Results for 'Patient autonomy'

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  1.  6
    Informed consent: patient autonomy and physician beneficence within clinical medicine.Stephen Wear - 1993 - Boston: Kluwer Academic Publishers.
    Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received (...)
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  2. Patient Autonomy, Clinical Decision Making, and the Phenomenological Reduction.Jonathan Lewis & Søren Holm - 2022 - Medicine, Health Care and Philosophy 25 (4):615-627.
    Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, (...)
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  3.  67
    Patient autonomy for the management of chronic conditions: A two-component re-conceptualization.Aanand D. Naik, Carmel B. Dyer, Mark E. Kunik & Laurence B. McCullough - 2009 - American Journal of Bioethics 9 (2):23 – 30.
    The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out (...)
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  4. Patient Autonomy and the Ethics of Responsibility.Alfred I. Tauber - 2005 - MIT Press.
    The principle of patient autonomy dominates the contemporary debate over medical ethics. In this examination of the doctor-patient relationship, physician and philosopher Alfred Tauber argues that the idea of patient autonomy -- which was inspired by other rights-based movements of the 1960s -- was an extrapolation from political and social philosophy that fails to ground medicine's moral philosophy. He proposes instead a reconfiguration of personal autonomy and a renewed commitment to an ethics of care. (...)
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  5.  71
    Patient autonomy and choice in healthcare: self-testing devices as a case in point.Anna-Marie Greaney, Dónal P. O’Mathúna & P. Anne Scott - 2012 - Medicine, Health Care and Philosophy 15 (4):383-395.
    This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue (...)
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  6.  12
    Older patients’ autonomy when cared for at emergency departments.Catharina Frank, Mats Holmberg, Elin Ekestubbe Jernby, Annika Sevandersson Hansen & Anders Bremer - 2022 - Nursing Ethics 29 (5):1266-1279.
    Background Older patients in emergency care often have complex needs and may have limited ability to make their voices heard. Hence, there are ethical challenges for healthcare professionals in establishing a trustful relationship to determine the patient’s preferences and then decide and act based on these preferences. With this comes further challenges regarding how the patient’s autonomy can be protected and promoted. Aim To describe nurses’ experiences of dealing with older patients’ autonomy when cared for in (...)
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  7. Patient Autonomy and the Family Veto Problem in Organ Procurement.Alexander Zambrano - 2017 - Social Theory and Practice 43 (1):180-200.
    A number of bioethicists have been critical of the power of the family to “veto” a patient’s decision to posthumously donate her organs within opt-in systems of organ procurement. One major objection directed at the family veto is that when families veto the decision of their deceased family member, they do something wrong by violating or failing to respect the autonomy of that deceased family member. The goal of this paper is to make progress on answering this objection. (...)
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  8.  40
    Patient autonomy: A view from the kitchen.Rita M. Struhkamp - 2005 - Medicine, Health Care and Philosophy 8 (1):105-114.
    In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the (...)
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  9. Patient autonomy and withholding information.Melissa Rees - 2023 - Bioethics 37 (3):256-264.
    Disclosure in clinical practice is aimed at promoting patient autonomy, usually culminating in patient choice (e.g., to consent to an operation or not, or between different medications). In medical ethics, there is an implicit background assumption that knowing more about (X) automatically translates to greater, or more genuine, autonomy with respect to one's choices involving (X). I challenge this assumption by arguing that in rare cases, withholding information can promote a patient's autonomy (understood as (...)
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  10.  24
    Patient Autonomy and Quality of Care in Telehealthcare.Giovanni Rubeis, Maximilian Schochow & Florian Steger - 2018 - Science and Engineering Ethics 24 (1):93-107.
    Telemedicine is a complex field including various applications and target groups. Especially telehealthcare is seen by many as a means to revolutionize medicine. It gives patients the opportunity to take charge of their own health by using self-tracking devices and allows health professionals to treat patients from a distance. To some, this means an empowerment of patient autonomy as well as an improvement in the quality of care. Others state the dangers of depersonalization of medicine and the pathologization (...)
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  11.  10
    Patient autonomy in an East-Asian cultural milieu: a critique of the individualism-collectivism model.Max Ying Hao Lim - forthcoming - Journal of Medical Ethics.
