As support for clinical ethics committees in the UK grows, care must be taken to define their function, membership and method of working and the status of their decisions.The modern practice of medicine raises a plethora of complex issues—medical, ethical and legal. Doctors and other healthcare professionals increasingly must try to resolve these and may sometimes have to do so in the face of contrary opinion expressed by patients and/or their surrogates. While clearly qualified in the medical arena, and although (...) there is now more ethics teaching in the medical curriculum, healthcare professionals are seldom qualified to adjudicate on ethical or legal matters, or even, perhaps, to recognise them when they arise. Yet, as Doyal says, “clinical life must go on and moral and legal indeterminacy within medicine cries out for practical resolution.”1 Meanwhile, the expectations of patients and their families—and, indeed, of wider society—are that decisions about patient care, resources and therapeutic regimes should be soundly based on appropriate ethicolegal, as well as scientific, principle.Recognition of these additional burdens on healthcare professionals has generated some interest in the provision of ethics consultation. In the USA this has been undertaken by a variety of tribunals and individuals. Hospital ethics committees and ethics consultants feature in many US hospitals and perform a variety of roles. In Europe, a number of countries have also established clinical ethics committees and they are becoming more common in the UK—primarily in England and Wales for the moment. Whereas, however, “[i]n North America, CECs have … become an integral part of the organisational infrastructure of hospitals ...”,1 in the United Kingdom they remain essentially ad hoc bodies, generated for a variety of reasons and with different goals, structures, membership, methods of working and functions. The initial impetus for the …. (shrink)

The patient-doctor relationship has recently come under intense scrutiny, resulting in a re-evaluation of the basis of that relationship. The papers by Glannon and Ross, and McKay seek to identify the sources of authority in the patient-doctor relationship by evaluating it in terms of the concept of altruism. In this paper I argue that the analysis of Glannon and Ross, and of McKay is unnecessary and that the analysis offered by the latter is also flawed. I do acknowledge, however, that (...) Glannon and Ross's description of doctors' responsibilities and patients' roles has much to commend it. (shrink)

This is an extremely readable and interesting contribution. The author takes the reader through the Patient Self-Determination Act in some depth, but doesn't make any attempt to look at its provisions in real detail. This cannot be taken as an omission, as the purpose of the book is to explore the principles underpinning the legislation and to explore its ethical content. In that respect, this is a very interesting exercise. On one ….

This is an extremely readable and interesting contribution. The author takes the reader through the Patient Self-Determination Act in some depth, but doesn't make any attempt to look at its provisions in real detail. This cannot be taken as an omission, as the purpose of the book is to explore the principles underpinning the legislation and to explore its ethical content. In that respect, this is a very interesting exercise. On one ….

The controversies in Bristol, Alder Hey and elsewhere in the UK surrounding the removal and retention of human tissue and organs have led to extensive law reform in all three UK legal systems. This paper reports a short study of the reactions of a range of health professionals to these changes. Three main areas of ethical concern were noted: the balancing of individual rights and social benefit; the efficacy of the new procedures for consent; and the helpfulness for professional practice (...) of the new legislation and regulation. Recognition of these concerns may help in forging a new partnership between professionals and patients and their families. (shrink)

ABSTRACTThis report on end‐of‐life decision‐making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters.Chapter 1 reviews what is known about end‐of‐life care and opinions about assisted dying in Canada.Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death.Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order.Chapter 4 reviews the (...) experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form.Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. (shrink)

Работа предназначена для ученых и специалистов, преподавателей, аспирантов, слушателей, студентов, а также всех интересующихся рассматриваемой темой.

