scholarly journals Ethical dimensions of paediatric nursing: A rapid evidence assessment

2016 ◽  
Vol 25 (1) ◽  
pp. 111-122 ◽  
Author(s):  
Annamaria Bagnasco ◽  
Lucia Cadorin ◽  
Michela Barisone ◽  
Valentina Bressan ◽  
Marina Iemmi ◽  
...  
Keyword(s):  
Decision Making ◽  
Ethical Issues ◽  
New Technology ◽  
Research Question ◽  
Direct Interaction ◽  
Educational Interventions ◽  
Care Plan ◽  
Decision Making Process ◽  
Inclusion Criteria ◽  
Face Complex

Background: Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, ‘What are the most common ethical dimensions and competences related to paediatric nursing?’ Research design: A rapid evidence assessment. Method: According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Findings: Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Conclusion: Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses’ perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan.

scholarly journals Charting Spiritual Care: Ethical Perspectives

2020 ◽  
pp. 199-211
Author(s):  
Guy Jobin
Keyword(s):  
Decision Making ◽  
Life History ◽  
Clinical Practice ◽  
Electronic Health Records ◽  
Ethical Issues ◽  
Care Team ◽  
Decision Making Process ◽  
Note Taking ◽  
Health Records ◽  
Joint Decision

Abstract The introduction of electronic health records (EHRs) into clinical practice appears to be irreversible. Where EHRs are used, chaplains have cooperated willingly with this way of reporting and sharing information with other members of the care team. They will have to, as a result, adapt their own note-taking practices to ensure effective, relevant and meaningful communication as part of the joint decision-making process. Although the specialized literature has addressed some of the “classic” ethical issues raised by EHRs, in particular those in connection with confidentiality and access, other questions, no less crucial, have received less attention and are addressed here. They include questions about the recognition of all players in the care relationship (both patients and caregivers) as subjects, and the communication of “non-generic” information about emotions, values, life history, etc. The fact that chaplains contribute to EHRs is both a sign of and a vector for recognition of their work within healthcare institutions – yet a recognition that could involve a price to pay for chaplains and patients.

Perspectives of individuals with multiple sclerosis on discontinuation of disease-modifying therapies

2019 ◽  
Vol 26 (12) ◽  
pp. 1581-1589
Author(s):  
Marisa P McGinley ◽  
Philip A Cola ◽  
Robert J Fox ◽  
Jeffrey A Cohen ◽  
John J Corboy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Decision Making ◽  
Structural Equation ◽  
Descriptive Analysis ◽  
Equation Modeling ◽  
Decision Making Process ◽  
Inclusion Criteria ◽  
Research Committee ◽  
Disease Modifying Therapies ◽  
Disease Modifying

Background: Therapeutic research in multiple sclerosis (MS) has focused on the development of treatments with little investigation regarding the possibility of discontinuation of disease-modifying therapies (DMTs). Objective: To understand the opinion of individuals with MS concerning stopping DMTs and the factors that influence the decision-making process. Methods: A mixed method approach was used starting with three focus groups from which a survey was developed. This survey was sent to 1000 participants in the North American Research Committee on Multiple Sclerosis registry who met inclusion criteria (age ⩾45 years; on most recent DMT for ⩾5 years). Descriptive analysis and structural equation modeling were used. Results: Of 1000 participants receiving the survey, 377 provided complete responses and met inclusion criteria. Only 11.9% of participants reported that if their disease was considered stable, they would consider coming off medications. A high level of external locus of control in influential others such as physicians significantly decreased the likelihood of considering discontinuation. Conclusions: Most individuals with MS report being unlikely to consider stopping MS therapy if their disease was considered “non-active.” As the results of studies concerning DMT discontinuation are obtained, information from providers will be an important part of individuals’ decision-making process.

The Cable Contract

2013 ◽  
pp. 1-7
Author(s):  
Ravichandran Ramamoorthy
Keyword(s):  
Decision Making ◽  
Ethical Dilemma ◽  
Small Businesses ◽  
Ethical Issues ◽  
Personal Values ◽  
Moral Values ◽  
Decision Making Process ◽  
Government Organization ◽  
Key Stakeholders

The case deals with an ethical dilemma of an entrepreneur. Chandran, a qualified contractor, had secured an electrical contract from a premier government organization. It was a turnkey project to be executed in a given period of time. In the process of work, he comes across major problems. He could not abandon the project or compromise on his moral values. He wanted a way out to salvage this project that was slowly slipping from his control. This case examines the ethical issues that confront small businesses, employees, suppliers and key stakeholders of every organization and explores the mindset of participants, their personal values and their decision making rationale. The participants get an opportunity to identify with the difficult choices a business situation may throw when ethical mindset clashes with the decision making process.

