scholarly journals Hospital chaplains as ethical consultants in making difficult medical decisions

2021 ◽  
pp. medethics-2020-107096
Author(s):  
Waldemar Głusiec
Keyword(s):  
Roman Catholic ◽  
Medical Decision ◽  
Medical Decisions ◽  
Hospital Chaplains ◽  
Specialist Knowledge ◽  
Hospital Ethics ◽  
Bioethical Education ◽  
Further Development

Background and aimsFew Polish hospitals have Hospital Ethics Committee (HECs) and the services are not always adequate. In this situation, the role of HECs, in providing, among others, ethical advice on the discontinuation of persistent therapies, may be taken over by other entities. The aim of our research was to investigate, how often and on what issues hospital chaplains are asked for ethical advice in reaching difficult medical decisions.MethodsA survey of 100 Roman Catholic chaplains was conducted, that is, at least 10% of all chaplains currently working in Polish hospitals.ResultsOf the participants, 29% confirmed receiving requests for advice in making a morally difficult medical decision. Receiving this type of request was not conditional on the place of their service, duration of their pastoral mission or HEC membership. The largest group of chaplains (21%) encounter questions concerning the ethical dilemmas associated with discontinuing persistent therapy. Patients and their families most often raise issues related to the methods of birth control, and the medical staff raise the issue of termination of pregnancy—as reported by 9% and 15% of chaplains, respectively. Most of the chaplains asked for help (79%) experience a deficit of specialist knowledge in the area of medicine or ethics.ConclusionsIn order to improve the quality of ethical consultations in Polish hospitals, in addition to further development of HECs, it is postulated to develop a system for bioethical education of chaplains.

The new futility? The rhetoric and role of “suffering” in pediatric decision-making

2019 ◽  
Vol 27 (1) ◽  
pp. 16-27
Author(s):  
Erica K Salter
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Medical Decision ◽  
Value Judgments ◽  
Medical Decisions ◽  
Surrogate Decision Makers ◽  
Surrogate Decision ◽  
Pediatric Decision Making

This article argues that while the presence and influence of “futility” as a concept in medical decision-making has declined over the past decade, medicine is seeing the rise of a new concept with similar features: suffering. Like futility, suffering may appear to have a consistent meaning, but in actuality, the concept is colloquially invoked to refer to very different experiences. Like “futility,” claims of patient “suffering” have been used (perhaps sometimes consciously, but most often unconsciously) to smuggle value judgments about quality of life into decision-making. And like “futility,” it would behoove us to recognize the need for new, clearer terminology. This article will focus specifically on secondhand claims of patient suffering in pediatrics, but the conclusions could be similarly applied to medical decisions for adults being made by surrogate decision-makers. While I will argue that suffering, like futility, is not sufficient wholesale justification for making unilateral treatment decisions, I will also argue that claims of patient suffering cannot be ignored, and that they almost always deserve some kind of response. In the final section, I offer practical suggestions for how to respond to claims of patient suffering.

Cognitive Health Counseling 40+

2013 ◽  
Vol 21 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Anne Eschen ◽  
Franzisca Zehnder ◽  
Mike Martin
Keyword(s):  
Outcome Variable ◽  
Pilot Phase ◽  
Subjective Memory ◽  
Cognitive Health ◽  
Health Counseling ◽  
Agents Of Change ◽  
Main Outcome Variable ◽  
Further Development

This article introduces Cognitive Health Counseling 40+ (CH.CO40+), an individualized intervention that is conceptually based on the orchestration model of quality-of-life management ( Martin & Kliegel, 2010 ) and aims at improving satisfaction with cognitive health in adults aged 40 years and older. We describe the theoretically deduced characteristics of CH.CO40+, its target group, its multifactorial nature, its individualization, the application of subjective and objective measures, the role of participants as agents of change, and the rationale for choosing participants’ satisfaction with their cognitive health as main outcome variable. A pilot phase with 15 middle-aged and six older adults suggests that CH.CO40+ attracts, and may be particularly suitable for, subjective memory complainers. Implications of the pilot data for the further development of the intervention are discussed.

scholarly journals The International Day of Light - May 16th

2017 ◽  
Vol 9 (4) ◽  
pp. 106
Author(s):  
Dominik Dorosz
Keyword(s):  
Energy Efficiency ◽  
Social Role ◽  
Basic Research ◽  
Social Awareness ◽  
Raising Awareness ◽  
The Social ◽  
The Rich ◽  
Further Development

During 39th session of UNESCO General Conference which held on 7 November 2017 the date May 16th was proclaimed as International Day of Light (IDL). This decision was made after the success of the International Year of Light (IYL) celebrated in 2015. It confirmed that raising awareness of the social role of photonics is crucial for further development. Based on the rich experience of IYL 2015 ("more than 13,000 activities took place in 147 countries to reach an estimated 100 million people"), the most important goals are to be followed by the IDL, including: raising social awareness, education, showing the influence of photonics on culture and art, promoting foreign cooperation and the important role of conducting basic research. As a result, it will lead to the creation of new solutions based on photonic technology, which has resulted in increased energy efficiency and improved quality of our life.

