Relevant bibliographies by topics / Grief – Psychological aspects

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters

Academic literature on the topic 'Grief – Psychological aspects'

Author: Grafiati
Published: 4 June 2021
Last updated: 31 July 2024

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Journal articles on the topic "Grief – Psychological aspects"

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Dobryakov, Igor’ Valerievich, Mariya Evgen’yevna Blokh, and Leonid Mikhaylovich Faerberg. "Perinatal loss: psychological aspects, the specificity of mourning, forms of psychological help." Journal of obstetrics and women's diseases 64, no. 3 (May 15, 2015): 4–10. http://dx.doi.org/10.17816/jowd6434-10.

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GOY,, ELIZABETH R., AMY SCHULTZ,, and LINDA GANZINI. "Psychological and psychiatric aspects of palliative care: An annotated bibliography." Palliative and Supportive Care 1, no. 2 (June 2003): 181–88. http://dx.doi.org/10.1017/s1478951503030293.

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Articles from the last decade that have propelled the field of palliative care are reviewed. The areas of depression, anxiety, substance abuse, delirium, and grief are represented by seminal articles that define, explore, or thoroughly review these topics.
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Calhoun, Lawrence G., and Richard G. Tedeschi. "Positive Aspects of Critical Life Problems: Recollections of Grief." OMEGA - Journal of Death and Dying 20, no. 4 (June 1990): 265–72. http://dx.doi.org/10.2190/qdy6-6pqc-kqwv-5u7k.

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Fifty-two adults were interviewed about their bereavement, with specific focus on the ways in which the experience led to positive psychological changes in their lives. Most respondents described themselves as stronger or more competent in several ways, for example, being more mature, more independent, and better able to face other crises. A large number also reported that bereavement had led to positive experiences with their social support systems. These results are discussed in terms of their generalizability to other life crises and populations, and the degree to which they represent accurate insight and psychological health.
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Bakanova, A. A. "Children's Grief: Theoretical Conceptualization of the Problem." Консультативная психология и психотерапия 31, no. 3 (October 23, 2023): 28–46. http://dx.doi.org/10.17759/cpp.2023310302.

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<p><strong>The relevance</strong> of the theoretical conceptualization of children's grief is due to the high importance of psychological assistance to children in the situation of loss of a parent. <strong>The purpose</strong> of this article is to describe the main theoretical positions conceptualizing the idea of children's grief based on the analysis of psychological literature. <strong>Results.</strong> Theoretical analysis has shown that the problem of child grief in the literature is represented by the following 4 aspects: the impact of the loss of a parent on the mental health of a child; age-related features of child grief; the stages of child grief; ideas about normal and complicated child grief. The analysis of these aspects allowed us to conclude that throughout the history of the study of childhood grief, the position of researchers has changed from indicating an unambiguous connection between the loss of a parent in childhood and subsequent mental health disorders in adulthood to recognizing the influence of many factors on childhood grief that can help a child adapt to loss. The main theoretical <strong>provisions </strong>conceptualizing the problem of child grief at the present stage of its study are formulated as conclusions.</p>
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Lākute, Inta, and Anda Upmane. "Forgiveness and Grief Symptoms in Women After Perinatal Loss." Baltic Journal of Psychology 23, no. 1/2 (December 20, 2022): 63–83. http://dx.doi.org/10.22364/bjp.23.04.

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The purpose of this research was to explore the relationship between aspects of forgiveness, grief symptoms and bereavement in women after perinatal loss. In addition, to explore to what extent forgiveness and bereavement aspects predict grief symptoms. Participating in the study were 440 women, aged between 20 to 45 years, (M = 33,2). They completed the Heartland Forgiveness scale (Thompson & Snyder, 2003), adapted by Vendija Balode (Balode, 2017) and the Traumatic Grief Inventory (Self-Report Version, Boelen, & Smid, 2017), which was adapted as a part of this study. The results of research showed that there were negative relationships between forgiveness and grief symptoms. Bereavement aspects, such as the severity of the perceived bereavement, experienced bonding with the lost baby, and the time since the loss were positive predictors of grief symptom, whereas forgiveness in general, having received psychological assistance and overcoming the perceived loss, were negative predictors of the symptoms of grief.
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Frost, Mary, and John T. Condon. "The Psychological Sequelae of Miscarriage: A Critical Review of the Literature." Australian & New Zealand Journal of Psychiatry 30, no. 1 (February 1996): 54–62. http://dx.doi.org/10.3109/00048679609076072.

