Alleviation of Pain and Symptoms With a Life-Shortening Intention

2008 ◽  
Vol 15 (5) ◽  
pp. 682-695 ◽  
Author(s):  
Grada (Ada) G van Bruchem-van de Scheur ◽  
Arie JG van der Arend ◽  
Huda Huijer Abu-Saad ◽  
Frans CB van Wijmen ◽  
Cor Spreeuwenberg ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Questionnaire Survey ◽  
Response Rate ◽  
Moral Values ◽  
End Of Life Decisions ◽  
Legal Rules ◽  
Ethical Norms ◽  
Professional Guidelines

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values.

Dutch Nurses' Attitudes Towards Euthanasia and Physician-Assisted Suicide

2008 ◽  
Vol 15 (2) ◽  
pp. 186-198 ◽  
Author(s):  
Ada van Bruchem-van de Scheur ◽  
Arie van der Arend ◽  
Frans van Wijmen ◽  
Huda Huijer Abu-Saad ◽  
Ruud ter Meulen
Keyword(s):  
Decision Making ◽  
Nursing Homes ◽  
The Netherlands ◽  
Home Care ◽  
Questionnaire Survey ◽  
Assisted Suicide ◽  
Decision Making Process ◽  
Physician Assisted Suicide ◽  
Common Practices

This article presents the attitudes of nurses towards three issues concerning their role in euthanasia and physician-assisted suicide. A questionnaire survey was conducted with 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The study was conducted in the Netherlands between January 2001 and August 2004. The results show that less than half (45%) of nurses would be willing to serve on committees reviewing cases of euthanasia and physician-assisted suicide. More than half of the nurses (58.2%) found it too far-reaching to oblige physicians to consult a nurse in the decision-making process. The majority of the nurses stated that preparing euthanatics (62.9%) and inserting an infusion needle to administer the euthanatics (54.1%) should not be accepted as nursing tasks. The findings are discussed in the context of common practices and policies in the Netherlands, and a recommendation is made not to include these three issues in new regulations on the role of nurses in euthanasia and physician-assisted suicide.

The logical component of thinking as a predictor of decision-making about the presence of corruption risk in a situation

2021 ◽  
Vol 42 (6) ◽  
pp. 25-34
Author(s):  
I. N. Pogozhina ◽  
◽  
M. V. Sergeeva ◽  
Keyword(s):  
Decision Making ◽  
Emotional Intelligence ◽  
Correlation Analysis ◽  
University Students ◽  
Moral Values ◽  
Moral Judgments ◽  
Diagnostic Tools ◽  
Leading Role ◽  
Decision Making System

The links between elements of the decision-making system on the presence of corruption risk (CR) in a situation with the logical component of thinking as a predictor are considered. The hypothesis of the role of logical reasoning component as a predictor of (1) perceptions of corruption, (2) indicators of emotional intelligence and (3) moral judgement was tested on a sample of Moscow university students (N=134; M=35±11 years old). The following diagnostic tools were used: (1) the author's test for recognising CR situations, (2) the method for assessing the content of ideas about corruption (Pogozhina, Pshenichnyuk, Sergeyeva), (3) D. Lucin’s EmIn questionnaire, (4) Molchanov's Justice-Care technique. Correlation analysis and structural modeling were used to process the data. The logical component of thinking was a significant positive predictor of the level of development of perceptions of corruption and understanding one’s own emotions and those of others. Also, the logical component significantly negatively predicted moral judgments based on instrumental individualism, reflexive empathic orientation and unconscious but internalized moral values. The findings suggest that the logical component will play a leading role in the CR decision-making system and should be specifically shaped.

scholarly journals The Role of Organizational Agility in Enhancing Organizational Excellence: A Study on Telecommunications Sector in Egypt

2016 ◽  
Vol 11 (4) ◽  
pp. 121 ◽  
Author(s):  
Nafei A. Wageeh
Keyword(s):  
Decision Making ◽  
Regression Analysis ◽  
Design Methodology ◽  
Response Rate ◽  
Organizational Agility ◽  
Telecommunication Sector ◽  
Organizational Excellence ◽  
The Relationship ◽  
Practical Implications

