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Patient autonomy and criminal law
Published in Paweł Daniluk, Patient Autonomy and Criminal Law, 2023
The right to self-determination implies that the patient is free to manage his/her life and health and that he/she is the ‘master' of his/her body. Thus, the patient has the right to freely decide on everything concerning his/her life and health, with two exceptions. The first exception to the right to self-determination exists in cases where it directly endangers the life and health of others, and the second is the prohibition of euthanasia. However, self-determination would also strictly mean that the patient decides which medical procedures on his/her body to take and which not, which can endanger his/her health as an unavailable legal good.
Informed consent
Published in Joseph Tham, Alberto García Gómez, Mirko Daniel Garasic, Cross-Cultural and Religious Critiques of Informed Consent, 2021
Capacity is essential in terms of voluntariness and understanding. A patient needs to have the capacity of self-determination to reflect, decide and consider when deciding to participate in a clinical trial or receiving medical treatment. It is also true that “(a)s the importance of the decision increases, and the information given is more specific and accurate, the threshold for considering a patient capable, is also higher.” The patient’s health literacy level will influence his/her capacity for understanding.
Changes in Health Care and the Physician’s Role
Published in Eldo E. Frezza, Medical Ethics, 2018
On the broad scope of freedom, we are allowed only a small arc, and that arc is narrowed daily by the administrative policies of academia, hospitals, insurance companies, and government. We are being reduced to “vendors” of health care; this status is not a firm base for the autonomy necessary for self-determination in our profession.
Evaluation of a mandatory theory-based physical activity course on motivation among predominantly Hispanic college students
Published in Journal of American College Health, 2023
Heather Barton-Weston, Wei-Ju Chen, David Fike, Randall Griffiths, Gregory Soukup, Lei-Shih Chen
It is worth noting that despite the increases in the other four types of motivation, there was a significant increase in amotivation (i.e., lacking interest in PA), which is at the lowest end of the self-determination range in SDT.17,22,23 This finding was not surprising among our sample for two reasons. First, Hassel et al. (2015)40 reported that participants’ amotivation scores on the BREQ-2 in a required PA course were significantly and positively correlated with vigorous PA participation. The types of PA in this course may have been vigorous in nature for participating students, particularly for those who were less engaged in exercise prior to enrolling in this course, which in turn may have increased their amotivation scores. Second, past studies have shown that self-determination is associated with one’s sense of autonomy.22,30 As this is a mandatory PA course, participating students might have felt as if they were being “forced” to participate in PA and thus lost their autonomy, which may have led to the increase of amotivation scores.
Against Over-Protectionism: Riskier Decisions Require Clearer Evidence of Capacity But Don’t Call for Stricter Criteria
Published in The American Journal of Bioethics, 2022
Manuel Trachsel, Paul S. Appelbaum
Notwithstanding the strong rhetoric that accompanies Pickering and colleague’s argument, the claim that harmful decisions are per se incompetent would be difficult to maintain. In many areas of life, we accept the right of persons to make their own unreasonable, “irrational,” risky, or even clearly dangerous choices, including smoking, recreational drug use, or extreme sports such as wingsuit base jumping (an activity in which the prospect of death is quite real [see e.g., Bisharat 2016]), as long as someone’s decision-making capacity is not in doubt. The associated potential for physical harm is accepted within the framework of the principle of self-determination and self-responsibility, and the resulting social costs are more or less carried in solidarity. Similarly, with regard to medical decisions, we generally respect persons’ wishes for self-determination; they can always decide against a suggested medically indicated, evidence-based treatment, again given that they fulfill the standard criteria for competence, i.e., the abilities to communicate a choice, to understand the relevant information, to appreciate the medical consequences of the situation, and to reason about the choices (Appelbaum 2007).
Searching for a dynamic equilibrium in decision making: the voices of adults with mild intellectual disability and their significant others in Hong Kong
Published in Disability and Rehabilitation, 2022
From the social-ecological perspective [27,28], the microsystem and mesosystem, such as family factors (e.g., family beliefs) and service environment, have been shown to influence self-determination. It is also recognized that cultural factors must be factored in when considering the development and opportunities of self-determination [27]. This calls for additional studies to be carried out with the aim of developing culturally responsive practices for people with ID with different cultural backgrounds [29]. In Hong Kong, the concept of self-determination has now been promoted in practice for a period of time, but comparatively little research on it has been conducted [7]. A few studies showed that self-management and self-regulation of people with ID have been encouraged by their parents and teachers/rehabilitation personnel [30] and they are expected to consider the collective common interest and environmental factors, as well as their own personal desires, before making decisions [31]. However, we still lack full knowledge of the mental processes in which people with ID engage when making decisions and how they interact with significant others when doing so. Furthermore, little is known about interpersonal processes between people with ID and their significant others, for example, how parents perceive the autonomy of their children in decision-making. There is also a lack of information about the psychological and implementation challenges faced by rehabilitation personnel when they attempt to facilitate the exercise of self-determination by service users.