    The practice of medicine—and especially the patient-doctor relationship—has seen exceptional shifts in ethical standards of care over the past few years, which by and large originate in occidental countries and are then extrapolated worldwide. However, this phenomenon is blind to the fact that an ethical practice of medicine remains hugely dependent on prevailing cultural and societal expectations of the community in which it serves. One model aiming to conceptualise the dichotomous efforts for global standardisation of medical care against differing (...)
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  12.  60
    Patient Autonomy and the Freedom to Act against One's Self-Interest.Jennifer Wilson Mulnix - 2008 - Clinical Laboratory Science 21 (2):114-115.
    A 16 year old Hodgkin lymphoma patient refuses to have his blood specimen drawn, thus canceling his scheduled oncologic treatment. As a 16 year old, he has no legal standing as an adult. His parents are split over his decision. One supports his right to choose; the other wishes the specimen to be drawn and the chemotherapy reinstated. The physicians at the hospital are seeking legal redress to have the court order the blood specimens to be taken.
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  13.  87
    Patient autonomy in emergency medicine.Anne-Cathrine Naess, Reidun Foerde & Petter Andreas Steen - 2001 - Medicine, Health Care and Philosophy 4 (1):71-77.
    Theoretical models for patient-physician communication in clinical practice are frequently described in the literature. Respecting patient autonomy is an ethical problem the physician faces in a medical emergency situation. No theoretical physician-patient model seems to be ideal for solving the communication problem in clinical practice. Theoretical models can at best give guidance to behavior and judgement in emergency situations. In this article the premises of autonomous treatment decisions are discussed. Based on a case-report we discuss different (...)
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  14.  18
    Patient autonomy in home care: Nurses’ relational practices of responsibility.Gaby Jacobs - 2019 - Nursing Ethics 26 (6):1638-1653.
    Background: Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. Aim: To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A (...)
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  15.  25
    Presuming patient autonomy in the face of therapeutic misconception.Pat McConville - 2017 - Bioethics 31 (9):711-715.
    Therapeutic misconception involves the failure of subjects either to understand or to incorporate into their own expectations the distinctions in nature and purpose of personally responsive therapeutic care, and the generic relationship between subject and investigator which is constrained by research protocols. Researchers cannot disregard this phenomenon if they are to ensure that subjects engage in research on the basis of genuine informed consent. However, our presumption of patient autonomy must be sustained unless we have compelling evidence of (...)
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  16. Shared decision-making and patient autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to (...)
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  17.  47
    Patient autonomy, assessment of competence and surrogate decision-making: A call for reasonableness in deciding for others.Kristine Baerøe - 2008 - Bioethics 24 (2):87-95.
    In this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline decision-making competence and 2) the practice of surrogate decision-making in general. I argue that none of these practices are currently aligned with respectful treatment of vulnerable individuals. Because of (...)
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  18.  14
    Patient Autonomy: How a Student’s Surgical Experience Highlights the Need for a New Standard Operating Procedure.Theresa McAlister Mairson - 2023 - Journal of Clinical Ethics 34 (3):285-287.
    The concerns regarding patient autonomy presented in August A. Culbert et al.’s “Navigating Informed Consent and Patient Safety in Surgery: Lessons for Medical Students and Junior Trainees” fall just short of addressing the main issue. Patient autonomy is not something that just one member of a team should consider, and it should not be something that any protocol should have the power to subvert, particularly in an environment as tenuous as the operating room. This article (...)
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  19. Patient Autonomy, Assessment of Competence and Surrogate Decision‐Making: A Call for Reasonableness in Deciding for Others.Kristine Bærøe - 2008 - Bioethics 24 (2):87-95.
    ABSTRACT In this paper, I address some of the shortcomings of established clinical ethics centring on personal autonomy and consent and what I label the Doctrine of Respecting Personal Autonomy in Healthcare. I discuss two implications of this doctrine: 1) the practice for treating patients who are considered to have borderline decision‐making competence and 2) the practice of surrogate decision‐making in general. I argue that none of these practices are currently aligned with respectful treatment of vulnerable individuals. Because (...)
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  20.  4
    Patient Autonomy Investigation Under the Technology-Based Health Care System.Yi Yang - 2012 - Bulletin of Science, Technology and Society 32 (2):163-170.
    With widespread advances in the diffusion and application of medical technologies, the phenomena of misuse and overuse have become pervasive. These phenomena not only increase the cost of health care systems and deplete the accessibility and availability of health care services, they also jeopardize patient autonomy. From a literature review on this aspect of medical technology, an impact on patient autonomy is found in almost all cases, with the exception of philosophical or ethical writings, in which (...)