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Miscarriage, although a common event in pregnancy, has been frequently overlooked in psychological research. This paper reviews the literature on the psychological sequelae of miscarriage, including the shortcomings of that literature. Best understood against the background of psychological changes in early pregnancy, the literature reveals aspects of grief specific to miscarriage. Important components of this grief comprise high levels of guilt, the loss of part of the self and a large impact upon personal identity. The psychological sequelae impact upon other family members, including partners and surviving children. Psychiatric consequences include depression, anxiety and posttraumatic stress disorder. Given the potentially serious nature of these sequelae, it behoves the psychiatrist to enquire routinely about pregnancy loss in all female patients.
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Franza, Francesco, Alba Cervone, Barbara Solomita, Wilma Di Napoli, Maurilio Tavormina, and Giuseppe Tavormina. "Psychological and Biological Aspects of “Without-Body Bereavement”: Reflections at COVID-19 Pandemic Time." Mental Illness 2024 (May 28, 2024): 1–10. http://dx.doi.org/10.1155/2024/4943726.

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Grief is an individual, family, and social psychological process following the death of a loved one, during which the pain caused by loss follows several stages that will lead to the reorganization and acceptance of the mourning event. In this article, we will examine some elaboration processes that can allow for an analysis of the cultural, social, and religious processes and structures as a consequence of the “grief without a body,” namely, the mourning by the relatives who have experienced the loss of a loved one without being able to ritualize the social function of the funeral because of the outbreak of the coronavirus pandemic. Furthermore, some biological and neurological processes that modulate and allow for the mourning process will be synthesized.
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Godress, Julia, Salih Ozgul, Cathy Owen, and Leanne Foley-Evans. "Grief Experiences of Parents Whose Children Suffer from Mental Illness." Australian & New Zealand Journal of Psychiatry 39, no. 1-2 (January 2005): 88–94. http://dx.doi.org/10.1080/j.1440-1614.2005.01518.x.

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Objective: To examine the grief experience of parents of adult children with a mental illness and its relationship to parental health and well-being and parent child attachment and affective relationship. Methods: Participants were recruited from a variety of organizations throughout Australia that provide support services for sufferers of mental illness and/or for their families. Seventyone participants (62 mothers and nine fathers) all of whom had a child diagnosed with mental illness volunteered to take part in the study. All completed measures of grief, health status and parent-child relationship. Results: Parents reported experiencing grief in relation to their child's illness as evidenced by intrusive thoughts and feelings and avoidance of behaviour as well as difficulties adapting to and distress associated with reminders of the illness. Parental grief appears to reduce over time, but only in some aspects of grief and after an extended period. Increased parental grief was related to lowered psychological well-being and health status and associated with an anxious/ambivalent and a negative affective parent-child relationship. Conclusion: The study provides important insights into the grief experiences of parents following their child's diagnosis with mental illness. The significant relationship between parental grief and parental psychological well-being and health status as well as to parentchild relationship has important implications for health professionals. Foremost amongst these are the need to validate the distress and grief of parents and to better understand how to provide interventions that promote grief work and family bonds while reducing emotional distress and life disruption.
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Avramchuk, Oleksandr. "Clinical and Psychological Aspects of the Bereavement and Diagnostic of Complicated Grief." Problems of Modern Psychology : Collection of research papers of Kamianets-Podilskyi National Ivan Ohiienko University, G. S. Kostiuk Institute of Psychology of the National Academy of Educational Sciences of Ukraine, no. 45 (June 27, 2019): 11–39. http://dx.doi.org/10.32626/2227-6246.2019-45.11-39.

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Avramchuk, Oleksandr. "Clinical and Psychological Aspects of the Bereavement and Diagnostic of Complicated Grief." Problems of Modern Psychology : Collection of research papers of Kamianets-Podilskyi National Ivan Ohiienko University, G. S. Kostiuk Institute of Psychology of the National Academy of Educational Sciences of Ukraine, no. 45 (June 27, 2019): 11–39. http://dx.doi.org/10.32626/2227-6246.2019.45.11-39.

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Dissertations / Theses on the topic "Grief – Psychological aspects"

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Clower, Christen E. "Pregnancy Loss: Disenfranchised Grief and Other Psychological Reactions." Thesis, University of North Texas, 2003. https://digital.library.unt.edu/ark:/67531/metadc4340/.

