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With a rapidly growing population of older adults with chronic illness in US prisons, the number of people who die while incarcerated is increasing. Support for patients’ medical decision-making is a cornerstone of quality care for people at the end of life (EOL). This study aims to identify, describe, and analyze existing policies regarding EOL decision-making in U.S. Departments of Corrections.

This study performed an iterative content analysis on all available EOL decision-making policies in US state departments of corrections and the Federal Bureau of Prisons.

This study collected and reviewed available policies from 37 of 51 prison systems (73%). Some areas of commonality included the importance of establishing health-care proxies and how to transfer EOL decision documents, although policies differed in terms of which patients can complete advance care planning documents, and who can serve as their surrogate decision-makers.

Many prison systems have an opportunity to enhance their patient medical decision-making policies to bring them in line with community standard quality of care. In addition, this study was unable to locate policies regarding patient decision-making at the EOL in one quarter of US prison systems, suggesting there may be quality-of-care challenges around formalized approaches to documenting patient medical wishes in some of those prison systems.

To the best of the authors’ knowledge, this is the first content analysis of EOL decision-making policies in US prison systems.

This chapter aims to provide an overview of the ethical framework and decision-making in clinical dementia research, and to analyze and discuss the ethical challenges and issues that can arise when conducting clinical dementia research.

Informed consent is the most scrutinized and controversial aspect of clinical research ethics. In clinical dementia research, assessing decision-making capacity may be challenging as the nature and progress of each disease influences decision-making capacity in diverse ways. Persons with dementia represent a vulnerable population deserving special attention when developing, implementing, and evaluating the informed consent process. In this chapter, particular attention will be given to vulnerability categories and how these influence decision-making capacity. Ethical frameworks with a pragmatic contour and implication are needed to protect vulnerable patients from potential harms and ensure their optimal participation in clinical dementia research.

In addition, this chapter analyses important ethical challenges and issues in clinical dementia research. If handled thoughtfully, they would not pose insuperable barriers to research. But if they are ignored, they could slow the research process, alienate potential study subjects and cause harm to research participants. Ethical considerations in research involving persons with dementia primarily concern the representation of the interests of the participants with dementia and protection of their vulnerabilities and rights.

A core set of ethical questions and recommendations are drawn to aid researchers, institutional review boards and potential research participants in the process of participating in clinical dementia research.

Documents issued by the Commission of the European Communities presenting forthcoming EEC food law policy are discussed. The issues are of major importance to United Kingdom food manufacturers, processors and retailers, and include such subjects as: mutual recognition of food products; compositional standards; additives; labelling; food for particular nutritional uses; materials and articles in contact with food and irradiated foods. It is acknowledged that an urgent case for completing the internal market in food products exists but there is much concern about the inability of the UK government to protect food manufacturers and retailers under the new system.

Health professionals are in an ethical dilemma. The patients should be assumed as competent. Involuntary treatment is a violation of human rights. Therefore incompetent patients should be protected. However, one cannot determine a patient's incompetency without testing him/her, which is a violation of the assumption of competency. Thus, we propose two different types of uses for competency tests. One is to measure the appropriateness of information disclosed,but with a poor test result the information should be repeated. Another is to measure the competency of the patients when making major decisions. A poor test result will be followed by the designation of a proxy so that incompetent patients can be protected.

The subject of this study is the availability of, and access to, information concerning individuals’ end‐of‐life health situations. The sensitive issues surrounding this subject are considered in detail, and the restraints, primarily legal, placed upon information availability highlighted. Questionnaires and interviews were used to determine public and professional awareness of, and attitudes towards, the issues and were compared with a similar, albeit larger, survey conducted by the Department of Health. Complementary to this fieldwork, a review of current and proposed clinical policies, guidelines and legislation and of media commentary was undertaken. The study revealed much public confusion and ignorance about how people can influence the medical treatment they receive when seriously or terminally ill. The study revealed an urgent need for Government initiatives to provide more information on patient rights in relation to consent forms and advance statements.

Ethical, legal and medical progress has been made in end‐of‐life care, addressing crucial issues in the application of principles to clinical cases. However, despite the progress, there are still unresolved issues concerning the scope and effectiveness of personal decision making and the proper use of last resort measures in terminal care. An analysis of the progress discloses both the advances and the problems still confronting patients and their families. From this perspective, one gains a better understanding of the reality of terminal care and areas that call for reform.

A historical analysis reveals the interrelation between moral and legal reasoning and their differences. It also discloses developments in the moral and legal realms that recognize rights of the patient with regard to treatment decisions. A critique of ethical and legal reasoning and medical practice pin‐points the salient problems.

