A Conceptual Framework for the Ethical Evaluation of Supported Decision-Making

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 159-160
Author(s):  
Matthé Scholten ◽  
◽  
Jakov Gather ◽  
Jochen Vollmann ◽  
◽  
...  
Keyword(s):  
Decision Making ◽  
Conceptual Framework ◽  
Ethical Issues ◽  
Plain Language ◽  
Undue Influence ◽  
Persons With Disabilities ◽  
Ethical Evaluation ◽  
Process Support ◽  
Wide Range ◽  
Outsourcing Decision

"Background: Supported decision-making (SDM) refers to all types of interventions support persons with impaired decision-making capacity (DMC) in making informed treatment decisions. It encompasses a wide range of interventions, such as enhanced consent procedures, elaborated plain language and involvement of family, friends or peers in the informed consent process. Empirical research showed that SDM can enhance DMC. The UN Convention on the Rights of Persons with Disabilities, which has been ratified by 180 states parties to date, pronounces in article 12(3) that “states parties shall take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity.” At the same time, medical ethicists and legal scholars have raised the concern that persons with impaired DMC are more likely to become subject to undue influence under SDM arrangements. Objectives: The aim of this presentation is to provide a conceptual framework to facilitate an ethical evaluation of various forms of supported decision-making. Methods: Empirically informed conceptual analysis. Various SDM interventions are analyzed. Findings: It is necessary to distinguish between input, process and output support. Input support involves influencing factors that are negatively correlated with DMC; process support involves interpreting a person’s preferences and carrying out intellectual processing; and output support involves enabling a person to communicate decisions to others. Conclusion: Most forms of input and output support are promising, but ethical issues in relation to framing and interpersonal leverage must be addressed. Forms of process support that involve “outsourcing” decision-making capacities are ethically problematic. "

scholarly journals Building information modelling to support maintenance management of healthcare built assets

Facilities ◽  
2019 ◽  
Vol 37 (7/8) ◽  
pp. 415-434 ◽  
Author(s):  
Nadeeshani Wanigarathna ◽  
Keith Jones ◽  
Adrian Bell ◽  
Georgios Kapogiannis
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Conceptual Framework ◽  
Asset Management ◽  
Building Information Modelling ◽  
Content Type ◽  
Information Modelling ◽  
Wide Range ◽  
Building Information ◽  
Use Phase

Purpose This paper aims to investigate how digital capabilities associated with building information modelling (BIM) can integrate a wide range of information to improve built asset management (BAM) decision-making during the in-use phase of hospital buildings. Design/methodology/approach A comprehensive document analysis and a participatory case study was undertaken with a regional NHS hospital to review the type of information that can be used to better inform BAM decision-making to develop a conceptual framework to improve information use during the health-care BAM process, test how the conceptual framework can be applied within a BAM division of a health-care organisation and develop a cloud-based BIM application. Findings BIM has the potential to facilitate better informed BAM decision-making by integrating a wide range of information related to the physical condition of built assets, resources available for BAM and the built asset’s contribution to health-care provision within an organisation. However, interdepartmental information sharing requires a significant level of time and cost investment and changes to information gathering and storing practices within the whole organisation. Originality/value This research demonstrated that the implementation of BIM during the in-use phase of hospital buildings is different to that in the design and construction phases. At the in-use phase, BIM needs to integrate and communicate information within and between the estates, facilities division and other departments of the organisation. This poses a significant change management task for the organisation’s information management systems. Thus, a strategically driven top-down organisational approach is needed to implement BIM for the in-use phase of hospital buildings.