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  21.  56
    Patient Autonomy and Medical Paternity: can nurses help doctors to listen to patients?Sarah Breier-Mackie - 2001 - Nursing Ethics 8 (6):510-521.
    Nurses are increasingly faced with situations in practice regarding the prolongation of life and withdrawal of treatment. They play a central role in the care of dying people, yet they may find themselves disempowered by medical paternalism or ill-equipped in the decision-making process in end-of-life situations. This article is concerned with the ethical relationships between patient autonomy and medical paternalism in end-of-life care for an advanced cancer patient. The nurse’s role as the patient’s advocate is explored, (...)
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  22.  66
    Patient autonomy and the challenge of clinical uncertainty.Mark Parascandola, Jennifer Susan Hawkins & Marion Danis - 2002 - Kennedy Institute of Ethics Journal 12 (3):245-264.
    : Bioethicists have articulated an ideal of shared decision making between physician and patient, but in doing so the role of clinical uncertainty has not been adequately confronted. In the face of uncertainty about the patient's prognosis and the best course of treatment, many physicians revert to a model of nondisclosure and nondiscussion, thus closing off opportunities for shared decision making. Empirical studies suggest that physicians find it more difficult to adhere to norms of disclosure in situations where (...)
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  23. Patient Autonomy in Talmudic Context: The Patient’s ‘‘I Must Eat’’ on Yom Kippur in the Light of Contemporary Bioethics.Zackary Berger & Joshua Cahan - 2016 - Journal of Religion and Health 5 (5):5.
    In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which (...)
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  24.  42
    Putting Patient Autonomy in its Proper Place; Professional Norm-Guided Medical Decision-Making.Thomas Huddle - 2016 - Kennedy Institute of Ethics Journal 26 (4):457-482.
    Since patient autonomy became a prominent theme in medical ethics in the 1970s and 1980s, it has had a troubled reputation among many physicians, to whom claims for its importance in medical decision making seem unrealistic and even undesirable. Of course the discussion has moved on since the early days in which informative or interpretive models of medical decision-making—in which physicians provided information and helped patients clarify and express preferences that then determined decisions—were contrasted with usual medical practice (...)
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  25. Patients' autonomy: Three models of the professional-lay relationship in medicine.David T. Ozar - 1984 - Theoretical Medicine and Bioethics 5 (1).
    Health care is not merely a matter of individual encounters between patients and physicians or other health care personnel. For patients and those who provide health care come to these encounters already possessed of learned habits of perception and judgment, valuation and action, which define their roles in relation to one another and affect every aspect of their encounter. So the presuppositions of these encounters must be examined if our understanding of patients' autonomy is to be complete. In this (...)
     
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  26.  29
    Chronic Patients’ Autonomy in Iranian Hospitals: A Qualitative Study.Hossein Ebrahimi, Efat Sadeghian, Naeimeh Seyedfatemi & Eesa Mohammadi - 2017 - Ethics and Behavior 27 (1):74-87.
    The autonomy of chronic patients in Iranian hospitals is challenged by impaired functioning resulting from chronic illness, a negative image in society, and effects related to hospitalization. Comprehensive interviews and observations of 34 patients, nurses, and physicians were performed to assess the autonomy of chronic patients in Iran. Conceptualization, constant comparison, and the combination of data resulted in the identification of 5 main categories related to autonomy: welcoming paternalism, self-expression, self-proof, shared decision making, and self-determination. Authority scrambling (...)
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  27. Patient autonomy, paternalism, and the conscientious physician.Stephen Wear - 1983 - Theoretical Medicine and Bioethics 4 (3).
    This paper concerns itself with the concept of diminished competence with particular regard to the problems and options that mentally compromised patients raise for medical management. It proceeds through three general stages: (1) a restatement of the sense and grounds of the new patients' rights ethos which the existence of such patients calls into question; (2) a consideration of what expanded responsibilities and tactics physicians should embrace to protect and enhance such patients' autonomy; and (3) the standards, criteria, and (...)
     
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  28.  28
    Patient Autonomy and Provider Beneficence Are Compatible.Howard Brody & Luana Colloca - 2013 - Hastings Center Report 43 (6):6-6.
    A commentary on “What's Not Being Shared in Shared Decision‐Making?” from the July‐August 2013.