Challenges faced by patients, relatives and clinicians in end-stage dementia decision-making: a qualitative study of swallowing problems

2020 ◽  
pp. medethics-2020-106222
Author(s):  
Joseph Dimech ◽  
Emmanuel Agius ◽  
Julian C Hughes ◽  
Paul Bartolo
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Ethical Issues ◽  
Tube Feeding ◽  
Care Plan ◽  
Term Care ◽  
Swallowing Problems ◽  
Swallowing Difficulties ◽  
Life Threatening ◽  
End Stage

BackgroundDecision-making in end-stage dementia (ESD) is a complex process involving medical, social, legal and ethical issues. In ESD, the person suffers from severe cognitive problems leading to a loss of capacity to decide matters regarding health and end-of-life issues. The decisional responsibility is usually passed to clinicians and relatives who can face significant difficulty in making moral decisions, particularly in the presence of life-threatening swallowing problems.AimThis study aimed to understand the decision-making processes of clinical teams and relatives in addressing life-threatening swallowing difficulties in ESD in long-term care in Malta.MethodThe study followed a qualitative approach where six case studies, involving six different teams and relatives of six different patients, were interviewed retrospectively to understand their decision-making in connection with the management of swallowing difficulties in ESD. Data were collected through semistructured interviews with each stakeholder. All data were transcribed and subjected to thematic analysis.ResultsFour themes were identified: the vulnerability of patients in dementia decision-making; the difficult role of relatives in decision-making; the decisional conflict between aggressive care through tube feeding versus oral comfort feeding; a consensus-building decision-making process as ideal to facilitate agreement and respect for patient’s dignity.ConclusionDecision-making to manage swallowing difficulties in ESD is a challenging process, which involves an interpretation of personal values, beliefs, patient preferences, care needs and clinical practice. Better communication between clinicians and relatives in dementia helps promote agreement between stakeholders leading to a care plan that respects the dignity of patients at their end of life.

scholarly journals Decision-Making Process in Comprehensive Medication Management Services: From the Understanding to the Development of a Theoretical Model

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 180 ◽  
Author(s):  
Isabela Viana Oliveira ◽  
Yone de Almeida Nascimento ◽  
Djenane Ramalho-de-Oliveira
Keyword(s):  
Decision Making ◽  
Medication Management ◽  
Educational Interventions ◽  
Professional Autonomy ◽  
Care Process ◽  
Decision Making Process ◽  
Structured Interviews ◽  
Service Data ◽  
Patient Care Process ◽  
Theoretical Proposal

In Comprehensive medication management (CMM), the practitioner applies a decision-making method to assess patients’ pharmacotherapy in order to identify and solve drug therapy problems. Grounded theory was used to understand how pharmacists make clinical decisions when providing CMM service. Data collection included individual semi structured interviews with 11 pharmacists, observation of clinical case discussions and CMM consultations provided by the participating pharmacists. Two main categories emerged: 1. Understanding the rational method of decision-making: the foundation of the patient care process. 2. Balancing the care equation: the objective and the subjective, which includes a theoretical proposal explaining the pharmacists’ decision-making process and the factors that can modify this process. The pharmacotherapy knowledge should guide the anamnesis. Thus, the professional can evaluate the indication, effectiveness, safety and convenience of medications used by the patient. After exploring patients’ medication experiences, pharmacists can follow two courses of action: helping the patient overcome barriers to medication use; or matching the pharmacotherapy to the patient’s routine. Professional autonomy and absence of the patient at the time of the decision were some factors that influenced the pharmacist’s decision. Findings provide a broad understanding of pharmacists’ decision-making process during the care of patients using medications. It can be applied as a basis for educational interventions to train professionals on decision-making.

Simply Academic: Linking Reporting Environments

2008 ◽  
Vol 23 (3) ◽  
pp. 455-466 ◽  
Author(s):  
Martin T. Stuebs
Keyword(s):  
Decision Making ◽  
Financial Reporting ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Decision Making Process ◽  
Academic Environment ◽  
Reporting Environment

This instructional case attempts to connect the environmental incentives and ethical issues from two different reporting environments. It provides two different scenarios that allow students to identify and grapple with multiple incentives and resultant ethical dilemmas present in the academic reporting environment. A summary then requires students to link stakeholders, activities, incentives, and dilemmas in the academic environment to corresponding situations in the financial reporting environment. The purpose of the case is threefold: (1) It makes students aware of the incentives and ethical issues present in various reporting environments. (2) By explicitly linking the academic and financial reporting environments, students see the relevance of ethics in their current lives and are motivated to develop ethical habits now in order to prepare for the challenges that will occur later in their careers. (3) The case forces students to practice making decisions in situations with conflicting incentives and ambiguous or nonexistent legal guidance. Strong conflicting incentives can cloud and compromise even the purest of intentions. Dealing with these conflicts early and often can mature one's judgments and improve the decision-making process.

