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European Journal of Heart Failure Apr 2010
Topics: Biomedical Research; Ethics, Research; Heart Failure; Humans; Informed Consent; Medication Adherence; Patient Rights; Personal Autonomy
PubMed: 20335347
DOI: 10.1093/eurjhf/hfq034 -
Bulletin of the World Health... Jan 2020The requires a paradigm shift from a medical model of disability to a social model that emphasizes overcoming the barriers to equality created by attitudes, laws,...
The requires a paradigm shift from a medical model of disability to a social model that emphasizes overcoming the barriers to equality created by attitudes, laws, government policies and the social, economic and political environment. The approach adopted by the social model recognizes that people with psychosocial disabilities have the same right to take decisions and make choices as other people, particularly regarding treatment, and have the right to equal recognition before the law. Consequently, direct or supported decision-making should be the norm and there should be no substitute decision-making. Although recent mental health laws in some countries have attempted to realize a rights-based approach to decision-making by reducing coercion, implementing the can be challenging because it requires continuous refinement and the development of alternatives to coercion. This article reviews the impact historical trends and current mental health frameworks have had on the rights affected by the practice of involuntary treatment and describes some legal and organizational initiatives that have been undertaken to promote noncoercive services and supported decision-making. The evidence and examples presented could provide the foundation for developing a context-appropriate approach to implementing supported decision-making in mental health care.
Topics: Coercion; Community Mental Health Services; Decision Making; History, 20th Century; History, 21st Century; Humans; Involuntary Treatment, Psychiatric; Mental Health Services; Mentally Ill Persons; Patient Acceptance of Health Care; Patient Rights; Social Support
PubMed: 31902962
DOI: 10.2471/BLT.19.234906 -
Journal of General Internal Medicine Jul 2010Personal autonomy is widely valued. Recognition of its vulnerability in health care contexts led to the inclusion of respect for autonomy as a key concern in biomedical... (Review)
Review
Personal autonomy is widely valued. Recognition of its vulnerability in health care contexts led to the inclusion of respect for autonomy as a key concern in biomedical ethics. The principle of respect for autonomy is usually associated with allowing or enabling patients to make their own decisions about which health care interventions they will or will not receive. In this paper, we suggest that a strong focus on decision situations is problematic, especially when combined with a tendency to stress the importance of patients' independence in choosing. It distracts attention from other important aspects of and challenges to autonomy in health care. Relational understandings of autonomy attempt to explain both the positive and negative implications of social relationships for individuals' autonomy. They suggest that many health care practices can affect autonomy by virtue of their effects not only on patients' treatment preferences and choices, but also on their self-identities, self-evaluations and capabilities for autonomy. Relational understandings de-emphasise independence and facilitate well-nuanced distinctions between forms of clinical communication that support and that undermine patients' autonomy. These understandings support recognition of the value of good patient-professional relationships and can enrich the specification of the principle of respect for autonomy.
Topics: Humans; Patient Rights; Personal Autonomy; Physician-Patient Relations
PubMed: 20213206
DOI: 10.1007/s11606-010-1292-2 -
Soins; La Revue de Reference Infirmiere Jun 2015
Topics: Humans; Nurse-Patient Relations; Patient Rights
PubMed: 26146317
DOI: 10.1016/j.soin.2015.04.014 -
Developmental Medicine and Child... Apr 2019
Topics: Child; Child Advocacy; Disabled Children; Humans; Neurosciences; Patient Rights
PubMed: 30835825
DOI: 10.1111/dmcn.14189 -
CMAJ : Canadian Medical Association... Jul 2006
Topics: Abortion, Induced; Canada; Female; Health Services Accessibility; History, 20th Century; Humans; National Health Programs; Patient Rights; Physician's Role; Women's Health
PubMed: 16818892
DOI: 10.1503/cmaj.060548 -
Journal of Medical Ethics Mar 1992
Topics: Beneficence; Biomedical Research; Confidentiality; Ethics, Medical; Humans; Informed Consent; Medical Records; Patient Access to Records; Patient Rights; Personal Autonomy; Social Justice
PubMed: 1573654
DOI: 10.1136/jme.18.1.5 -
Nursing Ethics Mar 2017Increasing attention to patients' rights and their ability to choose their healthcare provider have changed the way patients can respond to untoward, disempowering and...
BACKGROUND
Increasing attention to patients' rights and their ability to choose their healthcare provider have changed the way patients can respond to untoward, disempowering and abusive healthcare encounters. These responses are often seen as crucial for quality improvement, yet they are little explored and conceptualized.
OBJECTIVE
To explore patients' potential responses to untoward healthcare encounters and looking at their possible consequences for care quality improvement as well as for the individual patient.
RESEARCH DESIGN
The article is structured looking at two primary strategies: patient exit (leaving a healthcare provider) and patient voice (expressing grievances), derived from Hirschman (1970). These strategies were explored by the use of theoretical and empirical literature and applied to an individual patient case. The case functions as a pedagogical tool to illustrate and problematize what exit and voice strategies can mean for a single patient. Ethical considerations: The patient case is my version of a generalized scenario that is described elsewhere. It does not represent an individual patient's story, but aims to be realistic and recognizable.
FINDINGS AND CONCLUSION
Based on the existing literature, it is hypothesized that, in their current form, exit and voice strategies have a limited effect on care quality and can come at a price for patients. However, both strategies may be of value to patients and providers. Therefore, the healthcare system could empower patients to engage in action and could further develop ways for providers to effectively use patients' responses to improve practice and find ways to prevent patients from untoward experiences in healthcare.
Topics: Decision Making; Humans; Patient Dropouts; Patient Preference; Patient Rights; Patient Satisfaction; Professional-Patient Relations; Quality of Health Care
PubMed: 26174469
DOI: 10.1177/0969733015591074 -
Revista Da Sociedade Brasileira de... 2013Clinical research is essential for the development of new drugs, diagnostic tests and new devices. Clinical monitoring is implemented to improve the quality of research... (Review)
Review
Clinical research is essential for the development of new drugs, diagnostic tests and new devices. Clinical monitoring is implemented to improve the quality of research and attain high ethical and scientific standards. This review discusses the role of clinical monitors, taking into account the variety of scenarios in which medical research is developed, and highlights the challenges faced by research teams to ensure that patients rights are respected and that the social role of scientific research is preserved. Specific emphasis is given to the ethical dilemmas related to the multiple roles which clinical monitors play in the research framework, mainly those involving the delicate equilibrium between the loyalty to the sponsor and to the research subjects. The essential role of clinical monitoring for research developed in poor healthcare scenarios is highlighted as an approach to get the local infrastructure strengthening needed to achieve an adequate level of good clinical practices.
Topics: Biomedical Research; Clinical Trials as Topic; Ethics Committees, Research; Humans; Patient Rights
PubMed: 23563817
DOI: 10.1590/0037-868217342013 -
Soins; La Revue de Reference Infirmiere Jun 2015Thirteen years after the law of 4th March 2002, known as the "Kouchner law", what is the situation regarding the much talked about healthcare democracy? Individual and...
Thirteen years after the law of 4th March 2002, known as the "Kouchner law", what is the situation regarding the much talked about healthcare democracy? Individual and collective rights have been granted to the users of the health care system. In addition, a series of actions have been promoted in order to exert them. Finally, a number of places and processes favouring consultation have been put in place.
Topics: France; Health Care Reform; Humans; National Health Programs; Patient Participation; Patient Rights
PubMed: 26146320
DOI: 10.1016/j.soin.2015.04.006