scholarly journals Study of Obtaining Informed Consent in Pediatric Wards from the Viewpoint of Physicians and Children’s Parents

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Soodabeh Rezvani ◽  
Mohsen Fadavi ◽  
Shabnam Bazmi
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Test Method ◽  
Final Decision ◽  
Medical Team ◽  
Therapeutic Procedures ◽  
Right Relationship ◽  
Correct Communication ◽  
The One ◽  
The Right

Background: Obtaining informed consent for diagnostic and therapeutic procedures is of great moral and legal importance, which is more important in the field of pediatrics due to its specific issues. Objectives: Obtaining informed consent in the pediatric field is specific because of many factors, including the age of the patients and the necessity of obtaining consent from parents or legal guardians. This study aimed to evaluate the process of obtaining informed consent from the viewpoint of substitute decision-makers (parents or guardians) and physicians. Attention to the differences between the views of these two groups by establishing appropriate and correct communication skills between them can lead to greater satisfaction and increased effectiveness of treatments. Methods: In this descriptive study, the data were collected through questionnaires completed by 188 parents and 23 physicians. Finally, the statistical analysis was conducted using the one-sample t test method in SPSS 16. Results: In 96.3% of the cases, parents believed that where the patient, their relatives, and the medical team disagreed about the kind of treatment, the final decision was made by the medical team. One-third of them did not receive enough information or received no information at all. Informing parents about other possible treatments, complications of the procedures, considering the patients and their relatives’ opinions for the final decision, informing the child about his/her disease and treatment plans, and informing the parents about the possible outcomes were not in the favorable range. Physicians believed that decision about the treatment was made based on the opinion of the parents and the clinical committee, and only in 3.4% of the cases, their opinion was the basis for decision-making. Conclusions: The results showed that there was a gap between the parents and physicians’ opinions about informed consent, as the physicians believed that they act as the patients’ parents wish and the parents believed that their opinion played no important role in the final decision regarding the health of their children. Thus, it seems necessary to institutionalize the culture of participatory decision-making by physicians and parents in decisions related to the diagnosis and treatment of children, and more emphasis should be placed on establishing the right relationship between treatment staff and patients and their relatives.

Author reply: Empathy Does Provide Rational Support for Decisions. But Is It the Right Decision?

2012 ◽  
Vol 4 (1) ◽  
pp. 96-97 ◽  
Author(s):  
Fritz Breithaupt
Keyword(s):  
Decision Making ◽  
Rational Decision ◽  
Author Reply ◽  
Rational Decision Making ◽  
Rational Support ◽  
The One ◽  
The Right

This article examines the relation of empathy and rational judgment. When people observe a conflict most are quick to side with one of the parties. Once a side has been taken, empathy with that party further solidifies this choice. Hence, it will be suggested that empathy is not neutral to judgment and rational decision-making. This does not mean, however, that the one who empathizes will necessarily have made the best choice.

scholarly journals The politics of embedding and the right to remain in post-Brexit Britain

Ethnicities ◽  
2020 ◽  
pp. 146879682091341 ◽  
Author(s):  
Tiina Sotkasiira ◽  
Anna Gawlewicz
Keyword(s):  
Decision Making ◽  
European Union ◽  
United Kingdom ◽  
Union Membership ◽  
The Other ◽  
The European Union ◽  
The United Kingdom ◽  
Sense Of Security ◽  
The One ◽  
The Right

The European Union membership referendum (i.e. the Brexit referendum) in the United Kingdom in 2016 triggered a process of introspection among non-British European Union citizens with respect to their right to remain in the United Kingdom, including their right to entry, permanent residence, and access to work and social welfare. Drawing on interview data collected from 42 European Union nationals, namely Finnish and Polish migrants living in Scotland, we explore how European Union migrants’ decision-making and strategies for extending their stay in the United Kingdom, or returning to their country of origin, are shaped by and, in turn, shape their belonging and ties to their current place of residence and across state borders. In particular, we draw on the concept of embedding, which is used in migration studies to explain migration trajectories and decision-making. Our key argument is that more attention needs to be paid to the socio-political context within which migrants negotiate their embedding. To this end, we employ the term ‘politics of embedding’ to highlight the ways in which the embedding of non-British European Union citizens has been politicized and hierarchically structured in the United Kingdom after the Brexit referendum. By illustrating how the context of Brexit has changed how people evaluate their social and other attachments, and how their embedding is differentiated into ‘ties that bind’ and ‘ties that count’, we contribute to the emerging work on migration and Brexit, and specifically to the debate on how the politicization of migration shapes the sense of security on the one hand, and belonging, on the other.