Reducing overuse by recognising the unintended harms of good intentions

2019 ◽  
pp. bmjebm-2019-111247
Author(s):  
David Slawson ◽  
Allen F Shaughnessy
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Clinical Care ◽  
Critical Role ◽  
Medical Decision ◽  
Wide Acceptance ◽  
Hierarchy Of Evidence ◽  
Healthcare Interventions

Overdiagnosis and overtreatment—overuse—is gaining wide acceptance as a leading nosocomial intervention in medicine. Not only does overuse create anxiety and diminish patients’ quality of life, in some cases it causes harm to both patients and others not directly involved in clinical care. Reducing overuse begins with the recognition and acceptance of the potential for unintended harm of our best intentions. In this paper, we introduce five cases to illustrate where harm can occur as the result of well-intended healthcare interventions. With this insight, clinicians can learn to appreciate the critical role of probability-based, evidence-informed decision-making in medicine and the need to consider the outcomes for all who may be affected by their actions. Likewise, educators need to evolve medical education and medical decision-making so that it focuses on the hierarchy of evidence and that what ‘ought to work’, based on traditional pathophysiological, disease-focused reasoning, should be subordinate to what ‘does work’.

scholarly journals The role of non-medical factors in physicians’ decision-making process in a pediatric telemedicine service

2019 ◽  
Vol 26 (2) ◽  
pp. 1152-1176 ◽  
Author(s):  
Motti Haimi ◽  
Shuli Brammli-Greenberg ◽  
Yehezkel Waisman ◽  
Nili Stein ◽  
Orna Baron-Epel
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decision Making Process ◽  
Medical Decisions ◽  
Telemedicine Service ◽  
Medical Factors ◽  
Complex Process ◽  
Clinical Scenarios

The complex process of medical decision-making is prone also to medically extraneous influences or “non-medical” factors. We aimed to investigate the possible role of non-medical factors in doctors’ decision-making process in a telemedicine setting. Interviews with 15 physicians who work in a pediatric telemedicine service were conducted. Those included a qualitative section, in which the physicians were asked about the role of non-medical factors in their decisions. Their responses to three clinical scenarios were also analyzed. In an additional quantitative section, a random sample of 339 parent -physician consultations, held during 2014–2017, was analyzed retrospectively. Various non-medical factors were identified with respect to their possible effect on primary and secondary decisions, the accuracy of diagnosis, and “reasonability” of the decisions. Various non-medical factors were found to influence physicians’ decisions. Those factors were related to the child, the applying parent, the physician, the interaction between the doctor and parents, the shift, and to demographic considerations, and were also found to influence the ability to make an accurate diagnosis and “reasonable” decisions. Our conclusion was that non-medical factors have an impact on doctor’s decisions, even in the setting of telemedicine, and should be considered for improving medical decisions in this milieu.

scholarly journals Rola funduszy UE w promowaniu inkluzji cyfrowej w polskich regionach

2021 ◽  
Vol 66 (2) ◽  
pp. 52-66
Author(s):  
Małgorzata Dziembała ◽  
Keyword(s):  
Financial Support ◽  
Social Groups ◽  
Digital Inclusion ◽  
Wide Range ◽  
Its Regions ◽  
Ict Development ◽  
Digital Exclusion ◽  
Further Development

The digitalisation process implies many benefits for its active participants. However, some companies, individuals and social groups are excluded from this process, which leads to digital inequalities. The aim of the article is to evaluate Polish regions (NUTS 2) in terms of their digital inclusion and to indicate the importance of EU funds in supporting digital inclusion in Poland. It is claimed that the role of external financial support from EU funds is important in promoting digital inclusion in Polish regions. Support for ICT development is becoming very important in Poland and its regions. In the perspective of 2014–2020, an operational programme dedicated to promoting the development and use of ICT was developed: Digital Poland 2014–2020 Operational Programme. Also within the framework of regional operational programmes implemented in the regions of Poland, including Silesia, priorities or undertakings related to the support for ICT development were identified. This requires the implementation of a wide range of projects, from the improvement of access to the Internet, through the improvement of accessibility and quality of public e-services, to further development of digital competences. Without prompt actions in this regard, the problem of digital exclusion in Poland and its regions will further intensify.

