scholarly journals Ethical Issues of Decision Making and Communication in Health Care: An Intercultural and Interfaith Perspective

2021 ◽  
Vol 12 (1) ◽  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Ethical Issues

Ethical Issues

2021 ◽  
pp. 176-203
Author(s):  
Dena S. Davis ◽  
Paul T. Menzel
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Advance Directives ◽  
Moral Distress ◽  
Ethical Issues ◽  
Severe Dementia ◽  
Relevant Change ◽  
Decision Making Capacity ◽  
Behavioral Expression ◽  
Pain And Suffering

The implementation of advance directives to withhold food and water by mouth faces significantly more challenges than VSED by persons with decision-making capacity, though with sufficient care and attention, many of these can be resolved. Reduced awareness may leave the person with little understanding of her directive or no awareness at all. In severe dementia, is behavioral expression of a simple desire for food or drink a relevant change of mind about the directive, or by then does the person no longer have the capacity to make such a change? How relevant is the moral distress that caregivers and health care agents will often experience when implementing the person’s directive, or when they are unable to get it implemented? Patients in severe dementia also may be relatively content, with little pain and suffering—is the deterioration itself, without pain and suffering, a legitimate reason for implementing a VSED directive?

Why did some Danish counties introduce breast cancer screening and others not? An exploratory study of four selected counties

2008 ◽  
Vol 24 (03) ◽  
pp. 326-332
Author(s):  
Kasper Hjulmann ◽  
Hindrik Vondeling ◽  
Mickael Bech
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Priority Setting ◽  
Central Government ◽  
Ethical Issues ◽  
County Level ◽  
Healthcare Provision ◽  
Policy Documents ◽  
Explanatory Factors ◽  
A Minor

Objectives:Of the fourteen counties and two municipalities that until recently were responsible for healthcare provision in Denmark, five introduced mammography screening (MS) programs. The objective of this research is to explain this decision-making variation and to gain insight into priority setting processes in health-care provision at the county level in Denmark.Methods:Literature on priority setting in health care was used to derive seven explanatory factors for comparing decision making on MS between four selected counties, of which two had implemented MS. The relative importance of each explanatory factor in each county was determined by analyzing policy documents, supplemented with interviews of selected stakeholders. The results were combined and compared at the county level.Results:Evidence of effectiveness of MS was considered satisfactory and ethical issues related to MS were perceived relatively unproblematic only in those counties that introduced MS. Lack of resources, that is, radiologists, was an additional important factor for counties not implementing MS. Local opinion leaders have played a stimulating role, whereas advisory policy documents at the central government level and even legislation have had a minor impact.Conclusions:The four counties have based their decision making on the introduction of MS on different combinations of a limited number of factors that have been differentially weighted. The pattern of relevant factors in both counties not introducing MS is rather similar. The study elucidates the role of complementary factors to evidence in decision making. Of interest, recent public sector reforms have resulted in the decision to have MS implemented nationwide.

scholarly journals Understanding the principles of ethics in health care: a systematic analysis of qualitative information

2018 ◽  
Vol 5 (3) ◽  
pp. 822
Author(s):  
Vanishree M. Kemparaj ◽  
Umashankar G. Kadalur
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Research ◽  
Health Professional ◽  
Health Professionals ◽  
Ethical Issues ◽  
Ethical Principles ◽  
Qualitative Information ◽  
Systematic Analysis ◽  
Ethical Knowledge

Despite incorporating ethical teaching in medical curricula there is paucity in knowledge of ethics among our practitioners. To improve the ethical knowledge it is important to understand the ethical issues or challenges encountered in the present scenario. The issues encountered by the health professionals helps to understand how the ethical principles are in day to today practice. Empirical researches have shown that qualitative research brings research closer to decision making. Hence data obtained from peer-reviewed qualitative articles were used for assessing ethical principles in every day practice by health professional. The studies have shown that autonomy, beneficence, justices are some of the principles health professionals consider before taking the decisions in health care.

Preventive Ethics: The Development of Policies to Guide Decision-Making

1990 ◽  
Vol 1 (1) ◽  
pp. 169-177 ◽  
Author(s):  
June Levine-Ariff
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Ethical Issues ◽  
Disease Process ◽  
Underlying Disease ◽  
Therapeutic Interventions ◽  
Vital Functions ◽  
Ethical Conflicts ◽  
Preventive Ethics

Ethics as a discipline and certainly morals as a force in decision-making is not new. However, the remarkable advances in science and technology that have occurred during the past 30 years have brought to the bedside unforseen dilemmas, forcing health care professionals to take an ethical look at the care they deliver. Powerful diagnostic techniques, sophisticated surgical procedures, effective drugs, and worthwhile therapeutic interventions have enabled health care practitioners to eliminate many diseases and minimize disability. This progress has brought enormous human benefit. Unfortunately, coupled with these dramatic results is a reality that sometimes the quality of life produced is much less than what was desired. Our capacity to prolong life has not coincided with our ability to restore some level of health. Medical interventions have been able to maintain vital functions without always benefiting the underlying disease process. The rapidity with which technology has perpetuated ethical issues within the clinical setting has often lead to hasty and arbitrary decision-making. It is only with a thrust toward preventive ethics that decisions can be thoughtful and beneficial to patients and families. Thus, this article focuses on the implementation of policies that minimize and/or prevent ethical conflicts.

scholarly journals Evidence use as sociomaterial practice? A qualitative study of decision-making on introducing service innovations in health care

2021 ◽  
pp. 1-25
Author(s):  
Simon Turner ◽  
Danielle D´Lima ◽  
Jessica Sheringham ◽  
Nick Swart ◽  
Emma Hudson ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Evidence Use

scholarly journals Health Care Analysis on Myocardial Revascularization in Patients with Chronic Coronary Artery Disease: The Multicenter REVASK Study: Design and Protocol

2020 ◽  
Author(s):  
Andreas Beckmann ◽  
Eva-Maria Bitzer ◽  
Mareike Lederle ◽  
Peter Ihle ◽  
Jochen Walker ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Health Care ◽  
Decision Making ◽  
Coronary Artery ◽  
Myocardial Revascularization ◽  
Care Providers ◽  
Chronic Coronary Artery Disease ◽  
Care Guideline ◽  
Artery Disease

AbstractCoronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are available for revascularization of coronary artery disease (CAD) with the aims to reduce cardiovascular morbidity and mortality and to improve disease-related quality of life in particular. The German National Care Guideline (NVL-cKHK) on chronic CAD recommends the establishment of so-called heart teams for decision making in myocardial revascularization to improve the quality of care. Preferred recommendations for PCI or CABG are given for different patient subgroups depending on patient characteristics, concomitant diseases, and coronary morphology. The myocardial revascularization study (REVASK) is a noninterventional cohort study on care of patients undergoing PCI or CABG based on retrospective statutory health insurance (SHI) routine data, registry data from the German Cardiac Society (DGK) resp., the German Society for Thoracic and Cardiovascular Surgery (DGTHG), combined with prospective primary data collection from health care providers and patients. The primary goal is to investigate whether and to which extent heart teams, consisting of cardiologists and cardiac surgeons, increase guideline adherence in decision making for myocardial revascularization. Ultimately the study project aims to improve patient care in terms of decision making for appropriate myocardial revascularization. Through the consistent implementation of the German National Care Guideline on chronic Coronary Artery Disease (NVL-cKHK) and the European Guidelines on myocardial revascularization, the reduction of morbidity, mortality and the reduced need for subsequent revascularization procedures are also desirable from a health economics perspective.

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