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It is widely acknowledged in the literature that grief is most intense when it is experienced by parents whose children have died. However, as recently as 20 years ago, mothers whose children died at birth or before the pregnancy had reached full term were often dismissed as merely medical patients, and their psychological reactions were not considered or acknowledged by professionals, their friends, or their families. More recently fields such as psychology have recognized that women who have experienced pregnancy loss have complex psychological reactions to their loss. The present study examined the patterns of grief of women who have had a pregnancy end in spontaneous abortion or stillbirth and the ways in which these women gave meaning to their experiences. Participants were asked to complete several measures including the Perinatal Grief Scale (PGS), the Hogan Grief reaction Checklist (HGRC), the Perceived Social Support Scale (PSS), and the Inventory of Social Support (ISS). The participants also wrote a narrative account of their loss experience. These narratives were content analyzed to delineate common themes. The findings indicated several important factors which may be useful in understanding and assisting in post-loss adjustment.
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Mighton, Jane Diane. "The relationship of perceived maternal conflict to grief intensity in a genetically indicated abortion." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28793.

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The incidence of congenital anomalies or potential congenital anomalies of fetuses is two to three percent. Most women who have a positive diagnosis of a congenital anomaly choose to terminate the pregnancy. A review of the literature identifies conflict preabortion and grief postabortion as key variables for women terminating pregnancies for genetic indications. The purpose of this study was to study the degree of conflict in the decision-making process preabortion and the intensity of grief six weeks postabortion and to determine if a relationship exists between the conflict and grief variables. This was a descriptive, correlational study which used summary statistics to analyze the data. Women responded to a questionnaire six weeks postabortion about conflict experienced pretermination and current grief experienced. The sample included nine women who aborted in the second trimester of pregnancy following either ultrasound, chorionic villi sampling, or alpha-fetoprotein analysis of the fetus. The findings indicated that the women experienced conflict while deciding whether or not to abort the fetus and that at six weeks posttermination the intensity of grief experienced was still high. A scatter plot revealed a curvilinear relationship showing grief plateauing and then decreasing as the conflict scores rose. Recommendations were that objective counselling in the decision-making period prior to the termination be provided, and grief counselling should continue longer than six weeks posttermination for those who need counselling.
Applied Science, Faculty of
Nursing, School of
Graduate
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Scheepers, Lucas Johannes. ""Giving voice" to the bereaved : family grief and resilience after a child has died." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1021096.

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This study investigated family grief and resilience following a child’s death. Representing 23 families, 35 bereaved parents completed biographical questionnaires, the Family Hardiness Index, and the Family Attachment and Changeability Index 8. Significant positive correlations were found between family hardiness and family adaptation, and between parents’ age and family hardiness. Using grounded theory, interviews allowed for the formulation of categories including grief, continuing bonds, external support, religion, and family hardiness. The study reveals the need for exploring unique experiences of families bereaved by children’s deaths and identifies family hardiness as a potential resilience factor for this population
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McKegney, Sherrie. "Silenced suffering : the disenfranchised grief of birthmothers compulsorily separated from their children." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81253.

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Few efforts have been made to understand the subjective experiences of birthparents involved in the child welfare system, especially of those who have had their parental rights permanently removed. The research undertaken seeks an initial investigation of this neglected issue, providing accounts of four birthmothers' experiences of having one or more of their children involuntarily and permanently removed from their care as a result of child neglect. Implicit in this research is the assumption that these mothers do indeed suffer tremendous grief over the loss of their children, regardless of child welfare agencies' assessments of their parenting capacities. Furthermore, the research critically evaluates how child welfare practice and policy might serve to exacerbate incumbent issues of loss, ultimately disenfranchising this already isolated and stigmatized population. Therefore, this qualitative study endeavours to assist not only child protection workers, but also the greater community in better understanding what it is like to be a "child welfare parent" who has had her parental rights terminated, and to be aware of the existing imbalance of power between child welfare agencies and the clientele they serve. The study ultimately aims to help ensure that human dignity and genuine respect are not lost in the work of child protection.
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Shahbaz, Amy Renee. "Spiritual experience: The relationship with the grief process." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2118.