Psychiatry of the elderly

2021 ◽  
pp. 499-528
Author(s):  
Catherine Oppenheimer ◽  
Julian C. Hughes
Keyword(s):  
Decision Making ◽  
Old Age ◽  
Ethical Issues ◽  
The Elderly ◽  
Predictive Diagnosis ◽  
Truth Telling ◽  
Persons With Disabilities ◽  
Decision Making Capacity ◽  
The Face ◽  
Mental Capacity Act

This chapter describes the ethical issues that arise in the setting of mental illness, and particularly dementia, in old age. It affirms the importance of understanding each older person as an individual, embedded in a unique history and in relationships which sustain their identity even in the face of cognitive decline. Autonomy and paternalism are discussed, and the alternative concept of ‘parentalism’ introduced. Decision-making capacity and competence are extensively analysed from both philosophical and practical viewpoints, with particular reference to the Mental Capacity Act 2005, and to mechanisms for decision-making for noncompetent patients. Topics briefly treated include predictive diagnosis and mild cognitive impairment, end-of-life care, truth telling, sexuality, and the UN Convention on the Rights of Persons with Disabilities. The text is aimed at old age psychiatrists and other practitioners in the field, as well as at those with an interest in ethical issues in old age.

An ethical evaluation of animal biotechnology: the case of using clones in dairy cattle breeding

1995 ◽  
Vol 61 (3) ◽  
pp. 453-463 ◽  
Author(s):  
I. J. M. de Boer ◽  
F. W. A. Brom ◽  
J. M. G. Vorstenbosch
Keyword(s):  
Decision Making ◽  
Dairy Cattle ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Animal Husbandry ◽  
Cattle Breeding ◽  
Ethical Evaluation ◽  
Animal Biotechnology ◽  
Moral Principles ◽  
Dairy Cattle Breeding

AbstractThis paper presents an approach for ethical evaluation of biotechnology, which is illustrated by cloning in dairy cattle breeding. The approach for ethical decision-making that was followed, the so-called network model, started with determining fundamental moral principles that together constitute a framework for the detection of ethical issues in a given situation. In terms of human ethics, four fundamental principles have been defined: beneficence, non-maleficence, justice and autonomy. In the context of animal biotechnology, the same four fundamental moral principles as in humans are considered, except that autonomy is replaced by respect for the integrity of the animal. Based on a Dutch advisory committee concerning animal biotechnology, two additional principles were considered: irreversibility and veriflability. For each individual case, moral decision-making means balancing of moral intuitions, moral principles and morally relevant facts. The final outcome on moral acceptability of an action, therefore, will differ among people. The latter is demonstrated using three types of people (the ruler, the steward and the partner/participant). For each type of person, the fundamental attitude toward animals and nature is defined and a possible decision on the application of cloning in dairy cattle breeding is given. The authors' opinion, however, is that the benefits of cloning are relatively small, especially in the long term, whereas the moral drawbacks of cloning are considerable. The authors conclude that other ways of furthering animal husbandry should have priority.

Internal Party Democracy in Tanzania

2021 ◽  
pp. 267-292
Author(s):  
Edwin Babeiya
Keyword(s):  
Decision Making ◽  
Political Parties ◽  
Civic Education ◽  
Legal Framework ◽  
Social Stability ◽  
Senior Leadership ◽  
Undue Influence ◽  
Persons With Disabilities ◽  
Special Groups ◽  
Ruling Party

This chapter discusses the state of intraparty democracy in Tanzania. It traces the functioning and management of political parties since the country restored plural politics in 1992 by looking at both the ruling party and the opposition. Intraparty democracy is conceived of in this chapter as a key ingredient in ensuring social stability and harmony as well as the development of political parties. The chapter shows that intraparty democracy across all political parties is limited but that the situation is more disappointing in the case of the opposition. Using the two yardsticks of elections and decision-making, it maintains that limited internal party democracy can be attributed to several factors, including the undue influence of party founders, the dysfunctional nature of party structures, and the limited voice that ordinary members have as a result of their persistent disempowerment by senior leadership. Other factors include the influence of clientelistic networks and the weaknesses of oversight bodies and the legal framework. Against this backdrop, the chapter argues that making progress in promoting intraparty democracy would require a number of interventions. Among them are building the capacity of political parties and reviewing the legal framework so as to increase the rights and protection of members. The chapter also recommends actions to ensure greater representation of special groups—such as women and persons with disabilities—in decision-making, and suggests that civic education be provided to ordinary members of political parties to improve their ability to hold leadership to account.