The suspension of major sporting competitions due to the global COVID-19 pandemic had a substantial negative impact on the sporting industry. As such, a successful and sustainable return to sport will require extensive modifications to the current operations of sporting organizations. In this article we argue that methods from the realm of sociotechnical systems theory are highly suited for this purpose. The aim of the study was to use such methods to develop a model of an Australian Football League club’s (...) football department. The intention was to identify potential modifications to the club’s operations to support a return to competition following the COVID-19 crisis. Subject Matter Experts from an AFL club participated in three online workshops to develop Work Domain Analysis and Social Organization and Cooperation Analysis models. The results demonstrated the inherent complexity of an AFL football department via numerous interacting values, functions and processes influencing the goals of the system. Conflicts within the system were captured via the modeling and included pursing goals that may not fully reflect the state of the system, a lack of formal assessment of core values, overlapping functions and objects, and an overemphasis on specialized roles. The current analysis has highlighted potential areas for modification in the football department, and sports performance departments in general. (shrink)

The so-called genetics revolution rests on a history which at its least can be described as controversial. Modern genetics needs to bear this history in mind. In particular, as with the past, the area of reproductive choice seems particularly vulnerable to potential abuse. Courts in the UK and elsewhere have already shown themselves willing to interfere with the choices of women in the management of their pregnancies. Medical advance, perhaps particularly the capacity to visualise the developing foetus, has added complexity (...) to the question of whether the health care provider has one patient or two patients . Additionally, pregnancy is thoroughly monitored in modern medical practice and genetics may provide a further impetus or incentive to mandate increased policing of pregnancy. Gene therapy, once offered, will add further to the desire to ensure that women make the ‘right’ choice, especially when the invasion required is relatively minimal. Further, genetic information is at best predictive, but may, because of its scientific nature, appear to those receiving it to be certain. Thus, the provision of genetic information may reduce rather than enhance choice, unless carefully and sensitively provided. A mature and sophisticated debate about the role of genetics in reproduction is required—engaging rather than bypassing the public—if the real potential of genetics is to be vindicated. (shrink)

The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

Writings on Hindu cosmology and science.

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

In an international survey of rationing we have found that European physicians encounter scarcity-related ethical difficulties, and are dissatified with the resolution of many of these cases. Here we further examine survey results to explore whether ethics support services would be potentially useful in addressing scarcity related ethical dilemmas. Results indicate that while the type of help offered by ethics support services was considered helpful by physicians, they rarely referred difficulties regarding scarcity to ethics consultation. We propose that ethics consultants (...) could assist physicians by making the process less difficult, and by contributing to decisions being more ethically justifiable. Expertise in bringing considerations of justice to bear on real cases could also be useful in recognising an unjust limit, as opposed to a merely frustrating limit. Though these situations are unlikely to be among the most frequently referred to ethics support services, ethics consultants should be prepared to address them. (shrink)

The study aimed to identify the role of administrative procedures and systems in enhancing the performance of the educational institutions in the Islamic University in Gaza. To achieve the research objectives, the researchers used the analytical descriptive approach to collect information. The researchers used the questionnaire distributed to three categories of employees at the Islamic University (senior management, faculty members, their assistants and members of the administrative board). A random sample of 314 employees was selected and 276 questionnaires were retrieved (...) with a recovery rate of 88.1%. The Statistical Analysis Program (SPSS) was used to enter process and analyze data. The results of the research showed a positive role for the administrative procedures and systems in enhancing the performance of the Islamic University from the point of view of the members (senior management, teaching staff and their assistants and the administrative body), where the relative weight of all the paragraphs (73.728%). The analysis of the results revealed that the administrative procedures at the Islamic University in Gaza are used to an acceptable degree. The relative weight of all the paragraphs is 70%. This indicates a relationship between administrative procedures and regulations and the performance of the Islamic University in the Gaza Strip. The study found that there was a good degree of approval from the sample regarding the administrative procedures and their relationship to the job performance. There exist a sufficient degree of powers to the deans and department managers to carry out their tasks, with the use of plans as control tools. And that there are rules and procedures provided for decision-making in the University Council. It also has full powers to manage the university to improve the teaching and learning environment. The researchers also recommended a number of recommendations, including the need to follow up on the procedures and systems of management and update them continuously in the light of changes that may occur and to ensure the existence of a strong system of electronic information systems within the university. There is a need to provide mechanisms for obtaining information about the surrounding external environment, and effective mechanisms to provide managers with the necessary information in a timely manner. The importance of providing channels of communication that enables staff to communicate information about any violations and breaches. The study also recommended the follow-up, review, procedures and administrative systems, and work to modify them in line with the mission of the university and the objectives that the university seeks to reach. (shrink)

