central concern, I offer a new standard that avoids the problems while honoring our concerns for both autonomy and benevolence.

Professional Ethics in Obstetric Practice, Innovation, and Research

2021 ◽  
pp. 197-211
Author(s):  
Frank A. Chervenak ◽  
Laurence B. McCullough
Keyword(s):  
Medical Ethics ◽  
Professional Ethics ◽  
Home Birth ◽  
Ethical Framework ◽  
Ethical Challenges ◽  
Obstetric Practice ◽  
Ethical Concept ◽  
Practical Guidance ◽  
Planned Home Birth

Obstetric clinical practice, innovation, and research should be guided by professional ethics in obstetrics. In this chapter, the authors distinguish professional medical ethics from medical ethics and bioethics. They set out an ethical framework for obstetrics based on the invention of professional medical ethics by two eighteenth-century physician-ethicists, John Gregory (1724–1773) and Thomas Percival (1740–1804). Professional ethics in obstetrics appeals to the ethical principles of beneficence and respect for autonomy and the ethical concept of the fetus as a patient. This framework is deployed to provide ethically justified, practical guidance about two ethical challenges in obstetric practice: the professionally responsible role of nondirective counseling of pregnant women about induced abortion and the professionally responsible role of directive counseling about planned home birth. This framework is also deployed to provide ethically justified, practical guidance about professionally responsible obstetric innovation and research for fetal benefit.

Informed Consent: Does It Take a Village? The Problem of Culture and Truth Telling

2001 ◽  
Vol 10 (1) ◽  
pp. 34-46 ◽  
Author(s):  
MARK KUCZEWSKI ◽  
PATRICK J. McCRUDEN
Keyword(s):  
United States ◽  
Informed Consent ◽  
Medical Ethics ◽  
Social Groups ◽  
The United States ◽  
Dominant Culture ◽  
Truth Telling ◽  
Political Tradition ◽  
The Family

Bioethicists have become very interested in the importance of social groups. This interest has spawned a growing literature on the role of the family and the place of culture in medical decisionmaking. These ethicists often argue that much of medical ethics suffers from the individualistic bias of the dominant culture and political tradition of the United States. As a result, the doctrine of informed consent has come under some scrutiny. It is believed that therein lies the source of the problem because the doctrine incorporates the assumptions of the larger society. Thus, informed consent has been reexamined, reinterpreted, and even abandoned as unworkable.

scholarly journals [Medical practice with regard to physicians’ mistakes and disease complications]

2004 ◽  
Vol 10 (1-2) ◽  
pp. 198-207
Author(s):  
A. M. Mangoud
Keyword(s):  
Saudi Arabia ◽  
Medical Ethics ◽  
Medical Practice ◽  
Science And Technology ◽  
Historical Background ◽  
Religious Values ◽  
Islamic World ◽  
The Difference ◽  
Modern Era

This study gives a historical background on regulations implemented by Islamic scholars to codify medical practice, and highlights the advance of science and technology in the modern era and the need for physicians [along with science and technology] to adhere to religious values. It discusses physicians’ responsibilities, the issue of malpractice, and the difference between malpractice and complications. Recommendations are proposed to implement medical ethics in the curriculum of medical colleges around the Islamic world and to promote the role of medical religious committees in Islamic world as is being done in Saudi Arabia

scholarly journals 病人自主決定與醫療行善

1999 ◽  
Vol 2 (2) ◽  
pp. 83-93
Author(s):  
Hong CUI
Keyword(s):  
Self Determination ◽  
Chinese Patients ◽  
Value Conflict ◽  
Best Interest ◽  
Patients Rights ◽  
The Family ◽  
Fundamental Value ◽  
The Right ◽  
Chinese Physicians

