The landmark Roe vs Wade Supreme Court decision in 1973 established a constitutional right to abortion. In June 2022, the Dobbs vs Jackson Women’s Health Organization Supreme Court decision brought ...an end to the established professional practice of abortion throughout the United States. Rights-based reductionism and zealotry threaten the professional practice of abortion. Rights-based reductionism is generally the view that moral or ethical issues can be reduced exclusively to matters of rights. In relation to abortion, there are 2 opposing forms of rights-based reductionism, namely fetal rights reductionism, which emphasizes the rights for the fetus while disregarding the rights and autonomy of the pregnant patient, and pregnant patient rights reductionism, which supports unlimited abortion without regards for the fetus. The 2 positions are irreconcilable. This article provides historical examples of the destructive nature of zealotry, which is characterized by extreme devotion to one’s beliefs and an intolerant stance to opposing viewpoints, and of the importance of enlightenment to limit zealotry. This article then explores the professional responsibility model as a clinically ethically sound approach to overcome the clashing forms of rights-based reductionism and zealotry and to address the professional practice of abortion. The professional responsibility model refers to the ethical and professional obligations that obstetricians and other healthcare providers have toward pregnant patients, fetuses, and the society at large. It provides a more balanced and nuanced approach to the abortion debate, avoiding the pitfalls of reductionism and zealotry, and allows both the rights of the woman and the obligations to pregnant and fetal patients to be considered alongside broader ethical, medical, and societal implications. Constructive and respectful dialogue is crucial in addressing diverse perspectives and finding common ground. Embracing the professional responsibility model enables professionals to manage abortion responsibly, thereby prioritizing patients’ interests and navigating between absolutist viewpoints to find balanced ethical solutions.
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Children are a uniquely vulnerable patient population with restricted abilities for self-advocacy and autonomy, risking infringement upon their dignity. Yet the concept of dignity in pediatrics ...remains underexplored relative to the adult literature and other outcome measures.
To characterize how dignity is defined, evaluated, and/or measured in pediatrics.
We conducted a systematic review following PRISMA guidelines across the following databases: MEDLINE, Embase, Cumulative Index of Nursing and Allied Health, PsycINFO, Global Health, Social Science Premium Collection, and Dissertation and Theses. We included publications from database inception through April 2023, in English, involving children aged 0-18 years, and prioritizing dignity as a central theme with a focus on defining, evaluating, or measuring dignity. Study descriptions and pertinent characteristics were extracted and synthesized using a predefined form.
Forty-four articles met inclusion criteria; fewer than half comprised original research (20/44, 45%). Most studies (38/44, 86%) included description of the meaning of dignity, with emergence of salient themes around respect, communication, agency/autonomy, and privacy. Less than half (19/44, 43%) included a measurement or evaluation of dignity; approximately one-third described dignity therapy. More than one-third of publications focused on dignity at end of life (17/44, 39%) and included discussions of palliative care and hospice (15/44, 34%).
Relatively few published studies describe dignity in pediatrics. Opportunities exist to broaden scholarship on this topic in partnership with patients, families, and clinicians, with the goal of assessing and strengthening dignity-centered care across the illness course and at the end of life.
Stroke is the second leading cause of death worldwide and a leading cause of adult disability worldwide. More than a third of individuals presenting with strokes are estimated to have a preexisting ...disability. Despite unprecedented advances in stroke research and clinical practice over the past decade, approaches to acute stroke care for persons with preexisting disability have received scant attention. Current standards of research and clinical practice are influenced by an underexplored range of biases that may hinder acute stroke care for persons with disability. These trends may exacerbate unequal health outcomes by rendering novel stroke therapies inaccessible to many persons with disabilities. Here, we explore the underpinnings and implications of biases involving persons with disability in stroke research and practice. Recent insights from bioethics, disability rights, and health law are explained and critically evaluated in the context of prevailing research and clinical practices. Allowing disability to drive decisions to withhold acute stroke interventions may perpetuate disparate health outcomes and undermine ethically resilient stroke care. Advocacy for inclusion of persons with disability in future stroke trials can improve equity in stroke care delivery.
Current capacity-based legislation and practice overvalues autonomy to the detriment of other ethical principles. A balanced ethical approach would consider the patient's right to treatment, their ...relationships and interactions with society and not solely the patient's right to liberty and autonomous decision-making.
Abstract Background Recognizing patients’ rights as fundamental human rights, the global healthcare community, including the World Health Organization and various nursing organizations, has ...emphasized the critical role of nurses in upholding these rights through ethical practice and patient-centered care. However, in the complex landscape of healthcare, nurses in Vietnam face various ethical issues and challenges that may impede their ability to protect patient rights effectively, necessitating tools for better ethical decision-making and practice. Purpose This study aims to translate the Nurses’ Ethical Behaviours for Protecting Patient Rights Scale (NEBPPR) into Vietnamese and evaluate the validity and reliability of the V-NEBPPRS. Methods The original scale underwent a cross-cultural translation process to be adapted into Vietnamese. Construct validity was assessed using confirmatory factor analysis (CFA). The convergent validity, discriminant validity, and reliability of the V-NEBPPRS were evaluated. Results After removing four items with factor loading below 0.5, the V-NEBPPRS comprises 24 items divided into five factors. CFA demonstrated a good model fit (χ2/df = 2.86; GFI = 0.87; IFI = 0.85; CFI = 0.84; RMSEA = 0.07). Convergent and discriminant validity were confirmed with extracted mean variance ranging from 0.54 to 0.67, 0.54 to 0.67, and composite reliability from 0.73 to 0.81. Cronbach’s α coefficient was 0.85 for the total scale and ranged from 0.70 to 0.79 for five subscales. Conclusion The V-NEBPPRS is a reliable tool, providing nursing leaders and researchers with the means to utilize the V-NEBPPRS for assessing and promoting nurses’ awareness and behaviour in safeguarding patients’ rights, thereby contributing to improved overall health outcomes.