There are still problems in the application of legal and ethical principles to specific cases. These problems are complicated by poor physician‐patient communication, the ineffective use of advance directives and the impact of the market economy on comprehensive palliative care. These call for reform to protect personal rights and dignity at the end of life.

A historical approach, too often lacking, promotes insight into the complexities of end‐of‐life care. An analysis flowing from such a perspective pin‐points not only the advances in ethical, legal and medical practice but also the flaws and inconsistencies that call for a more realistic approach in reasoning and practice.

This paper introduces the special issue “Rebuilding trust: Sustainability and non-financial reporting, and the European Union regulation”. Inspired by the studies published in the special issue, this study aims to examine the concept of accountability within the context of the European Union (EU) Directive on non-financial disclosure (hereafter the EU Directive) to offer a critique and a novel perspective for future research into mandatory non-financial reporting (NFR) and to advance future practice and policy.

The authors review the papers published in this special issue and other contemporary studies on the topic of NFR and the EU Directive.

Accountability is a fundamental concept for building trust in the corporate reporting context and emerges as a common topic linking contemporary studies on the EU Directive. While the EU Directive acknowledges the role of accountability in the reporting practice, this study argues that regulation and practice on NFR needs to move away from an accounting-based conception of accountability to promote accountability-based accounting practices (Dillard and Vinnari, 2019). By analysing the links between trust, accountability and accounting and reporting, the authors claim the need to examine and rethink the inscription of interests into non-financial information (NFI) and its materiality. Hence, this study encourages research and practice to broaden mandatory NFR practice over the traditional boundaries of accountability, reporting and formal accounting systems.

Considering the challenges posed by the COVID-19 crisis, this study calls for further research to investigate the dialogical accountability underpinning NFR in practice to avoid the trap of focusing on accounting changes regardless of accountability. The authors advocate that what is needed is more timely NFI that develops a dialogue between companies, investors, national regulators, the EU and civil society, not more untimely standalone reporting that has most likely lost its relevance and materiality by the time it is issued to users.

By highlighting accountability issues in the context of mandatory NFR and its linkages with trust, this study lays out a case for moving the focus of research and practice from accounting-based regulations towards accountability-driven accounting change.

Employment law recognised the value of whistleblowing with the enactment of the Public Interest Disclosure Act 1998, protecting a ‘worker’ against dismissal and victimisation. Whistleblowers are particularly vulnerable in the gig economy as they may fall outside the statutory definition of ‘worker’ for the purposes of the whistleblowing legislation. This makes a study of whistleblowing in the gig economy pertinent. This chapter explores the statutory definition of ‘worker’ with regard to the current whistleblowing provisions and considers the barriers it presents for gig workers. Judicial interpretation of the definition is examined through an analysis of recent case law that shows much inconsistency and a conflict of judicial approach. The resulting blurred boundaries of the legal term leave a gig worker uncertain as to the level of their protection for blowing the whistle. The need for reform to protect individuals in a wide range of working relationships is clear. It is argued that the new EU Whistleblowing Directive, in protecting ‘work-related activity’, provides better protection for all whistleblowers. The role of human rights in extending the status of work is also advanced. Finally, the implications of developments in this area for key stakeholders in the gig economy are considered highlighting the importance of creative new approaches to give voice to all workers.

India’s Mental Healthcare Act 2017 provides a right to mental healthcare, revises admission and review procedures, effectively decriminalises suicide and has strong non-discrimination measures, among other provisions. The purpose of this paper is to examine Indian mental health professionals’ views of these changes as they relate to stigma and inclusion of the mentally ill.

The authors held nine focus groups in three Indian states, involving 61 mental health professionals including 56 psychiatrists.

Several themes relating to stigma and inclusion emerged: stigma is ubiquitous and results in social exclusion; stigma might be increased rather than remedied by certain regulations in the 2017 Act; stigma is not adequately dealt with in the legislation; stigma might discourage people from making “advance directives”; and there is a crucial relationship between stigma and education.

Implementation of India’s 2017 Act needs to be accompanied by adequate service resourcing and extensive education, including public education. This has commenced but needs substantial resources in order to fulfil the Act’s potential.

India’s mental health legislation governs the mental healthcare of 1.3bn people, one sixth of the planet’s population; seeking to use law to diminish stigma and enhance inclusion in such a large country sets a strong example for other nations.

This is the first study of stigma and inclusion since India’s 2017 Act was commenced and it highlights both the potential and the challenges of such ambitious rights-based legislation.