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There were four major purposes of this study: (1) to evaluate the level of grief experience by bereaved individuals who attend either a grief support group or grief psycho-educational group in the Inland Empire, (2) to evaluate the level of spirtuality experienced by bereaved individuals who attend either a grief support or grief psycho-educational group in the Inland Empire, (3) to correlate the level of grief reactions with the level of spiritual experience within bereaved individuals, and (4) to describe demongraphic and grief/spiritual-related factors that may influence a bereaved individual's spiritual experience and grief process.
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Dill, Sandra, and University of Lethbridge Faculty of Education. "What is grief and what can it teach us?" Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 1999, 1999. http://hdl.handle.net/10133/107.

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While a growing body of grief research focuses on how death affects the lives and the menatl well-being of survivors, death continues to be a mystery and the ultimate human crisis. Grief is now emerging as a concept of increasing significance for health care professionals and it is influencing the care doctors and nurses provide for dying patients and their families. A narrative inquiry format supports this phenomenological study of death and dying from the dual perspectives of the author's professional death experience as a nurse and her personal grief experiences as a daughter. Following the death experience the researcher's elderly father, the author examined grief and considered the grieving process form a phonomenological perspective which extends the scope of the stages of grief (Kubler-Ross, 1969) that are the most familiar to health care professionals. The narrative inquiry emphasizes the interrelatedness of various aspects associated with grief, including knowledge, advocacy, autonomy, support, and spirituality. The study articulates the connections between these aspects on professional and personal levels. The author also discusses trends that are influencing the increasing need for greater understanding of the care of the dying and the ability of the family and health care professionals to respond. Although the family retains an important role in end-of-life-care, in the decades ahead some of their responsiblities may shift to a more formal involvement that will influence the grieving process of the survivors. Whithin the phemonological framework of the researcher's death and dying experience, the author presents information, options, and coping strategies for those involved in such experiences.
xxi, 182 leaves ; 29 cm.
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Tsui, Ka-yee Yenny, and 徐嘉怡. "The dimensions of grief among Chinese in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B31450416.

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Stevenson, Sue Louise Mahan. "The sense of meaning and purpose of hospice family members during the grief process." Diss., The University of Arizona, 1989. http://hdl.handle.net/10150/184790.

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This study was designed to assess the process of meaning loss for family members who cared for their terminally ill loved ones during the grief process as well as determine factors that might be related to loss of meaning. The Purpose in Life Test (PIL) was used as the dependent measure. The independent variables consisted of age, education level, relationship to patient, gender, ethnicity, whether counseling was received, types of counseling received, and time between diagnosis, death and the present. The data were gathered on 87 caregivers who were participating in the St. Mary's Hospice program in Tucson, Arizona. All caregivers were over age 18 and between three and thirteen months past the death of their loved one. The data analyzed in four stages beginning with the development of descriptive statistics. During the second stage a correlation matrix was constructed and explored. A multiple regression was performed during the third stage to assess which of the independent variables could explain any variance obtained with the dependent measure. In the last stage a factor analysis was done and compared with a factor structure from previous research with the PIL Test. Nine hypotheses were tested producing the following results: Meaning in life tended to be higher for those less close in relationship to the patient such as nieces, nephews, and in-laws. There was no significant difference between a caregiver being a spouse, child, sibling or parent of the deceased loved one and meaning in life. There was no significant difference in age, education level, gender, ethnicity, whether counseling was received, types of counseling received and time between diagnosis, death and the present and meaning in life. The factor analysis revealed a five factor solution. It was concluded that the PIL Test taps two factors that can be labeled Purpose in Life and Contentedness With Life. The overall conclusion of the study was that caregivers in the sample possess a unique and similar sense of meaning in life that may be due to a sharing a common experience. There may also be some unifying factor about those choosing to enter a Hospice program that may attract a homogeneous group of people.
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Bell, Kerry Macfarlane. "Walking with the bereaved : a phenomenological investigation of the experience of the companion in grief." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28963.

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This research study sought to respond to the question; what is the meaning of the experience of the companion to a grieving person? This was accomplished through using a phenomenological method of research. The researcher was guided by dramatic form in creating a common story of the experience and its structural meanings. This study included three co-researchers, who were selected on the basis that they had each been a companion to a mother who had grieved the loss of her child through death. The co-researchers were Interviewed and asked to give detailed descriptions of their experience, which were taperecorded and transcribed, and the transcripts or protocols were analyzed by the researcher. A Phenomenological protocol analysis was used to extract meaning units and common themes from the three protocols. The themes were woven into an integrated narrative description, which was condensed into the essential structure or meaning of the experience. At each stage of the analysis, the researcher and co-researchers cooperated so that all the results were validated by the final interview. The results of the study included a list of twenty-four themes, a narrative description of the experience being investigated, and the essential structure, which presented the meaning of the experience as concisely as possible. It was posited in the discussion that the study had particular implications for practice.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate
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Sennett, Margot Jane. "A phenomenological explication of the experience of having one's bereavement denied by others." Thesis, Rhodes University, 1988. http://hdl.handle.net/10962/d1004527.