Males are often found to outperform females in tests of mathematics achievement and it has been proposed that this may in part be explained by differences in cognitive style. This study investigated the relation between Wholistic-Analytic and Verbal-Imagery cognitive style, gender and mathematics achievement in a sample of 190 Australian primary school students aged between 8?11?years (M?=?9.77, SD?=?1.05). It was hypothesised that males would outperform females in mathematics achievement tests, and that gender would interact with cognitive style on mathematics performance. (...) A significant gender/cognitive style interaction was found. Boys with an Analytic/Imagery style achieved significantly higher results than the girls with an Analytic/Imagery style, supporting the contention that certain cognitive styles affect boys and girls mathematics performance differently. Implications of results and strategies for improving mathematics achievement among girls are discussed. (shrink)

The study aims to identify the efficiency of the university education performance from the perspective of postgraduate and undergraduate students in international and Palestinian universities. The analytical descriptive approach was used for this purpose and the questionnaire was used as a main tool for data collection. The study community consists of: post graduate students, (23850) graduate students and (146355) undergraduate students. The sample of the study was 378 graduate students and 383 undergraduate students. The random stratified sample was used. The (...) Statistical Package of Social Sciences (SPSS) was also used for data analysis. The study reached a number of results, the most important of which are: The level of efficiency of educational performance in Palestinian and international universities from the point of view of postgraduate and undergraduate students was high. And that there are significant differences between the average views of the sample of the study on the efficiency of educational performance in Palestinian and international universities attributed to the University and to the benefit of international universities. The study concluded many recommendations, the most important of which is the necessity of continuing to develop e-learning strategies that affect the efficiency of educational performance and research commensurate with the university's position in the local and international community, which puts it on the best classification between local and international universities through e-learning. (shrink)

The aim of the research is to identify the relationship between the performance criteria and the achievement of the objectives of supervision which is represented in the performance of the job at the Islamic University in Gaza Strip. To achieve the objectives of the research, the researchers used the descriptive analytical approach to collect information. The questionnaire consisted of (22) paragraphs distributed to three categories of employees of the Islamic University (senior management, faculty members, their assistants and members of the (...) administrative board). A random sample of 314 employees was selected, 276 responses were retrieved with a return rate of 88.1%. The SPSS program was used to enter, process, and analyze the data. The results of the study showed a positive relationship between the performance criteria and the achievement of the control objectives represented by the job performance in the Islamic University from the point of view of the members (senior management, faculty and their assistants and the administrative board). The researchers also recommended a number of recommendations, including the provision of an appropriate level of control system components today through the continuous updating and development of performance standards and the need to provide the necessary physical and financial resources to continue the development and achievement within the university. Expand the development of technology in the various activities of the university through the construction of a complete and integrated system to support the control systems in the university to suit its size. The researchers also recommended the follow-up, review of the performance standards and work to modify them in line with the mission of the university and the goals that the university seeks to reach. (shrink)

The system of clinical ethics committees (CECs) in the United Kingdom is based on goodwill. No formal requirements exist as to constitution, membership, range of expertise or the status of their recommendations. Healthcare professionals are not obliged to use CECs where they exist, nor to follow any advice received. In addition, the make-up of CECs suggests that ethics itself may be under-represented. In most cases, there is one member with a training in ethics – the rest are healthcare professionals or (...) administrators, although a lawyer is generally also included in the membership. This begs the question as whether CECs can ‘do ethics’, as well whether or not they can take seriously the requirements of due process, formal justice and human rights. Moreover, the role of the patient in this system is opaque. (shrink)