scholarly journals Un modèle multi-niveau de prise de décision éthique pour les relations publiques

2017 ◽  
pp. 73-93
Author(s):  
Yanick Farmer
Keyword(s):  
Decision Making ◽  
Public Relations ◽  
Conceptual Framework ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Professional Associations ◽  
Reputation Management ◽  
Nous Allons ◽  
Prise De Décision

Afin de soutenir leurs membres qui sont aux prises fréquemment avec des problèmes de nature éthique, plusieurs associations professionnelles en relations publiques se sont dotées de modèles de prise de décision éthique qu’elles mettent à la disposition de leurs membres à des fins de référence et de formation continue. Cependant, comme nous le démontrons dans cet article, les modèles proposés sont nettement insuffisants lorsqu’il s’agit d’aborder des questions éthiques plus complexes. Ainsi, l’objectif de cet article est de fournir aux théoriciens et aux praticiens des outils conceptuels permettant de mieux penser cette complexité dans la prise de décision éthique. Pour répondre à cet objectif, nous présenterons, dans un premier temps, un cadre conceptuel qui comprend le champ d’application du modèle, ses bases théoriques, de même que des techniques avancées de pondération, de mise en équilibre des intérêts et de gestion de la réputation. Parallèlement à cet effort de théorisation, nous allons voir quelques applications de ce cadre conceptuel à travers l’analyse de cas pratiques. En guise de conclusion, nous allons faire une synthèse des points saillants et évoquer d’autres avenues pour la recherche sur ces questions. Mots-clés: éthique, prise de décision, relations publiques, réputation, gestion du risque.   To support their members who frequently face ethical issues, several professional associations in public relations have developed models of ethical decision-making that they make available to their members for reference and training. However, as we demonstrate in this paper, these models are clearly insufficient to address more complex ethical issues. Thus, the aim of this article is to provide theoreticians and practitioners with conceptual tools to better reflect this complexity in ethical decision-making. To meet this objective, we will first present a conceptual framework that includes the scope of the model, its theoretical foundations, as well as advanced techniques for weighting interests and reputation management. In addition to this theoretical effort, we will see some applications of this conceptual framework through case analysis. In conclusion, we will summarize the highlights and discuss other avenues for research on these issues. Keywords: ethics, decision-making, public relations, reputation, risk management.

scholarly journals Patterns of ethical issues and decision-making challenges in clinical practice among Ghanaian physiotherapists

2020 ◽  
Vol 54 (3) ◽  
pp. 179-185
Author(s):  
Gifty Nyante ◽  
Caleb Andoh ◽  
Ajediran Bello
Keyword(s):  
Decision Making ◽  
Ethical Issues ◽  
Code Of Ethics ◽  
Research Work ◽  
Sampling Technique ◽  
Healthcare Setting ◽  
Cross Sectional Study ◽  
Public Healthcare ◽  
Cross Sectional ◽  
Wide Range

Objectives: To determine the patterns of ethical issues and decision-making challenges encountered by practicing physiotherapists in Ghana.Design: This is a cross-sectional study in which the stratified sampling technique was adopted to sample the participants.Setting: The study involved physiotherapists at the private healthcare setting and from different levels of public healthcare facilities.Participants: Eighty-two duly registered physiotherapists who were practising in Ghana participated in the study.Interventions: Participants completed a 30-item questionnaire related to ethical issues and challenges encountered in making ethical decisions. Data analysis was premised on the frequency of occurrence of ethical tensions and difficulty in decision making which were dichotomized as 'high' and 'low' issues, and 'extreme' and 'low' difficult decisions, respectively.Results: The age range of the participants was 21-49 years (mean 31.5 ± 1.4years). 18 (22%), 31 (37.8%) and 33 (40.2%) physiotherapists practice in the primary, secondary and tertiary healthcare settings respectively. 56 (68.3%) and 43 (52.4%) of the participants affirmed that 'establishing priorities for patient's treatment amidst limited time resources' was the most frequently encountered and the most extremely difficult ethical issue to make a decision on respectively. Whereas, limiting physical therapy services for personal or organizational gains sub-theme was the least occurred issue which was also the least difficult to make a decision on as indicated by the respective 16 (19.5%) and 18 (22.0%) physiotherapists.Conclusion: A wide range of primary and secondary ethical issues were reported by the sampled physiotherapists, which tend to pose difficulty during the decision-making process in practice.Keywords: Ethical issues; code of ethics; decision making; physiotherapy practice, ethical judgementFunding: The research work was self-funded by the authors.

