Stewardship of the Aged: Meeting the Ethical Challenge of Ageism

The Elderly ◽  
2017 ◽  
pp. 199-210
Author(s):  
David C. Thomasma
Keyword(s):  
Ethical Challenge

The “Ghastly Spectacle”

2018 ◽  
Author(s):  
Ian Finseth
Keyword(s):  
Civil War ◽  
Affect Theory ◽  
Traumatic Experience ◽  
Ethical Challenge ◽  
The Dead ◽  
War Dead ◽  
Social Logic

This chapter focuses on how witneᶊes to Civil War death made sense of their traumatic experience. The ethical challenge was one of recognition: to see and know the often-anonymous dead for who and what they were. Yet the dead were invariably integrated into familiar frameworks of meaning and into the conventions of aesthetics and rhetoric. Drawing on insights from phenomenology, pragmatism, Freudian psychology, and affect theory, the chapter shows that the psychological proceᶊes of abstraction and typification underlay a social logic of necrophilic dependency that both thrived on the dead and yet resisted their complex individuality. This problem is then connected to a long-standing cultural and historical melancholia whereby the Civil War dead have been internalized and eternalized as representational artifacts within a society that remains divided and ambivalent over the meaning of the war.

Expanding the concept of the professional integrity of obstetrics during a public health emergency

2020 ◽  
Vol 48 (5) ◽  
pp. 435-437 ◽  
Author(s):  
Frank A. Chervenak ◽  
Amos Grünebaum ◽  
Eran Bornstein ◽  
Shane Wasden ◽  
Adi Katz ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
Clinical Judgment ◽  
Ethical Judgment ◽  
Population Based ◽  
Public Health Emergency ◽  
Ethical Challenge ◽  
Professional Integrity ◽  
Increased Risk ◽  
Obstetric Services

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has placed great demands on many hospitals to maximize their capacity to care for affected patients. The requirement to reassign space has created challenges for obstetric services. We describe the nature of that challenge for an obstetric service in New York City. This experience raised an ethical challenge: whether it would be consistent with professional integrity to respond to a public health emergency with a plan for obstetric services that would create an increased risk of rare maternal mortality. We answered this question using the conceptual tools of professional ethics in obstetrics, especially the professional virtue of integrity. A public health emergency requires frameshifting from an individual-patient perspective to a population-based perspective. We show that an individual-patient-based, beneficence-based deliberative clinical judgment is not an adequate basis for organizational policy in response to a public health emergency. Instead, physicians, especially those in leadership positions, must frameshift to population-based clinical ethical judgment that focuses on reduction of mortality as much as possible in the entire population of patients served by a healthcare organization.

scholarly journals When Scarcity Meets Disparity: “Resources Allocation and COVID-19 Patients with Diabetes”

2021 ◽  
pp. 193229682199111
Author(s):  
Jacob M. Appel
Keyword(s):  
Risk Factors ◽  
Resource Allocation ◽  
Life Expectancy ◽  
Ethical Challenge ◽  
Severe Illness ◽  
Resources Allocation ◽  
Economic Disparity ◽  
Patients With Diabetes ◽  
Current Stage

The COVID-19 pandemic raised distinct challenges in the field of scarce resource allocation, a long-standing area of inquiry in the field of bioethics. Policymakers and states developed crisis guidelines for ventilator triage that incorporated such factors as immediate prognosis, long-term life expectancy, and current stage of life. Often these depend upon existing risk factors for severe illness, including diabetes. However, these algorithms generally failed to account for the underlying structural biases, including systematic racism and economic disparity, that rendered some patients more vulnerable to these conditions. This paper discusses this unique ethical challenge in resource allocation through the lens of care for patients with severe COVID-19 and diabetes.

Bare Nature

2017 ◽  
Vol 21 (1) ◽  
pp. 4-17 ◽  
Author(s):  
Rob Shields
Keyword(s):  
Direct Costs ◽  
Consumption Patterns ◽  
State Of Exception ◽  
Ethical Challenge ◽  
Natural Ecosystems ◽  
Implicit Relation ◽  
Personal Cost ◽  
Ethical Implications ◽  
The Past ◽  
The Status

This article considers the ethical implications of a stance toward or relation with the natural environment that could be characterized as dominant across many sectors of not only the economy but consumption patterns generally. Despite popular perception or denial of climate change over the past decades, this is an implicit relation toward the collateral risks and damages to ecosystems by human activity. Not only are livelihoods sustained on the basis of natural resources but the direct costs of hydrocarbon development are borne locally in the environment. For some, this is understood to be without a personal cost despite the fears expressed. The article quotes from interviews with residents. It stages a broader, continuing conversation about the ambivalence of being dependent on hydrocarbons. This article explores the difficulty of developing an ethical engagement with the nonhuman and natural ecosystems when they are relegated to the status of what will be referred to as “bare nature.” Rather than state of exception or standing reserve, nonhuman nature is only present as a form of absence and as nonentities and does not present an ethical challenge or claim.

Ethical challenges when using coercion in mental healthcare: A systematic literature review

2016 ◽  
Vol 25 (1) ◽  
pp. 92-110 ◽  
Author(s):  
Marit Helene Hem ◽  
Elisabeth Gjerberg ◽  
Tonje Lossius Husum ◽  
Reidar Pedersen
Keyword(s):  
Patient Autonomy ◽  
Moral Distress ◽  
Mental Healthcare ◽  
Healthcare Personnel ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Best Interest ◽  
Ethical Considerations ◽  
Search Terms ◽  
Healthcare It

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress.

Intensive care nurses’ experiences of Covid-19 care: A practical and ethical challenge – a qualitative descriptive design

2021 ◽  
pp. 205715852110627
Author(s):  
Anna-Lena Stenlund ◽  
Gunilla Strandberg
Keyword(s):  
Intensive Care ◽  
Qualitative Content Analysis ◽  
Treatment Strategies ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Structured Interviews ◽  
Intensive Care Nurses ◽  
Qualitative Descriptive ◽  
Heavy Burden ◽  
New Treatment

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies, and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and its ethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis was used. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailored intensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protect ethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibility for the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was to strive to make the best of the situation.

The Ethics of Placebo and Nocebo in Psychotherapy

2021 ◽  
Author(s):  
Jens Gaab ◽  
Cosima Locher ◽  
Manuel Trachsel
Keyword(s):  
Psychotherapy Research ◽  
Psychological Problems ◽  
Effective Intervention ◽  
Ethical Challenge ◽  
Research And Practice ◽  
Ongoing Controversy

There is as little doubt as much as there is empirical proof that psychotherapy is an effective intervention for psychological problems and disorders. However, there is ongoing controversy about the mechanisms underlying these often impressive, but also often overestimated effects, reaching back to the very origins of psychotherapy research. While this “great psychotherapy debate” vivifies both psychotherapy research and practice, it finally poses an ethical challenge for both psychotherapists and psychotherapy scholars. Basically, the lack of agreed and validated mechanisms impedes the attempt to inform patients about how changes of psychotherapy are brought about. Thus, even though patients can readily be furnished with possible and expectable benefits, costs and strains, the situation becomes more complex and less certain with regard to the specific mechanisms and determinants of change. In this chapter, psychotherapy scholars’ strivings and troubles for specificity will be briefly covered, touching the uncomfortable relationship with placebo and nocebo and finishing with an ethical plea for transparency in psychotherapy and of psychotherapists.

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