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Bereavement is the natural human reaction to the death of a significant other. Often the experience of the bereaved person is denied expression in the social context. The aim of this thesis is to examine what it means to have one's bereavement denied by others. The relevant literature was reviewed. Theories which have both reflected and influenced the way the bereaved are perceived in contemporary western society have been discussed. The historical background to changing attitudes towards death was described and the reasons for the "denial of death" were examined . The narcissistic personality in particular was considered . Using the Phenomenological method, a question was formulated to elicit the lived structure of the experience being researched. This was asked of thirteen voluntary subjects who had experienced the denial of their bereavement by others. Five written answers (protocols) were chosen and explicated. The lived structure of the experience can be described as "a profound and fundamental distancing of the world of the bereaved from the world of others." The implications of this for the bereaved person, bereavement support groups, health care professionals, future research and society as a whole were then critically discussed .
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Books on the topic "Grief – Psychological aspects"

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Beckelman, Laurie. Grief. Parsippany, N.J: Crestwood House, 1995.

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Barber, Kenneth E. Bereavement, grief, mourning. Pullman, Wash: Cooperative Extension, College of Agriculture & Home Economics, Washington State University, 1986.

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Littlewood, Jane. Aspects of grief: Bereavement in adult life. London: Tavistock/Routledge, 1992.

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Waszak, Emily Lane. Grief: Difficult times, simple steps. Washington, DC: Accelerated Development, 1997.

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J, Doka Kenneth, ed. Disenfranchised grief. Lexington, Mass: Lexington Books, 1989.

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Zaugg, Sandra L. Surviving grief. Nampa, Idaho: Pacific Press Pub. Association, 2010.

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Lorraine, Sherr, ed. Grief and AIDS. Chichester: Wiley, 1995.

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KUBLER-ROSS, Elisabeth. On grief and grieving: Finding the meaning of grief through the five stages of loss. Waterville, Me: Thorndike Press, 2006.

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C, Nieto Beatriz, ed. Healing and the grief process. Albany, NY: Delmar, 1997.

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Saynor, John K. Genesis: A personal guide through grief. Ajax, Ont: W.L. Smith & Associates, 1991.

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Book chapters on the topic "Grief – Psychological aspects"

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"Bereavement: grief and psychological aspects of multiple birth loss." In Prenatal Assessment of Multiple Pregnancy, 892–903. CRC Press, 2018. http://dx.doi.org/10.4324/9780429462023-118.

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"Bereavement: Grief and Psychological Aspects of Multiple Birth Loss." In Multiple Pregnancy, 892–903. CRC Press, 2005. http://dx.doi.org/10.1201/b14615-115.

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Stebnicki, Mark A. "Psychosocial Counseling Aspects of Grief, Dying, and Death." In The Psychological and Social Impact of Chronic Illness and Disability. 8th ed. New York, NY: Springer Publishing Company, 2023. http://dx.doi.org/10.1891/9780826151117.0015.

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Snaman, Jennifer M., Terrah Foster Akard, Sue E. Morris, and Lori Wiener. "Anticipatory Grief and Bereavement." In Interdisciplinary Pediatric Palliative Care, edited by Joanne Wolfe, Pamela S. Hinds, and Barbara M. Sourkes, 199–218. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190090012.003.0015.

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Grief is a universal process among children with serious illness and their parents and family members. The grieving process often begins at time of diagnosis, continues throughout the illness, and into bereavement. The death of a child is a devastating event that results in grief that is long-lasting. Parents, siblings, extended family members, friends, members of the care team, and the wider community are all affected by the loss and may require support. Grief can result in different psychological, spiritual, or physical manifestations, and there are many cultural, spiritual, and/or religious familial aspects to grief that must be considered. Interdisciplinary care providers should be aware of the factors associated with anticipatory grief and bereavement as well as supportive interventions that can be provided throughout the disease process, at the end of life, and following the child’s death.
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Matsayi Aji, Lucy, Ahmad Baba Muhammad, and Hassan Abubakar. "Psychosocial Care." In Tertiary Care - Medical, Psychosocial, and Environmental Aspects [Working Title]. IntechOpen, 2023. http://dx.doi.org/10.5772/intechopen.112016.