Background: Complaints are expressions of dissatisfaction that need to be addressed and are a very effective tool for improving the quality of care and treatment services. This study was conducted to ...investigate the complaints received in 2020 in the treatment supervision department of the Iran University of Medical Sciences.
Methods: The present study is a retrospective descriptive study. All registered complaints, including written, oral and telephone, were reviewed by the complaints officer of the treatment supervision office in 2020. The data obtained from the review of complaints provided by clients of affiliated centres, including personal information of the complainant, the complainant was classified in an Excel file and analyzed by using descriptive statisticsSuch as number and percentage.
Results: Of the total number of complaints received in 2020 with 2121, the cases included complaints about the provision of care and medical services 809cases, tariff 301 cases, health and infection control 222 cases, the activity of unauthorized persons 194 cases, visit services 125 cases, defects, respectively, Technical equipment 76 cases, lack of licenses 76 cases, admission and clearance services 69 cases, induced demand 66 cases, drugs 64 cases, how to deal 63 cases, center closure and non-service 20 cases, forgery and misuse 18 cases, illegal advertising 10 cases, manpower shortage 8 cases.
Conclusion: It seems that by identifying the effective factors in the occurrence of complaints and dissatisfaction and adopting solutions regarding Training in improving behavioural, communication and professional skills, periodic monitoring visits, reporting functional deficiencies to affiliated centres to correct and eliminate deficiencies, can be done to satisfy and prevent dissatisfaction so that the patient and with a pleasant memory of the process if necessary, refer others to the mentioned centre if necessary.
Aim
The aim of this study was to develop a self‐assessment scale for nurses' ethical behaviours for protecting patients' rights and to determine its reliability and validity.
Methods
This was a ...methodological study. This study was conducted in public, private and university hospitals in Turkey between August 2018 and May 2019. The sample group consisted of 450 nurses. The item pool was formed with 44 items. After five experts' assessment for content validity, the draft scale was formed with 37 items with a 5‐point Likert‐type scale. The item‐total score correlation and exploratory factor analysis were used.
Results
The scale included 28 items and five subscales (respect for right to information and decision making, providing fair care, providing benefit‐not harming, respect for patient values and choices, attention to privacy). Cronbach's alpha was 0.84 for the whole scale.
Conclusion
Validity and reliability have been demonstrated for a newly developed scale to measure nurses' ethical behaviours to protect patients' rights.
Summary statement
What is already known about this topic?
Valid and reliable measurement tools can provide nurses with data on the extent to which nurses internalize the information they have acquired to protect patients' rights.
No scale has yet been developed to determine nurses' behaviours to protect patients' rights.
What this paper adds?
The Nurses' Ethical Behaviours for Protecting Patients' Rights Scale is a valid and reliable data collection tool.
Nurses' ethical behaviours for protecting patients' rights can now be measured with a valid and reliable tool.
The implications of this paper
The Nurses' Ethical Behaviours for Protecting Patients' Rights Scale could play guiding role in organizing activities for determining and developing nurses' behaviours for protecting patients' rights.
Purpose
Continuous observation of psychiatric inpatients aims to protect those who pose an acute risk of harm to self or others, but involves intrusive privacy restrictions. Initiating, conducting ...and ending continuous observation requires complex decision-making about keeping patients safe whilst protecting their privacy. There is little published guidance about how to balance privacy and safety concerns, and how staff and patients negotiate this in practice is unknown. To inform best practice, the present study, therefore, aimed to understand how staff and patients experience negotiating the balance between privacy and safety during decision-making about continuous observation.
Methods
Thematic analysis of qualitative interviews with thirty-one inpatient psychiatric staff and twenty-eight inpatients.
Results
Most patients struggled with the lack of privacy but valued feeling safe during continuous observation. Staff and patients linked good decision-making to using continuous observation for short periods and taking positive risks, understanding and collaborating with the patient, and working together as a supportive staff team. Poor decision-making was linked to insufficient consideration of observation’s iatrogenic potential, insufficient collaboration with patients, and the stressful impact on staff of conducting observations and managing risk.
Conclusions
Best practice in decision-making about continuous observation may be facilitated by making decisions in collaboration with patients, and by staff supporting each-other in positive risk-taking. To achieve truly patient-centred decision-making, decisions about observation should not be influenced by staff’s own stress levels. To address the negative impact of staff stress on decision-making, it may be helpful to improve staff training, education and support structures.
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