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  29.  38
    A Fine Balance: Reconsidering Patient Autonomy in Light of the UN Convention on the Rights of Persons with Disabilities.Jillian Craigie - 2014 - Bioethics 29 (6):398-405.
    The Convention on the Rights of Persons with Disabilities is increasingly seen as driving a paradigm shift in mental health law, particularly in relation to the understanding that it requires a shift from substituted to supported decisions. This article identifies two competing moral commitments implied by this shift, both of which appeal to the notion of autonomy. It is argued that because of these commitments the Convention is in tension with more general calls in the medical ethics literature for (...)
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  30. Promoting patient autonomy: Looking back.Gene H. Stollerman - 1984 - Theoretical Medicine and Bioethics 5 (1).
    The pinnacle of the physician's clinical skills is his ability to develop the autonomy of his patients in the management of their health affairs. To do this requires the forging of a relationship in which patients' attitudes toward their health and illness are products of the doctor-patient relationship rather than unilateral behavior by either one. Modern medicine is beset with problems that make it difficult for physicians to develop and exercise the skills that lead to patient (...). An erosion of public confidence in physicians is being caused by several mojar forces that include: (1) the power of science over life; (2) medical technology's dehumanizing effect; (3) legalization of medical ethics; and (4) industrialization and commercialization of medical care. To restore the kind of confidence that makes the physician an effective proponent of his patient's autonomy will require a major emphasis upon all aspects of medical ethics in the medical curriculum and in medical practice. Clinical investigation of this subject is highly appropriate. Clinical faculties should be developed in greater numbers who are authorities in the humanities as well as in science. Our medical schools need also to develop and to utilize models of health care in which relations with patients are personalized, continuous, and comprehensive so that ethical ideals such as patient autonomy can be demonstrated by precept and example, and can also be researched. (shrink)
     
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  31.  51
    Patient Autonomy and Social Fairness.Joshua Cohen - 2000 - Cambridge Quarterly of Healthcare Ethics 9 (3):391-399.
    In this paper, an attempt is made to give patient autonomy added conceptual clarity. A concept of patient autonomy grounded in both negative and positive freedoms is defended. Amartya Sen's capabilities approach is used as a conceptual framework in which patient autonomy and fairness are defined compatibly. It is argued that in a socially fair healthcare system, everyone should have at least the degree of patient autonomy that affords access to those healthcare (...)
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  32.  20
    Patient autonomy writ large.Barbara Russell - 2009 - American Journal of Bioethics 9 (2):32 – 34.
  33.  31
    Patient Autonomy and the Twenty-First Century Physician.Jeremy R. Garrett & John D. Lantos - 2011 - Hastings Center Report 41 (5):3-3.
    In this issue of the Report, Daniel Groll suggests new ways to understand old tensions between autonomy and paternalism. He categorizes disagreements between doctors and patients in four ways. Some are about the ends or goals of medical treatment. For these, he claims, patient choices are based upon patient values, and physicians should neither challenge nor assess them. More common are disagreements about the appropriate means to achieve an agreed-upon goal. These subdivide into two distinct categories—those in (...)
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  34.  31
    Patient Autonomy Is a Right, But Exercising That Right May Not Be an Obligation for Patients and Kin.Thor Willy Ruud Hansen - 2018 - American Journal of Bioethics 18 (1):32-33.
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  35.  45
    Patient autonomy as a non-idealised “naturalistic autonomy”.Lara Huber - 2006 - Ethik in der Medizin 18 (2):133-147.
    ZusammenfassungOnora O’Neill hat 1984 den Zusammenhang zwischen grundsätzlichen Bedenken gegenüber dem ethischen Autonomiebegriff und der Kritik an der paternalistisch geprägten medizinethischen Praxis hergestellt, nicht die tatsächliche Einwilligung des konkreten Patienten zu berücksichtigen, sondern die angenommene, hypothetische Einwilligung, die ein idealisierter, völlig rationaler Patient geben würde. Im Anschluss an experimentalpsychologische Studien zur subliminalen Wahrnehmung, zu Volition und Handlungskontrolle erfahren kompatibilistische Theorien menschlicher Freiheit innerhalb der theoretischen Philosophie neue Popularität. Eine Handlung ist demnach frei, wenn sie das Resultat bestimmter Fähigkeiten einer (...)
