Book Reviews: Marrying Well; The Clinician's Guide to Premarital Counseling, Counseling Strategies for Loss and Grief, Sexual Abuse and the Culture of Catholicism: How Priests and Nuns Become Perpetrators, Criminal Justice Ethics: Theory and Practice, Decision Making near the End of Life: Issues, Developments, and Future Directions, The Colors of Grief: Understanding a Child's Journey through Loss from Birth to Adulthood, Families Change: Coping with Stressful Events and Transitions, The Majesty of Your Loving: A Couple's Journey through Alzheimer's, at the Cinema: Dead Poet's Society

2010 ◽  
Vol 18 (3) ◽  
pp. 279-297
Author(s):  
Richard B. Gilbert ◽  
Harold Ivan Smith ◽  
Robert G. Stevenson ◽  
Barbara Rubel ◽  
Gerry Cox
Keyword(s):  
Decision Making ◽  
Sexual Abuse ◽  
Premarital Counseling ◽  
Stressful Events ◽  
Theory And Practice ◽  
Future Directions ◽  
Loss And Grief ◽  
Life Issues ◽  
End Of Life Issues

Neuroethics

2017 ◽  
Author(s):  
Stephen J. Morse
Keyword(s):  
Legal Theory ◽  
Civil Liberty ◽  
Functional Brain Imaging ◽  
Theory And Practice ◽  
Criminal Cases ◽  
Normal Functioning ◽  
Scientific Status ◽  
Life Issues ◽  
End Of Life Issues ◽  
Do So

This chapter discusses whether the findings of the new neuroscience based largely on functional brain imaging raise new normative questions and entail normative conclusions for ethical and legal theory and practice. After reviewing the source of optimism about neuroscientific contributions and the current scientific status of neuroscience, it addresses a radical challenge neuroscience allegedly presents: whether neuroscience proves persons do not have agency. It then considers a series of discrete topics in neuroethics and neurolaw, including the “problem” of responsibility, enhancement of normal functioning, threats to civil liberty, competence, informed consent, end-of-life issues, neuroevidence in criminal cases, and the ethics of caution. It suggests that the ethical and legal resources to respond to the findings of neuroscience already exist and will do so for the foreseeable future.

scholarly journals PROBLEMATIKA DI AKHIR KEHIDUPAN PASIEN DEMENSIA BERAT

2018 ◽  
Vol 36 (1) ◽  
Author(s):  
Diatri Lastri Nari
Keyword(s):  
Decision Making ◽  
Antibiotic Use ◽  
Nutrition Status ◽  
Dementia Patient ◽  
Severe Dementia ◽  
Goals Of Care ◽  
Life Issues ◽  
Swallowing Difficulty ◽  
End Of Life Issues ◽  
Surrogate Decision

  END-OF-LIFE ISSUES IN ADVANCED DEMENTIAABSTRACTThe number of people living with dementia worldwide in 2015 was estimated at 47.47 million, reaching 75.63 million in 2030. Dementia could cause many issues such as establishing goals of care, feeding difficulty, swallowing difficulty, dehydration, pneumonia, and decision making when the patient cannot actively participate. Goals of care for patient with severe dementia are person-centered. To keep hydration and nutrition status in patients with severe dementia, the best approach is risk-managed eating or comfort feeding. The main consideration for antibiotic use in dementia patient with pneumonia is goals of care. In a decision-making discussion, physician should prepare to promote compassionate and evidence-based counselling to minimize the burden of decision making for the surrogate decision maker.Keywords: Advanced dementia, goals of care, decision making, feeding and swallowing difficultyABSTRAKJumlah penderita demensia di dunia pada tahun 2015 diperkirakan mencapai 47,47 juta jiwa dan akan mencapai 75,63 juta jiwa pada tahun 2030. Demensia dapat menimbulkan berbagai masalah, seperti kesulitan menentukan tujuan perawatan, masalah terkait perawatan (sulit makan, sulit menelan, dehidrasi, dan pneumonia), serta pengambilan keputusan ketika pasien tidak dapat lagi berpartisipasi secara aktif. Tujuan perawatan pada pasien demensia berat haruslah berpusat pada pasien. Untuk menjaga status hidrasi dan nutrisi pada pasien demensia berat yang kesulitan menelan atau makan, pendekatan yang paling baik adalah risk-managed eating atau comfort feeding. Demikian pula pertimbangan utama penggunaan antibiotik pada pasien demensia. Dalam diskusi mengenai keputusan yang akan diambil, dokter sebaiknya menyiapkan konseling dengan empati dan berdasarkan bukti ilmiah untuk meminimalisasi beban pengambilan keputusan oleh pengganti pengambil keputusan (surrogate decision-maker).Kata kunci: Demensia berat, pengambilan keputusan, kesulitan makan dan menelan 

scholarly journals Patient experiences of shared decision-making are associated with implantable cardioverter defibrillator recipients" openness to discuss device deactivation at end-of-life

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
OJ Oh ◽  
KS Lee ◽  
J Miller ◽  
M Hammash ◽  
DR Thompson ◽  
...  
Keyword(s):  
United States ◽  
Decision Making ◽  
End Of Life ◽  
Shared Decision Making ◽  
The United States ◽  
Public Institution ◽  
Shared Decision ◽  
Icd Implantation ◽  
Life Issues ◽  
End Of Life Issues

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): In Australia, this study received funding from a faculty grand by Australian University Faculty of Health Sciences Research grant. In the United States, the study was funded by a research professor award from University of Kentucky. Background. Shared decision-making is important for ICD recipients to fully contemplate and rationally decide about ICD deactivation at end-of-life. Although discussions about device deactivation at end-of-life are recommended to be held before ICD implantation and throughout the illness trajectory, such discussions rarely occur in clinical practice. Purpose. To identify whether ICD recipients’ experiences of end-of-life discussions with clinicians are associated with openness to discussing ICD deactivation at end-of-life. Methods. This cross-sectional study included 293 ICD recipients living in the United States, Australia, and South Korea (mean age 59, 22.5% female, mean ICD implantation 10 years). Hierarchical logistic regression was used to determine whether patients’ experiences of shared decision-making were associated with openness to discuss device deactivation at end-of-life after controlling for relevant covariates (i.e. age, gender, ICD implantation years, ICD shock experience, general ICD experience, ICD knowledge, and concerns related to the ICD). Results. About half of the participants (57.7%) were open to discussing ICD deactivation at end-of-life with clinicians. Almost one-quarter (23.5%) had no prior experience of discussing any end-of-life issues with clinicians. Patients’ past experiences of end-of-life discussions with clinicians were significantly associated with openness to discuss device deactivation at end-of-life (OR: 1.30) after adjusting for covariates. Conclusion. Our results highlight that clinicians’ willingness to discuss sensitive end-of-life issues such as battery replacement and deactivation of defibrillation therapy empowers patients to actively engage in end-of-life discussions.

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