Search results

The paper aims to compare and discuss the findings of discursive constructions of patients in legal texts from the three Scandinavian countries. Since traditional welfare state systems in Scandinavia are being challenged by new governance systems, new questions are being raised about patient positions and agency, carrying with them potential ethical dilemmas for healthcare professionals.

The methodology of the paper is inspired by critical discourse analysis. Comprehensively analysing the findings of previous discourse studies on how “the patient” is constructed in central policy texts, this study compares the position of the patient in Norway, Sweden and Denmark.

The paper reveals ideological struggles across the Scandinavian countries, operating at a political level, a legislative level and a healthcare level. It is shown that national governance systems still exert hegemonic power by strongly influencing patients' degree of choice and autonomy. The discursive struggle between welfare state governance and other governance systems in Scandinavia indicates a shift towards a commercial healthcare market although a traditional welfare model is advocated by professionals and researchers.

Because of the specific conditions of Scandinavian healthcare policy, the findings lack generalisability. The research approach should therefore be explored further in additional contexts.

The findings of this study can inform policymakers, professionals and patients of the ideological values underlying seemingly objective shifts in national policy.

A comparative critical discourse analysis can expose patterns in the Scandinavian approaches to patient rights.

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.

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.

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.

This paper aims to report findings of a service evaluation using a human rights-based approach in the training and education of staff in palliative settings.

A non-randomly sampled, uncontrolled, pre- and post-test design. Data was collected at three points over a six-month period during the period April 2017 to September 2019. As a service evaluation no ethical approval was required. Consent was implied by self-completion and submission of questionnaires. In total, 1,402 people attended the training, 480 completed pre- and post-training questionnaires (146 completed the questionnaire at six months), with 86 completing a questionnaire at all three data collection points.

Findings show increased levels of self-reported knowledge and confidence at two weeks and six months post-training. Implementing human rights in the workplace is complex. Difficulties maintaining knowledge and keeping up to date with changes in legislation and traditional ways of working were cited as barriers to service users’ human rights.

More evaluation is required to ensure the positive elements in this evaluation can be applied more widely.

Human rights education has a contribution to make in supporting staff to manage the challenges involved. It may also increase the complexity of decision-making. Training needs to incorporate systems wide approaches and its benefits measured.

The aim was to provide staff with the knowledge to make objective and proportionate decisions about personalised care. The assumption was this would help improve the experience of end of life care.

This is the first evaluation in the UK that we are aware of that has examined the impact of human rights education on end of life care.

Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the introduction of the Human Rights Act 1998. Examines these issues from a legal perspective. Concludes that successful risk management, careful monitoring and the implementation of authoritative guidelines hold the key to legal change.

In April 1988, the National Reference Center for Bioethics Literature (NRC) (see sidebar) published “AIDS: Law, Ethics and Public Policy.” As part of the NRC's Scope Note Series, the paper offered a current overview of issues and viewpoints related to AIDS and ethics. Not meant to be a comprehensive review of all AIDS literature, it contained selected citations referring to facts, opinion, and legal precedents, as well as a discussion of different ethical aspects surrounding AIDS. Updating the earlier work, this bibliography provides ethical citations from literature published from 1988 to the present.

Bioethics and environmental ethics have been largely separated, in principle. However, the two types of ethics do overlap when dealing with significant issues such as human embryos, animal experimentation, and responsibility to future generations. In this paper, the possibility of synthesizing these two ethics through the concept of care is considered. Accordingly, the range of the object of the concept of care is similarly broadened. Moreover, after considering the serious defects of care-based theory, a care-based position, which regards human rights or their substitute as a complement to care, is advanced. This position can be said to be a Japanese approach to bioethics.

This paper has two purposes: one is to analyse how the policy of freedom of choice emerged and was formed in the Swedish health care discourse; the second is related to how free choice influences the discourse in health care and how subjects are formed within the field, i.e. what the language of choice in health care does.

The research strategy is inspired by a combined theoretical framework borrowed from Michel Foucault's concepts of “discursive formation” and “subjectivization” completed with Judith Butler's concept of performativity.

The language of “freedom of choice” calls to mind the rhetoric of promises, i.e. that the patient should be free and responsible, in his or her relation to health care. Since patients seem to be insufficiently informed and supported about the actual benefits of possibilities and limitations associated with the severely restricted reform of free choice, the statements concerning opportunities to make personal health decisions will lose their significance. The advocacy of discourses of freedom of choice seems therefore mostly like empty words, as they are producing weak patients instead of free and empowered people.

As the reform was initiated in the beginning of 2000 it is rather fresh.

The paper produces insights into the rhetoric of political promises and the limitations of the reform dealing with freedom of choice in health care.

The prime objective of this article is related to dignified human beings as patients in clinical interventions. The main attention of such a perception focuses on observance of humaneness in relationships among physicians, patients, family members, and community at large. This paper aims to address these issues.

The paper examines in depth, analytical deliberations concerning traditional and modern values of medical care and healthcare knowledge and practices.

Therefore, we need to attest that we live in a global village in which multicultural people must live side‐by‐side, if they desire to peacefully coexist. We must assume that human values are based upon general agreements about ethical issues. Such agreements rely on a framework of equitable treatments of all mankind. Medical ethics is about committed codes and oaths of professional medical authorities to protect natural rights, human rights, and civil rights of patients in clinical interventions. It strives to achieve professional objectives to facilitate patients to be recovered from pain and suffering and regain their health in order to live the good life.

This paper is devoted to define the notions relevant to the philosophies of quality of life, ethical, and moral problems concerning clinical medicine, and preventive care systems. It analyzes certain ethical and moral distinctions between medical care and healthcare services, and indicates that cautions should be observed in discussing these notions within the context of preventive care and clinical care systems.

This paper explores the following questions: What is the meaning of a psychosomatic normal life? How life should be respected? What are the meta‐medical practices? What should be the logical and philosophical foundations for medical care and healthcare ethics? How should clinicians and practitioners respect not only cost‐benefit analysis but also consider cost‐effectiveness analysis in providing and promoting medical care and healthcare services for patients?