scholarly journals Federal vs. Central Foreign Policy German Foreign Policy Structure An Analysis of Decision-Making Process

2020 ◽  
Author(s):  
Rebin Dr. Fard
Keyword(s):  
Decision Making ◽  
Foreign Policy ◽  
Policy Making ◽  
Research Method ◽  
Research Question ◽  
German Foreign Policy ◽  
Decision Making Process ◽  
Policy Structure ◽  
Policy Making Process ◽  
Domestic Level

<p>To answer the research question , I focus on the domestic level to draw up a profile of the German foreign policy making process. For the analysis content analysis is used as a research method in order to examine the legitimate actors who make foreign policy decisions and determine the guidelines of German foreign policy. </p>

scholarly journals Inerrogating Variables Affecting Consumers' EV Purchasing Decision

2021 ◽  
Author(s):  
Nadia Sultana
Keyword(s):  
Decision Making ◽  
Research Question ◽  
Hierarchical Cluster ◽  
Decision Making Process ◽  
Purchasing Decision ◽  
Tree Modeling ◽  
Vehicle Production ◽  
Consumer Data ◽  
Changes Over Time ◽  
Toyota Prius

This paper takes a multi-step approach to answer the research question “What are the factors that affect the consumers’ EV purchasing decision-making process and how do they affect it?” In order to answer this question, this paper studies consumer data from the last 15 years. Using Hierarchical cluster analysis, this paper shows how the importance of the factors changes over time. A predictive model has been developed using Ethnographic Decision tree Modeling (EDTM) for the decision-making process of the owners of the 4 top selling EV. The top selling EVs includes models of Nissan Leaf, Tesla, Chevy Volt, and Toyota Prius, from year 2009 to 2014. This EDTM model indicates that while consumers prefer variables such as gas requirement, performance and mile coverage over other variables when deciding to purchase an EV, when given several options of EV they consider other variable such as the environment, brand and country of vehicle production to be more important.

The ethics of semantics in medicine

2021 ◽  
pp. medethics-2020-107192
Author(s):  
David Shaw ◽  
Alex Manara ◽  
Anne Laure Dalle Ave
Keyword(s):  
Decision Making ◽  
Healthcare Professional ◽  
Ethical Issues ◽  
Decision Making Process ◽  
Medical Terms ◽  
Lay Perspective ◽  
Lay People ◽  
Course Of Action ◽  
Medical Term ◽  
Technical Terms

In this paper, we discuss the largely neglected topic of semantics in medicine and the associated ethical issues. We analyse several key medical terms from the informed perspective of the healthcare professional, the lay perspective of the patient and the patient’s family, and the descriptive perspective of what the term actually signifies objectively. The choice of a particular medical term may deliver different meanings when viewed from these differing perspectives. Consequently, several ethical issues may arise. Technical terms that are not commonly understood by lay people may be used by physicians, consciously or not, and may obscure the understanding of the situation by lay people. The choice of particular medical terms may be accidental use of jargon, an attempt to ease the communication of psychologically difficult information, or an attempt to justify a preferred course of action and/or to manipulate the decision-making process.

The Vulnerability of Urban Elementary School Arts Programs: A Case Study

2017 ◽  
Vol 65 (4) ◽  
pp. 393-415 ◽  
Author(s):  
Ryan D. Shaw
Keyword(s):  
Decision Making ◽  
School District ◽  
Belief Systems ◽  
Research Question ◽  
Decision Making Process ◽  
Instrumental Case Study ◽  
Urban Elementary School ◽  
Arts Programs ◽  
Arts Teachers

With the intent of improving understanding of cuts to elementary arts programs, the purpose of this research was to investigate how one urban school district (Lansing School District in Lansing, Michigan) eliminated its elementary arts specialists. Research questions were (1) What policy conditions enabled the Lansing School District’s decision to cut its elementary arts specialists? and (2) How did the decision-making process unfold? This instrumental case study drew on policy analysis, and data sources included 18 interviews with former Lansing School District teachers, current employees, and community arts provider representatives as well as related documents and researcher memos. After coding for themes, I used the Advocacy Coalition Framework to organize findings by research question. Findings showed that a confluence of macro- and microlevel policy conditions enabled the cuts, including declining enrollment, budget problems, and a negative perception of elementary arts teachers facilitated by permissive teacher certification/assignment policies. Analysis also showed that the decision-making process was characterized by rival coalitions whose membership was defined by belief systems. Based on the findings, I offer critical reflection on a number of topics and offer general recommendations as well as implications for researchers.

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