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Respect
Published in Robert S. Holzman, Anesthesia and the Classics, 2022
As a medical culture, we are currently deeply concerned about the idea of respect for persons, or more specifically, respect for patients as persons.1 In the context of emotional support for trainees, this extends to medical students and house officers, clearly influencing their developing concepts of respect in conjunction with the health care team2 and further contributing to improved team performance as a whole.3
What can we expect of professional codes of conduct, practice and ethics?
Published in Stephen Pattison, Roisin Pill, Values in Professional Practice: lessons for health, social care and other professionals, 2020
Paul Wainwright, Stephen Pattison
A recent comparison of nursing codes of conduct in six European countries (European Council of Nursing 2002) suggested that the ethical principle of autonomy is discussed in most such codes. As the principle of autonomy rests on the notion of respect for persons, this must refer to the autonomy of both the nurse as an independent professional practitioner and to the patient as a recipient of care and treatment. However, no professional practitioner working in a healthcare institution is exempt from the restrictions on their autonomy imposed by an employer through the contract of employment. Furthermore, professionals are bound by legal statutes and the limitations of their licence to practise.
Legal and Ethical Problems in Clinical Research*
Published in Gary M. Matoren, The Clinical Research Process in the Pharmaceutical Industry, 2020
Robert J. Levine, Angela R. Holder
The principle of respect for persons incorporates two basic ethical convictions: first, that individuals should be treated as autonomous agents and, second, that persons with diminished autonomy and thus in need of protection are entitled to it. As defined by the Commission, an autonomous person is an individual capable of deliberation about personal goals and of acting under the direction of such deliberation. To show respect for autonomous persons requires that we leave them alone, even to the point of allowing them to choose activities that might be harmful unless they agree (consent) that we may do otherwise. We are not to touch them or to encroach upon their privacy unless such touching or encroachment is in accord with their wishes. Clearly, not every human being is capable of self-determination. Respect for those who are not, either temporarily or permanently, may require one to offer protection to them during their period of incapacity.
Theorizing Religion in Its Meanings for Bioethics
Published in The American Journal of Bioethics, 2020
In any case, one instance offered as problematic in clinical ethics—with its overemphasis on autonomy—is the undocumented patient needing hemodialysis in the United States, because the U.S. government subsidizes treatment only for citizens and certain others. McCarthy et al. say: “What a patient [who is undocumented] wants is immediately confronted by structural inequality, which affects a large portion of our community beyond questions of citizenship.” I am at loss to understand how this undesirable outcome has its roots in a moral principle of respect for persons, which is—at least as expressed in the Belmont Report—the conceptual rationale for putting autonomy at the center of healthcare decisions. Is the idea that autonomy cannot be respected if healthcare services are not available for everything a patient might want? And that this non-availability necessarily implicates a structural inequality? If so, every government’s sponsored healthcare seems indictable on the grounds that it does not cover every healthcare need and/or apportions healthcare on the grounds of civic status.
Respect and Trustworthiness in the Patient-Provider-Machine Relationship: Applying a Relational Lens to Machine Learning Healthcare Applications
Published in The American Journal of Bioethics, 2020
The Target Article rightly points out that application designers must select outcomes and goals that are relevant to key stakeholders. More specifically, patient values and needs should be a driving force in identifying goals for machine learning applications and determining where and how to invest development resources. One way of conceptualizing respect for persons is that it requires appreciating patients as unique individuals and acting in recognition of the demands that individuality places upon one’s behavior (Dickert 2009). While choices regarding machine learning design and development occur on a systems level and may not have an immediate and direct impact on patients, the ethical obligation to act with respect for patients is no less important in this setting, as each choice has the potential to affect the patient experience. Centering patients in decision-making at an early stage—including ensuring the problems being addressed are meaningful and relevant to those the application purports to help—is a critical component of building respect for persons into every decision point.
Ethics of Recruiting Research Subjects Through Social Media
Published in The American Journal of Bioethics, 2019
Brittany N. Ferrigno, Robert M. Sade
Respect for persons requires that vulnerable populations have additional protections. In the context of research recruitment on social media, vulnerable subjects may include those who suffer from conditions or diseases that are rare or not readily treated with standard procedures. Approximately 8% of subjects involved in research found the trials in which they are enrolled by searching social media platforms (How do patients find clinical trials? 2015). Ethical issues may arise when patients suffering from rare diseases or conditions that are not readily treatable are interested in becoming research subjects, because, for example, about 69% of those with rare diseases suffer from depression, while 82% experience anxiety and stress (Nunn 2017). Delayed diagnosis and lack of standard treatment and control over their lives can at least partially explain such statistics (Nunn 2017). Additionally, patients with rare diseases who have survived to adulthood have likely suffered tremendously and faced a reduced quality of life, or even may be approaching death (Nunn 2017). As posts on social media have the potential to mislead even when deception is not intended, recruiters must be cautious to avoid posting statements that could be misunderstood by vulnerable patients in search of hope for some type of cure.