ARTIFICIAL INTELLIGENCE AND "PREDICTED JUSTICE": FOREIGN EXPERIENCE

Lex Russica ◽  
2019 ◽  
pp. 79-87
Author(s):  
P. N. Biryukov
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Relevant Information ◽  
Final Decision ◽  
Legal Information ◽  
The Right ◽  
Task Interpretation ◽  
Short Time ◽  
Analytical Tools

The paper deals with the problems of application of artificial intelligence (AI) in the field of justice. Present day environment facilitates the use of AI in law. Technology has entered the market. As a result, "predicted justice" has become possible. Once an overview of the possible future process is obtained, it is easier for the professional to complete the task-interpretation and final decision-making (negotiations, litigation). It will take a lot of work to bring AI up to this standard. Legal information should be structured to make it not only readable, but also effective for decision-making. "Predicted justice" can help both the parties to the case and the judges in structuring information, and students and teachers seeking relevant information. The development of information technology has led to increased opportunities for "predicted justice" programs. They take advantage of new digital tools. The focus is on two advantages of the programs: a) improving the quality of services provided; b) simultaneously monitoring the operational costs of the justice system. "Predicted justice" provides algorithms for analyzing a huge number of situations in a short time, allowing you to predict the outcome of a dispute or at least assess the chances of success. It helps: choose the right way of defense, the most suitable arguments, estimate the expected amount of compensation, etc. Thus, it is not about justice itself, but only about analytical tools that would make it possible to predict future decisions in disputes similar to those that have been analyzed.

scholarly journals KNOWLEDGE MANAGEMENT DAN PENGARUHNYA DALAM PENGAMBILAN KEPUTUSAN PADA BADAN PEMBENTUKAN PERATURAN DAERAH DEWAN PERWAKILAN RAKYAT DAERAH KABUPATEN TAKALAR

2020 ◽  
Vol 2 (2) ◽  
pp. 121-127
Author(s):  
Muh. Said ◽  
Fatmawati Fatmawati ◽  
Lukman Hakim
Keyword(s):  
Decision Making ◽  
Knowledge Management ◽  
Quantitative Methods ◽  
Explicit Knowledge ◽  
Decision Making Process ◽  
Fast Time ◽  
Daily Work ◽  
Future Challenges ◽  
The One ◽  
The Right

Changes in the environment experienced by organizations require organizations to make adjustments to answer all future challenges. The strength that must be possessed by the organization is to realize the concrete concept that becomes a tool to make changes. One of them is knowledge management, because knowledge management is an organizational activity that manages knowledge as an asset, wherein various strategies there is the right distribution of knowledge to the right people in a fast time until they interact with each other from various knowledge and apply it in daily work for performance improvement. Knowledge Management integration in the decision-making process can be interpreted as a structured and systematic process in acquiring, distributing, and utilizing knowledge to support the decision-making process. The position of knowledge management in decision making is between two poles of knowledge, namely tacit knowledge on the one hand and the utilization of explicit knowledge in decision making on the other. Explicit knowledge emphasizes the implicit role of knowledge management in influencing actors involved in decision making. Research design using quantitative methods. The instruments used in this study were questionnaires. The results showed that the implementation of Knowledge management has a positive effect on decision making in the Regional Development Agency of Takalar regency.

Exceptions to the Legal Requirements: Emergency, Waiver, Therapeutic Privilege, and Compulsory Treatment

2001 ◽  
Author(s):  
Jessica W. Berg ◽  
Paul S. Appelbaum ◽  
Charles W. Lidz ◽  
Lisa S. Parker
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Consent To Treatment ◽  
Health Related ◽  
Consent Requirement ◽  
The Right ◽  
Therapeutic Privilege

