Margaret Nagle
UMaineToday
Fall/Winter 2018
Here is an excerpt:
Mention philosophy and for most people, images of the bearded philosophers of Ancient Greece pontificating in the marketplace come to mind. Today, philosophers are still in public arenas, Miller says, but now that engagement with society is in K–12 education, medicine, government, corporations, environmental issues and so much more. Public philosophers are students of community knowledge, learning as much as they teach.
The field of clinical ethics, which helps patients, families and clinicians address ethical issues that arise in health care, emerged in recent decades as medical decisions became more complex in an increasingly technological society. Those questions can range from when to stop aggressive medical intervention to whether expressed breast milk from a patient who uses medical marijuana should be given to her baby in the neonatal intensive care unit.
As a clinical ethicist, Miller provides training and consultation for physicians, nurses and other medical personnel. She also may be called on to consult with patients and their family members. Unlike urban areas where a city hospital may have a whole department devoted to clinical ethics, rural health care settings often struggle to find such philosophy-focused resources.
That’s why Miller does what she does in Maine.
Miller focuses on “building clinical ethics capacity” in the state’s rural health care settings, providing training, connecting hospital personnel to readings and resources, and facilitating opportunities to maintain ongoing exploration of critical issues.
The article is here.
Showing posts with label Medical Decision. Show all posts
Showing posts with label Medical Decision. Show all posts
Monday, February 25, 2019
Tuesday, March 1, 2016
Does Bioethics Tell Us What to Do?
by J.S. Blumenthal-Barby, Ph.D.
bioethics.net
Originally posted February 15, 2016
Applied ethicists—including bioethicists—are in the business of making normative claims. Unlike, say, claims in meta-ethics, these are meant to guide action. Yet, when one examines the literature and discourse in applied ethics, there are three common barriers to these claims being action-guiding. First, they often lack precision and accuracy when examined under the lens of deontic logic. Second, even when accurately articulated in deontic language, they often fall into the category of claims about “permissibility,” a category that yields low utility with respect to action guidance. Third, they are often spectrum based rather than binary normative claims, which also yield low utility with respect to action guidance.
The blog post is here.
bioethics.net
Originally posted February 15, 2016
Applied ethicists—including bioethicists—are in the business of making normative claims. Unlike, say, claims in meta-ethics, these are meant to guide action. Yet, when one examines the literature and discourse in applied ethics, there are three common barriers to these claims being action-guiding. First, they often lack precision and accuracy when examined under the lens of deontic logic. Second, even when accurately articulated in deontic language, they often fall into the category of claims about “permissibility,” a category that yields low utility with respect to action guidance. Third, they are often spectrum based rather than binary normative claims, which also yield low utility with respect to action guidance.
The blog post is here.
Monday, February 23, 2015
Parents who wish no further treatment for their child
By M.A. de Vos, A.A. Seeber, S.K.M. Gevers, A.P. Bos, F. Gevers, and D.L. Williams
J Med Ethics 2015;41:195-200 doi:10.1136/medethics-2013-101395
Abstract
Background
In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents.
Objective
To discuss who can best protect a child's interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership.
Methods
We describe the case of a 3-year-old boy with acquired brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians.
Conclusions
Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team.
The entire article is here.
J Med Ethics 2015;41:195-200 doi:10.1136/medethics-2013-101395
Abstract
Background
In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents.
Objective
To discuss who can best protect a child's interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership.
Methods
We describe the case of a 3-year-old boy with acquired brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians.
Conclusions
Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team.
The entire article is here.
Thursday, January 1, 2015
Who Should Decide What's in a Child's Best Interest?
By Robert MacDougall
Impact Ethics
Originally posted December 8, 2014
Here is an excerpt:
One might argue that state intervention would not constitute an imposition of Western values on First Nations families and children. Instead, one might claim that state intervention merely prevents First Nations Canadians from imposing their values on their children, who are not yet old enough to decide for themselves whether to follow the Western medical paradigm or the traditional aboriginal one. But this assumes that the default position of the state should be to treat children in accordance with the Western paradigm until the child is old enough to decide for him or herself. Rather than assume the Western paradigm when making treatment decisions for First Nations children, it makes more sense to treat them according to the values of their own parents.
The entire article is here.
Impact Ethics
Originally posted December 8, 2014
Here is an excerpt:
One might argue that state intervention would not constitute an imposition of Western values on First Nations families and children. Instead, one might claim that state intervention merely prevents First Nations Canadians from imposing their values on their children, who are not yet old enough to decide for themselves whether to follow the Western medical paradigm or the traditional aboriginal one. But this assumes that the default position of the state should be to treat children in accordance with the Western paradigm until the child is old enough to decide for him or herself. Rather than assume the Western paradigm when making treatment decisions for First Nations children, it makes more sense to treat them according to the values of their own parents.
The entire article is here.
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