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Psychosocial care refers to the provision of emotional, social, and spiritual support to individuals or groups of people who are experiencing psychological or emotional distress, such as anxiety, depression, grief, trauma, or chronic illness. This type of care aims to promote the individual’s mental health and well-being by addressing the psychological and social factors that may contribute to their distress and by helping them, develop coping skills and strategies to manage their emotions and behaviors. Psychosocial care can be provided by a variety of healthcare professionals, including psychologists, psychiatrists, social workers, counselors, and nurses, among others. It can take many forms, such as individual or group therapy, cognitive-behavioral therapy, art therapy, mindfulness-based interventions, and support groups. The ultimate goal of psychosocial care is to help individuals regain a sense of control and meaning in their lives, enhance their quality of life, and improve their overall mental health and well-being.
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Irvine, William B. "Duty." In A Guide to the Good Life, 127–33. Oxford University PressNew York, NY, 2008. http://dx.doi.org/10.1093/oso/9780195374612.003.0010.

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Abstract As we have seen, the Stoics advise us to seek tranquility. They realized, however, that this recommendation is not, by itself, very helpful, so they went on to offer guidance on how best to attain tranquility. They advise us, to begin with, to practice the psychological techniques described in part 2 of this book. They also offer advice on specific aspects of daily living. They counsel us, for example, not to seek fame and fortune, since doing so will likely disrupt our tranquility. They warn us to be careful in choosing our associates; other people, after all, have the power to shatter our tranquility—if we let them. They go on to offer advice on how to deal with insults, anger, grief, exile, old age, and even on the circumstances under which we should have sex.
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Abascal, Elena, and Frances T. McCarthy. "Suffering of Infants, Parents, and Families." In The Nature of Suffering and the Goals of Nursing, 53—C5P62. 2nd ed. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/oso/9780197667934.003.0005.

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Abstract This chapter examines how suffering is experienced in the perinatal and neonatal period by patients, their families, and health care providers. The authors consider the role of physical pain in suffering while also exploring emotional, psychological, social, and spiritual aspects of suffering. It examines perinatal and neonatal suffering from the perspective of both the baby and those around them, within a variety of contexts including perinatal losses, prenatal diagnoses, and in the neonatal intensive care unit. It considers the concept of prenatal suffering in babies diagnosed with life-limiting conditions, genetic anomalies, or chronic conditions and the challenges parents of medically complex babies face before and after birth. Concepts including liminality and disenfranchised grief are used to illustrate the causes of anxiety and distress among parents of critically ill infants or those who have experienced a perinatal loss. Finally, this chapter discusses the effect of suffering on health care providers and the concept of resilience as it applies to both parents and nurses.
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Halpern, Jodi, and Aleksa Owen. "Scaffolding Autonomy." In The Ethics of Shared Decision Making, 49–67. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197598573.003.0005.

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Adolescents and adults with intellectual and/or developmental disabilities who have partial capacities to exercise autonomy require respect as well as protection throughout medical decision making. Using an ethical lens that prioritizes respect for persons based on a conception of relational autonomy over beneficence, this chapter explores two contrasting yet related cases where developmental issues may complicate shared decision making. Young adolescents and some adults with intellectual or developmental disabilities may have limited capacities to form and express their values and yet may also need sensitive empathic communication and cognitive scaffolding to make decisions that enact their fundamental values. This chapter examines the conscious and unconscious emotional aspects of conveying diagnoses, prognoses, and other aspects of shared decision making. Empathic scaffolding looks different for each patient in their specific care and familial context but tracks how the patient’s sense of futurity and agency are affected by the clinician’s communication—is the communication accessible, empowering, and offering options that the patient can work with? Empathic health care communication also requires that the clinicians strive for awareness of how their own unconscious psychological processes might be conveying emotional messages to vulnerable patients, including, for example, their suppressed grief after witnessing pediatric patients go through failed bone marrow transplants. Shared decision making thus requires much more than a procedural commitment to respecting individual autonomy but rather calls for addressing the inescapable emotional, relational basis of clinician-patient decision making at vulnerable moments for especially vulnerable patients.
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