LANGUAGE NOTE | Document text in Chinese; abstract also in English.通過對“喉梗阻”患兒案例的分析和感受，本文試圖分別從醫生、患者和哲學研究者的角度進行較客觀的思考。從醫生的角皮看：“自主決定”和醫療行善存在矛盾，削弱了醫生的“自主”決定，醫生的角色是單純的醫療技術掌握者還是用此技術全心全意為病人服務的行善者？從患者的角度看：患者是否都有“自主決定”的能力？若醫生只是單純的醫療技術的掌握者，與患者無情感的溝通，患者在醫院是否有心理上的安全感？從思考者的角度看：在前面論述的基礎上，提出了“善”是相對的，“自主”是適度的，任何絕對的病人自主和醫生自主都行不通。總之，醫療行善，不能拘泥於某一形式。It is important to respect for patients' rights. The patient should be informed of medical interference and the physician must obtain the patient's consent to perform serious treatment. This is a sense of patients' self-determination in contemporary medical practice. This paper argues that, granted its importance, patients' self-determination should not be given unique emphasis independent of physicians' medical beneficence.The paper considers this issue from both Chinese physicians' and patients' perspectives. First, from the physician's perspective, the role of the physician as a professional ought not to be overlooked. Should the physician play a role no more than that of an ordinary salesman by displaying everything for the customer to choose? Traditionally Chinese medicine has always insisted that the physician should do more than. Having studied both human and technical values, the physician should play an active function to help the patient make the right decision. He should not passively follow whatever the patient chooses on the excuse of respecting for the patient's self-determination.Instead, being physician, he is naturally determined to do medical beneficence toward the patient. Of course, there may be fundamental value conflicts between the patient and the physician. For instance, they may believe in different religions. This difference may sometimes lead the patient to want or refuse something that the physician takes to be against the patient's interest. In such cases the physician and patient may best respect each other's fundamental values. However, most medical cases are unlike this. They don't involve any fundamental value conflict. The physician should do his best to persuade the patient to make the right decision, rather than passively to accept whatever the patients chooses.Moreover, Chinese patients' perspective also supports physicians' beneficence. The patient would say this. Look, the physician has been trained specially in their work. Technically they should know better regarding what the patient should do. Being sick is a weak time in the patient's life. The patient does not want to confront it lonely. On the one hand, the patient wants the family to take care of her and take the burden of making the decision in her best interest. On the other hand, the patient wants the physician to help the family in this difficult process of decision making. It is not appropriate for the physician to play a role of salesman and leaves everything in my hands. This is against the nature of physicians as the beneficent healers.In short, both Chinese physicians' and patients' perspectives support the combination of patients' determination and physicians' beneficence. It is inappropriate simply to stress the importance of patients' rights or self-determination without giving significant weight to the role of medical beneficence that physicians should play in medical practice.DOWNLOAD HISTORY | This article has been downloaded 17 times in Digital Commons before migrating into this platform.

Non-Normative Events and Family Functioning: The Role of the Family Psychologist

1993 ◽  
Author(s):  
Michele Harway ◽  
◽  
Nancy Boyd-Franklin ◽  
Robert Geffner ◽  
Marsali Hansen ◽  
...  
Keyword(s):  
Family Functioning ◽  
The Family

Mental Health of War-Affected Youth in Two Conflicts: The Role of the Family, Community and Classroom

2008 ◽  
Author(s):  
Ivelina Borisova ◽  
Theresa Betancourt ◽  
Wietse Tol ◽  
Ivan Komproe ◽  
Mark Jordans ◽  
...  
Keyword(s):  
Mental Health ◽  
The Family

Mindfulness and Parental Stress Among Parents of Children with Developmental Delays: The Role of the Family Environment

2014 ◽  
Author(s):  
Merideth A. Robinson ◽  
Andrea C. Lewallen ◽  
Robyn Finckbone ◽  
Kristin Crocfer ◽  
Keith P. Klein ◽  
...  
Keyword(s):  
Family Environment ◽  
Parental Stress ◽  
Developmental Delays ◽  
The Family

HUBUNGAN PERAN FAMILY CAREGIVER TERHADAP QUALITAS HIDUP LANSIA

2019 ◽  
Vol 11 (1) ◽  
pp. 51-56
Author(s):  
RIANI PRADARA JATI ◽  
Sekar Farah Nabila
Keyword(s):  
Quality Of Life ◽  
Family Caregiver ◽  
Random Sampling ◽  
Simple Random Sampling ◽  
The Elderly ◽  
Chi Square ◽  
The Poor ◽  
The Family