In the preceding chapter we spoke of the requirement for informed consent in absolute terms, as something that was an invariable component of medical decision making. Over the years, courts have come to recognize that there are a number of situations in which physicians are permitted to render treatment without patients’ informed consent. Even under the earlier simple consent requirement, consent to treatment was not required in all situations. There are different kinds of situations in which requiring disclosure and obtaining consent could be detrimental to the patient, such as in an emergency or when the disclosure itself would harm the patient, and therefore in these situations informed consent is not required. Patients may also waive, or give up, the right to be informed and/or to consent. Here the concern is not with promoting health values but with promoting autonomy. Informed consent may also be dispensed with in a fourth set of cases, those of legally required treatment, in which the harm from requiring informed consent is not necessarily to the patient (or the patient alone) but to other important societal interests (e.g., civil commitment of the dangerous mentally ill—see Chapter 11—or forced treatment of patients with infectious disease). In addition, informed consent requirements are modified when a patient is incompetent (see Chapter 5). Each of these exceptions contains the potential for undermining the values sought to be implemented by the informed consent doctrine: self-determination and informed decision making. Exceptions that are too broadly defined and applied are a threat to these values. On the other hand, these exceptions are an important vehicle for the interjection into the decisionmaking process of another set of values, society’s interest in promoting the health of individuals. When judiciously defined and applied, the exceptions accord health-related values their due. However, the exceptions can be, and sometimes have been, defined so broadly as to dilute, if not dissolve, the fundamental duties imposed by the doctrine and to undermine its essential purpose of assuring patient participation in medical decision making (1).

scholarly journals Investigation and Prioritizing the Effective Factors on Increasing the Human Resources Productivity in Agriculture Bank Using Multi-Attribute Decision Making Model

2016 ◽  
Vol 10 (5) ◽  
pp. 21
Author(s):  
Amir Abachi
Keyword(s):  
Decision Making ◽  
Human Resources ◽  
Statistical Population ◽  
Effective Factors ◽  
Frequency Table ◽  
Multi Attribute Decision Making ◽  
The One ◽  
The Right ◽  
Decision Making Model ◽  
Descriptive Survey

As organizations are going to develop, the need for efficient manpower becomes more apparent. Obviously, productivity of the manpower requires the attention of managers to the complexity of human behavior and appropriate utilization of the principles, techniques and skills of the management. This study aims to prioritize the effective factors on productivity of human resources in the Agriculture Bank. Productivity is beyond the performance, it also contains the effectiveness concept, and in other words, productivity is not just doing the right things. An activity may be done correctly and in the best way, while it has no role in achieving the goal. In this case, the performance is available but there is no productivity. Difference between the performance and is rooted in the effectiveness or in the direction of doing a work. The current paper is a descriptive survey. Statistical population includes all experts in the Research and Strategic Planning center of the Agricultural Bank (33 persons). The data obtained from the questionnaire were analyzed using descriptive statistics in the form of frequency table. Questions were examined based on the one-group- t-test and using SPSS.  Effective factors on increasing the human resources productivity were prioritized using Multi- Attribute Decision Making (MADM). After comparison of the alternatives, the related tables were prepared and prioritizing or ranking were done by determining the weight of each factor indexes and finally determining the weight of the four main factors. TOPSIS was used to evaluate the results of the MADM. Our research aims to prioritize the four factors according to the MADM.

scholarly journals Patient Rights: Awareness and Practice in a Tertiary Care Indian Hospital

2014 ◽  
Vol 2 (1) ◽  
pp. 25-30
Author(s):  
Alphonsa B Fernandes ◽  
Sweta D'Cunha ◽  
Sucharita Suresh
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Tertiary Care ◽  
Access To Healthcare ◽  
Patient Rights ◽  
Hospitalized Patients ◽  
Lower Percentage ◽  
The Right ◽  
Right Of Access ◽  
Choice Of Care