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  36.  18
    Overriding Patient Autonomy to Enhance It: Not the Role of a Consultation Team.John J. Paris, Robert L. Fogerty, Brian M. Cummings & M. Patrick Moore Jr - 2016 - American Journal of Bioethics 16 (8):11-13.
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  37.  16
    Reluctant Patients: Autonomy and Delegating Medical Decisions.Jodi Halpern - 2002 - Journal of Clinical Ethics 13 (1):78-84.
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  38. Communication behaviors and patient autonomy in hospital care: A qualitative study.Zackary Berger - 2017 - Patient Education and Counseling 2017.
    BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were (...)
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  39.  31
    Respecting Patient Autonomy Versus Protecting the Patient's Health.James M. Badger, Rosalind Ekman Ladd & Paul Adler - 2009 - Jona's Healthcare Law, Ethics, and Regulation 11 (4):120-124.
  40. Patient autonomy: a turn in the tide.R. Bailey-Harris - 2000 - In Michael D. A. Freeman & A. D. E. Lewis (eds.), Law and Medicine. Oxford University Press.
     
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  41.  23
    Patient Autonomy and the Unfortunate Choice between Repatriation and Suboptimal Treatment.Kevin Wack & Toby Schonfeld - 2012 - American Journal of Bioethics 12 (9):6-7.
    The American Journal of Bioethics, Volume 12, Issue 9, Page 6-7, September 2012.
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  42.  14
    Patients' autonomy and privacy in nursing interventions.H. Leino-Kilpi, M. Välimäki, T. Dassen, M. Gasull, C. Lemonidou, A. P. Scott & M. Arndt - 1999 - Nursing Ethics 6 (4):337.
  43.  9
    Preserve Patient Autonomy; Resist Expanding the Harm Principle to Override Decisions by Competent Patients.Edward McArdle - 2022 - American Journal of Bioethics 22 (10):84-86.
    In this thoughtful article analyzing a UK court decision upholding a patient’s refusal of dialysis, the authors make the provocative but ultimately unpersuasive argument tha...
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  44.  10
    Patient autonomy between right and duty. Patient health education programmes: a cost containment measure - way of controlling the demand.Patricia Majdak - 2002 - Disputatio Philosophica 4 (1):181-185.
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  45.  8
    Patient autonomy and professional expertise in decisions near the end of life: commentary on Francis Kamm.Robert D. Truog - 2017 - Journal of Medical Ethics 43 (9):587-588.
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  46.  9
    Patient Autonomy: Imperfect, Insufficient, but Still Quite Necessary.Lainie Friedman Ross - 2002 - Journal of Clinical Ethics 13 (1):57-62.
  47.  24
    Ideals of patient autonomy in clinical decision making: a study on the development of a scale to assess patients' and physicians' views.A. M. Stiggelbout - 2004 - Journal of Medical Ethics 30 (3):268-274.
    Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the (...)
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  48.  31
    Supporting Stroke Patients' Autonomy During Rehabilitation.Ireen M. Proot, Ruud H. J. ter Meulen, Huda Huijer Abu-Saad & Harry F. J. M. Crebolder - 2007 - Nursing Ethics 14 (2):229-241.
    In a qualitative study, 22 stroke patients undergoing rehabilitation in three nursing homes were interviewed about constraints on and improvements in their autonomy and about approaches of health professionals regarding autonomy. The data were analysed using grounded theory, with a particular focus on the process of regaining autonomy. An approach by the health professionals that was responsive to changes in the patients’ autonomy was found to be helpful for restoration of their autonomy. Two patterns in (...)
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  49.  25
    Green bioethics, patient autonomy and informed consent in healthcare.David B. Resnik & Jonathan Pugh - forthcoming - Journal of Medical Ethics.
    Green bioethics is an area of research and scholarship that examines the impact of healthcare practices and policies on the environment and emphasises environmental values, such as ecological sustainability and stewardship. Some green bioethicists have argued that healthcare providers should inform patients about the environmental impacts of treatments and advocate for options that minimise adverse impacts. While disclosure of information pertaining to the environmental impacts of treatments could facilitate autonomous decision-making and strengthen the patient–provider relationship in situations where patients (...)
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  50.  44
    Physicians' silent decisions: Because patient autonomy does not always come first.Simon N. Whitney & Laurence B. McCullough - 2007 - American Journal of Bioethics 7 (7):33 – 38.
    Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions - not all - are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, (...)
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