scholarly journals Nursing Home and Vaccination Consent: The Italian Perspective

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 429
Author(s):  
Nunzia Cannovo ◽  
Roberto Scendoni ◽  
Marzia Maria Fede ◽  
Federico Siotto ◽  
Piergiorgio Fedeli ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Informed Consent ◽  
General Principle ◽  
Scientific Evidence ◽  
Herd Immunity ◽  
Healthcare Services ◽  
Decision Making Processes ◽  
Vaccination Campaigns ◽  
To Receive

Since the beginning of the Covid-19 pandemic, many countries have begun vaccination campaigns, with different methods and timelines, with the goal of vaccinating over 75% of the population and thus achieving herd immunity. Initially it was necessary to identity the categories of citizens who should be the first to receive the vaccines, on the basis of scientific evidence. On the basis of this information, elderly residents in nursing homes and the staff who care for them should be the highest priority subjects for vaccination. In this context, obtaining informed consent to Covid-19 vaccination presents a considerable challenge, as the advanced age and frequent comorbidities of a significant number of the residents may mean that they are incapable of expressing consent themselves. The legislation of various Western nations substantially agrees on the general principle that those capable of judgement must be asked for their consent for healthcare services, and that even those with psychological weaknesses that limit their full ability to decide must be involved in these decision-making processes. The article can help systematize the processes to be implemented to protect the health of individuals as members of a close and fragile community.

Certified Patient Decision Aids: Solving Persistent Problems with Informed Consent Law

2017 ◽  
Vol 45 (1) ◽  
pp. 12-40 ◽  
Author(s):  
Thaddeus Mason Pope
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Treatment ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Legal Doctrine ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Decision Making Processes

The legal doctrine of informed consent has overwhelmingly failed to assure that the medical treatment patients get is the treatment patients want. This Article describes and defends an ongoing shift toward shared decision making processes incorporating the use of certified patient decision aids.

scholarly journals The Duty to Consult the Sámi in Norwegian Law

2020 ◽  
Vol 11 (0) ◽  
pp. 233
Author(s):  
Øyvind Ravna
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
International Law ◽  
Indigenous Peoples ◽  
General Review ◽  
Decision Making Processes

This article deals with the duty to consult indigenous peoples and the obligation to involve these peoples in decision-making processes in matters that concern them. After a general review of international legislation and obligations, particularly the ILO Convention no. 169 on Indigenous and Tribal Peoples, the article focuses on how these obligations are implemented towards the indigenous Sámi in Norwegian law. Here, the consultation agreement from 2005 and the Sámi Rights Committee’s 2007 draft are still central. The review includes an analysis of the extent to which these duties meet international law requirements, and a deliberation on the concept of free, prior and informed consent.

Territorial Changes to Municipalities and Inter-Municipal Cooperation: A Comparative Overview and Orientations for Slovenia

2014 ◽  
Vol 12 (3) ◽  
pp. 731-748 ◽  
Author(s):  
Iztok Rakar ◽  
Bojan Tičar ◽  
Maja Klun
Keyword(s):  
Decision Making ◽  
Local Level ◽  
Local Communities ◽  
Democratic Legitimacy ◽  
Local Democracy ◽  
The Past ◽  
The People ◽  
Decision Making Processes ◽  
To Receive ◽  
Public Decision

Local self-government has faced a number of challenges over the past decade. The financial crisis has revealed new dimensions of the eternal question of financing self-governing local communities, while distrust and a lack of interest in participation in local democracy among the people have led to considerations of different approaches to public decision-making concerning local issues. A comparative overview shows that the question of the “perfect size” of municipalities is currently very relevant and aimed at finding dimensions that would enable the municipality to ensure both local-level democracy and identity and economic efficiency in the delivery of public services. The most popular tool for achieving this goal is the merger of municipalities, although other approaches also exist, including various forms of inter-municipal cooperation. Some forms of inter-municipal cooperation have already taken firm hold in Slovenia, although the question of the potential impacts of alternative forms of inter-municipal cooperation on the democratic legitimacy of decision-making processes and the potential of these processes for the developmental breakthrough of Slovenian municipalities has yet to receive adequate attention.

scholarly journals Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Laura E. Slosky ◽  
Marilyn Stern ◽  
Natasha L. Burke ◽  
Laura A. Siminoff
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Randomized Clinical Trials ◽  
Pediatric Intensive Care ◽  
Phase Iii ◽  
Older Children ◽  
Decision Making Processes ◽  
Surrogate Decision Makers ◽  
Surrogate Decision ◽  
Participation Decisions

Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomized clinical trial (RCT).Method. Participants were 76 children under sedation in a PICU and their surrogate decision makers. Measures included the Post Decision Clinician Survey, observer checklist, and post-decision interview.Results. Age of the pediatric patient was related to participation decisions in the RCT such that older children were more likely to be enrolled. Mentioning the sponsoring institution was associated with declining to participate in the RCT. Type of health care provider and overt recommendations to participate were not related to enrollment.Conclusion. Decisions to participate in research by surrogates of children in the PICU appear to relate to child demographics and subtleties in communication; however, no modifiable characteristics were related to increased participation, indicating that the informed consent process may not be compromised in this population.

scholarly journals COVID-19 Vaccinations: A Comprehensive Review of Their Safety and Efficacy in Special Populations