<p><strong>Purpose: </strong>The purpose of this research is to identify the types of OA (sensing agility, decision-making agility and acting agility) and its role in promoting OE at the Telecommunication sector in Egypt.</p><p><strong>Research Design/Methodology:<em> </em></strong>To assess positive OA, refer to (OA questionnaire, Jaworski and Kohli 1993) and OE (OE survey Kandula, 2002; Hesseblin &amp; Gohanston, 2002). The data of the study was collected from the employees at Telecommunication sector in Egypt. Out of the 290 questionnaires that were distributed to employees, 250 usable questionnaires were returned, a response rate of 86%. Multiple Regression Analysis (MRA) was used to confirm the research hypotheses.</p><p><strong>Findings:</strong> OA factors have an impact on OE is investigated. In other words, sensing agility, decision-making agility and acting agility significantly correlated with OE. The study findings support the view that OA and OE are related constructs. In other words, the research has found that the study subjects do agree that OA directly affects the dimensions of OE at Telecommunication sector in Egypt.</p><p><strong>Practical implications:</strong> The study suggests that the Telecommunication sector in Egypt can improve OE by influencing its OA, specifically, by developing sensing agility, decision-making agility and acting agility. The study provided that it is necessary to pay more attention to the dimensions of OA as a key source for organizations to enhance the competitive advantage which is of prime significance for OE.</p><strong>Originality/value: </strong>The study observes that there is a critical shortage of OA and that a greater understanding of the factors that influence the OE is needed. Therefore, this study examines the relationship between OA and OE at Telecommunication sector in Egypt. This research dealt with OA in terms of its concept and dimensions, in addition to dealing with the role of OA in promoting OE at Telecommunication sector in Egypt.

What parents want from doctors in end-of-life decision-making for children

2013 ◽  
Vol 99 (3) ◽  
pp. 216-220 ◽  
Author(s):  
J Sullivan ◽  
P Monagle ◽  
L Gillam
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Decision Maker ◽  
Semistructured Interview ◽  
End Of Life Decisions ◽  
Parental Autonomy ◽  
End Of Life Decision ◽  
Life Decision

ObjectiveEnd-of-life decision-making is difficult for everyone involved, as many studies have shown. Within this complexity, there has been little information on how parents see the role of doctors in end-of-life decision-making for children. This study aimed to examine parents’ views and experiences of end-of-life decision-making.DesignA qualitative method with a semistructured interview design was used.SettingParent participants were living in the community.ParticipantsTwenty-five bereaved parents.Main outcomesParents reported varying roles taken by doctors: being the provider of information without opinion; giving information and advice as to the decision that should be taken; and seemingly being the decision maker for the child. The majority of parents found their child's doctor enabled them to be the ultimate decision maker for their child, which was what they very clearly wanted to be, and consequently enabled them to exercise their parental autonomy. Parents found it problematic when doctors took over decision-making. A less frequently reported, yet significant role for doctors was to affirm decisions after they had been made by parents. Other important aspects of the doctor's role were to provide follow-up support and referral.ConclusionsUnderstanding the role that doctors take in end-of-life decisions, and the subsequent impact of that role from the perspective of parents can form the basis of better informed clinical practice.

scholarly journals Decision making in the end-of-life care of patients who are terminally ill with cancer – a qualitative descriptive study with a phenomenological approach from the experience of healthcare workers.

2021 ◽  
Author(s):  
Angela Luna-Meza ◽  
Natalia Godoy-Casasbuenas ◽  
José Andrés Calvache ◽  
Eduardo Diaz ◽  
Fritz Gempeler ◽  
...  
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
End Of Life Decisions ◽  
Care Plans ◽  
Qualitative Descriptive ◽  
Imminent Death

Abstract Background: In Colombia, recent legislation regarding end-of-life decisions includes palliative sedation, advance directives and euthanasia. We analysed which aspects influence health professionals´ decisions regarding end-of-life medical decisions and care for cancer patients.Methods: Qualitative descriptive–exploratory study based on phenomenology using semi-structured interviews. We interviewed 28 oncologists, palliative care specialists, general practitioners and nurses from three major Colombian institutions, all involved in end-of-life care of cancer patients: Hospital Universitario San Ignacio and Instituto Nacional de Cancerología in Bogotá and Hospital Universitario San José in Popayan. Results: When making decisions regarding end-of-life care, professionals consider: 1. Patient’s clinical condition, cultural and social context, in particular treating indigenous patients requires special skills. 2. Professional conditions: training in palliative care and experience in discussing end-of-life options and fear of legal consequences. Physicians indicate that many patients deny their imminent death which hampers shared decision-making and conversations. They mention frequent unclarity regarding who initiates conversations regarding end-of-life decisions with patients and who finally takes decisions. Patients rarely initiate such conversations and the professionals normally do not patients directly for their preferences. Fear of confrontation with family members and lawsuits leads doctors to carrying out interventions such as initiating artificial feeding techniques and cardiopulmonary resuscitation, even in absence of expected benefits. The opinions regarding the acceptability of palliative sedation, euthanasia and use of medications to accelerate death without the patients´ explicit request vary greatly. 3. Conditions of the insurance system: limitations exist in the offer of oncology and palliative care services for important proportions of the Colombian population. Colombians have access to opioid medications, barriers to their application are largely in delivery by the health system, the requirement of trained personnel for intravenous administration and ambulatory and home care plans which in Colombia are rare.Conclusions: to improve end-of-life decision making, Colombian physicians and patients need to openly discuss wishes, needs and care options and prepare caregivers. Promotion of palliative care education and development of palliative care centres and home care plans is necessary to facilitate access to end-of-life care. Patients and caregivers’ perspectives are needed to complement physicians’ perceptions and practices. Key Message: The results highlight the importance of improving access to end-of-life care in Colombia, and diminish the “denial of imminent death” among patients and caregivers to facilitate end-of-life discussions and shared decisions; interventions to prepare caregivers and promote home care.