  Penempatan peran yang baik bagi Family Caregiver sangatlah membantu lansia dalam meningkatkah qualitas hidupnya, meningkatkan motivasi dalam menjalankan hidup Penelitian ini bertujuan Mengetahui hubungan peran Family Caregiver dalam pemenuhan qualitas hidup bagi lansia di Kelurahan Langenharjo Kabupaten Kendal. DesainPenelitianDeskriptifKorelasional menggunakan pendekatan Krosectional,tehnikSamplingStratified Simple Random Sampling dengan karakteristik heterogen, dari populasi mempunyai hak yang sama untuk diseleksi sebagai sampel teknik undianPengambilan data dengan menggunakan kuesioner yang telah diuji validitas dan reliabilitasnya. Uji statistik Chi-square, dengan taraf signifikasi 5%jumlah sampel pada penelitian ini 70 sampel pada Family Caregiver dari 213 populasi yang ada. Hasil penelitian dari 70 responden didapatkan Peran Family Caregiver tidak baik dengan qualitas hidup tidak baik 33 (47,1%), sedangkan Peran Family Caregiver kurang baik dengan qualitas hidup lansia baik 3 (4,3%). Untuk distribusi Peran Family Caregiver kurang baik dengan qualitas hidup lansia tidak baik sebanyak 6 responden (8,6%) sedangkan untuk distribusi Peran Family Caregiver kurang baik dengan qualitas hidup lansia baik sebanyak 23 responden (32,9%). Terakhir, untuk distribusi Peran Family Caregiver baik dengan qualitas hidup lansia tidak baik didapatkan hasil 2 responden (2, 9%) sedangkan untuk distribusi Peran Family Caregiver baik dengan qualitas hidup lansia baik didapatkan hasil 3 responden (4,3%)Menunjukkan nilai ρ value 0,001 (ρ < 0,05) berarti ada hubungan antara dukungan keluarga dengan kepatuhan lansia dalam keikutsertaan posyandu lansia. Disarankan kepada semua Family Cregiver lansia untuk mampu memahami pentingnya perhatian, dukungan bagi lansia dalammeningkatkan qualitas hidup yang lebih baik bagi lansia.   Kata kunci : Peran family caregiver, qualitas hidup, lansia.   ABSTRACT Placement of a good role for Family Caregiver is very helpful for the elderly to improve their quality of life, increase motivation in living life Research Objective: To know the relationship between the role of Family Caregiver in fulfilling quality of life for the elderly in Langenharjo Village, Kendal Regency. Descriptive Correlational Research Design uses a cross sectional approach, Sampling Stratified Simple Random Sampling technique with heterogeneous characteristics, from the population has the same right to be selected as a sample lottery technique Retrieving data using a questionnaire that has been tested for validity and reliability. Test Chi-square statistics, with a significance level of 5% the number of samples in this study 70 samples on the Family Caregiver from 213 populations. Results of the Study Of 70 respondents found the role of Family Caregiver was not good with poor quality of life 33 (47.1%) , while the role of the Family Caregiver is not good with the quality of life of a good elderly 3 (4.3%). For the distribution of the role of Family Caregiver is not good with the quality of life of the poor family as many as 6 respondents (8.6%) while for the distribution of the Role of Family Caregiver is not good with the quality of life of good elderly as many as 23 respondents (32.9%). Finally, the distribution of the Role of Family Caregiver with good quality of life for the poor is obtained by 2 respondents (2, 9%), while the distribution of the Role of Family Caregiver with good quality of life for the elderly is obtained by 3 respondents (4.3%). 0.001 (ρ <0.05) means that there is a relationship between family support and the compliance of the elderly in the participation of the elderly posyandu. It is recommended to all elderly Cregiver families to be able to understand the importance of attention, support for the elderly in improving the quality of life better for the elderly   Keywords: Role of Family Caregiver, Quality of Life, Elderly

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