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1097
Author(s):  
Zhipeng Yan ◽  
Ming Yang ◽  
Ching-Lung Lai
Keyword(s):  
Decision Making ◽  
Herd Immunity ◽  
Significant Proportion ◽  
Special Populations ◽  
Safety And Efficacy ◽  
Comprehensive Review ◽  
Vaccination Programs ◽  
Vaccination Decision ◽  
Immunocompromised State ◽  
To Receive

COVID-19 has been spreading worldwide since late 2019. There is no definitive cure to date. Global vaccination programs are urgently required to confer herd immunity, reducing the incidence of COVID-19 infections and associated morbidity and mortality. However, a significant proportion of special populations are hesitant to receive vaccination due to their special conditions, namely, age (pediatrics and geriatrics), immunocompromised state, autoimmune diseases, chronic cardiovascular and pulmonary conditions, active or treated cancers, and pregnancy. This review aims to evaluate the existing evidence of COVID-19 vaccinations on these special populations and to provide clues to guide vaccination decision making to balance the benefits and risks of vaccinations.

scholarly journals Nothing about us without us: Canadian vaccine decision making must involve disabled people

2021 ◽  
Author(s):  
Holly Witteman ◽  
Gabrielle Peters ◽  
Cassandra Vujovich-Dunn ◽  
Amine Ouertani ◽  
Sharmistha Mishra
Keyword(s):  
Decision Making ◽  
Scientific Evidence ◽  
Severe Disease ◽  
National Policy ◽  
Risk Groups ◽  
Policy Recommendations ◽  
Disabled People ◽  
Pandemic Planning ◽  
Vaccination Campaigns ◽  
Vaccine Decision Making

Across Canada, national and provincial Covid-19 vaccine prioritization guidance and strategies have failed to appropriately include people with disabilities. Since the early goal of vaccination was to reduce severity, those at higher risk of severe disease if infected were meant to be prioritized early in vaccination campaigns, directly reducing their chance of death due to Covid-19. Older adults and some other higher-risk groups were therefore accorded high priority. However, younger disabled people were not prioritized for vaccines at levels commensurate with their risk of severe Covid-19 outcomes. Consequently, Canadian national policy recommendations have been incongruent with peer countries’ vaccine prioritization, scientific evidence, and priorities expressed by Canadians regarding how we should allocate Covid-19 vaccines. To avoid repeating these mistakes, current and future pandemic planning must include disabled people as full members of decision-making committees, in keeping with the longstanding demand of disabled people: “Nothing about us without us.” (1)

Evaluation of smart health technologies with hesitant fuzzy linguistic MCDM methods

2020 ◽  
Vol 39 (5) ◽  
pp. 6363-6375
Author(s):  
Gülçin Büyüközkan ◽  
Esin Mukul
Keyword(s):  
Decision Making ◽  
Healthcare Services ◽  
Analytic Hierarchy ◽  
Health Technologies ◽  
Health Related ◽  
Decision Making Processes ◽  
Smart Health ◽  
Smart Technologies ◽  
Intelligence Support ◽  
Fuzzy Linguistic

Smart health applications are raising a growing interest around the world thanks to its potential to act proactively and solve health related problems with smart technologies. Smart health technologies can provide effective healthcare services such as personalization of treatments through big data, robotics in cure and care, artificial intelligence support to doctors, etc. The mixed structure of the evaluation of smart health technologies involves various contradictory criteria. However, when information is of uncertain nature, it is difficult to decide on how to treat. A hesitant fuzzy linguistic term set (HFLTS) approach is applied to overcome such uncertainties related to this multi-criteria decision-making (MCDM) problem. This approach can be used to facilitate experts’ decision-making processes in complex and uncertain situations. In this study, an integrated hesitant fuzzy linguistic (HFL) MCDM approach is proposed to evaluate smart health technologies. The criteria are weighted with HFL Analytic Hierarchy Process (AHP), and then, smart health technologies are evaluated with the HFL Combinative Distance-based Assessment (CODAS) method. A comparative analysis with HFL COPRAS and HFL TOPSIS is applied. Lastly, the potential of this approach is presented through a case study.

scholarly journals Family caregivers’ involvement in decision-making processes regarding admission of persons with dementia to nursing homes

Dementia ◽  
2018 ◽  
Vol 19 (6) ◽  
pp. 2038-2055 ◽  
Author(s):  
Lill Sverresdatter Larsen ◽  
Bodil Hansen Blix ◽  
Torunn Hamran
Keyword(s):  
Decision Making ◽  
Family Caregivers ◽  
Service Providers ◽  
Healthcare Services ◽  
Positioning Theory ◽  
Ageing In Place ◽  
Decision Making Processes ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Depth Interviews

The current Western health policy of ageing in place relies on a triad collaboration among patients, healthcare service providers and family caregivers. Such collaborations presuppose involvement in a vague juridical landscape. This article explores family caregivers’ experiences with involvement in and influence on nursing home decision-making processes for persons with dementia. The data consist of 12 in-depth interviews with family caregivers. Using positioning theory, we demonstrate how family caregivers strive to balance their assumed duty to care for the person with their needs to care for themselves. Their involvement (or non-involvement) in the complex decision-making process is demonstrated through the following seven positions: (1) self-condemning determiner, (2) dominant, (3) proponent, (4) saluting, (5) pending, (6) prisoner, and (7) stooge. Furthermore, we discuss why expedient positions are more available for some individuals and the consequences of family caregivers’ various positions on the healthcare policy aims of collaboration and equal healthcare services.

Sign in / Sign up

Export Citation Format

Share Document