scholarly journals Morality and Values in Sports Among Young Athletes: The Role of Sport Type and Parenting Styles – A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yosi Yaffe ◽  
Orr Levental ◽  
Dalit Lev Arey ◽  
Assaf Lev
Keyword(s):  
Decision Making ◽  
Pilot Study ◽  
Parenting Styles ◽  
Team Sport ◽  
Moral Values ◽  
Moral Decision ◽  
Moral Decision Making ◽  
Young Athletes ◽  
Sport Type

Given the great importance of morality and values in modern sports, especially among young athletes, in this pilot study, we sought to broaden the exploration of the factors that may play role in these contexts, which have not been widely researched to date. Accordingly, the study tested the relationships between sport type (team or individual) and parenting styles (authoritative vs. non-authoritative), and moral decision-making in sport and sport values among 110 adolescent athletes whose age ranges from 11 to 22 (M = 16.04, SD = 2.86). The findings indicated that participants with authoritative parents, as compared to those with non-authoritative parents, are significantly less accepting of cheating in sport, while they also tend more to keep winning in proportion and hold significantly stronger moral values toward sports. Moreover, participants whose main sport is a team sport type tend to accept more cheating and gamesmanship than participants whose main sport is an individualistic sport type. While no differences were recorded between these groups in moral values, team athletes tend to value status in sport more than individual athletes, while the latter tend to value competence regarding their sport. The implications of the findings are discussed in light of no interaction between the effects of parenting styles and sport type on moral and sport values.

scholarly journals Doctors Are Inconsistent in Estimating Survival after CPR and Are Not Using Such Predictions Consistently in Determining DNACPR Decisions

Geriatrics ◽  
2019 ◽  
Vol 4 (2) ◽  
pp. 33
Author(s):  
Andrew C Kidd ◽  
Katie Honney ◽  
Lesley K Bowker ◽  
Allan B Clark ◽  
Phyo K Myint ◽  
...  
Keyword(s):  
Decision Making ◽  
Cardiopulmonary Resuscitation ◽  
Median Survival ◽  
Questionnaire Survey ◽  
Response Rate ◽  
Clinical Scenarios ◽  
Significant Difference ◽  
Different Order

Background: It is unclear whether doctors base their resuscitation decisions solely on their perceived outcome. Through the use of theoretical scenarios, we aimed to examine the ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decision-making. Methods: A questionnaire survey was sent to consultants and specialty trainees across two Norfolk (UK) hospitals during December 2013. The survey included demographic questions and six clinical scenarios with varying prognosis. Participants were asked if they would resuscitate the patient or not. Identical scenarios were then shown in a different order and doctors were asked to quantify patients’ estimated chance of survival. Results: A total of 137 individuals (mean age 41 years (SD 7.9%)) responded. The response rate was 69%. Approximately 60% were consultants. We found considerable variation in clinician estimates of median chance of survival. In three out of six of our scenarios, the survival estimated varied from <1% to 95%. There was a statistically significant difference identified in the estimated median survival between those clinicians who would or would not resuscitate in four of the six scenarios presented. Conclusion: This study has highlighted the wide variation between clinicians in their estimates of likely survival and little concordance between clinicians over their resuscitation decisions. The diversity in clinician decision-making should be explored further.

Elaborating the role of reflection and individual differences in the study of folk-economic beliefs

2018 ◽  
Vol 41 ◽  
Author(s):  
Kevin Arceneaux
Keyword(s):  
Decision Making ◽  
Individual Differences ◽  
Cognitive Processes ◽  
Evolutionary History ◽  
Behavioral Responses ◽  
History Of ◽  
Economic Beliefs

AbstractIntuitions guide decision-making, and looking to the evolutionary history of humans illuminates why some behavioral responses are more intuitive than others. Yet a place remains for cognitive processes to second-guess intuitive responses – that is, to be reflective – and individual differences abound in automatic, intuitive processing as well.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

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