ABSTRACT Aim and objectives To study the awareness and practice of Patient rights and to compare the same between general and private ward hospitalized patients of a selected hospital. Materials and methods Descriptive research approach was adopted wherein data was collected from 120 hospitalized patients, i.e. 60 from general and 60 from private ward using a structured questionnaire. It was then analyzed by frequency, percentage and significance test to interpret the awareness and practice of patient rights in the hospital. Results The study reveals that awareness of patient rights was high in most of the cases. There was 71% awareness about the right to confidentiality, 67% awareness of the right to grievance redressal, 65% awareness about the right to be informed, 58% awareness of the right of access to healthcare and 55% awareness about the patient's right to choice of care and decision making. But low (39%) awareness was noted in case of patient's right to informed consent. With regards to practice of patient rights, it was seen that certain rights were well-practiced like 95% practice of the right of access to healthcare, 89% practice of the right to confidentiality and 64% practice of the right to choice of care and decision making. But relatively lower percentage of practice was observed for right to be informed (49%), right to informed consent (44%) and the right to grievance redressal (21%). There was significant difference in the level of awareness and practice of patient rights among private and general ward patients in most of the rights. Conclusion The study was vital in finding that most respondents were aware of patient rights. So also, most of the patient rights were practiced in the hospital in varying degrees, while a few needed immediate rectification and management action. How to cite this article Fernandes AB, D'Cunha S, Suresh S. Patient Rights: Awareness and Practice in a Tertiary Care Indian Hospital. Int J Res Foundation Hosp Healthc Adm 2014;2(1):25-30.

An Agenda for the Future

2001 ◽  
Author(s):  
Jessica W. Berg ◽  
Paul S. Appelbaum ◽  
Charles W. Lidz ◽  
Lisa S. Parker
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Care ◽  
Large Scale ◽  
Medical Setting ◽  
Clear Understanding ◽  
Doctor Patient Communication ◽  
Legal Rules ◽  
The Individual ◽  
The Right

The cornerstone of our approach to informed consent is the belief that the right of patients to authorize their own medical treatment, usually called the right to autonomy in decision making, is a moral value worth promoting. When medical care is required, patients should be met by physicians’ openness and willingness to present and discuss a variety of options, with the clear understanding that patients can play a role, if they desire, in shaping the ultimate decision. Our instinctive assumption that most patients would endorse this approach was confirmed by a large-scale study sponsored by the President’s Commission (1). Patients do want to know about and have the option of influencing the nature of their medical care, even if they may not always exercise that option (2). Our society’s deepseated traditions of respect for the integrity of the individual reinforce the importance of protecting patients’ interests in the medical decisionmaking process. Legal initiatives by themselves are insufficient to accomplish these results (see Chapter 7). Endless proposals to refine the legal mechanisms by which the doctrine of informed consent is enforced are not likely to achieve their goals. The legal rules governing informed consent operate at a level of generality that makes it difficult for physicians to take them into account in dealing with patients. Some surveys have found that physicians are completely ignorant of the operative standard for disclosure in their state (1), and others have found that even when physicians are aware of the standard, they do not apply it properly (3). More significantly, however, the medical setting seems relatively impervious to regulation in this area. Physicians and administrators have control over the structure of medical care and over the content of physician-patient interactions. Regardless of the law of informed consent, if the structure of hospital and office practice provides negligible opportunities for doctor-patient communication, little disclosure or shared decision making will occur. If physicians are resistant to the moral imperatives of informed consent, tinkering with standards of disclosure is unlikely to affect their behavior.

The Difficulties of Applied Ethics

2018 ◽  
pp. 23-48
Author(s):  
Barry Hoffmaster ◽  
Cliff Hooker
Keyword(s):  
Decision Making ◽  
Expected Utility ◽  
Applied Ethics ◽  
Moral Problem ◽  
Logical Inference ◽  
Formal Rationality ◽  
The Many ◽  
The One ◽  
The Right

A second kind of formal rationality, complementary to the maximizing expected utility in Chapter 1, is logical inference. In much of moral philosophy and in standard bioethics decision making is applied ethics. Moral theories are taken to be comprised of principles that are applied to the facts of cases to deduce conclusions about what ought to be done. The canonical depiction of bioethics, for instance, consists of the four principles of non-maleficence, beneficence, autonomy, and justice. The real examples in this chapter expose the many failings of that applied ethics. Most of the cases are about when to die and how to die, but the term ‘euthanasia’ is indeterminate. The crucial notion of ‘autonomy’ also is indeterminate. Both need to be clarified and specified. But how is this to be done? Similarly, when principles and rules conflict, as they often do, how is the one that prevails to be determined? There are no higher principles or rules that can be applied to get the right answer in any of these cases. More broadly, what makes a problem a moral problem, and what does being a moral problem mean? These issues require non-formal rational deliberation, not the formal rationality of deduction.

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