How Scientists Communicate

2020 ◽  
Author(s):  
Alan Kelly
Keyword(s):  
Ethical Issues ◽  
Scientific Communication ◽  
Scientific Publication ◽  
Good Communication ◽  
Wide Range ◽  
Conference Presentations ◽  
Scientific Papers ◽  
History Of ◽  
The Media ◽  
Broad Overview

What is scientific research? It is the process by which we learn about the world. For this research to have an impact, and positively contribute to society, it needs to be communicated to those who need to understand its outcomes and significance for them. Any piece of research is not complete until it has been recorded and passed on to those who need to know about it. So, good communication skills are a key attribute for researchers, and scientists today need to be able to communicate through a wide range of media, from formal scientific papers to presentations and social media, and to a range of audiences, from expert peers to stakeholders to the general public. In this book, the goals and nature of scientific communication are explored, from the history of scientific publication; through the stages of how papers are written, evaluated, and published; to what happens after publication, using examples from landmark historical papers. In addition, ethical issues relating to publication, and the damage caused by cases of fabrication and falsification, are explored. Other forms of scientific communication such as conference presentations are also considered, with a particular focus on presenting and writing for nonspecialist audiences, the media, and other stakeholders. Overall, this book provides a broad overview of the whole range of scientific communication and should be of interest to researchers and also those more broadly interested in the process how what scientists do every day translates into outcomes that contribute to society.

An Overview of Ethics and Environmental Health

2019 ◽  
pp. 697-703
Author(s):  
David B. Resnik
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Environmental Ethics ◽  
Ethical Issues ◽  
Biomedical Ethics ◽  
Public Health Ethics ◽  
Social Utility ◽  
Toxic Substances ◽  
Health Ethics ◽  
Wide Range

This chapter provides an overview of the ethics of environmental health, and it introduces five chapters in the related section of The Oxford Handbook of Public Health Ethics. A wide range of ethical issues arises in managing the relationship between human health and the environment, including regulation of toxic substances, air and water pollution, waste management, agriculture, the built environment, occupational health, energy production and use, environmental justice, population control, and climate change. The values at stake in environmental health ethics include those usually mentioned in ethical debates in biomedicine and public health, such as autonomy, social utility, and justice, as well as values that address environmental concerns, such as animal welfare, stewardship of biological resources, and sustainability. Environmental health ethics, therefore, stands at the crossroads of several disciplines, including public health ethics, environmental ethics, biomedical ethics, and business ethics.

Persons with Disabilities and Public Health Ethics

2019 ◽  
pp. 218-231
Author(s):  
Monika Mitra ◽  
Linda Long-Bellil ◽  
Robyn Powell
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Ethical Issues ◽  
The United States ◽  
Policy And Practice ◽  
Persons With Disabilities ◽  
Public Health Decision ◽  
Health Decision ◽  
Health Policy And Practice

This chapter draws on medical, social, and legal perspectives to identify and highlight ethical issues pertaining to the treatment, representation, and inclusion of persons with disabilities in public health policy and practice. A brief history of disability in the United States is provided as a context for examining the key ethical issues related to public health policy and practice. Conceptual frameworks and approaches to disability are then described and applied. The chapter then discusses the imperativeness of expanding access to public health programs by persons with disabilities, the need to address implicit and structural biases, and the importance of including persons with disabilities in public health decision-making.

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