Futurology and Present: from improving the quality of human life to immortality

2021 ◽  
pp. 28-31
Author(s):  
L.M. Allachverdiev ◽  
◽  
N.V. Ponomarenko
Keyword(s):  
Social Life ◽  
Human Life ◽  
High Tech ◽  
Alternative Future ◽  
The Social ◽  
The Future ◽  
Further Development

Analyzed is the prospects for further development of humankind in future in the field of medical technologies. Trend “The science of the future” began to develop actively in the second half of the twentieth century. Futurology as a scientific and philosophical direction always actualizes the possible and alternative future, the ways of implementing the most fantastic ideas so far. Identifying possible lines of development and outlining the sphere of moral responsibility, futurology together with philosophy looks for opportunities to achieve immortality as a long-term goal. Then we consider the latest scientific medical projects to achieve a technical progress in improving quality and length of human life, bringing us closer to real immortality. While the first steps are being taken new methods of disease prevention are being tested, the causes of various pathologies are reconsidered and strategies for overcoming them are being developed. As a subject of study, the authors of the article review the role of medicine in the social life in the future as one of the most cutting-edge and high-demand areas of high-tech business, requiring philosophical reflection and fragmentation of the zone of responsibility on the way to real immortality.

The theoretical analysis of the problem of social and pedagogical support of orphans

2020 ◽  
Vol 1(16) (2020) ◽  
pp. 104-108
Author(s):  
Valentyn Marchuk ◽  
Keyword(s):  
Research Methods ◽  
Theoretical Aspect ◽  
Well Being ◽  
Socially Disadvantaged ◽  
Interpersonal Communications ◽  
Professional Self ◽  
The Individual ◽  
Further Development

Social and pedagogical support is a guarantee of effective solution of the basic problems of various socially disadvantaged groups. Orphans stand out among all categories, because the quality of their future life depends on quality of social support. The article presents the theoretical aspect of social and pedagogical support as a means of socialization of orphans. The conceptual provisions of social and pedagogical support in working with orphans are revealed. The understanding of the concepts of “help and support” is differentiated. The author emphasizes that orphans remain one of the most socially neglected and least socially protected communities in the country, and the orphan environment accumulates the most complex problems of social and psychological development of the individual. The terminological features of social and pedagogical support, their focus on the preventive and operational nature of assistance in solving problems related to social well-being, interpersonal communications, life and professional self-determination, the role of a social worker in this process are revealed. The aim of the study. The article is devoted to the study of the problem of social and pedagogical support of orphans. Research methods. The research methods used are the following: search of the available methodological and scientific literature with analysis of the found material, elucidation of causal relationships, systematization, abstraction and concretization, analysis of the results of researchers on the problem of the study. The work is based on the analysis of scientific and methodical literature, methodical manuals, scientific articles, periodicals and developments of modern and previous scientists and researchers in the field of social work. Result. The emphasis is placed on the relevance of further development of social and pedagogical support at the appropriate level and outlines promising areas of research in the medium term.

Role of the Electronic Patient Record in the Development of General Practice in the Netherlands

1999 ◽  
Vol 38 (04/05) ◽  
pp. 350-354 ◽  
Author(s):  
J. A. Knottnerus
Keyword(s):  
General Practice ◽  
Clinical Training ◽  
Care Quality ◽  
Professional Organizations ◽  
Patient Acceptance ◽  
Decisive Importance ◽  
Care Improvement ◽  
Further Development

AbstractFrom the end of the seventies practice computer systems have been introduced in Dutch general practice. In 1998 90% of the GPs had a practice computer and 60% used it for medical purposes, with good patient acceptance. Collaboration between pioneer GPs, professional organizations, academic institutions and software manufacturers has been of decisive importance. While the practice computer is early recognized as a powerful tool for administrative purposes, it is increasingly supporting clinical and preventive care, quality of care improvement, clinical training of students and vocational training of general practice trainees. Also for scientific research and practice supporting research, automatization has proven to be innovating. Much attention is paid to designing valid databases and database-related research. In addition, practice automatization has opened new perspectives for health policy and management. Further development of technical and methodological issues is needed, and, very importantly, of patients‘ and consumers’ involvement. EPR technology in general practice does not optimally work without good numerator and denominator data, and a good quality patient-doctor relationship over time. While the EPR is a useful tool to facilitate a better performance, it may enable the doctor to focus more on the health care essentials.

scholarly journals How are exemplar representations transformed by encoding, retrieval, and explicit knowledge? A commentary on Ambridge (2020)

2020 ◽  
Vol 40 (5-6) ◽  
pp. 564-568 ◽  
Author(s):  
Patricia J. Brooks ◽  
Vera Kempe
Keyword(s):  
Second Language Acquisition ◽  
Explicit Knowledge ◽  
Long Term Memory ◽  
Exemplar Model ◽  
Memory Representations ◽  
Perceptual Representations ◽  
Further Development

The radical exemplar model resonates with work on perceptual classification and categorization highlighting the role of exemplars in memory representations. Further development of the model requires acknowledgment of both the fleeting and fragile nature of perceptual representations and the gist-based, good-enough quality of long-term memory representations. Retrieval operations potentially serve as a mechanism for abstraction as representations of exemplars are distorted through reconstructive processes. As a framework applicable to both first and second language acquisition, the model needs to account for how explicit knowledge arises and its role in filtering input via selective attention.

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